Enterogastric reflux and gastric clearance of refluxate in normal subjects and in patients with and without bile vomiting following peptic ulcer surgery
A noninvasive scintigraphic technique was used to estimate enterogastric reflux and subsequent gastric evacuation of refluxate in 35 normal, healthy subjects and 55 patients previously treated by vagotomy or partial gastrectomy. Reflux was provoked by a milk drink and quantitated by counting 99Tcm-E...
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| Veröffentlicht in: | Ann. Surg.; (United States) 1986-11, Vol.204 (5), p.537-542 |
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| description | A noninvasive scintigraphic technique was used to estimate enterogastric reflux and subsequent gastric evacuation of refluxate in 35 normal, healthy subjects and 55 patients previously treated by vagotomy or partial gastrectomy. Reflux was provoked by a milk drink and quantitated by counting 99Tcm-EHIDA activity within the gastric area during gamma camera imaging. Seven normal subjects (20%) showed reflux of 5-18% of initial activity (mean: 10%), with peak values occurring at 5-30 minutes (mean: 14 minutes) following the milk. Gastric evacuation of activity in these subjects was monoexponential (r = 0.993, T1/2 = 24.1 minutes). Reflux occurred more frequently than normal in patients with truncal vagotomy and drainage (22/28 patients) and partial gastrectomy (20/21 patients). All of 16 patients with Billroth II anastomoses exhibited reflux, which was excessive compared with refluxing normal subjects (mean: 25%; p less than 0.01) and occurred later into the study (mean: 34 minutes; p less than 0.01). Ten of 11 asymptomatic patients showed reflux of similar amounts of activity (mean: 21%) compared with 16 patients who complained of bile vomiting (mean: 22%). However, asymptomatic patients exhibited gastric evacuation of refluxate at a rate similar to that of refluxing normal subjects, while bile vomiters showed significant gastric retention of refluxate at 25-30 minutes following peak gastric activity (p less than 0.05). This result confirms that post-operative bile vomiting is essentially a problem of gastric emptying. |
| doi_str_mv | 10.1097/00000658-198611000-00005 |
| format | Article |
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Reflux was provoked by a milk drink and quantitated by counting 99Tcm-EHIDA activity within the gastric area during gamma camera imaging. Seven normal subjects (20%) showed reflux of 5-18% of initial activity (mean: 10%), with peak values occurring at 5-30 minutes (mean: 14 minutes) following the milk. Gastric evacuation of activity in these subjects was monoexponential (r = 0.993, T1/2 = 24.1 minutes). Reflux occurred more frequently than normal in patients with truncal vagotomy and drainage (22/28 patients) and partial gastrectomy (20/21 patients). All of 16 patients with Billroth II anastomoses exhibited reflux, which was excessive compared with refluxing normal subjects (mean: 25%; p less than 0.01) and occurred later into the study (mean: 34 minutes; p less than 0.01). Ten of 11 asymptomatic patients showed reflux of similar amounts of activity (mean: 21%) compared with 16 patients who complained of bile vomiting (mean: 22%). However, asymptomatic patients exhibited gastric evacuation of refluxate at a rate similar to that of refluxing normal subjects, while bile vomiters showed significant gastric retention of refluxate at 25-30 minutes following peak gastric activity (p less than 0.05). This result confirms that post-operative bile vomiting is essentially a problem of gastric emptying.