Contractions move contents by changing the configuration of the isolated cat stomach

1998 ◽  
Vol 274 (2) ◽  
pp. G359-G369 ◽  
Author(s):  
Konrad Schulze-Delrieu ◽  
Robert J. Herman ◽  
Siroos S. Shirazi ◽  
Bruce P. Brown
Keyword(s):  
Pressure Wave ◽  
Video Camera ◽  
Gastric Volume ◽  
Gastric Body ◽  
Proximal Stomach ◽  
Gastric Contents ◽  
Gastric Lumen ◽  
Remote Sites ◽  
Greater Curvature ◽  
Gastric Contractions

To understand how contractions move gastric contents, we measured, in isolated cat stomachs, the effects of contractions on gastric length, diameters, pressures, and emptying. Movements of the stomach and of gastric contents were monitored by video camera and ultrasound and were related to mechanical events. Based on pressures, we defined the following four phases of contractions: 1) Po, a steady pressure associated with tonic contraction of proximal stomach; 2) P′, a pressure wave during which the contraction indents the gastric body; 3) a pressure nadir while the contraction lifts the gastric sinus toward the incisura; and 4) a second pressure wave, P”, as the contraction advances through the antrum. In open preparations, liquid output and shortening of the greater curvature are large during Po, stop during P′, and resume with P”. Contractions generate higher pressures when gastric volume is held steady. Contractions increase wall thickness and decrease gastric diameters at sites they involve and have opposite effects at remote sites. Contractions move the incisura and hence redraw the borders between gastric segments and shift volumes back and forth within the gastric lumen. Contractions furthermore stir up, compress, and disperse particulate beans without moving them to the pylorus. We conclude that gastric contractions 1) reverse changes in gastric length that occur during gastric filling, 2) move gastric contents directly through local contact and indirectly by changing the configuration of the stomach, and 3) interact with structures such as the incisura in retaining and breaking up solid gastric contents.

scholarly journals Successful revision surgery for very late-onset stomal obstruction following Gomez gastroplasty: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Yudai Hojo ◽  
Yasunori Kurahashi ◽  
Toshihiko Tomita ◽  
Tsutomu Kumamoto ◽  
Tatsuro Nakamura ◽  
...  
Keyword(s):  
Revision Surgery ◽  
Preoperative Diagnosis ◽  
Late Onset ◽  
Staple Line ◽  
Weight Loss Surgery ◽  
Wedge Resection ◽  
Gastric Pouch ◽  
Sudden Onset ◽  
Gastric Body ◽  
Greater Curvature

Abstract Background Gomez gastroplasty, which was developed in the 1970s as one of the gastric restrictive surgeries for severe obesity, partitions the stomach using a stapler from the lesser towards the greater curvature at the upper gastric body, leaving a small channel. This procedure is no longer performed due to poor outcomes, but surgeons can encounter late-onset complications even decades after the surgery. Here, we report a case of very late-onset stomal obstruction following Gomez gastroplasty which was successfully treated by revision surgery. Case presentation A 58-year-old man was referred to our institution with sudden-onset nausea and vomiting. He underwent weight loss surgery in the USA in 1979, but the details of the surgery were unclear. Esophagogastroduodenoscopy demonstrated a stoma at the greater curvature of the upper gastric body, and fluoroscopy showed retention of contrast medium in the fundus and poor outflow through the stoma. Abdominal computed tomography revealed a staple line partitioning the stomach. Considering these preoperative investigation findings and the period during which the surgery was performed, the patient was diagnosed with very late-onset stomal obstruction following Gomez gastroplasty. Supporting the preoperative diagnosis, the surgical findings revealed a staple line extending from the lesser towards the greater curvature of the upper gastric body and a channel reinforced by a running seromuscular suture on the greater curvature. Moreover, gastric torsion caused by the enlarged proximal gastric pouch was found. Re-gastroplasty involving wedge resection of the original channel was performed followed by construction of a new channel. Postoperative course was uneventful, and the patient no longer had symptoms of stomal obstruction after revision surgery. Conclusions Re-gastroplasty was safe and feasible for very late-onset stomal obstruction following Gomez gastroplasty. Accurate preoperative diagnosis based on the patient’s interview and the investigation findings was important for surgical planning. A careful follow-up is required to prevent excessive weight regain after revision surgery.

