The blind area in routine gastric lavage and its clinical significance / 中华消化内镜杂志

ABSTRACT

Objective To observe the blind area in routine gastric lavage and evaluate its significance. Methods Each of 10 healthy volunteers drank 60 ml water containing 185 MBq 99mTc. Images of mouth, esophagus and stomach of all subjects were collected from anterior position with gamma camera, and intraoral and intraesophageal radiocounts were monitored with " Region of Interesting" technique at 0, 0.5, 1,2,3 and 4 hours. Ratios of the counts at subsequent time points vs the count of 0 hour were calculated. For other 13 volunteers, 100 ml, 200 ml, 300 ml and 400 ml normal saline containing 25% compound meglucamine diatrizoate were drunk and injected into stomachs through stomach tube respectively. After that, X-ray chest films were taken at the dorsal and left lateral decubitus positions to observe the oral and e-sophageal developments. Results The images of mouths and esophagus of 10 subjects could be identified more than 4 hours after the administration of 99mTc. The ratios of oral counts and esophageal counts at 0. 5 ,1, 2, 3 and 4 hrs were 30. 7% , 10. 5% , 6. 3% , 4. 7% , 3. 7% , and 18. 6% , 4. 4% , 3. 5% , 3. 0% ,2. 7% respectively. The ratios of both oral and esophageal counts were 49. 3% , 14. 9% , 9. 8% , 7. 7% and 6.4%. When the liquid was drunk, full oral and esophageal developments could be identified. While the liquid was injected through the tube, no development was found. Conclusions Liquid drug may remain in mouth and esophagus for a long period of time after administration. Routine gastric lavage through nasogastric tube can not clean the oral and esophageal drug residues. There are oral and esophageal blind areas when routine gastric lavage is employed.