COMPLICATIONS OF GASTRIC SURGERY Flashcards Preview

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Flashcards in COMPLICATIONS OF GASTRIC SURGERY Deck (10)
1

What are the possible complications of gastric surgery?

Recurrent ulceration
Afferent loop syndrome
Dumping syndrome
Diarrhoea
Anaemia
Malabsorption
Carcinoma

2

Why are people who have had a partial gastrectomy more at risk of recurrent ulceration?

Continued acid production without vagotomy

3

What is afferent loop syndrome?

A mechanical partial or complete obstruction of the afferent loop (duodenum supplying enzymes and bile) post gastric surgery. This resulting in incomplete drainage of bile and pancreatic secretions. Most commonly associated with Billroth II distal subtotal gastrectomy. Complete obstruction is a surgical emergency.

4

How do people with afferent loop syndrome present?

Abdominal pain up to 1 hour after meals
Distension
Nausea
Vomiting - which relieves symptoms somewhat

5

How do you treat afferent loop syndrome?

Surgical revision of the loop

6

What is dumping syndrome?

Complication of gastric surgery. Ingested foods bypass the stomach too rapidly and enter the small intestine largely undigested. It happens when the small intestine expands too quickly due to the presence of hyperosmolar contents in the stomach. It is a vasovagal response.

Late dumping seems also to be related to hypoglycaemia as a result of excessive insulin release.

7

What are the two types of dumping syndrome?

Early dumping - occurs within 30 minutes after a meal

Late dumping - occurs between 90 minutes and 3 hours after a meal

8

What are the clinical features of early dumping syndrome?

Palpitations
Light headedness
Postural hypotension
Abdominal discomfort
Hypokalaemia

9

What are the clinical features of late dumping syndrome?

Lightheadedness
Palpitations
Sweating
Postural hypotension
Syncope
Hypokalaemia

10

How do you manage someone with dumping syndrome post gastric surgery?

Dietary advice - small frequent meals
If very severe can use somatostatin analogue.