scholarly journals Gastric Mucosal Changes Caused by Lugol's Iodine Solution Spray: Endoscopic Features of 64 Cases on Screening Esophagogastroduodenoscopy

2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
Author(s):  
Daisuke Tsurumaru ◽  
Takashi Utsunomiya ◽  
Shuji Matsuura ◽  
Masahiro Komori ◽  
Satoshi Kawanami ◽  
...  
Keyword(s):  
Gastric Mucosa ◽  
Gastric Body ◽  
Gastric Disease ◽  
Iodine Solution ◽  
Lugol’S Iodine ◽  
Reticular Pattern ◽  
Before And After ◽  
Mucosal Changes ◽  
Greater Curvature ◽  
Gastric Mucosal Changes

Aim. To clarify the endoscopic mucosal change of the stomach caused by Lugol's iodine solution spray on screening esophagogastroduodenoscopy (EGD).Methods. Sixty-four consecutive patients who underwent EGD for esophageal squamous cell carcinoma screening were included in this study. The records for these patients included gastric mucosa findings before and after Lugol's iodine solution was sprayed. The endoscopic findings of the greater curvature of the gastric body were retrospectively analyzed based on the following findings: fold thickening, exudates, ulcers, and hemorrhage.Results. Mucosal changes occurred after Lugol's solution spray totally in 51 patients (80%). Fold thickening was observed in all 51 patients (80%), and a reticular pattern of white lines was found on the surface of the thickened gastric folds found in 28 of the patients (44%). Exudates were observed in 6 patients (9%).Conclusion. The gastric mucosa could be affected by Lugol's iodine; the most frequent endoscopic finding of this effect is gastric fold thickening, which should not be misdiagnosed as a severe gastric disease.

Assessment of antral grinding of a model solid meal with echo-planar imaging

2001 ◽  
Vol 280 (5) ◽  
pp. G844-G849 ◽  
Author(s):  
Luca Marciani ◽  
Penny A. Gowland ◽  
Annette Fillery-Travis ◽  
Pretima Manoj ◽  
Jeff Wright ◽  
...  
Keyword(s):  
Mathematical Modeling ◽  
Gastric Volume ◽  
Physical Factors ◽  
Resonance Imaging ◽  
Planar Imaging ◽  
Agar Gel ◽  
Solid Meal ◽  
Gel Beads ◽  
Gastric Contents ◽  
Echo Planar

Mathematical modeling of how physical factors alter gastric emptying is limited by lack of precise measures of the forces exerted on gastric contents. We have produced agar gel beads (diameter 1.27 cm) with a range of fracture strengths (0.15–0.90 N) and assessed their breakdown by measuring their half-residence time (RT1/2) using magnetic resonance imaging. Beads were ingested either with a high (HV)- or low (LV)-viscosity liquid nutrient meal. With the LV meal, RT1/2was similar for bead strengths ranging from 0.15 to 0.65 N but increased from 22 ± 2 min (bead strength <0.65 N) to 65 ± 12 min for bead strengths >0.65 N. With the HV meal, emptying of the harder beads was accelerated. The sense of fullness after ingesting the LV meal correlated linearly (correlation coefficient = 0.99) with gastric volume and was independently increased by the harder beads, which were associated with an increased antral diameter. We conclude that the maximum force exerted by the gastric antrum is close to 0.65 N and that gastric sieving is impaired by HV meals.

scholarly journals Endoscopic Sleeve Gastrectomy Conversion to Roux-en-Y Gastric Bypass

2020 ◽  
Vol 2 (3) ◽  
Author(s):  
Sorin Cimpean ◽  
Marechal Marie-Therese ◽  
Benjamin Cadiere ◽  
Guy-Bernard Cadiere
Keyword(s):  
Weight Loss ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Gastric Motility ◽  
Gastric Volume ◽  
Endoscopic Suturing ◽  
Endoscopic Sleeve Gastroplasty ◽  
Insufficient Weight Loss ◽  
Sleeve Gastroplasty ◽  
Greater Curvature

Endoscopic Sleeve Gastroplasty (ESG) is a restrictive endoscopic bariatric procedure that provides a reduction of the gastric volume and an alteration of the gastric motility. The volume of the stomach is reduced by approximately 70% through plication of the greater curvature of the stomach using an endoscopic suturing device. In case of failure, the surgical conversion is possible. We present a case of a patient with previous ESG with insufficient weight loss and gastro-oesophageal reflux. We performed a conversion to Roux-en-Y Gastric Bypass with satisfactory results.

