RESUMO
We studied serum hepatic enzyme alterations in 36 patients receiving continuous enteral hyperalimentation. In 50% of the patients studied a marked increase in liver enzymes could be noticed. Elevations returned to normal either spontaneously during enteral feeding or after feeding was discontinued. In 7 patients, alkaline phosphatase decreased significantly 21 +/- 13 days after institution of tube feeding. The rise in liver enzyme values could not be accounted for by preexistent hepatobiliary affection, caloric load or composition of the formula diet. Further studies are needed to determine whether cyclic isocaloric enteral nutrition will minimize complications and hepatic enzyme changes after enteral nutrition.
Assuntos
Ingestão de Energia , Nutrição Enteral , Alimentos Formulados , Fígado/enzimologia , Adolescente , Adulto , Idoso , Alanina Transaminase/sangue , Fosfatase Alcalina/sangue , Aspartato Aminotransferases/sangue , Peso Corporal , Feminino , Gastroenteropatias/enzimologia , Humanos , Hepatopatias/enzimologia , Masculino , Pessoa de Meia-IdadeRESUMO
Gastric bezoars are a common late complication of gastric surgery. Their treatment may be difficult. This is the first report on the removal of a very firm gastric phytobezoar by perendoscopic lithotripsy. The bezoar was detected 20 years after an unknown type of operation on the stomach, presumably truncal vagotomy and pyloroplasty. We propose the use of the lithotripter through the endoscope as an alternative treatment of firm and large gastric bezoars.
Assuntos
Bezoares/terapia , Litotripsia/instrumentação , Estômago , Endoscópios , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/terapia , Úlcera Gástrica/cirurgiaRESUMO
Since previous experiments in dogs suggested L-tryptophan to disturb the migrating motor complex (MMC) we set out to study its effects in man. In six healthy volunteers intraduodenal instillation of 50 mmol L-tryptophan did not disrupt the interdigestive motility pattern. In comparison to saline L-tryptophan caused a brief and local increase of motor activity in the upper small bowel. There was no change in small bowel transit time. The oral intake of 560 kcal liquid formula diet produced a typical digestive pattern for 160-209 min. The increase and the maximum of serum gastrin levels did not correspond to the changes of motor activity.