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1.
Arch. argent. pediatr ; 120(2): e98-e101, abril 2022. tab
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1363992

ABSTRACT

La prucaloprida acelera el vaciamiento gástrico en adultos con gastroparesia. No existen estudios con este medicamento en niños con gastroparesia. Se presenta un niño de 8 años que consultó por síntomas posprandiales de un mes de duración, con diagnóstico de gastroparesia por gammagrafía de vaciamiento gástrico. No mejoró con metoclopramida, domperidona, eritromicina y esomeprazol. Recibió prucaloprida durante dos períodos (durante 178 y 376 días) a dosis de 0,03-0,04 mg/kg/día. Presentó mejoría en el seguimiento con el índice cardinal de síntomas de gastroparesia y gammagrafías de vaciamiento gástrico. Por la buena respuesta, la prucaloprida podría ser una opción terapéutica en la gastroparesia pediátrica.


Prucalopride has been used in adults with gastroparesis, accelerating gastric emptying. There are no studies with this drug in gastroparetic children. An 8-year-old boy is presented who consulted for a month of postprandial symptoms, with a diagnosis of gastroparesis by gastric emptying scintigraphy. He did not improve with metoclopramide, domperidone, erythromycin, and esomeprazole. He received prucalopride for two periods (for 178 and 376 days) at doses: 0.03 - 0.04 mg/kg/day, presenting improvement in the follow-up with the cardinal gastroparesis symptom index and gastric emptying scintigraphy. Due to the good response, prucalopride may be a therapeutic option in pediatric gastroparesis.


Subject(s)
Humans , Male , Child , Benzofurans/therapeutic use , Gastroparesis/diagnosis , Gastroparesis/drug therapy , Domperidone/therapeutic use , Gastric Emptying
2.
Autops. Case Rep ; 11: e2021337, 2021. tab, graf
Article in English | LILACS | ID: biblio-1345356

ABSTRACT

Sarcina ventriculi is a gram-positive bacterium, able to survive in extreme low pH environment. It's first description dates from 1842, by John Goodsir. Since then, just a few cases have been reported. In veterinary medicine, especially in ruminants, it causes bloating, vomiting, gastric perforation and death of the animal. It is commonly associated with delayed gastric emptying or obstruction to gastric outlet, although it's pathogenicity in humans is not fully understood. We report two cases with identification of the bacteria in gastric specimens stained with hematoxylin-eosin staining, in different clinical settings. The first patient is a young female patient, presenting cardiac arrest and death after gastric perforation and the second patient an adult male presenting with gastric adenocarcinoma, treated with partial gastrectomy followed by adjuvant chemoradiation. In our literature review, we identified forty-five cases reporting Sarcina ventriculi appearance, with a sudden increase since 2010.


Subject(s)
Humans , Male , Female , Adolescent , Middle Aged , Sarcina/pathogenicity , Clostridium Infections/pathology , Gastroparesis/complications
3.
ABCD arq. bras. cir. dig ; 34(2): e1592, 2021. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1345019

ABSTRACT

ABSTRACT Background: The delay in gastric emptying is the second most frequent complication after duodenopancreatectomy with pyloric preservation, that increases hospitalization time and hospital costs. Aim: To identify factors that contribute to the appearance the delay in this surgical procedure. Method: Ninety-five patients were submitted to duodenopancreatectomy with pyloric preservation. After retrospective analysis of the medical records, it was observed that 60 had prolonged hospitalization due to complications. Thus, univariate and multivariate logistic regression were used to analyze predictors of delayed gastric emptying. Results: Delay was present in 65% (n=39) and pancreatic fistula in 38.3% (n=23). Univariate analysis revealed that the presence of pancreatic complications (pancreatic fistula, p=0.01), other intracavitary complications with the appearance of abdominal collections (p=0.03) and hypoalbuminemia (p=0.06) were responsible, also confirmed by the multivariate analysis. In those who presented delay without a determined cause, it was observed that high levels of total bilirubin (p=0.01) and direct bilirubin (p=0.01) could be related to it. Conclusion: The delay in gastric emptying in patients undergoing duodenopancreatectomy with pyloric preservation is due to intracavitary complications.