Motilin effects on the proximal stomach in patients with functional dyspepsia and healthy volunteers

2003 ◽  
Vol 284 (5) ◽  
pp. G776-G781 ◽  
Author(s):  
Ingrid M. C. Kamerling ◽  
Aernout D. Van Haarst ◽  
Jacobus Burggraaf ◽  
Rik C. Schoemaker ◽  
Izak Biemond ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Healthy Volunteers ◽  
Functional Dyspepsia ◽  
Motor Response ◽  
Constant Pressure ◽  
Gastric Volume ◽  
Proximal Stomach ◽  
Visual Analog Scales ◽  
Abdominal Symptoms ◽  
Plasma Motilin

This study investigates motilin effects on the proximal stomach in patients with functional dyspepsia (FD) and healthy volunteers. Eight healthy volunteers and 12 patients with FD were infused with synthetic motilin or placebo. Proximal gastric volume was measured with a barostat at constant pressure and during isobaric distensions. Abdominal symptoms were scored by visual analog scales. Plasma motilin concentrations were measured by radioimmunoassay. Motilin concentrations and baseline gastric volumes were similar for patients and healthy volunteers. Motilin, compared with placebo, reduced gastric volume by 112 ml [ F(29,195); confidence interval (CI) 95%] in patients and by 96 ml [ F(−7,200); CI 95%] in healthy volunteers. In patients, motilin decreased compliance by 76 ml/mmHg [ F(9,143); CI 95%] compared with placebo, which was similar in volunteers [66 ml/mmHg; F(11,120); CI 95%]. Patients were more nauseous during motilin compared with placebo ( P = 0.04), whereas healthy volunteers did not experience nausea. We conclude that in a fasted condition, FD patients have a similar proximal gastric motor response to motilin as healthy volunteers, but experience an exaggerated sensation of nausea.

scholarly journals Ranitidine Prophylaxis before Anaesthesia in Early Pregnancy

1985 ◽  
Vol 13 (1) ◽  
pp. 29-32 ◽  
Author(s):  
B. L. Duffy ◽  
P. C. Woodhouse ◽  
M. D. Schramm ◽  
C. M. Scanlan
Keyword(s):  
At Risk ◽  
Early Pregnancy ◽  
Sodium Citrate ◽  
Gastric Volume ◽  
Gastric Ph ◽  
Control Group ◽  
Ph Measurements ◽  
Orogastric Tube ◽  
Gastric Contents ◽  
Mendelson’S Syndrome

Forty patients presenting for vaginal termination of pregnancy, divided randomly into four groups, received either no medication, sodium citrate 30 ml orally, ranitidine 150 mg orally or ranitidine 50 mg intravenously. During the procedure, gastric contents were removed by orogastric tube for volume and pH measurements. Ranitidine, orally and intravenously, significantly increased gastric pH and reduced gastric volume. In the control group only one pH was greater than 2.5. Sodium citrate raised the pH above 2.5 in 6 out of 10 patients. Fasting patients in the first months of pregnancy may be at risk of developing Mendelson's syndrome. Ranitidine is very effective in increasing gastric pH and at the same time reducing gastric volume in such patients.

scholarly journals Hypertrophic gastropathy associated with gastric sarcoma in a dog

2020 ◽  
Vol 33 (1) ◽  
pp. 112-115
Author(s):  
Mariarita Romanucci ◽  
Paolo E. Crisi ◽  
Maria Veronica Giordano ◽  
Morena Di Tommaso ◽  
Francesco Simeoni ◽  
...  
Keyword(s):  
Smooth Muscle ◽  
Smooth Muscle Actin ◽  
Periodic Acid ◽  
Neuron Specific Enolase ◽  
Partial Gastrectomy ◽  
Abdominal Ultrasound ◽  
Gastric Body ◽  
Gastric Glands ◽  
Periodic Acid Schiff ◽  
Gastric Lumen

A 14-y-old spayed female Labrador Retriever was presented with an 8-mo history of chronic vomiting. Abdominal ultrasound and gastrointestinal endoscopy revealed a mass protruding into the gastric lumen, with cytologic features suggestive of sarcoma. A partial gastrectomy was performed; the gastric body and antrum were thickened, with a cerebriform appearance of the mucosal surface. