Reporte de un caso de tratamiento de gastroparesia pediátrica con prucaloprida: una terapia novedosa / A case report of prucalopride treatment in pediatric gastroparesis: a novel therapy

La prucaloprida acelera el vaciamiento gástrico en adultos con gastroparesia. No existen estudios con este medicamento en niños con gastroparesia. Se presenta un niño de 8 años que consultó por síntomas posprandiales de un mes de duración, con diagnóstico de gastroparesia por gammagrafía de vaciamiento gástrico. No mejoró con metoclopramida, domperidona, eritromicina y esomeprazol. Recibió prucaloprida durante dos períodos (durante 178 y 376 días) a dosis de 0,03-0,04 mg/kg/día. Presentó mejoría en el seguimiento con el índice cardinal de síntomas de gastroparesia y gammagrafías de vaciamiento gástrico. Por la buena respuesta, la prucaloprida podría ser una opción terapéutica en la gastroparesia pediátrica.

Prucalopride has been used in adults with gastroparesis, accelerating gastric emptying. There are no studies with this drug in gastroparetic children. An 8-year-old boy is presented who consulted for a month of postprandial symptoms, with a diagnosis of gastroparesis by gastric emptying scintigraphy. He did not improve with metoclopramide, domperidone, erythromycin, and esomeprazole. He received prucalopride for two periods (for 178 and 376 days) at doses: 0.03 - 0.04 mg/kg/day, presenting improvement in the follow-up with the cardinal gastroparesis symptom index and gastric emptying scintigraphy. Due to the good response, prucalopride may be a therapeutic option in pediatric gastroparesis.

A case report of prucalopride treatment in pediatric gastroparesis: a novel therapy. / Reporte de un caso de tratamiento de gastroparesia pediátrica con prucaloprida: una terapia novedosa.

Prucalopride has been used in adults with gastroparesis, accelerating gastric emptying. There are no studies with this drug in gastroparetic children. An 8-year-old boy is presented who consulted for a month of postprandial symptoms, with a diagnosis of gastroparesis by gastric emptying scintigraphy. He did not improve with metoclopramide, domperidone, erythromycin, and esomeprazole. He received prucalopride for two periods (for 178 and 376 days) at doses: 0.03 - 0.04 mg/ kg/day, presenting improvement in the follow-up with the cardinal gastroparesis symptom index and gastric emptying scintigraphy. Due to the good response, prucalopride may be a therapeutic option in pediatric gastroparesis.

La prucaloprida acelera el vaciamiento gástrico en adultos con gastroparesia. No existen estudios con este medicamento en niños con gastroparesia. Se presenta un niño de 8 años que consultó por síntomas posprandiales de un mes de duración, con diagnóstico de gastroparesia por gammagrafía de vaciamiento gástrico. No mejoró con metoclopramida, domperidona, eritromicina y esomeprazol. Recibió prucaloprida durante dos períodos (durante 178 y 376 días) a dosis de 0,03-0,04 mg/kg/ día. Presentó mejoría en el seguimiento con el índice cardinal de síntomas de gastroparesia y gammagrafías de vaciamiento gástrico. Por la buena respuesta, la prucaloprida podría ser una opción terapéutica en la gastroparesia pediátrica.

Gastrointestinal dysmotility in a patient with advanced lung cancer: paraneoplastic or drug-induced?

A 75-year-old man was hospitalised for bronchoscopy with biopsy due to a suspicious pulmonary mass at chest tomography. He had significant dyspnoea, constipation, nausea, vomiting, anorexia and a 33% loss of weight in the past 3 months. Biopsy revealed a pulmonary squamous cell carcinoma, which was inoperable. Tramadol used at home for 3 months was replaced by morphine on admission. The patient remained constipated despite prokinetics and laxatives, leading to the diagnostic hypothesis of paraneoplastic motility disorder and opioid-induced constipation. Abdominal tomography ruled out the possibility of mechanical obstruction. As complications, the patient presented superior vena cava syndrome and opioid (morphine) intoxication. The patient died a few days later. The management of this case highlights the importance of multidisciplinary care and the challenges of palliative oncology care. Paraneoplastic motility disorder must always be considered among the mechanisms of intestinal dysfunction in patients with advanced oncological disease.

