This case report discusses dumping syndrome in the postbariatric mother. Diagnostically a challenge, the symptoms of postprandial hypoglycaemia mimic common early gestation complaints and may go undiagnosed, thus requiring a high index of suspicion. As weight-loss surgery gains traction, it is pertinent to note at booking and followups. The pregnancy is at-risk and multidisciplinary team management is central. The mainstay of management remains diet modification. There have been case reports of successful medical treatment of dumping syndrome in pregnancy with good maternal and fetal outcomes. However, more data is needed regarding the usage of these medical treatments in pregnancy.
Dumping Syndrome ; pregnancy

We report four patients suffering from dumping syndrome treated effectively with Keishito and its additional prescription. Case1was a 57-year old male who received subtotal gastrectomy 30 years ago. After the operation he felt shaking sensations and eyes flickering after meals for10minutes to 4 hours. These symptoms tended to occur along with hunger. After taking Keishito, these symptoms improved. Case 2 was a 63-year old male who received subtotal gastrectomy 7 years ago. In recent years, he has had noticeable sweat and fatigability 20-30 minutes after meals. After taking Keishito, these dumping syndrome symptoms disappear. Case 3 was a 71-year old female who received subtotal gastrectomy 9 years ago. Thereafter, cold sweats and dizziness came to appear regardless of what she ate. After taking keishikashakuyakuto or shokenchuto the aforementioned symptoms disappeared. Case 4 was a 72-year old female who received subtotal gastrectomy 2 years ago. Sweats and hot flushes began to occur after meals for 30 minutes to 3 hours, from last July. These symptoms were improved simply by licking candy. After taking Keishito, these symptoms also disappeared.
symptoms <1> ; Gastrectomy ; Dumping Syndrome ; Cases ; Hour

No abstract available.
Adult ; Dumping Syndrome ; Gastrostomy ; Humans ; Persistent Vegetative State

Dumping syndrome is a common complication of esophageal or gastric surgery. Patients with late dumping syndrome usually suffer from hypoglycemic symptoms such as palpitation, tremor, and general weakness. Hypoglycemia induced convulsive seizure due to late dumping syndrome is rarely reported. We report a 46-year-old man with postprandial hypoglycemic convulsive seizure as the first symptom of late dumping syndrome.
Dumping Syndrome ; Humans ; Hypoglycemia ; Middle Aged ; Seizures ; Tremor

The need for gastric surgery for peptic ulcer disease has decreased since the discovery of Helicobacter pylori and the development of proton pump inhibitors. Nevertheless, the total frequency of gastric surgery has increased due to the frequent detection of early gastric cancer and the increasing morbidity of pathological obesity. After gastric surgery, several unwanted gastrointestinal (GI) problems can develop as a result of the altered anatomy, volume reduction, or vagal impairment. Acute organic GI problems after gastric surgery include intraoperative or postoperative intestinal bleeding, leakage, and obstruction. Chronic organic problems include anastomosis site strictures, various metabolic disturbances, retained antrum syndrome, afferent or efferent loop syndrome, and gallstones. Chronic functional problems after gastric surgery include dumping syndrome, acid or bile regurgitation, postvagotomy diarrhea, and gastroparesis. Recently, concern about patients' postoperative quality of life and life expectancy after gastric surgery has increased. To avoid undesirable outcomes after gastric surgery, the early detection and appropriate management of surgery-related disturbances are important. Therefore, it will be helpful to review these problems here.
Bile ; Constriction, Pathologic ; Diarrhea ; Dumping Syndrome ; Gallstones ; Gastrectomy ; Gastrointestinal Diseases ; Gastroparesis ; Helicobacter pylori ; Hemorrhage ; Life Expectancy ; Obesity ; Peptic Ulcer ; Proton Pump Inhibitors ; Quality of Life ; Stomach Neoplasms

