PubMed · 1236365
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T Murakami, T Kawasaki. 1975. [Dumping syndrome].. https://pubmed.ncbi.nlm.nih.gov/1236365/
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Octreotide inhibits intestinal motility and reduces gastrointestinal secretions. These actions have led to its evaluation in two postsurgical conditions: dumping syndrome and short bowel syndrome. Octreotide substantially reduces symptoms of early and late dumping and prevents the associated phenomena including the increase in packed cell volume considered to be indicative of reduced plasma volume. Its therapeutic benefit probably relates both to slowing of gastric emptying and small bowel transit and inhibition of the release of putative mediators (peptide hormones) of the vasomotor symptoms. Octreotide also reduces intestinal efflux in some patients with the short bowel syndrome. This can lead to a reduction in the volume of intravenous fluid requirements but does not allow an intravenous fluid-dependent patient to change back to an oral regimen. The major mechanism of octreotide's therapeutic effect in this situation may be its ability to reduce endogenous gastric acid secretion.
To avoid dumping after Billroth gastrectomy, we designed pylorus and antroseromuscular-flap preserving subtotal gastrectomy (PAFPG). The mean maximal plasma level of VIP (vasoactive intestinal peptide) in PAFPG after oral hypertonic glucose was close to that in the control. Compared with PAFPG group, the plasma VIP concentrations after hypertonic glucose ingestion in BI and BII group were significantly higher, and the concentration of plasma VIP in dumpers was significantly higher than that in non-dumpers after BI or BII gastrectomy. The results suggest that the amount of VIP release is related to the type of reconstruction after gastrectomy.
Dumping syndrome in infancy is a rare complication following gastric surgery. We describe an 11-month-old infant affected by recurrent peptic oesophagitis who underwent a combined Nissen fundoplication and pyloroplasty. Early dumping symptoms such as irritability, pallor, sweating, abdominal distension and watery diarrhoea were observed postoperatively after bolus feeding. Gastric emptying, measured after the administration of 150 ml of regular cow milk mixed with 200 microCi (8 MBq) of technetium-99m sulfur colloid (99mTc-SC), demonstrated an early rapid and massive emptying of the isotopes into the small intestine, followed by duodenogastric reflux and a second wave of emptying and reflux at 9 min. The initial pattern of gastric emptying and duodenogastric reflux was followed by a slow emptying phase with half-emptying time of 81 min. Isotope studies should be used to investigate motility disorders caused by this type of anti-reflux operation.