Botulinum Toxin as a Treatment for Feeding Difficulties in Young Children.

OBJECTIVE: To determine the effectiveness of intrapyloric botulinum toxin injection (IPBI) for treatment of feeding disorders and associated gastrointestinal symptoms in very young children. STUDY DESIGN: A single-center retrospective study of patients 2 months to 5 years old who received IPBI at Boston Children's Hospital from May 2007 to June 2019 was performed. Charts were reviewed for demographic data, comorbidities, symptoms leading to IPBI, oral and tube feeding data, symptom improvement after IPBI, and need for repeat injections. The primary outcome was symptom improvement at the first gastroenterology clinic visit following IPBI. Secondary outcomes included improvement in oral feeding, decreases in tube feeding, and need for repeat injections. The χ2 or Fisher exact tests and multivariate logistic regression were used to identify factors associated with symptomatic improvement. RESULTS: A total of 85 patients who received 118 injections were included in the final analysis; 57 patients (67%) had partial or complete improvement in symptoms after IPBI. Among the 55 patients with enteral tubes, there was an improvement in feeding, with more patients receiving at least some oral feeds after IPBI compared with before (26/55 vs 15/55; P = .004) and fewer patients receiving postpyloric feeds after IPBI compared with before (12/55 vs 21/55; P = .01). Twenty-six patients (31%) received repeat IPBI within 1 year, with only 6 patients receiving IPBI more than twice. CONCLUSIONS: IPBI is safe and effective in young children. Children with enteral tubes show improvement in oral feeding and reduction in need for postpyloric feeding after IPBI.

Reflux Symptoms in Gastroparesis: Correlation With Gastroparesis Symptoms, Gastric Emptying, and Esophageal Function Testing.

GOAL: The goal of this study was to determine the relationship of reflux with gastroparesis (Gp), looking both at symptoms and objective testing. BACKGROUND: Gp patients often experience gastroesophageal reflux symptoms. How the severity of reflux correlates with the severity of Gp is not known. STUDY: Patients referred to our academic center with symptoms of Gp completed the Patient Assessment of Upper Gastrointestinal Symptoms, Hospital Anxiety and Depression Scale, and Patient Health Questionnaire (PHQ)-15. They underwent 4-hour gastric emptying scintigraphy; and, if indicated, high-resolution esophageal manometry and esophageal pH impedance (EpHI). RESULTS: Of 755 patients from July 2013 to May 2018, 432 had Gp with Gastroparesis Cardinal Symptom Index (GCSI) total score of 3.2±0.1 (mean±SEM) and heartburn/regurgitation subscore of 2.0±0.1. A fourth (27.1%) of all Gp patients had moderate to very severe heartburn/regurgitation symptoms. Heartburn/regurgitation subscore had strong correlation with GSCI total score (r=0.56, P<0.01), and weak correlation with 4-hour gastric retention (r=0.11, P=0.02). In total, 103 Gp patients underwent EpHI monitoring; time esophageal pH<4 had no correlation with heartburn/regurgitation subscore. Less than half (41.7%) of the patients undergoing EpHI had gastroesophageal reflux disease by EpHI. Gp patients with gastroesophageal reflux disease had more severe 4-hour gastric retention, and more frequently had decreased lower esophageal sphincter resting pressure and esophageal motility disorders. Heartburn/regurgitation subscore had moderate correlation with somatic symptoms, and weak correlations with anxiety and depression. CONCLUSIONS: The severity of reflux symptoms in Gp has strong correlation with GCSI total score, weak correlation with gastric retention, and no correlation with esophageal pH monitoring.

