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Alexandre Toledo Maciel
This report describes a patient with gastroparesia and frequent emesis admitted with severe metabolic alkalaemia, hyperlactataemia and acute renal failure. Metabolic alkalaemia was not only due to hypochloraemia but also due to unmeasured cations. These cations were found to be present by calculating anion gap and strong ion gap (both were negative, which is rare). After massive gastric bleeding the patient had a cardiac arrest; following cardiopulmonary resuscitation and infusion of a large volume of normal saline, new blood tests revealed improvement in chloraemia but also a significant increase in the anion gap, suggesting that unmeasured anions rapidly overcame unmeasured cations...
2009: BMJ Case Reports
C Angot, O Facy
No abstract text is available yet for this article.
January 2011: Clinics and Research in Hepatology and Gastroenterology
Walter José Minicucci
Both Continuous Subcutaneous Insulin Infusion (CSII) and Multiple Daily Injections (MDI) are effective ways of implementing intensive management of DM1 to attain near normal glycemic levels and a more flexible lifestyle. CSII is as safe as MDI and has some advantages over it mostly in diabetic patients with frequent hypoglycemias with important dawn phenomenum, gastroparesia, during pregnancy, in children and in patients with an erratic way of living. CSII allows a better chance to reach better glycemic control with less hypoglycemia, asymptomatic hypoglycemias and a better quality of life...
March 2008: Arquivos Brasileiros de Endocrinologia e Metabologia
B García Vila, T Grau
Enteral nutrition has demonstrated to be a useful and safe method to nourish critically ill patients admitted to the Intensive Care Unit. Although the time a severely ill patient can stand without nutrition is unknown, accelerated catabolism and fasting may be deleterious in those patients, and the more common recommendation is to start on artificial nutrition when a fasting period longer than seven days is foreseen. At an experimental level, advantages of enteral nutrition over parenteral nutrition are evident since the use of nutritional substrates via the gastrointestinal tract improves the local and systemic immune response and maintains the barrier functions of the gut...
March 2005: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
B Granel, J Serratrice, P Disdier, R Laugier, P-J Weiller
UNLABELLED: This observation recalls that gastric phytobezoar should lead to a search for an underlying disease and that a iron deficiency can be associated and hide macrocytosis related to a vitamin B12 deficiency. CASE REPORT: A 19 year-old woman consulted for asthenia. Microcyte anaemia associated with iron deficiency was diagnosed. Upper digestive endoscopy revealed severe, totally asymptomatic phytobezoar. Biological investigations revealed a vitamin B12 deficiency, high serum gastrin level and strong positivity for gastric antiparietal anti-cell antibodies, suggestive of an autoimmune gastritis...
October 9, 2004: La Presse Médicale
B Dousset, N Molinier
Duodenopancreatectomy with preservation of the tail for pancreatic adenocarcinoma is not contraindicated by age except in case of comorbidity. Curative excision is contraindicated in case of metastasis to the liver, peritoneum or distal nodes or in case of arterial invasion. Inversely, isolated venous invasion is not incompatible with curative surgery if one can accept the potential overmortality due to the vascular risk. Palliative surgery may be indicated for tumors limited to the pancreas in selected patients as it appears to improve survival and quality of life over derivation surgery...
August 2000: Journal de Chirurgie
P Valensi
This paper considers the risks related to each of the complications of diabetic autonomic neuropathy. Gastroparesia induces its own functional disorders in the digestive tract but is also probably involved in an undetermined proportion of unstable diabetes. Neural bladder, in its aspect of hypoactive, hypocontractile and hypoaesthesic bladder, makes patients prone to urinary chronic retention and repeated urinary infections or even kidney disease. In patients with hypoglycaemia unawareness, the responsibility of autonomic neuropathy may be suspected in those with severe cardiac autonomic neuropathy (CAN) or selective autonomic neuropathy characterised only by a defect in adrenergic contraregulation of hypoglycaemia...
November 1998: Diabetes & Metabolism
C Mathis, C H Malbert
Erythromycin overcomes postvagotomy gastroparesia in patients without a distal stomach and functional pylorus. We investigate the role of the vagus in gastric emptying increased by erythromycin, using a model that preserves the physiology of the distal stomach and pylorus. The effects of erythromycin lactobionate (10 mg/kg) on transpyloric flow pattern and pyloric resistance were evaluated during repetitive bilateral vagal cooling in anesthetized pigs. Vagal cooling during erythromycin infusion produced a marked decreased of pyloric outflow (23 +/- 1...
January 1998: American Journal of Physiology
K Slim, D Pezet, Y Riff, J F Richard, J Chipponi
OBJECTIVES: Prophylactic gastrojejunostomy remains a controversial issue in the management of unresectable pancreatic cancer. The main disadvantage of the gastrojejunostomy being the postoperative delayed gastric emptying (gastroparesia and circulus vitiosus through the nonobstructed duodenum). In the aim to reduce the effects of delayed gastric emptying we advocated the adjunct of an antral exclusion to simplify antrectomy by eliminating antral dysfunction and duodenal circulus vitiosus...
April 20, 1996: La Presse Médicale
R González Gomis
A series of 12 patients with digestive symptoms, pointing to gastroparesia, were studied. An attempt was made to correlate the symptoms and their intensity with the quantitative measurement of the mean time of evacuation of solids. No correlation was found between the intensity of the symptoms and the evacuation of solids. The sensitivity of the symptoms or their combinations is only 63%. Their specificity was not determined in this phase of the study. It is concluded that it is necessary to perform the quantitative study of evacuation of solids to confirm the presence of gastroparesia...
September 1990: Revista Médica de Panamá
P Jonard, M Schapira, M Servais, C Dive
Patients with gastroparesia or intestinal pseudo-obstruction frequently have a motility disorder of the antro-pyloric region that makes the passage of tubes through the pylorus impossible or a very long procedure. We describe a rapid endoscopic method, inspired by the one used for nasobiliary drainage, that simplifies this procedure. In our manometric studies, we observed that spontaneous positioning needed a mean of 57 min (SD 34) in nondyspeptic subjects and a mean of 147 min (SD 68) in non-organic highly dyspeptic patients...
July 1990: Acta Gastro-enterologica Belgica
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