</description><identifier>ISSN: 0003-4932</identifier><identifier>EISSN: 1528-1140</identifier><identifier>DOI: 10.1097/00000658-198611000-00005</identifier><identifier>PMID: 3767485</identifier><identifier>CODEN: ANSUA5</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott</publisher><subject>Adult ; Aged ; BETA DECAY RADIOISOTOPES ; BETA-MINUS DECAY RADIOISOTOPES ; BILE ; Bile - metabolism ; Biological and medical sciences ; BIOLOGICAL MATERIALS ; BODY ; BODY FLUIDS ; COUNTING TECHNIQUES ; DIAGNOSTIC TECHNIQUES ; DIGESTIVE SYSTEM ; Duodenogastric Reflux - diagnostic imaging ; Duodenogastric Reflux - etiology ; Duodenogastric Reflux - physiopathology ; Female ; GASTRECTOMY ; GASTRIC ACID ; Gastric Acid - metabolism ; Gastric Emptying ; Gastroenterology. Liver. Pancreas. Abdomen ; GASTROINTESTINAL TRACT ; HOURS LIVING RADIOISOTOPES ; Humans ; Imino Acids ; INTERMEDIATE MASS NUCLEI ; ISOMERIC TRANSITION ISOTOPES ; ISOTOPES ; Male ; MATERIALS ; Medical sciences ; MEDICINE ; Middle Aged ; NUCLEI ; ODD-EVEN NUCLEI ; ORGANS ; Other diseases. Semiology ; PATIENTS ; Peptic Ulcer - surgery ; Postoperative Complications - diagnostic imaging ; Postoperative Complications - etiology ; RADIOISOTOPE SCANNING ; RADIOISOTOPES ; RADIOLOGY AND NUCLEAR MEDICINE ; Radionuclide Imaging ; SCINTISCANNING ; STOMACH ; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus ; SURGERY ; SYMPTOMS ; Technetium ; TECHNETIUM 99 ; TECHNETIUM ISOTOPES ; Technetium Tc 99m Diethyl-iminodiacetic Acid ; Vagotomy ; VOMITING ; Vomiting - etiology ; YEARS LIVING RADIOISOTOPES 550601 -- Medicine-- Unsealed Radionuclides in Diagnostics</subject><ispartof>Ann. Surg.; (United States), 1986-11, Vol.204 (5), p.537-542</ispartof><rights>1987 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c471t-7fb2dac6c7e6753618fc3b39bffb74da92a0f33dc1291918a70c0fbc149b73de3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1251336/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1251336/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=8060919$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/3767485$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.osti.gov/biblio/6935516$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>MACKIE, C</creatorcontrib><creatorcontrib>HULKS, G</creatorcontrib><creatorcontrib>CUSCHIERI, A</creatorcontrib><creatorcontrib>Ninewells Hospital and Medical School, Dundee, Scotland</creatorcontrib><title>Enterogastric reflux and gastric clearance of refluxate in normal subjects and in patients with and without bile vomiting following peptic ulcer surgery</title><title>Ann. Surg.; (United States)</title><addtitle>Ann Surg</addtitle><description>A noninvasive scintigraphic technique was used to estimate enterogastric reflux and subsequent gastric evacuation of refluxate in 35 normal, healthy subjects and 55 patients previously treated by vagotomy or partial gastrectomy. Reflux was provoked by a milk drink and quantitated by counting 99Tcm-EHIDA activity within the gastric area during gamma camera imaging. Seven normal subjects (20%) showed reflux of 5-18% of initial activity (mean: 10%), with peak values occurring at 5-30 minutes (mean: 14 minutes) following the milk. Gastric evacuation of activity in these subjects was monoexponential (r = 0.993, T1/2 = 24.1 minutes). Reflux occurred more frequently than normal in patients with truncal vagotomy and drainage (22/28 patients) and partial gastrectomy (20/21 patients). All of 16 patients with Billroth II anastomoses exhibited reflux, which was excessive compared with refluxing