Estudio centellográfico del vaciamiento gástrico con estaño coloidal / Scintigraphic Study of Colloidal Tin Gastric Emptying

Introducción: la gastroparesia se define como un retardo en el vaciamiento gástrico, en ausencia de obstrucción mecánica, asociado a síntomas como náusea y/o vómitos, sensación de plenitud gástrica posprandial, saciedad precoz o dolor epigástrico por más de 3 meses. Las causas que más frecuentemente se relacionan son la diabetes mellitus y la idiopática. La prueba de oro en el diagnóstico del retardo del vaciamiento gástrico es la gammagrafía y el radiofármaco que más se ha utilizado el 99mTc-sulfuro coloidal.Objetivo: evaluar el vaciamiento gástrico y mostrar los resultados obtenidos con el uso del estaño coloidal en el estudio centellográfico del vaciamiento gástrico.Métodos: se realizó un estudio descriptivo en 64 pacientes de más de 18 años utilizando como radiofármaco 99mTc-Sn coloidal.Resultados: el 31 por ciento del total de pacientes presentó síntomas. El tiempo de vaciamiento fue normal en 44 casos y la asociación de síntomas y gastroparesia se observó en 20 (15 diabéticos y 5 no diabéticos), 9 pacientes tuvieron un vaciamiento retardado, pero no referían síntomas. La gastroparesia fue más frecuente en mujeres que en hombres (35 por ciento versus 21 por ciento). El 21 por ciento de los casos tenían un retardo moderado del vaciamiento gástrico.Conclusiones: los resultados obtenidos con 99mTc-Sn coloidal son comparables con los reportados por otros autores que utilizan el 99mTc-SC en la evaluación gammagráfica del vaciamiento gástrico(AU)

Introduction: gastroparesis is defined as a delay in gastric emptying in the absence of mechanical obstruction, associated with symptoms such as nausea and/or vomiting, postprandial gastric fullness feeling, early satiety or epigastric pain for more than 3 months. Diabetes mellitus and idiopathic are the most frequent causes related. The gold standard in the diagnosis of delayed gastric emptying is gammagraphy and 99mTc-sulfur colloid is the most widely used radiopharmaceutical.Objective: assess gastric emptying and show the results obtained with the use of colloidal tin in the gammagraphy study of gastric emptying.Methods: a descriptive study was conducted in 64 patients older than 18 years using 99mTc-sulfur colloid radiopharmaceutical.Results: 31 percent of patients had symptoms. The emptying time was normal in 44 cases and the association of gastroparesis symptoms was observed in 20 (15 diabetics and 5nondiabetics), 9 patients had delayed emptying, but they did not report symptoms. Gastroparesis was more frequent in women than in men (35 percent versus 21 percent). 21 percent of patients had moderate delayed gastric emptying.Conclusions: results obtained with colloidal Tc-Sn 99m are comparable with those reported by other authors using 99mTc-SC in gammagraphy assessment of gastric emptying(AU)

Relationship of gastrointestinal symptoms and psychosocial distress to gastric retention in children.

OBJECTIVES: To determine whether gastrointestinal (GI) symptoms (abdominal pain, nonpain GI symptoms, nausea) and/or psychosocial distress differ between children with/without gastroparesis and whether the severity of GI symptoms and/or psychosocial distress is related to the degree of gastroparesis. STUDY DESIGN: Children aged 7-18 years (N = 100; 63 female patients) undergoing a 4-hour gastric emptying scintigraphy study completed questionnaires evaluating GI symptoms, anxiety, and somatization for this prospective study. Spearman correlation, Mann-Whitney, t-test, and χ(2) tests were used as appropriate for statistical analysis. RESULTS: Children with gastroparesis (n = 25) were younger than those with normal emptying (12.6 ± 3.5 vs 14.3 ± 2.6 years, P = .01). Because questionnaire responses from 7- to 10-year-old children were inconsistent, only patient-reported symptoms from 11- to 18-year-olds were used. Within this older group (n = 83), children with gastroparesis (n = 17) did not differ from children with normal emptying in severity of GI symptoms or psychosocial distress. In children with gastroparesis, gastric retention at 4 hours was related inversely to vomiting (r = -0.506, P = .038), nausea (r = -0.536, P = .019), difficulty finishing a meal (r = -0.582, P = .014), and Children's Somatization Inventory score (r = -0.544, P = .024) and positively correlated with frequency of waking from sleep with symptoms (r = 0.551, P = .022). CONCLUSIONS: The severity of GI symptoms and psychosocial distress do not differ between children with/without gastroparesis who are undergoing gastric emptying scintigraphy. In those with gastroparesis, gastric retention appears to be inversely related to dyspeptic symptoms and somatization and positively related to waking from sleep with symptoms.

