A case of late dumping syndrome

Area of Science:

• Gastroenterology
• Endocrinology

Background:

• Partial gastrectomy for bleeding peptic ulcer can lead to long-term complications.
• Late dumping syndrome is a rare post-gastric surgery complication characterized by delayed hypoglycemic symptoms.

Observation:

• A 49-year-old female presented with unexplained syncopal attacks unrelated to meals or posture.
• Gynecological evaluation for uterine fibroid led to an oral glucose tolerance test.

Findings:

• The oral glucose tolerance test revealed a delayed hypoglycemic reaction, indicative of late dumping syndrome.
• Hypoglycemic coma occurred at 2 hours (blood glucose 50 mg/dL, hypocount 47 mg/dL), resolving with dextrose infusion.
• Repeat testing confirmed late dumping syndrome.

Implications:

• This case highlights the importance of considering late dumping syndrome in patients with a history of gastric surgery presenting with unexplained syncopal episodes.
• Dietary adjustments are effective in managing symptoms of late dumping syndrome.
• Timely diagnosis and intervention are crucial for preventing severe hypoglycemic events.