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PubMed1976

After gastrectomy.

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Anemia, Hypochromic↗
PubMed1980

[Malabsorption from the surgical viewpoint].

Malabsorption following surgical procedures on the GI-tract happens only in rare cases, such as blindloop-syndrome, short gut-syndrome, internal fistulae and dumping syndrome after partial gastric resection. Pathophysiological background and therapeutical possibilities as well as parenteral nutrition are discussed in detail.

Avitaminosis↗
PubMed1978

Intussusception as a complication of partial gastrectomy. A case report.

The causes of postgastrectomy syndrome are multiple and differ in their relative frequency. Among the more unusual is intussusception of the small bowel into the stomach or into the jejunojejunostomy. We describe a patient with acute retrograde intussusception of the efferent loop into the jejunojejunostomy occurring 14 months after partial gastrectomy with Billroth II anastomosis. Several theories regarding etiology are mentioned, among them functional causes, mechanical causes and derangements in stomal function. In our case, the circulatory derangement might possibly be a causal factor. The diagnostic problems are discussed, and the importance of early diagnosis is pointed out. A chronic form of intussusception is mentioned by several authors. Often the differential diagnosis is difficult, but epigastric pain, vomiting--ultimately of blood--and a palpable mass, constitute a classic triad. X-ray and endoscopy are supplementary aids to the diagnosis. Several types of operative treatment have been used, but no operative procedure seems to be fully effective as a safeguard against recurrence.

Aged↗
PubMed1994

65 cases of preserving pylorus pancreatoduodenectomy: experience and problems.

Sixty-five patients with neoplasm (62 cases) or pancreatitis (3 cases) were treated with preserving pylorus pancreatoduodenectomy (PPPD) from 1984 to 1991. One postoperative death occurred. Follow-up studies were performed in 35 patients who had been treated by PPPD or the standard Whipple's procedure; they were questioned carefully concerning clinical symptoms. Further studies were performed in 20 patients with or without pylorus preservation (10 patients, respectively). Nutritional status and gastrointestinal digestive and absorptive functions were evaluated by determination of serum components, gastric analysis, barium emptying time, D-xylose absorption test, 14CO2 breath test, PABA, and other methods. The results demonstrated malnutrition and postgastrectomy syndromes in some patients after the standard Whipple's procedure, but not in those with PPPD. The quality of life was better in the latter. Pylorus preservation may be the main reason for this above difference. Delayed gastric emptying in the early postoperative period was a complication in some patients (21%) treated by PPPD. We recommend PPPD for pancreatoduodenectomy.

Adenocarcinoma↗
PubMed1977

Location of the site of bacterial bile-salt deconjugation by combining abdominal scintigraphy with expired C-14.

A combined 14CO2 bile-salt breath and scintigraphic test has proved useful in determining the site of bile-salt deconjugation by bacteria. Data suggest that the procedure can be shortened to less than 8 hr with Tc-99m sulfur colloid abdominal scintigrams added to locate the labeled meal. Moreover the cumulative 14CO2 excretion, which is an indes of the rate of bile-salt deconjugation, gives clearer separation than peak specific activity between normals and either high or low deviations from normal, The test should be helpful in a number of difficult diagnostic problems involving chronic diarrhea, and offers as well both as well both a guide to appropriate therapy and a monitor for relapse in enfected blind-loop syndromes,

Bile Acids and Salts↗
PubMed1976

Malabsorption following gastric resection.

We have tried to stress the complexity of the bacterial ecology that may exist in the intestine of patients and experimental animals with small intestinal bacterial overgrowth. The multiplicity of organisms often makes the management of these patients quite frustrating. A number of metabolic derangements of varying severity may occur in any given patient. Although many of the observed abnormalities are secondary to disturbed events with the luminal environment of the small intestine, the significance of direct damage to the small intestinal epithelium has been emphasized. Since intestinal cultures are both cumbersome and difficult to perform on a routine basis, the use of labeled substrate breath tests will allow guided, outpatient therapy more easily than in the past. Since full correction of the malabsorption is seldom achieved with antibiotic therapy, nutritional supplementation deserves more attention than it has previously received.

Animals↗