Wireless motility capsule test in children with upper gastrointestinal symptoms.

OBJECTIVE: To compare scintigraphic gastric emptying and antroduodenal manometry (ADM) studies with the wireless motility capsule test in symptomatic pediatric patients. STUDY DESIGN: Patients aged 8-17 years with severe upper gastrointestinal symptoms (ie, nausea, vomiting, retching, abdominal pain) referred for ADM were recruited. A standardized protocol for ADM was used. On a different day, participants were given a standardized meal and then swallowed the wireless motility capsule. A wireless receiver unit worn during the study recorded transmitted data. If not performed previously, a 2-hour scintigraphic gastric emptying study was completed at the time of ADM testing. RESULTS: A total of 22 patients were recruited, of whom 21 had complete scintigraphic gastric emptying study data and 20 had complete ADM data. The wireless motility capsule test had 100% sensitivity and 50% specificity in detecting gastroparesis compared with the 2-hour scintigraphic gastric emptying study. The wireless motility capsule test detected motor abnormalities in 17 patients, compared with 10 detected by ADM. Dichotomous comparison yielded a diagnostic difference between ADM and the wireless motility capsule test (P<.01). Migrating motor complexes were recognized in all patients by both ADM and the wireless motility capsule test. The wireless motility capsule test was well tolerated in all patients, and there were no side effects. CONCLUSION: In symptomatic pediatric patients, the wireless motility capsule test is highly sensitive compared with scintigraphic gastric emptying studies in detecting gastroparesis, and seems to be more sensitive than ADM in detecting motor abnormalities.

Gastroparesia y dispepsia funcional: diagnóstico y tratamiento / Gastroparesis and functional dyspepsia: diagnosis and treatment

Gastroparesis corresponds to the clinical picture of a non-obstructive alteration in gastric emptying. The most common causes are idiopathic, postsurgical and diabetes mellitus. Endoscopy and gastric emptying scintigraphy are necessary for diagnosis. Fractionating the diet and avoiding fat are recommended actions. Prokinetics are fundamental in gastroparesis therapy. Domperidone is the first choice because it has a better safety profile. It is advisable to rotate prokinetics. In refractory cases it is suggested to try other prokinetics (such as erythromycin or prucalopride), effective management of nausea and nutrition optimization. In selected cases, therapies such as electrical stimulation could be evaluated. Functional dyspepsia is defined as symptoms that probably originate in the gastroduodenal region, having ruled out other possibilities. Therefore, endoscopy should show no alterations that could explain the symptoms. The most frequently encountered pathophysiological alterations are slow gastric emptying, impaired accommodation and hypersensitivity. None has been linked unequivocally to a pattern of symptoms. It is suggested to start with proton-pump inhibitors therapy. In refractory cases, prokinetics should be added. If there is no adequate response, 24-hour pH monitoring and gastric emptying should be ordered. In case of altered gastric emptying, adjust prokinetics. If gastric emptying is normal, bupirone or mianserin could be used.