RESUMO Racional: O retardo do esvaziamento gástrico é a segunda complicação mais frequente após a realização da duodenopancreatectomia com preservação pilórica, aumentando o tempo de internação e custos hospitalares. Objetivo: Identificar fatores que contribuem para o aparecimento desse retardo nesse procedimento cirúrgico. Método: Noventa e cinco doentes foram submetidos à duodenopancreatectomia com preservação pilórica. Após análise retrospectiva dos prontuários observou-se que 60 apresentaram internação prolongada por complicações. Assim, utilizou-se a regressão logística uni e multivariada para análise de fatores preditores do retardo. Resultados: O retardo esteve presente em 65% (n=39) e a fístula pancreática em 38,3% (n=23). A análise univariada revelou que a presença de complicações pancreáticas (fístula pancreática, p=0,01), outras complicações intracavitárias com aparecimento de coleções abdominais (p=0,03) e hipoalbuminemia (p=0,06) foram os responsáveis, resultados estes também confirmados pela análise mutilvariada. Naqueles que apresentaram retardo sem causa determinada, observou-se que níveis elevados de bilirrubina total (p=0,01) e bilirrubina direta (p=0,01) poderiam estar relacionados a ele. Conclusão: O retardo do esvaziamento gástrico nos pacientes submetidos à duodenopancreatectomia com preservação pilórica é decorrente de complicações intracavitárias.


Subject(s)
Humans , Pancreaticoduodenectomy/adverse effects , Gastroparesis/etiology , Postoperative Complications/etiology , Retrospective Studies , Pancreatic Fistula , Gastric Emptying
4.
Adv Rheumatol ; 61: 5, 2021. tab, graf
Article in English | LILACS | ID: biblio-1152733

ABSTRACT

Abstract Background: Abdominal symptoms in patients with primary Sjögren syndrome (pSS) are poorly documented. The objective of the study was to describe the abdominal symptoms of patients with pSS and to assess their association with characteristics of the disease. Methods: One hundred and fifty patients with pSS were evaluated using a composite global symptom score for abdominal symptoms and their severity. Data concerning the clinical and biological characteristics of pSS and abdominal disorders were also collected. Results: Of the patients with pSS, 95% suffered from abdominal symptoms (median global symptom score 7.5 ±5.5 points out of 30). More than half of the patients experienced abdominal tension (68%), upper abdominal pain (54%), abdominal discomfort (58%) and/or constipation (54%). Regarding the pSS activity, in relation to European League Against Rheumatism (EULAR) Sjogren syndrome disease activity index score items, general and central nervous system involvement wereassociated with a high global symptom score. The EULAR Sjogren Syndrome Patient Reported Index (ESSPRI) symptom score was positively correlated with the global symptom score (p < 0.01). Multivariate analysis showed a significant association between a high global symptom score and SSA seronegativity, gastroparesis, and ESSPRI score (p < 0.01 for each). Conclusions: The majority of patients with pSS suffered abdominal symptoms. There is currently no therapeutic recommendation because of the lack of information on the underlying pathophysiological mechanisms. Trial registration: NCT03157011. Date of registration: July 17, 2017.(AU)


Subject(s)
Humans , Quality of Life , Sjogren's Syndrome/etiology , Abdominal Pain , Gastroparesis/etiology
5.
Rev. colomb. gastroenterol ; 35(4): 471-484, dic. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1156330

ABSTRACT

Resumen El vaciamiento gástrico normal refleja un esfuerzo coordinado entre diferentes regiones del estómago y el duodeno, y también una modulación extrínseca por parte del sistema nervioso central y factores del intestino distal. Los principales eventos relacionados con el vaciamiento gástrico normal incluyen el fondo de relajación para acomodar la comida, contracciones antrales para triturar partículas grandes de comida, contracción pilórica para permitir la liberación de comida del estómago y coordinación antropiloroduodenal de los fenómenos motores de relajación. La dismotilidad gástrica incluye el vaciamiento tardío del estómago (gastroparesia), vaciamiento gástrico acelerado (síndrome de dumping) y otras disfunciones motoras, como el deterioro del fondo de distensión, que se encuentra con mayor frecuencia en la dispepsia funcional. Los síntomas de la gastroparesia son inespecíficos y pueden simular otros trastornos estructurales.


