delayed gastric emptying
Introduction
Introduction Diabetes is prone to delay in gastric emptying. Among the gastrointestinal neuropathy caused by diabetes, gastroparesis caused by diabetes is a common complication of diabetic patients, and it is a clinical syndrome characterized by low gastric motility caused by gastric autonomic dysfunction secondary to diabetes. Including: nausea, early satiety, feeling of fullness in the upper abdomen after meals, belching, loss of appetite, vomiting, upper abdominal pain, stomach retention or solid food emptying due to indigestion to form stomach stones, and can lead to weight loss.
Cause
Cause
Delayed gastric emptying refers to the need to place gastric tube more than 10 days after surgery. Alkaline reflux gastritis is based on clinical manifestations and gastroscopy. Roux retention syndrome refers to the symptoms of upper abdominal abdomen, pain, nausea and vomiting after repeated episodes of eating more than 3 months after surgery. The causes of gastroscopy to exclude other lesions of the upper digestive tract are generally considered to be possible and retained. Poor blood supply in the duodenum is associated with surgical damage to the latarjet nerve or removal of the duodenal pacemaker and suppression of gastric exercise pace.
Examine
an examination
Related inspection
Determination of gastric emptying and imaging of gastric motility
Diagnosis: After the gastric tube is removed, the fluid is introduced or the fluid is changed to a semi-liquid diet. After the abdominal distension, nausea, vomiting (non-spray), the vomiting volume is 800~1 200ml, containing residual food and bile. Physical examination: the upper abdomen is full, the stomach type is visible, there is no intestinal type and peristaltic wave, the upper abdomen is mildly tender, no rebound pain, the stomach can be smelled and the bowel sounds weaken or disappear. X-ray film of abdominal peritoneal or abdominal position showed dilatation of the stomach, a large amount of gastric fluid retention, no obvious expansion of the intestine and gas-liquid level. 2 cases underwent sputum angiography, and 4 cases underwent 76% diatrizoate angiography. The contrast agent was left in the stomach cavity for a long time. The gastric peristalsis was very weak or disappeared. The contrast agent only entered the duodenum or jejunum in a small amount; 6 cases underwent gastroscopy. Examination, in which no abnormality was found in 2 cases of non-gastric resection, 4 cases underwent gastroscopy 12 to 16 days after gastrectomy, see edema of anastomotic and residual gastric mucosa, a large amount of retention fluid in the stomach, gastroscope can pass the anastomosis The mouth enters the duodenum or jejunum and enters the sputum and has no mechanical obstruction.
Diagnosis
Differential diagnosis
Delayed gastric emptying should be differentiated from the following symptoms:
1. Gastroparesis Syndrome refers to a group of clinical symptoms characterized by delayed gastric emptying. The examination revealed no organic lesions in the upper digestive tract or upper abdomen. According to the cause can be divided into two types of primary and secondary. Primary, also known as idiopathic gastroparesis, occurs mostly in young women. According to the onset of illness and the length of the disease, the gastroparesis can be divided into acute and chronic. Clinically more common, symptoms persist or recurrent often for months or even more than 10 years.
2. Diabetes is a common disease caused by the interaction of genetic and environmental factors. Hyperglycemia is the main marker. Common symptoms include polydipsia, polyuria and polydipsia, and diabetes such as weight loss can cause multiple systemic damage. It causes absolute or relative secretion of insulin and the sensitivity of target tissue cells to insulin, causing a series of metabolic disorders such as protein fat water and electrolytes, of which a high blood sugar is the main marker.