La gastroparesia corresponde a un cuadro clínico debido a mal vaciamiento gástrico no obstructivo del estómago. Sus causas más frecuentes son idiopática, diabetes mellitus y postquirúrgica. La endoscopia y el cintigrama de vaciamiento gástrico son necesarios para el diagnóstico. Se recomienda fraccionar la dieta y evitar las grasas. Los procinéticos son fundamentales en el tratamiento de la gastroparesia. La domperidona es la primera opción por su mejor perfil de seguridad. Es aconsejable rotar los procinéticos. En casos refractarios se puede intentar otros procinéticos (como eritromicina o prucalopride), manejar específicamente las náuseas y optimizar la nutrición. En casos seleccionados se puede intentar terapias como estimulación eléctrica. La dispepsia funcional está definida por síntomas que probablemente se originan en la región gastroduodenal, habiendo descartado otras posibilidades. Por esto, requiere un estudio endoscópico sin alteraciones que expliquen los síntomas. Los hallazgos fisiopatológicos más frecuentemente encontrados son alteraciones del vaciamiento gástrico, trastornos de la acomodación e hipersensibilidad. Ninguno de ellos ha sido asociado inequívocamente a algún patrón de síntomas. Se sugiere iniciar tratamiento con inhibidores de la bomba de protones. En casos refractarios, es aconsejable agregar procinéticos. Si no hay adecuada respuesta, se sugiere estudiar con una ph-metría de 24 horas y vaciamiento gástrico. En caso de vaciamiento alterado, ajustar los procinéticos. En caso de vaciamiento normal, se sugiere uso de buspirona o mianserina.

Gastroparesia: temas de atualização e revisão em clínica médica / Gastroparesis: themes of updating and revision in medical clinic

Gastroparesia é uma dificuldade no esvaziamento gástrico sem que haja qualquer obstrução mecânica ao livre trânsito gastroduodenal. Trata-se de condição estritamente relacionada à função do estômago, podendo decorrer de distúrbios neural (p. ex.: diabetes mellitus), eletrolítico (p. ex.: hipopotassemia) ou hormonal (p. ex.: hipotireoidismo), dentre outros. Náuseas, vômitos, plenitude pós-prandial e saciedade precoce estão presentes. Não existe exame laboratorial capaz de identificar a gastroparesia, no entanto, eles podem indicar a etiologia da mesma. A radiografia simples de abdome pode demonstrar distensão gástrica; a seriografia gastroduodenal, bem como a endoscopia digestiva, são mais úteis na avaliação de obstrução mecânica. Na atualidade, o padrão ouro para o diagnóstico da gastroparesia é cintilografia gástrica.

Gastroparesis is a difficulty in gastric emptying without any mechanical obstruction gastroduodenal. Is is strictly related to the condition of the stomach, likely to arise of neural disorder (diabetes mellitus), electrolytic (hipopotassemy), or hormone (hypothyroidism), among others. Nausea, vomiting, early postprandial and early satiety are present. There is no laboratory examination identifies the gastroparesis, however, they can indicate the etiology. The simple radiography may demonstrate abdominal distension, gastroduodenal seriography, as well digestive endoscopy, are most useful in evaluating mechanical obstruction. Today the gold standard for the diagnosis of gastroparesis is gastric scintigraphy.

Terapia nutricional na gastroparesia diabética: [revisão] / Terapia nutricional para la gastroparesia diabética: [revisión] / Nutrition therapy for diabetic gastroparesis: [review]