Abstract Normal gastric emptying reflects a coordinated effort between different regions of the stomach and the duodenum, and also an extrinsic modulation by the central nervous system and distal bowel factors. The main events related to normal gastric emptying include relaxation of the fundus to accommodate food, antral contractions to triturate large food particles, the opening of the pyloric sphincter to allow the release of food from the stomach, and anthropyloroduodenal coordination for motor relaxation. Gastric dysmotility includes delayed emptying of the stomach (gastroparesis), accelerated gastric emptying (dumping syndrome), and other motor dysfunctions, e.g., deterioration of the distending fundus, most often found in functional dyspepsia. The symptoms of gastroparesis are nonspecific and may mimic other structural disorders.


Subject(s)
Humans , Therapeutics , Gastroparesis , Diagnosis , Dumping Syndrome , Literature
7.
Autops. Case Rep ; 10(2): e2020164, Apr.-June 2020. graf
Article in English | LILACS | ID: biblio-1131820

ABSTRACT

Emphysematous gastritis (EG) is a rare and potentially lethal process caused by invasive, gas-producing bacteria leading to inflammation and gas dissection of the stomach. The most common etiologic agents are Clostridium infections, but other organisms, including enterobacteria, staphylococcus, and fungi have also been identified. We report the first case of EG due to Sarcina ventriculi in a solid organ transplant recipient, who presented with epigastric pain and vomiting. The patient had a history of type 1 diabetes mellitus (DM) with recurrent episodes of ketoacidosis and systemic diabetic complications, including severe gastroparesis. CT scan studies demonstrated EG with venous air, and endoscopy showed severe gastritis and ulcerations. In the gastric biopsies, abundant Sarcina ventriculi were noted in areas of mucosal/submucosal necrosis. Antibiotic treatment was instituted at admission, and subsequent endoscopy demonstrated the disappearance of Sarcina, with some improvement of the gastric inflammation; however, the patient developed septic shock with multiorgan failure and expired. This case highlights the need to consider other infectious etiologies in transplant patients, in addition to the well-known opportunistic infections.


Subject(s)
Humans , Adult , Diabetes Complications , Transplant Recipients , Infections/etiology , Autopsy , Opportunistic Infections/etiology , Cholestasis , Clostridium Infections , Liver Failure , Fatal Outcome , Gastroparesis/complications , Renal Insufficiency/complications , Graft Rejection
8.
Article in Chinese | WPRIM | ID: wpr-826730

ABSTRACT

OBJECTIVE@#To explore the clinical therapeutic effect of herb-partitioned moxibustion at point in patients of diabetic gastroparesis differentiated as spleen and stomach deficiency and retention of turbid dampness as well as its effect mechanism.@*METHODS@#A total of 134 patients with diabetic gastroparesis were randomized into an observation group and a control group, 67 cases in each one. In the observation group, herb-partitioned moxibustion at point was adopted, 40 min each time, once a day for 5 times a week. In the control group, itopride hydrochloride tablets were prescribed for oral administration, 50 mg each time, three times a day. A total of 6 weeks of treatment was required in the two groups. Before and after treatment, the gastroparesis cardinal symptom index (GCSI) scores, 4-hour gastric emptying rate, TCM symptom score, as well as the levels of plasma motilin and serum gastrin were observed in the patients of the two groups. Additionally, the clinical therapeutic effect was evaluated in the two groups.@*RESULTS@#After treatment, the score of every item of GCSI, TCM symptom scores and the levels of plasma motilin and serum gastrin were all reduced as compared with those before treatment in the patients of the two groups (<0.05), and those in the observation group were lower than the control group (<0.05). Regarding 4-hour gastric emptying rates, which were increased as compared with those before treatment in the two group (<0.05), and the rate in the observation group was higher remarkably than that in the control group (<0.05). The total effective rate was 92.5% (62/67) in the observation group, higher than 74.6% (50/67) in the control group (<0.05).@*CONCLUSION@#Herb-partitioned moxibustion at point relieves the clinical symptoms in the patients with diabetic gastroparesis and increases the gastric emptying rate, which is probably related to the regulation of the levels of plasma motilin and serum gastrin.


