Bilious vomiting after gastric surgery: A symptom of sliding esophageal hiatus hernia

Turner, Fennell P.

doi:10.1007/bf02235941

Cited by 5 publications

(7 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These authors suggested that this could occur as a result of an impaired LES barrier function caused by the high resection line and lymphadenectomy at the lesser curvature. As in the Turner study, 45 they did not test this hypothesis. The findings in the present study of reductions in MRP and MEP without significant modification in the total and abdominal lengths of the esophagus, and without alteration in the diaphragmatic crura pressure, suggest that the decreased pressure in these patients was due to functional alterations and not to direct destruction of the esophagogastric junction caused by the surgical procedure.…”

Section: Discussionmentioning

confidence: 78%

“…Turner (1969) 45 suggested that the destruction of the phrenoesophageal membrane might diminish the competence of the LES and predispose towards an occurrence of a hiatal hernia. However, this author did not develop a study along these lines.…”

Section: Discussionmentioning

confidence: 99%

“…In the absence of these two conditions, studies in the literature show that after a gastrectomy and even after gastric tumor resection, there is an increase in gastroesophageal reflux, and the same occurs after gastrectomy for treatment of peptic ulcers. [2][3][4][5][6][7][8][10][11][12][13][14]16,[45][46][47][48][49][50] Therefore, the increase in gastroesophageal reflux disease has always been associated with gastric resection and not with presence of a tumor. On the other hand, six patients with stomach cancer had MRP and MEP that were lower before the operation than afterwards.…”

Section: Discussionmentioning

confidence: 99%

“…However, lymphadenectomy of the N1 and N2 (D2) chains involves extensive resection of the stomach and the destruction of anatomical elements that have been considered to be important for supporting the EGJ (such as the phrenoesophageal ligament). Turner (1969) 45 suggested that the destruction of the phrenoesophageal membrane might diminish the competence of the LES and predispose towards an occurrence of a hiatal hernia. However, this author did not develop a study along these lines.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Manometric study of the lower esophageal sphincter and esophagus in subtotal gastrectomy patients

et al. 2008

View full text Add to dashboard Cite

There is controversy in the literature regarding the motor function behavior of the lower esophageal sphincter and esophagus following partial gastrectomy. We studied 26 patients with gastric adenocarcinoma of the distal corpus and/or antrum who underwent radical subtotal gastrectomy with Roux-en-Y reconstruction. There were 15 women (57.69%) and 11 men (42.31%) with a mean age of 57.2 years; 21 were White (80.8%) and five were of African descent (19.2%). Before the surgery and 3 months afterwards, every patient underwent manometric and endoscopic examinations. The lower esophageal sphincter showed reductions in mean respiratory pressure (19.41-15.59 mmHg, P= 0.02) and maximum expiratory pressure (8.13-5.54 mmHg, P= 0.02) without significant alteration in diaphragmatic crura pressure (32.92-30.64 mmHg, P= 0.37). An increase in peristaltic wave amplitude (91.43-124.86 mmHg, P < 0.01) and peristaltic wave conduction velocity (3.29 cm/s to 4.23 cm/s; P= 0.024) were detected in esophageal function. The presence of erosive esophagitis decreased from 10 (38.46%) patients to none (P= 0.002). We concluded that following surgery the lower esophageal sphincter function was impaired, through decreased pressure in the esophageal component without alteration in diaphragmatic crura pressure. On the other hand, there was significant increase in peristaltic wave amplitude and velocity, and improvement of the erosive esophagitis. The authors suggest that subtotal gastrectomy, with gastroesophageal junction preservation, and Roux-en-Y reconstruction should be the preferred operation for distal gastric cancer to minimize esophageal dysfunction and gastroesophageal reflux disease.

show abstract

Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Manometric study of the lower esophageal sphincter and esophagus in subtotal gastrectomy patients

et al. 2008

View full text Add to dashboard Cite

show abstract

“…This could be the cause of vomiting in patients with the combination of achlorhydria, bile reflux, gastritis on endoscopy and normal barium meal findings. Unrecognized incompetence of the cardia may be an associated factor in predisposing to vomiting in some (Turner, 1969).…”

Section: Discussionmentioning

confidence: 99%

The features and course of bile vomiting following gastric surgery

Griffiths

1974

Journal of British Surgery

View full text Add to dashboard Cite

In a retrospective study I19 (9.1 per cent) of 1311 patients undergoing peptic ulcer surgery developed postoperative bile vomiting. Patients aged over 60 years at operation appeared particularly at risk. The sex distribution was equal. Operations that aim at reducing acid secretion had a similar incidence of vomiting, although the complication was not seen following 55 simple gastrojejunostomies. Vomiting developed within I month of operation in 39 per cent of patients, and 57per cent suffered a signiJicant degree of disability f o r 6-14 years after onset. Twenty-four per cent of patients underwent reoperation. Aetiological factors were gastric outlet obstruction and gastritis due to bile reflux; pre-existing constitutional and psychological abnormality seldom contributed signiJicantly to the syndrome. It is concluded that bile vomiting as a persistent and disabling complication of gastric surgery demands objective physical and psychological assessment prior to a decision regarding management.

show abstract

Postoperative Bilious Vomiting

Turner¹

1973

Arch Surg

View full text Add to dashboard Cite

Bilious vomiting after gastric surgery: A symptom of sliding esophageal hiatus hernia

Cited by 5 publications

References 3 publications

Manometric study of the lower esophageal sphincter and esophagus in subtotal gastrectomy patients

Manometric study of the lower esophageal sphincter and esophagus in subtotal gastrectomy patients

The features and course of bile vomiting following gastric surgery

Postoperative Bilious Vomiting

Contact Info

Product

Resources

About