normal subjects (mean: 25%; p less than 0.01) and occurred later into the study (mean: 34 minutes; p less than 0.01). Ten of 11 asymptomatic patients showed reflux of similar amounts of activity (mean: 21%) compared with 16 patients who complained of bile vomiting (mean: 22%). However, asymptomatic patients exhibited gastric evacuation of refluxate at a rate similar to that of refluxing normal subjects, while bile vomiters showed significant gastric retention of refluxate at 25-30 minutes following peak gastric activity (p less than 0.05). This result confirms that post-operative bile vomiting is essentially a problem of gastric emptying.</description><subject>Adult</subject><subject>Aged</subject><subject>BETA DECAY RADIOISOTOPES</subject><subject>BETA-MINUS DECAY RADIOISOTOPES</subject><subject>BILE</subject><subject>Bile - metabolism</subject><subject>Biological and medical sciences</subject><subject>BIOLOGICAL MATERIALS</subject><subject>BODY</subject><subject>BODY FLUIDS</subject><subject>COUNTING TECHNIQUES</subject><subject>DIAGNOSTIC TECHNIQUES</subject><subject>DIGESTIVE SYSTEM</subject><subject>Duodenogastric Reflux - diagnostic imaging</subject><subject>Duodenogastric Reflux - etiology</subject><subject>Duodenogastric Reflux - physiopathology</subject><subject>Female</subject><subject>GASTRECTOMY</subject><subject>GASTRIC ACID</subject><subject>Gastric Acid - metabolism</subject><subject>Gastric Emptying</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>GASTROINTESTINAL TRACT</subject><subject>HOURS LIVING RADIOISOTOPES</subject><subject>Humans</subject><subject>Imino Acids</subject><subject>INTERMEDIATE MASS NUCLEI</subject><subject>ISOMERIC TRANSITION ISOTOPES</subject><subject>ISOTOPES</subject><subject>Male</subject><subject>MATERIALS</subject><subject>Medical sciences</subject><subject>MEDICINE</subject><subject>Middle Aged</subject><subject>NUCLEI</subject><subject>ODD-EVEN NUCLEI</subject><subject>ORGANS</subject><subject>Other diseases. Semiology</subject><subject>PATIENTS</subject><subject>Peptic Ulcer - surgery</subject><subject>Postoperative Complications - diagnostic imaging</subject><subject>Postoperative Complications - etiology</subject><subject>RADIOISOTOPE SCANNING</subject><subject>RADIOISOTOPES</subject><subject>RADIOLOGY AND NUCLEAR MEDICINE</subject><subject>Radionuclide Imaging</subject><subject>SCINTISCANNING</subject><subject>STOMACH</subject><subject>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</subject><subject>SURGERY</subject><subject>SYMPTOMS</subject><subject>Technetium</subject><subject>TECHNETIUM 99</subject><subject>TECHNETIUM ISOTOPES</subject><subject>Technetium Tc 99m Diethyl-iminodiacetic Acid</subject><subject>Vagotomy</subject><subject>VOMITING</subject><subject>Vomiting - etiology</subject><subject>YEARS LIVING RADIOISOTOPES 550601 -- Medicine-- Unsealed Radionuclides in Diagnostics</subject><issn>0003-4932</issn><issn>1528-1140</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1986</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVUU2PFCEQJUazjqs_wYQY460VmqahLyZms34km3jRMwEaZtjQ0AK96_4Tf670TO9EuUC9V_WqqAcAxOg9RgP7gNbTU97ggfcY16BZEfoE7DBtK4w79BTsKkSabiDtc_Ai51uEcMcRuwAXhPWs43QH_lyHYlLcy1yS0zAZ65ffUIYRPkLaG5lk0AZGu_GyGOgCDDFN0sO8qFujSz5WVXiWxZlQ43tXDkdwfcSlQOW8gXdxcsWFPbTR-3i_vmYzl9pp8dqkKpf2Jj28BM-s9Nm82u5L8PPz9Y-rr83N9y_frj7dNLpjuDTMqnaUutfM9IySHnOriSKDslaxbpRDK5ElZNS4HfCAuWRII6s07gbFyGjIJfh40p0XNZlR18mT9GJObpLpQUTpxP9McAexj3cCtxQT0leBNyeBmIsTWbti9EHHEOpORD8QSvGa9G7rkuKvxeQiJpe18V4GE5csGEOcspbXRH5K1CnmXNd9ngQjsVovHq0XZ-uPEK2lr__9yblw87rybzdeZi29XU11-ZzGUY_qishffJ67xQ</recordid><startdate>19861101</startdate><enddate>19861101</enddate><creator>MACKIE, C</creator><creator>HULKS, G</creator><creator>CUSCHIERI, A</creator><general>Lippincott</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>OTOTI</scope><scope>5PM</scope></search><sort><creationdate>19861101</creationdate><title>Enterogastric