Subject(s)
Acupuncture Points , Diabetes Mellitus , Gastric Emptying , Gastrins , Blood , Gastroparesis , Therapeutics , Humans , Motilin , Blood , Moxibustion
10.
Diaeta (B. Aires) ; 37(166): 41-48, mar. 2019. tab
Article in Spanish | LILACS | ID: biblio-1039679

ABSTRACT

La lesión cerebral induce a la aparición de complicaciones gastrointestinales, especialmente gastroparesia, la cual es considerada uno de los pilares de la intolerancia digestiva alta. Se mide por el aumento en el residuo gástrico, reflujo gastroesofágico, vómitos, distención abdominal y/o diarrea. Como consecuencia, la nutrición enteral (NE) se inicia de manera tardía o ineficientemente, impidiendo lograr la meta calórico-proteica, aumentando el riesgo de neumonía aspirativa, prolongándose la estadía hospitalaria e incrementando la mortalidad. Se realizó una revisión bibliográfica con el objetivo de actualizar y describir el rol de la gastroparesia en el alcance de la meta calórica-proteica en el paciente neurocrítico. Se consultaron bases de datos electrónica: MEDLINE, EMBASE, LILACS, Cochrane, desde el 2007 a 2017. Se incluyeron 8 estudios, cuatro ensayos controlados y aleatorizados (ECA), dos observacionales y dos revisiones sistemáticas y metaanálisis. En tres ECA cuando la NE es postpilórica se logra un mayor aporte calórico y proteico. Dos estudios no encontraron diferencias en las calorías recibidas entre los pacientes alimentados a estómago o yeyuno. Dos revisiones y metaanálisis confirman menor riesgo de neumonía aspirativa pero no presentan diferencias en el porcentaje de adecuación a la NE por ambas vías. La mortalidad, días de asistencia respiratoria mecánica, estancia en la unidad de cuidados intensivos (UCI) y hospitalaria no fue diferente cuando la NE fue a estómago o intestino. En conclusión, la persistencia del retraso del vaciamiento gástrico favorece al déficit energético y proteico, debido a la intolerancia a la NE lo que dificulta la progresión. A la fecha, pocos estudios recomiendan la vía postpilórica para mejorar la eficiencia nutricional. Futuros estudios deberán valorar las implicancias de alcanzar la meta calórica-proteica en los resultados clínicos de acuerdo a la vía de la NE, en esta población de pacientes(AU).


The brain injury induces the appearance of gastrointestinal complications, especially gastroparesis, which is considered one of the pillars of high digestive intolerance. It is measured by the increase in gastric residue, gastroesophageal reflux, vomiting, abdominal distension and / or diarrhea. As a consequence, enteral nutrition (EN) begins late or inefficiently, preventing the caloric-protein goal from being achieved, increasing the risk of aspiration pneumonia, prolonging the hospital stay and increasing mortality. A literature review was carried out with the objective of updating and describing the role of gastroparesis in the scope of the caloric-protein goal in the neurocritical patient. Electronic databases were consulted: MEDLINE, EMBASE, LILACS, Cochrane, from 2007 to 2017. 8 studies were included, four randomized controlled trials (RCTs), two observational studies and two systematic reviews and meta-analyzes. In three RCTs when the EN is post-pyloric, a greater caloric and protein intake is achieved. Two studies found no difference in the calories received between patients fed via stomach or jejunum. Two reviews and meta-analyzes confirm a lower risk of aspiration pneumonia, but there are no differences in the percentage of adaptation to the EN by both routes. Mortality, days of mechanical ventilation, stay in the intensive care unit (ICU) and hospital stay were not different when the EN was via stomach or intestine. In conclusion, the persistence of delayed gastric emptying favors protein and energy deficit, due to intolerance to EN, which hinders progression. To date, few studies recommend the postpyloric route to improve nutritional efficiency. Future studies should evaluate the implications of reaching the caloric-protein goal in clinical results according to the EN route, in this patient population(AU).


