RESUMO
In order to test whether the "dumping" syndrome occurs in Jamaicans after gastric surgery, we studied 48 patients and six normal volunteers. Subjective assessment and objective testing were carried out after a standard hypertonic (provocative) glucose meal. Serial packed cell volume estimations were carried out, and the percentage fall in plasma volume (an indication of dumping) was calculated from a standard equation. Forty percent of patients reported symptoms of dumping after gastric surgery, and even more (55 percent) had a significant fall in plasma volume. The syndrome occured most commonly after gastric resection or a drainage procedure, and was least prevalent after the operation of highly selective vagotomy (AU)
Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Síndrome de Esvaziamento Rápido/epidemiologia , Síndrome de Esvaziamento Rápido/etiologia , Gastrectomia , Complicações Pós-Operatórias , Estômago/cirurgia , Vagotomia , JamaicaRESUMO
A case is presented in which a pancreatico-bilary fistula followed gastrectomy for a chronic benign gastric ulcer. The common bile duct and the pancreatic duct are shown to be abnormally placed and draining into the third part of the duodenum as can rarely occur. It is concluded that the fistula was originally an internal one, and was unmasked by the operation. The patient has done well after choledochoduodenostomy and pancreatico-gastrostomy (AU)
Assuntos
Idoso , Humanos , Masculino , Fístula Biliar/etiologia , Ducto Colédoco/diagnóstico por imagem , Fístula Pancreática/etiologia , Úlcera Gástrica/complicações , Doença Crônica , Gastrectomia , Úlcera Gástrica/cirurgia , BarbadosRESUMO
Hitherto the diagnosis of gastric carcinoma has been made by the clinician with the assistance of the gastrocopist and radiologist. The results remain dissappointing for not more than 50 percent of the cases are operable when first seen and of these only about 10 percent survive post-operatively for five years or more. An earlier diagnosis is required if results are to be improved. Exfoliative gastric cytology is a new diagnostic procedure which in the hands of the trained pathologist can reveal the presence of malignant cells in gastric washings in over 90 percent of gastric cancers. Experience has shown that cells are shed from even the smallest carcinoma in situ and that by cytology it is possible to detect a growth before there is any radiological or positive gastroscopic evidence of it. Gastric resections in these cases furnish material for the study of these early lesions and the surgeon may reasonably hope that his results will be vastly improved. The associations of such lesions with chronic atrophic gastritis suggests that this is a malignant condition (AU)
