Subject(s)
Esophagitis, Peptic/surgery , Gastrectomy/adverse effects , Gastritis/surgery , Gastroesophageal Reflux/surgery , Achlorhydria/complications , Achlorhydria/surgery , Duodenal Ulcer/surgery , Esophagitis, Peptic/etiology , Gastrectomy/methods , Gastritis/complications , Gastroesophageal Reflux/complications , Humans , Male , Middle AgedABSTRACT
It has been established that gastric resection as well as truncal vagotomy with antrumectomy should not be used in the surgery of duodenal ulcers in cases with sharp subacidity . In such cases non-resection methods should be used in combination with vagotomy.
Subject(s)
Achlorhydria/surgery , Duodenal Ulcer/surgery , Gastric Acid/metabolism , Drainage/methods , Duodenal Ulcer/physiopathology , Female , Follow-Up Studies , Gastrectomy/methods , Gastric Acidity Determination , Humans , Male , Pyloric Antrum/surgery , Vagotomy/methodsABSTRACT
Elevation in fasting serum gastrin levels was found in three patients being evaluated for persistent upper abdominal pain without radiographic evidence of peptic ulcer disease. Fiberoptic endoscopy of the upper gastrointestinal tract in each patient revealed characteristic changes of chronic atrophic gastritis. Gastric biopsies showed diffuse chronic inflammation in the lamina propria, a decrease in the number of parietal cells, and "intestinalization" of gastric mucosa. Total achlorhydria was demonstrated after a maximal histalog stimulus; however, serum levels of vitamin B12 and Schilling test values were normal in all three patients. Parietal cell antibodies were found in the serum in all patients in a dilution of 1:20 to 1:80. These cases represent autoimmune (type A) chronic atrophic gastritis and should be distinguished from chronic simple (type B) gastritis, in which serum gastrin levels are normal and no parietal cell antibodies are found in the serum. Patients with autoimmune gastritis should be observed at frequent intervals for the occurrence of pernicious anemia or gastric carcinoma.
Subject(s)
Achlorhydria/immunology , Autoimmune Diseases/immunology , Gastrins/blood , Gastritis/immunology , Achlorhydria/surgery , Adult , Antacids/administration & dosage , Atrophy , Autoantibodies/analysis , Chronic Disease , Female , Gastrectomy , Gastritis/surgery , Humans , Middle AgedABSTRACT
A women had hypergastrinaemia associated with the variety of gastritis (Type A) that is associated usually with pernicious anaemia, together with recurring bouts of severe abdominal pain. Fasting serum gastrin levels ranged between 600 and 2750 pg/ml. There was a rise in serum gastrin levels after a standard protein meal, indicative of a large G cell mass, and a fall after intragastric HCI, which led to a trial of treatment with HCI; this gave some symptomatic relief. After surgical antrectomy there was a profound fall of serum gastrin from a pre-operative level of 2500 pg/ml to constant values of 16--25 pg/ml, and complete and lasting relief from the bouts of abdominal pain.
