gastric retention
Introduction
Introduction to gastric retention Gastric retention or delayed emptying refers to the accumulation of gastric contents and not emptying in time. Any food that has been ingested 4 to 6 hours before vomiting, or fasting for more than 8 hours, residual in the stomach. >200ml, indicating that there is gastric retention. The disease is divided into two types: organic and functional. The former includes pyloric obstruction caused by peptic ulcer, and pyloric obstruction caused by primary or secondary cancer compression and obstruction of gastric antrum and its adjacent organs. basic knowledge The proportion of sickness: 0.8% Susceptible people: no specific population Mode of infection: non-infectious Complications: anemia
Cause
Cause of gastric retention
Functional gastric retention is caused by gastric atony. In addition, gastric motility disorders caused by stomach or other abdominal surgery, central nervous system diseases, neuropathy caused by diabetes, and vagus nerve cutting can cause The disease, uremia, acidosis, hypokalemia, hypocalcemia, systemic or intra-abdominal infections, severe pain, severe anemia, and the use of antipsychotics and anticholinergic drugs can also cause the disease.
Prevention
Gastric retention prevention
When starting to eat, you should give a small amount of rice soup, glutinous rice and other light liquid foods, each time 30 ~ 60 ml, if there is no discomfort, can be gradually added to 150 ml, any liquid with easy to produce slag and milk are not suitable for consumption.
Complication
Gastric retention complications Complications anemia
Different degrees of anemia, hypoalbuminemia, electrolyte and acid-base balance disorders and pre-renal azotemia can be seen.
Symptom
Symptoms of gastric retention, common symptoms, abdominal pain, dull pain, fasting, abdomen, water, sound, dehydration, weight loss
If there is vomiting and eating, if there is a sound of water in the abdomen on an empty stomach, that is, gastric retention, after 4 hours of eating, food can be taken out from the stomach cavity from the stomach tube.
During gastrointestinal barium meal examination, the expectorant remains 50% after 4 hours, or is not empty after 6 hours. It is the evidence of this disease. The identification of organic and functional gastric retention should be noted. The former gastric peristalsis is increased. In the latter case, the gastric tension is lowered and the gastric peristalsis is reduced.
Vomiting is the main manifestation of this disease. It can occur day and night. One to several times a day, vomit is often a food, usually does not contain bile. The upper abdomen is full of swelling and pain. The abdominal pain can be dull pain, colic or Burning pain, symptoms can be temporarily relieved after vomiting, acute patients can cause dehydration and electrolyte metabolism disorders; chronic patients can have malnutrition and weight loss, severe or long-term vomiting, due to massive loss of gastric acid and potassium ions, can cause alkali Poisoned and caused convulsions.
Physical examination showed dehydration performance, upper abdominal distension, middle and upper abdomen tenderness accompanied by water sound, stomach type, and left to right gastric peristalsis enhanced, more suggestive obstruction at the stomach outlet; The type without a peristaltic wave suggests a lack of gastric tension.
Examine
Stomach retention check
(1) Blood examination: different degrees of anemia, hypoproteinemia, hypokalemia, hypocalcemia, blood gas analysis and examination suggest that the acid-base balance disorder, some patients may have elevated urea nitrogen.
(2) Gastrointestinal X-ray examination: X-rays suggest that the expectorant remains 50% after 4 hours, or has not been emptied after 6 hours.
(3) Ultrasound: gastrointestinal ultrasound can be seen in the upper abdomen or left upper abdomen to detect the solid mass of the capsule, that is, the stomach type, the inner echoless area, the floating light spot and the light group, moving with the body position to the low gravity, the lower stomach tube After aspiration, the mass also shrinks.
(4) Gastroscopic examination: A large amount of retentate is visible under the gastroscope.
(5) Gastric tube absorption: The stomach tube can suck out the food that was ingested 4 hours ago.
Diagnosis
Gastric retention diagnosis
According to clinical symptoms and laboratory tests can be diagnosed.
Attention should be paid to the identification of organic and functional gastric retention, the former increased gastric peristalsis, the latter decreased gastric tension, and less gastric peristalsis.