Subject(s)
Gastroparesis , Brain Injuries , Eating
12.
Article in English | WPRIM | ID: wpr-765970

ABSTRACT

BACKGROUND/AIMS: Association between symptoms, quality of life and gastric emptying in dyspepsia is inconsistent in the literature. The aim of our study is to investigate if gastric emptying is associated with specific symptoms and quality of life in dyspeptic patients. METHODS: We reviewed retrospectively gastric emptying measured by ¹³C-labelled octanoate breath testing for more than 6 hours in 198 consecutive patients with dyspepsia complaints. Gastrointestinal symptoms were assessed using a 5-points Likert scale and by a symptomatic composite score, whereas quality of life was measured by the GIQLI. RESULTS: In our cohort, 90 patients (45%) had a delayed gastric emptying (half emptying time above 166 minutes when assessed over 6–8 hours). There was no difference in symptoms or quality of life between patients with or without delayed gastric emptying. However, patients with severely delayed gastric emptying (half emptying time above 200 minutes) had increased postprandial fullness (P = 0.012), abdominal pain (P = 0.026), bloating (P = 0.044), early satiety (P = 0.018), symptomatic composite score (P = 0.005), and a lower quality of life (P = 0.018). This association was no longer observed if the calculation of gastric emptying was limited to the first 4-hour samples. CONCLUSIONS: There is no association between symptoms, quality of life and gastric emptying in an overall dyspeptic population. However, there is an association between symptoms, quality of life of delayed gastric emptying in the subgroup of patients with severely delayed gastric emptying. An 8-hour measurement of gastric emptying should be recommended.


Subject(s)
Abdominal Pain , Breath Tests , Cohort Studies , Dyspepsia , Gastric Emptying , Gastroparesis , Humans , Quality of Life , Retrospective Studies
13.
Article in English | WPRIM | ID: wpr-765932

ABSTRACT

BACKGROUND/AIMS: Current evidence suggests the presence of motility or functional abnormalities in one area of the gastrointestinal tract increases the likelihood of abnormalities in others. However, the relationship of gastroparesis to chronic constipation (slow transit constipation and dyssynergic defecation) has been incompletely evaluated. METHODS: We retrospectively reviewed the records of all patients with chronic dyspeptic symptoms and constipation who underwent both a solid gastric emptying scintigraphy and a high-resolution anorectal manometry at our institution since January 2012. When available, X-ray defecography and radiopaque marker colonic transit studies were also reviewed. Based on the gastric emptying results, patients were classified as gastroparesis or dyspepsia with normal gastric emptying (control group). Differences in anorectal and colonic findings were then compared between groups. RESULTS: Two hundred and six patients met the inclusion criteria. Patients with gastroparesis had higher prevalence of slow transit constipation by radiopaque marker study compared to those with normal emptying (64.7% vs 28.1%, P = 0.013). Additionally, patients with gastroparesis had higher rates of rectocele (88.9% vs 60.0%, P = 0.008) and intussusception (44.4% vs 12.0%, P = 0.001) compared to patients with normal emptying. There was no difference in the rate of dyssynergic defecation between those with gastroparesis vs normal emptying (41.1% vs 42.1%, P = 0.880), and no differences in anorectal manometry findings. CONCLUSIONS: Patients with gastroparesis had a higher rate of slow transit constipation, but equal rates of dyssynergic defecation compared to patients with normal gastric emptying. These findings argue for investigation of possible delayed colonic transit in patients with gastroparesis and vice versa.