reflux and gastric clearance of refluxate in normal subjects and in patients with and without bile vomiting following peptic ulcer surgery</title><author>MACKIE, C ; HULKS, G ; CUSCHIERI, A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c471t-7fb2dac6c7e6753618fc3b39bffb74da92a0f33dc1291918a70c0fbc149b73de3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1986</creationdate><topic>Adult</topic><topic>Aged</topic><topic>BETA DECAY RADIOISOTOPES</topic><topic>BETA-MINUS DECAY RADIOISOTOPES</topic><topic>BILE</topic><topic>Bile - metabolism</topic><topic>Biological and medical sciences</topic><topic>BIOLOGICAL MATERIALS</topic><topic>BODY</topic><topic>BODY FLUIDS</topic><topic>COUNTING TECHNIQUES</topic><topic>DIAGNOSTIC TECHNIQUES</topic><topic>DIGESTIVE SYSTEM</topic><topic>Duodenogastric Reflux - diagnostic imaging</topic><topic>Duodenogastric Reflux - etiology</topic><topic>Duodenogastric Reflux - physiopathology</topic><topic>Female</topic><topic>GASTRECTOMY</topic><topic>GASTRIC ACID</topic><topic>Gastric Acid - metabolism</topic><topic>Gastric Emptying</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>GASTROINTESTINAL TRACT</topic><topic>HOURS LIVING RADIOISOTOPES</topic><topic>Humans</topic><topic>Imino Acids</topic><topic>INTERMEDIATE MASS NUCLEI</topic><topic>ISOMERIC TRANSITION ISOTOPES</topic><topic>ISOTOPES</topic><topic>Male</topic><topic>MATERIALS</topic><topic>Medical sciences</topic><topic>MEDICINE</topic><topic>Middle Aged</topic><topic>NUCLEI</topic><topic>ODD-EVEN NUCLEI</topic><topic>ORGANS</topic><topic>Other diseases. Semiology</topic><topic>PATIENTS</topic><topic>Peptic Ulcer - surgery</topic><topic>Postoperative Complications - diagnostic imaging</topic><topic>Postoperative Complications - etiology</topic><topic>RADIOISOTOPE SCANNING</topic><topic>RADIOISOTOPES</topic><topic>RADIOLOGY AND NUCLEAR MEDICINE</topic><topic>Radionuclide Imaging</topic><topic>SCINTISCANNING</topic><topic>STOMACH</topic><topic>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</topic><topic>SURGERY</topic><topic>SYMPTOMS</topic><topic>Technetium</topic><topic>TECHNETIUM 99</topic><topic>TECHNETIUM ISOTOPES</topic><topic>Technetium Tc 99m Diethyl-iminodiacetic Acid</topic><topic>Vagotomy</topic><topic>VOMITING</topic><topic>Vomiting - etiology</topic><topic>YEARS LIVING RADIOISOTOPES 550601 -- Medicine-- Unsealed Radionuclides in Diagnostics</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>MACKIE, C</creatorcontrib><creatorcontrib>HULKS, G</creatorcontrib><creatorcontrib>CUSCHIERI, A</creatorcontrib><creatorcontrib>Ninewells Hospital and Medical School, Dundee, Scotland</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>OSTI.GOV</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Ann. Surg.; (United States)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>MACKIE, C</au><au>HULKS, G</au><au>CUSCHIERI, A</au><aucorp>Ninewells Hospital and Medical School, Dundee, Scotland</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Enterogastric reflux and gastric clearance of refluxate in normal subjects and in patients with and without bile vomiting following peptic ulcer surgery</atitle><jtitle>Ann. Surg.; (United States)</jtitle><addtitle>Ann