[Pathogenesis, diagnosis and therapy of the dumping syndrome]

The dumping-syndrome is a severe complication of gastric surgery after operations which destroy or weaken the sphincter mechanism of the pylorus. The pathogenesis involves the release of kinins, the triggering of neurogen reflex mechanisms by distending the jejunum, the massive flow of fluid in jejunal lumen, the loss of the reservoir function of the stomach, and, possibly, the pathologic release of gastrointestinal hormones. Preoperatively, intensive diagnostic efforts are necessary, which must include a psychiatric check-up. For surgical treatment several modifications of reversal operations from Billroth II to Billroth I with reconstruction of duodenal passage have been developed. Our own modification includes, beside testitution of the duodenal passage, the construction of a gastric pouch.