O diabetes mellitus (DM) é condição causal da neuropatia autonômica, complicação crônica decorrente da ausência de um controle glicêmico eficiente ao longo dos anos. A gastroparesia consequentemente à neuropatia é um dos distúrbios de motilidade mais comuns entre os diabéticos e afeta cerca de 58% dos indivíduos com DM. Apesar dos avanços no conhecimento relacionado à sua fisiopatologia, a gastroparesia diabética ainda constitui uma complicação de difícil abordagem clínica, com sucesso terapêutico limitado. Seu tratamento inclui medidas dietéticas e nutricionais e o uso de drogas pró-cinéticas. O rigoroso controle glicêmico, juntamente a medidas dietéticas, constitui o eixo central da prevenção e da terapêutica da gastroparesia. A dieta direcionada ao paciente com DM tem por objetivo contribuir para a normalização da glicemia, atingir e manter o peso corpóreo adequado para o indivíduo, diminuir os fatores de risco cardiovascular, prevenir as complicações agudas e crônicas do DM e promover a saúde por meio de nutrição adequada. O manejo nutricional na gastroparesia diabética implica em modificações na consistência da dieta, oferecimento de pequenos volumes durante as refeições, exclusão de alimentos não tolerados e de difícil digestão, utilização de suplementos líquidos se os alimentos sólidos não forem tolerados, e nutrição enteral e parenteral se necessário. Este teve como objetivo realizar uma revisão bibliográfica sobre a terapia nutricional na gastroparesia diabética, complicação pouco conhecida, entretanto, bastante prevalente entre os pacientes diabéticos. A pesquisa bibliográfica foi realizada em diferentes bases de dados, utilizando artigos nacionais e internacionais, datados a partir do ano de 1988.

La diabetes mellitus (DM) es una condición causal de la neuropatía autonómica, las complicaciones crónicas derivadas de la falta de un control de glucosa en sangre eficaz en los últimos años. La gastroparesia la neuropatía es una consecuencia de trastornos de la motilidad más común entre los diabéticos y afecta a alrededor del 58% de las personas con DM. A pesar de los avances en los conocimientos relacionados con la fisiopatología, la gastroparesia diabética sigue siendo una complicación de difícil abordaje clínico, con un éxito terapéutico limitado. Su tratamiento incluye medidas nutricionales y dietéticas y el uso de fármacos procinéticos. El control estricto de la glucemia, junto con las medidas dietéticas, es el eje de la prevención y el tratamiento de la gastroparesia. La dieta dirigida a los pacientes diabéticos tiene como objetivo contribuir a la normalización de la glucosa en la sangre para lograr y mantener un peso corporal adecuado para la persona, reducir los factores de riesgo cardiovascular, la prevención de complicaciones agudas y crónicas de la diabetes y promover la salud a través de una nutrición adecuada. Manejo nutricional en la gastroparesia diabética implica cambios en la consistencia de la dieta, ofrecer pequeñas cantidades con las comidas, excluidos los alimentos no se tolera y difícil de digerir, el uso de suplementos líquidos que los alimentos sólidos no se toleran, y es la nutrición enteral y parenteral es necesario. Este objetivo de llevar a cabo una revisión bibliográfica sobre la terapia nutricional en la gastroparesia diabética, una complicación poco conocida, sin embargo, bastante frecuente entre los pacientes diabéticos. La búsqueda bibliográfica se realizó en diferentes bases de datos, el uso de artículos nacionales e internacionales, que data del año 1988.

Diabetes mellitus (DM) is a causal condition of autonomic neuropathy, chronic complications arising from the absence of an effective blood glucose control over the years. The gastroparesis the neuropathy is a consequence of motility disorders more common among diabetics and affects about 58% of individuals with DM. Despite advances in knowledge related to its pathophysiology, diabetic gastroparesis is still a complication of difficult clinical approach, with limited therapeutic success. His treatment includes nutritional and dietary measures and use of prokinetic drugs. Strict glycemic control, along with dietary measures, is the lynchpin of prevention and treatment of gastroparesis. The diet aimed at the diabetic patients aims to contribute to the normalization of blood glucose to achieve and maintain appropriate body weight for the individual, reduce cardiovascular risk factors, prevention of acute and chronic complications of diabetes and promote health through adequate nutrition. Nutritional management in diabetic gastroparesis involves changes in diet consistency, offer small amounts with meals, excluding food is not tolerated and difficult to digest, use of liquid supplements that solid foods are not tolerated, and enteral and parenteral nutrition is necessary. This aimed to conduct a literature review on nutritional therapy in diabetic gastroparesis, a complication little known, however, quite prevalent among diabetic patients. The literature search was performed in different databases, using national and international articles, dating from the year 1988.

Wavelet analysis in a canine model of gastric electrical uncoupling.