PURPOSE: The proper reconstruction technique to use after a distal subtotal gastrectomy for a gastric carcinoma, there has been a subject for debated what is the proper reconstruction technique. The aim of this study was to compare the gastric- emptying time and the quality of life following both B-I and B-II reconstructions after a distal gastrectomy for a gastric adenocarcinoma. MATERIALS AND METHODS: We studied 122 patients who had undergone a distal gastrectomy for a gastric adenocarcinoma between June 1999 and July 2002 at our hospital. 51 patients underwent B-I group, and 71 patients underwent B-II group. To evaluate the gastric-emptying time, we analyzed the T1/2 time by means of radionuclide scintigraphy using a gamma camera after ingestion of an (99m)Tc-tin-colloid steamed egg. The nutritional status was measured by the weight change. Postgastrectomy syndrome was evaluated using an abdominal symptoms survey. Dumping syndrome was measured using the Sigstad dumping score. RESULTS: The gastric-emptying time was somewhat delayed in the B-I group after a 6 month period, but there was no difference after 12 months between the two groups. There was less weight loss in the B-I group than in the B-II group (P=0.023). Fewer abdominal symptoms were occurred in the B-I group than in the B-II group. Dumping syndrome occurred less frequently in the B-I group than in the B-II group (P=0.013). CONCLUSION: In our study, the Billroth I reconstruction led to less weight loss, a better nutritional status, and a better quality of life than the Billroth II reconstruction. We concluded that after a distal subtotal gastrectomy, the Billroth I reconstruction would be considered when the procedure is oncologically suitable.
Adenocarcinoma ; Dumping Syndrome ; Eating ; Gamma Cameras ; Gastrectomy ; Gastroenterostomy* ; Humans ; Nutritional Status ; Ovum ; Postgastrectomy Syndromes ; Quality of Life ; Radionuclide Imaging ; Steam ; Stomach Neoplasms ; Weight Loss

PURPOSE: In treating carcinoma of the esophagus, a gastric drainage procedure seems to be necessary with esophago gastrostomies because of the inevitable incidental bilateral truncal vagotomy which occurs during the esophagectomy. There are potential hazards with a pyloroplasty such as jeopardizing the blood supply to the mobilized stmach, shortening its length for substitution, leakage, dumping syndrome, and bile reflux gastritis. The aims of the study are to compare the postoperative outcome of patients with and without pyloroplasty after an esophagectomy for esophageal cancer, and to evaluate the necessity of pyloroplasty in the vagotomized intrathoracic stomach after esophageal surgery. METHODS: During the years 1996 to 2001, 23 patients with carcinoma of the esophagus underwent an esophagectomy followed by esophagogastrostomy with or without pyloroplasty. The medical records of the patients were evaluated retrospectively. RESULTS: There were no statiscally significant differences between the pyloroplasty group and the no-pyloroplasty group with regards to the average hospital stay, resumption of oral feeding, removal of the nasogastric tube, and the daily gastric drainage. CONCLUSION: Postoperative symptomatic evaluation of patients who had esophageal cancer and underwent an esoph-agectomy and an esophagogastrostomy, with or without pyloroplasty supports the concept that the drainage procedure is unnecessary in the gastric replacement of the esophagus.
Bile Reflux ; Drainage ; Dumping Syndrome ; Esophageal Neoplasms ; Esophagectomy* ; Esophagus* ; Gastritis ; Gastrostomy ; Humans ; Length of Stay ; Medical Records ; Retrospective Studies ; Stomach ; Vagotomy, Truncal

