Ischemic gastroparesis: resolution after revascularization.

摘要: Patients with chronic nausea and vomiting frequently present challenging diagnostic therapeutic problems. In such patients, gastroparesis of unknown cause, or "idiopathic" gastroparesis, may be the only objective finding. Two middle-aged women nausea, vomiting, weight loss 10 26 kg over 6 18 months, respectively, were evaluated. Routine laboratory barium study results normal. Solid-phase gastric emptying studies showed severe in both patients. Upper endoscopies excluded outlet obstruction. Gastric dysrhythmias (4-cpm 1-cpm patterns) recorded using cutaneous electrodes. An abdominal bruit was ascultated one patient. Abdominal arteriograms patients total occlusion all three major mesenteric vessels collaterals supplied via hemorrhoidal arteries. Bypass grafting procedures celiac superior arteries patient artery other performed. Six months after revascularization, upper gastrointestinal symptoms had resolved original weights regained. Furthermore, normal 3-cpm myoelectrical activity solids restored these ischemia resulted a novel reversible cause dysrhythmias, accompanying symptoms.