Abnormal gastric motility function could be related to gastric electrical uncoupling, the lack of electrical, and respectively mechanical, synchronization in different regions of the stomach. Therefore, non-invasive detection of the onset of gastric electrical uncoupling can be important for diagnosing associated gastric motility disorders. The aim of this study is to provide a wavelet-based analysis of electrogastrograms (EGG, the cutaneous recordings of gastric electric activity), to detect gastric electric uncoupling. Eight-channel EGG recordings were acquired from 16 dogs in basal state and after each of two circular gastric myotomies. These myotomies simulated mild and severe gastric electrical uncoupling, while keeping the separated gastric sections electrophysiologically active by preserving their blood supply. After visual inspection, manually selected 10 min EGG segments were submitted to wavelet analysis. Quantitative methodology to choose an optimal wavelet was derived. This 'matching' wavelet was determined using the Pollen parametrization for 6-tap wavelet filters and error minimization criteria. After a wavelet-based compression, the distortion of the approximated EGG signals was computed. Statistical analysis on the distortion values allowed us to significantly (p < 0.05) distinguish basal state from mild and severe gastric electrical uncoupling groups in particular EGG channels.

Gastroparesia: mecanismo, diagnóstico e tratamento / Gastroparesis: mechanisms, diagnostic and treatment

Gastroparesia é definida como condição de média ocorrência, com significativa repercussão no bem-estar e no estado nutricional dos acometidos. Sua fisiopatologia é descrita ressaltando-se o papel central do aparato neuromuscular e dos diferentes mediadores químicos implicados no seu desencadeamento. Os aspectos diagnósticos da condição são abordados quanto às manifestações clínicas observadas e os variados métodos de investigação disponíveis. Por fim são apresentadas algumas opções terapêuticas, suas limitações e as novas perspectivas em andamento

Colocación de sondas transpilóricas a ciegas en pacientes críticos / Placement to transpyloric catheters to blind in critical patients

La alimentación enteral precoz tendría ciertos efectos beneficiosos en pacientes severamente injuriados, pero estos pacientes suelen tener gastroparesia (retardo de la evacuación gástrica) que dificulta o imposibilita la alimenación enteral en el estómago y obliga a colocar una sonda transpilórica, mediante ayuda endoscópica o radioscópica o con alguna técnica "a ciegas". Objetivo: evaluar la eficacia de una técnica para colocar sondas transpilóricas y el rol que cumplen en el éxito o fracaso de la técnica la situación clínica y varios procedimientos terapéuticos, reconocidos como factores que alteran la evacuación gastrica. Durante un periodo de 14 meses se realizaron 167 procedimientos para colocar sondas transpilóricas, en pacientes internados en terapia intensiva...(AU)

Colocación de sondas transpilóricas a ciegas en pacientes críticos / Placement to transpyloric catheters to blind in critical patients

La alimentación enteral precoz tendría ciertos efectos beneficiosos en pacientes severamente injuriados, pero estos pacientes suelen tener gastroparesia (retardo de la evacuación gástrica) que dificulta o imposibilita la alimenación enteral en el estómago y obliga a colocar una sonda transpilórica, mediante ayuda endoscópica o radioscópica o con alguna técnica "a ciegas". Objetivo: evaluar la eficacia de una técnica para colocar sondas transpilóricas y el rol que cumplen en el éxito o fracaso de la técnica la situación clínica y varios procedimientos terapéuticos, reconocidos como factores que alteran la evacuación gastrica. Durante un periodo de 14 meses se realizaron 167 procedimientos para colocar sondas transpilóricas, en pacientes internados en terapia intensiva...

Postviral gastroparesis: presentation, treatment, and outcome.

We describe the clinical features and long-term outcome of 11 children who had persistent gastroparesis after an acute viral illness, eight of whom tested positive for rotavirus. Gastric emptying was delayed in the 10 children evaluated with scintigraphy. Antroduodenal manometry confirmed postprandial antral hypomotility in 10 subjects. All children recovered within 6 to 24 months.