Subject(s)
Colon , Constipation , Defecation , Defecography , Dyspepsia , Gastric Emptying , Gastrointestinal Tract , Gastroparesis , Humans , Intussusception , Manometry , Pelvic Floor Disorders , Prevalence , Radionuclide Imaging , Rectocele , Retrospective Studies
14.
Journal of Gastric Cancer ; : 365-371, 2019.
Article in English | WPRIM | ID: wpr-764494

ABSTRACT

The role of surgical intervention in patients with diabetic gastroparesis is unclear. We report a case of a 37-year-old man with a history of recurrent episodes of vomiting and long-standing type 2 diabetes mellitus. Esophagogastroduodenoscopy did not reveal any findings of reflux esophagitis or obstructive lesions. A gastric emptying time scan showed prolonged gastric emptying half-time (344 minutes) indicating delayed gastric emptying. Laboratory tests revealed elevated fasting serum glucose and glycosylated hemoglobin (HbA1c, 12.9%) and normal fasting C-peptide and insulin levels. We performed Roux-en-Y reconstruction after subtotal gastrectomy to treat gastroparesis and improve glycemic control, and the patient showed complete resolution of gastrointestinal symptoms postoperatively. Barium swallow test and gastric emptying time scan performed at follow-up revealed regular progression of barium and normal gastric emptying. Three months postoperatively, his fasting serum glucose level was within normal limits without the administration of insulin or oral antidiabetic drugs with a reduced HbA1c level (6.9%). Long-limb Roux-en-Y reconstruction after subtotal gastrectomy may be useful to treat severe diabetic gastroparesis by improving gastric emptying and glycemic control.


Subject(s)
Adult , Barium , Blood Glucose , C-Peptide , Diabetes Mellitus , Diabetes Mellitus, Type 2 , Endoscopy, Digestive System , Esophagitis, Peptic , Fasting , Follow-Up Studies , Gastrectomy , Gastric Emptying , Gastroparesis , Glycated Hemoglobin A , Humans , Hypoglycemic Agents , Insulin , Vomiting
15.
Neonatal Medicine ; : 67-71, 2019.
Article in Korean | WPRIM | ID: wpr-741661

ABSTRACT

Pylorospasm is a cause of delayed gastric emptying in young infants. As in patients with hypertrophic pyloric stenosis, most pylorospasm patients present with projectile vomiting. However, unlike that in case of hypertrophic pyloric stenosis, no persistent pyloric stenotic lesions are present. As such, follow-up using serial gastrointestinal fluoroscopy or ultrasonography can be helpful in diagnosing patients with clinical signs of gastroparesis. Most cases can be treated conservatively, but some patients require pharmacologic treatment. Antispasmodics have been proposed as a treatment for pylorospasm, but their use in neonates and infants has rarely been reported. Herein, we present a case of pylorospasm diagnosed in the neonatal period and successfully treated with intravenous atropine.


Subject(s)
Atropine , Fluoroscopy , Follow-Up Studies , Gastric Emptying , Gastroparesis , Humans , Infant , Infant, Newborn , Parasympatholytics , Pyloric Stenosis, Hypertrophic , Pylorus , Spasm , Ultrasonography , Vomiting
16.
Article in Chinese | WPRIM | ID: wpr-774422