Surg</addtitle><date>1986-11-01</date><risdate>1986</risdate><volume>204</volume><issue>5</issue><spage>537</spage><epage>542</epage><pages>537-542</pages><issn>0003-4932</issn><eissn>1528-1140</eissn><coden>ANSUA5</coden><abstract>A noninvasive scintigraphic technique was used to estimate enterogastric reflux and subsequent gastric evacuation of refluxate in 35 normal, healthy subjects and 55 patients previously treated by vagotomy or partial gastrectomy. Reflux was provoked by a milk drink and quantitated by counting 99Tcm-EHIDA activity within the gastric area during gamma camera imaging. Seven normal subjects (20%) showed reflux of 5-18% of initial activity (mean: 10%), with peak values occurring at 5-30 minutes (mean: 14 minutes) following the milk. Gastric evacuation of activity in these subjects was monoexponential (r = 0.993, T1/2 = 24.1 minutes). Reflux occurred more frequently than normal in patients with truncal vagotomy and drainage (22/28 patients) and partial gastrectomy (20/21 patients). All of 16 patients with Billroth II anastomoses exhibited reflux, which was excessive compared with refluxing normal subjects (mean: 25%; p less than 0.01) and occurred later into the study (mean: 34 minutes; p less than 0.01). Ten of 11 asymptomatic patients showed reflux of similar amounts of activity (mean: 21%) compared with 16 patients who complained of bile vomiting (mean: 22%). However, asymptomatic patients exhibited gastric evacuation of refluxate at a rate similar to that of refluxing normal subjects, while bile vomiters showed significant gastric retention of refluxate at 25-30 minutes following peak gastric activity (p less than 0.05). This result confirms that post-operative bile vomiting is essentially a problem of gastric emptying.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott</pub><pmid>3767485</pmid><doi>10.1097/00000658-198611000-00005</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0003-4932 |
| ispartof | Ann. Surg.; (United States), 1986-11, Vol.204 (5), p.537-542 |
| issn | 0003-4932 1528-1140 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_1251336 |
| source | Journals@Ovid Ovid Autoload; MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central |
| subjects | Adult Aged BETA DECAY RADIOISOTOPES BETA-MINUS DECAY RADIOISOTOPES BILE Bile - metabolism Biological and medical sciences BIOLOGICAL MATERIALS BODY BODY FLUIDS COUNTING TECHNIQUES DIAGNOSTIC TECHNIQUES DIGESTIVE SYSTEM Duodenogastric Reflux - diagnostic imaging Duodenogastric Reflux - etiology Duodenogastric Reflux - physiopathology Female GASTRECTOMY GASTRIC ACID Gastric Acid - metabolism Gastric Emptying Gastroenterology. Liver. Pancreas. Abdomen GASTROINTESTINAL TRACT HOURS LIVING RADIOISOTOPES Humans Imino Acids INTERMEDIATE MASS NUCLEI ISOMERIC TRANSITION ISOTOPES ISOTOPES Male MATERIALS Medical sciences MEDICINE Middle Aged NUCLEI ODD-EVEN NUCLEI ORGANS Other diseases. Semiology PATIENTS Peptic Ulcer - surgery Postoperative Complications - diagnostic imaging Postoperative Complications - etiology RADIOISOTOPE SCANNING RADIOISOTOPES RADIOLOGY AND NUCLEAR MEDICINE Radionuclide Imaging SCINTISCANNING STOMACH Stomach. Duodenum. Small intestine. Colon. Rectum. Anus SURGERY SYMPTOMS Technetium TECHNETIUM 99 TECHNETIUM ISOTOPES Technetium Tc 99m Diethyl-iminodiacetic Acid Vagotomy VOMITING Vomiting - etiology YEARS LIVING RADIOISOTOPES 550601 -- Medicine-- Unsealed Radionuclides in Diagnostics |
| title | Enterogastric reflux and gastric clearance of refluxate in normal subjects and in patients with and without bile vomiting following peptic ulcer surgery |
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