Pylorus-preserving gastrectomy (PPG) is a function-preserving surgery for the treatment of early gastric cancer (EGC), aiming to decrease the complication rate and improve postoperative quality of life. According to the Japanese gastric cancer treatment guidelines, PPG can be performed for cT1N0M0 gastric cancer located in the middle-third of the stomach, at least 4.0 cm away from the pylorus. Although the length of the antral cuff gradually increased, from 1.5 cm during the initial use of the procedure to 3.0 cm currently, its optimal length still remains unclear. Standard procedures for the preservation of pyloric function, infra-pyloric vessels, and hepatic branch of the vagus nerve, make PPG technically more difficult and raise concerns about incomplete lymph node dissection. The short- and long-term oncological and survival outcomes of PPG were comparable to those for distal gastrectomy, but with several advantages such as a lower incidence of dumping syndrome, bile reflux, and gallstone formation, and improved nutritional status. Gastric stasis, a typical complication of PPG, can be effectively treated by balloon dilatation and stent insertion. Robot-assisted pylorus-preserving gastrectomy is feasible for EGC in the middle-third of the stomach in terms of the short-term clinical outcome. However, any benefits over laparoscopy-assisted PPG (LAPPG) from the patient's perspective have not yet been proven. An ongoing Korean multicenter randomized controlled trial (KLASS-04), which compares LAPPG and laparoscopy-assisted distal gastrectomy for EGC in the middle-third of the stomach, may provide more clear evidence about the advantages and oncologic safety of PPG.
Asian Continental Ancestry Group ; Bile Reflux ; Dilatation ; Dumping Syndrome ; Gallstones ; Gastrectomy* ; Gastroparesis ; Humans ; Incidence ; Lymph Node Excision ; Nutritional Status ; Pylorus ; Quality of Life ; Stents ; Stomach ; Stomach Neoplasms* ; Vagus Nerve

Patients with diabetes undergo bariatric surgery to improve sugar metabolism and to achieve weight loss. However, possible complications after bariatric surgery must be carefully considered. We report a case of uncontrolled blood sugar after bariatric surgery despite weight loss in a severely obese patient with diabetes. The patient underwent bariatric surgery in 2009 in order to lose weight and improve glycemic control. Six months after the surgery, the patient experienced dumping syndrome. The patient did actually lose weight; however, as the visceral fat/subcutaneous fat+visceral fat ratio increased, insulin resistance was not improved, and glycemic control was aggravated. The patient received proper medication for dumping syndrome including nutritional support and exercise education. Due to these efforts, the patient has maintained her weight loss, and her blood sugar level was controlled within the target range.
Bariatric Surgery ; Blood Glucose ; Diabetes Mellitus, Type 2 ; Dumping Syndrome ; Education ; Humans ; Insulin Resistance ; Insulin ; Intra-Abdominal Fat ; Metabolism ; Nutritional Support ; Protein-Energy Malnutrition ; Weight Loss

Following gastric surgery, 25~50% of patients experience dumping symptoms. Early dumping usually involves both gastro-intestinal and vasomotor complaints, while late dumping involves mainly the latter. Management is mainly achieved by dietary modification. Drug therapy has been investigated without consistent success. However, the somatostatin analogue octreotide alleviates dumping by slowing gastric emptying, inhibiting insulin release, decreasing enteric peptide secretion and intestinal absorption of water and sodium, slowing monosaccharide absorption, increasing gut transit time and preventing hemodynamic changes. We report a case with the place of octreotide in the medical management of the dumping syndrome. The patient was 71-year-old male who had taken total gastrectomy for gastric cancer in 1987. He had been well except intermittent abdominal pain for 8 years after total gastrectomy. But he had suffered from sudden symptoms such as hypoglycemic shock and fainting, which start 2~3 hours after ingesting of a meal for recent 5 years. Studies for diagnosing insulinoma were all negative. We start diet modification and medication such as acarbose to him with impression of dumping syndrome, but there were no improvement of his symptoms. Then we start octreotide, 50 g, given subcutaneously, three-times per day, 30 min prior to each meal. His symptom was dramatically improved.
Abdominal Pain ; Absorption ; Acarbose ; Aged ; Drug Therapy ; Dumping Syndrome* ; Food Habits ; Gastrectomy ; Gastric Emptying ; Hemodynamics ; Humans ; Hypoglycemia ; Insulin ; Insulinoma ; Intestinal Absorption ; Male ; Meals ; Octreotide* ; Shock* ; Sodium ; Somatostatin ; Stomach Neoplasms ; Syncope ; Water