Enterogastric Reflux in Normal Subjects and Patients with Bilroth II Gastroenterostomy
1979; Elsevier BV; Volume: 77; Issue: 5 Linguagem: Inglês
10.1016/s0016-5085(79)80073-6
ISSN1528-0012
AutoresRichard D. Tolin, Leon S. Malmud, Fred Stelzer, Richard Menin, P TODD MAKLER, Greg Applegate, Robert S. Fisher,
Tópico(s)Gallbladder and Bile Duct Disorders
ResumoInitially, scintigraphy was established as a valid method for detecting and quantitating enterogastric reflux.A new, tubeless technique for the measurement of enterogastric reflux was developed.99mTc bound to [(2,6 dimethylphenylcarbamoylmethyl) iminodiacetic acid1 (5 mCi) was administered.intravenously to visualize the liver and biliary tract.One hour later, a standard liquid meal labeled with 111In bound to diethylene-triamine penta-acetic acid (250 /LCi) was given.The 99mTc and 111In activities were recorded simultaneously for 1-min periods at 15-min intervals for 2 hr over liver, gallbladder, and gastric areas of interest.Enterogastric reflux indices were determined.Ten normal subjects and 13 patients with vagotomy, hemigastrectomy, and Bilroth II gas- trojejunostomy were evaluated.The enterogastric reflux index in asymptomatic postsurgical patients was increased significantly to 24.6 ± 4.7 compared with 8.2 ± 6.0 (P < 0.01) in normal subjects.In postsurgical patients with the syndrome of alkaline gastritis, the enterogastric reflux index was increased significantly to 86.3 ± 7.1 (P < 0.01) compared with asymptomatic postsurgical patients.Retlux of bile and digestive enzymes from the small bowel into the stomach has been observed in patients with a variety of gastrointestinal disorders, including postsurgical alkaline gastritis,1-5 gastric ulcer,6-10 reflux esophagitis,"-14 gallstone dyspepsia,t5 and functional dyspepsia.1s The role of enterogastric reflux in the pathogenesis of these disorders is
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