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Dumping in infancy diagnosed by radionuclide gastric emptying technique
J E Lavine1, R S Hattner, M B Heyman
1Department of Pediatrics, University of California, San Francisco.
Journal of Pediatric Gastroenterology and Nutrition
|July 1, 1988
Summary
Dumping syndrome in infants can occur after gastrostomy tube feeding or certain surgeries. Radionuclide gastric emptying studies revealed rapid formula release into the small intestine, causing symptoms.
Area of Science:
- Pediatric Gastroenterology
- Nuclear Medicine
Background:
- Dumping syndrome is a common complication following gastric surgery or feeding tube placement.
- Infantile anorexia, weight loss, and agitation can be symptoms of gastrointestinal dysfunction.
Observation:
- Two infants presented with anorexia, weight loss, agitation, and diaphoresis after bolus gastrostomy tube feeding.
- One infant had hyperglycemia and glycosuria, indicative of metabolic disturbance.
Findings:
- Radionuclide gastric emptying studies (using 99mTc-sulfur colloid-labeled formula) demonstrated extremely rapid initial gastric emptying in both infants.
- Over one-third of the formula passed from the stomach to the small intestine in under 2 minutes.
- A biphasic gastric emptying pattern was observed, with an initial rapid phase followed by slow, monoexponential decay.
Implications:
- Gastrostomy tube placement in the gastric antrum can lead to inadvertent duodenal feeding and dumping syndrome.
- Waterston colonic interposition for esophageal atresia may also predispose to dumping syndrome.
- Accurate assessment of gastric emptying is crucial for diagnosing and managing feeding-related complications in infants.