ABSTRACT

OBJECTIVE@#To establish a modified endoscopic Freka Trelumina placement (mEFTP) for modifying or substituting the traditional endoscopic Freka Trelumina placement (EFTP) and to explore the safety and feasibility of mEFTP in patients requiring enteral nutrition and gastrointestinal decompression in general surgery.@*METHODS@#A retrospective cohort study was conducted to analyze the clinical data of patients undergoing EFTP or mEFTP at General Surgery Department of 920 Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army from January 2016 to January 2018.@*INCLUSION CRITERIA@#the function of lower digestive tract was normal; patients who could not eat through mouth or nasogastric tube needed to have enteral nutrition and gastrointestinal decompression; the retention time of Freka Trelumina (FT) was not expected to exceed 2 months.@*EXCLUSION CRITERIA@#contraindication for gastroscopy; suspected shock or digestive tract perforation; suspected mental diseases; infectious diseases of digestive tract; thoracoabdominal aortic aneurysm. mEFIP procedure was as follow. FT was inserted into stomach through one side nasal cavity, gastroscope was inserted into stomach cavity, and the front part of FT was clamped with biopsy forceps through biopsy hole. Biopsy forceps and FT were inserted into the pylorus or anastomosis under gastroscope, and they were pushed into the duodenum or output loop. During pushing, the gastroscope did not pass through the duodenum or output loop. The biopsy forceps was released and pushed out, and FT was pushed with biopsy forceps synchronously into the duodenum or output loop more than 5 cm. The foreign body forceps was inserted through the biopsy hole, and the FT tube was held in the stomach and pushed to the duodenum or output loop. The previous steps repeated until the suction cavity reached the pylorus or anastomosis. The gastroscope was exited gently; the guide wire was pulled out slowly. EFTP procedure: foreign body forceps was used to clamp the front part of FT, and gastroscope, foreign body forceps and FT pass the pylorus or anastomosis simultaneously to reach the descendent duodenum or output loop as a whole. The time of catheterization was recorded and position of FT was examined by X-ray within 1 h after catheterization. The success rate of catheterization and morbidity of complications after catheterization were evaluated and compared between the two groups.@*RESULTS@#A total of 141 patients were enrolled, 72 in the mEFTP group and 69 in the EFTP group. In mEFTP group, 45 cases were males and 27 were females with an average age of 55.8(37-76) years; 27 cases had normal upper gastrointestinal anatomy (postoperative gastroplegia syndrome due to colon cancer in 17 cases, due to rectal cancer in 10 cases) and 45 had upper gastrointestinal anatomic changes (gastric cancer with pylorus obstruction in 18 cases and anastomotic block after gastroenterostomy in 27 cases). In the EFTP group, 41 were males and 28 were females with an average age of 55.3(36-79) years; 33 cases had normal upper gastrointestinal anatomy (postoperative gastroplegia syndrome due to colon cancer in 20 cases, due to rectal cancer in 13 cases) and 36 had upper gastrointestinal anatomic changes (gastric cancer with pylorus obstruction in 15 cases and anastomotic block after gastroenterostomy in 21 cases). In patients with normal upper digestive tract anatomy, the average catheterization time of mEFTP was (4.9±1.7) minutes which was shorter than (7.6±1.7) minutes of EFTP(t=6.683, P0.05). In patients with upper gastrointestinal anatomic changes, the success rate of catheterization in mEFTP was even higher than that in EFTP, but the difference was not significant [97.8%(41/45) vs. 86.1%(31/36), χ²=2.880, P=0.089]; while the morbidity of catheterization complication in mEFTP was lower than that in EFTP [0 vs. 8.3%(3/36), χ²=3.894, P=0.048].@*CONCLUSIONS@#Whether the upper gastrointestinal anatomy is normal or not, mEFTP presents shorter catheterization time, higher success catheterization rate than EFTP, and is safety. mEFTP can be widely applied to clinical practice for patients requiring enteral nutrition and gastrointestinal decompression.


Subject(s)
Adult , Aged , Decompression, Surgical , Methods , Enteral Nutrition , Methods , Female , Gastric Outlet Obstruction , General Surgery , Gastroparesis , General Surgery , Gastroscopy , Methods , Humans , Intubation, Gastrointestinal , Methods , Male , Middle Aged , Retrospective Studies , Stomach Diseases , General Surgery
17.
Article in Korean | WPRIM | ID: wpr-761586

