Post-gastrectomy syndrome
Last reviewed: 23.04.2024
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[Dumping postgastoresection syndrome
Dumping postgastorezektsionny syndrome - the most common functional disorder after operations on the stomach. It is often combined with other disorders. The main links: rapid evacuation of food masses from the stump of the stomach, rapid passage through the small intestine, dysfunction of the pancreas, glands, vasomotor circulatory disorders.
Characterized by severe weakness, sweating, headache, dizziness, palpitations, a desire to lie down, often cutting pains in the upper abdomen or throughout the abdomen, increased intestinal peristalsis with diarrhea. Severity depends on the severity of the disorders. With mild degree, seizures develop 1-2 times a week, 10-15 minutes after eating, usually after taking sweet and dairy food, last 10-20 minutes. At moderate severity, seizures occur almost daily, lasting up to an hour. When severe form occurs after each meal, continue for up to two hours, there is a pronounced weight loss of the patient, even light physical exertion is impossible due to constant weakness, often there are neuropsychic disorders. Confirm the diagnosis of fluoroscopy of the stomach (preferably FGS). In severe cases, they are sent to a surgical hospital.
Hypoglycemic postgastrectomy syndrome
At the heart of its development are sharp fluctuations in blood sugar levels with the development of hypoglycemia, down to hypoglycemic coma. It is often combined with dumping syndrome and is based on dysfunction of the pancreas, especially the insular apparatus, or morphological changes occur in it as pancreatodystrophy (often sclerosis).
The attack begins 2-3 hours after eating, accompanied by dizziness, weakness, a sharp sense of hunger, euphoria; patients note sucking pains in epigastrium, trembling, sweating, palpitations. Characteristic decrease in blood pressure and bradycardia. Phenomena are quickly stopped by taking a small amount of food, especially carbohydrate. The diagnosis is based on the clinic and laboratory blood test data for sugar (before meals and after meals).
Reflux syndrome (adductor-loop syndrome)
It often develops after the operation of resection by Billroth II. The basis is the violation of the evacuation of the contents from the leading loop with the transfer of contents into the stump of the stomach and dyskinesia of the outflow loop. As a result, develop: anastomosis, reflux gastritis, jejunitis, can be a relapse of the ulcer, a violation of the liver and pancreas.
The clinic manifests as bursting pains in the epigastrium and the right hypochondrium, a feeling of heaviness that intensifies after eating. The intensity of pain gradually increases, and they end with a profuse vomiting of bile, sometimes with an admixture of reduced food, which brings considerable relief. External manifestations are sometimes: protrusion of the swollen leading loop in the right hypochondrium, which gives an asymmetry of the abdomen, which disappears after vomiting, icteric sclera, weight loss, until exhaustion. Vomiting can be up to several times a day, and bile can stand up to -500-700 ml per day. Confirm the diagnosis of fluoroscopy of the stomach and FGS, laboratory studies of complete blood biochemistry and salt composition. The patient should be referred to a surgical hospital for a corrective operation.
Chronic post-gastrectomy syndrome
It flows like a painful form of chronic pancreatitis. It is often combined with, reflux-syndrome and dumping syndrome. The treatment is conservative.
Metabolic post-gastrectomy syndrome
Combined with all the above syndromes and is expressed in the violation of protein metabolism, which is expressed in the patient's weight loss, the development of chronic water-electrolyte disorders, the development of iron deficiency and B12-deficiency anemia, etc. Treatment is conservative.