Pathophysiology, diagnosis and management of postoperative dumping syndrome

摘要: Dumping syndrome is a frequent complication of esophageal, gastric or bariatric surgery. Rapid emptying, with the delivery to small intestine significant proportion solid food as large particles that are difficult digest, key event in pathogenesis this syndrome. This occurrence causes shift fluid from intravascular component intestinal lumen, which results cardiovascular symptoms, release several gastrointestinal and pancreatic hormones late postprandial hypoglycemia. Early dumping symptoms comprise both vasomotor symptoms. Late result reactive Besides assessment clinical alertness endoscopic radiological imaging, modified oral glucose tolerance test might help establish diagnosis. The first step treating introduction dietary measures. Acarbose can be added these measures for patients hypoglycemia, whereas studies advocate guar gum pectin slow emptying. Somatostatin analogs most effective medical therapy syndrome, slow-release preparation treatment choice. In treatment-refractory surgical reintervention continuous enteral feeding considered, but outcomes such approaches variable.