ABSTRACT

The prevalence of small bowel cancer is relatively low. The abdominal pain that patients with small bowel cancer present as a symptom is non-specific and often interpreted as a normal finding on radiographic studies. To prevent delayed diagnosis of small bowel cancer, practitioners must maintain a certain level of suspicion. We report a case of delayed diagnosis of jejunal cancer as it was misdiagnosed as gastroparesis. A 69-year-old woman complained of recurrent nausea and vomiting. At the beginning of her hospitalization, we could not diagnose mechanical obstruction through esophagogastroduodenoscopy and abdominal computed tomography. A gastric emptying study revealed delayed gastric emptying. Although the patients received treatments, including administration of prokinetics and botulinum toxin injection, for gastroparesis, her symptoms aggravated. Subsequently, plain radiography of the abdomen revealed a double-bubble sign. Abdominal computed tomography was performed under the suspicion of small bowel obstruction; however, the diagnosis was not clear. Consequently, exploratory laparoscopy was performed. She underwent surgical management, including small bowel segmental resection and duodenojejunostomy, due to the jejunal mass with involvement of the stomach, pancreatic head, and mesentery of the transverse colon. The postoperative pathological results revealed a moderately differentiated adenocarcinoma of the jejunum.


Subject(s)
Abdomen , Abdominal Pain , Adenocarcinoma , Aged , Botulinum Toxins , Colon, Transverse , Delayed Diagnosis , Diagnosis , Endoscopy, Digestive System , Female , Gastric Emptying , Gastroparesis , Head , Hospitalization , Humans , Jejunal Neoplasms , Jejunum , Laparoscopy , Mesentery , Nausea , Prevalence , Radiography , Stomach , Vomiting
18.
Journal of Korean Diabetes ; : 160-167, 2018.
Article in Korean | WPRIM | ID: wpr-726699

ABSTRACT

Diabetic autonomic neuropathy (DAN) is a serious and common complication of diabetes, although it is often overlooked. Abnormal autonomic function tests are often found in peoples with diabetic peripheral neuropathy. Autonomic neuropathies affect the autonomic neurons (parasympathetic, sympathetic, or both) and are associated with a variety of site-specific symptoms. The symptoms and signs of DAN should be elicited carefully during the medical history and physical examination. Major clinical manifestations of DAN include hypoglycemia unawareness, resting tachycardia, orthostatic hypotension, gastroparesis, constipation, diarrhea, fecal incontinence, erectile dysfunction, neurogenic bladder, and sudomotor dysfunction with either increased or decreased sweating. When a patient has signs and symptoms of DAN, various autonomic function tests should be performed. Recognition and management of DAN may improve symptoms, reduce sequelae, and improve quality of life. Clinically relevant diabetic autonomic neuropathies such as cardiovascular, gastrointestinal, genitourinary, and sudomotor dysfunction should be considered in the optimal care of patients with diabetes. The present review summarizes the latest knowledge regarding clinical presentation, diagnosis, and management of DAN.


Subject(s)
Constipation , Diabetic Neuropathies , Diagnosis , Diarrhea , Erectile Dysfunction , Fecal Incontinence , Gastroparesis , Humans , Hypoglycemia , Hypotension, Orthostatic , Male , Neurons , Peripheral Nervous System Diseases , Physical Examination , Quality of Life , Sweat , Sweating , Tachycardia , Urinary Bladder, Neurogenic
19.
Journal of Korean Diabetes ; : 180-185, 2018.
Article in Korean | WPRIM | ID: wpr-726696

ABSTRACT

Gastroparesis is one of complications in diabetic patients which need different management with diabetic patients without complication. Diabetic gastroparesis is a chronic disease and has clinical symptoms such as early satiety, nausea, vomiting and abdominal pain. Patients with diabetic gastroparesis have a high risk of malnutrition, which may result in poor quality of life. Therefore, in patients with have a gastrointestinal disorder, such as delayed gastric emptying in the early stages of malnutrition, we should consider diagnosis and management for diabetic gastroparesis. This review focused on diagnosis, symptoms and proper nutritional management of patients with diabetic gastroparesis. To reduce gastrointestinal disorders, patients with diabetic gastroparesis provide information on the type of food, the number of meals, the intake of fats, the intake of dietary fiber, and the intake of vitamin minerals.


Subject(s)
Abdominal Pain , Chronic Disease , Diabetes Mellitus , Diagnosis , Dietary Fiber , Fats , Gastric Emptying , Gastroparesis , Humans , Malnutrition , Meals , Minerals , Miners , Nausea , Quality of Life , Vitamins , Vomiting
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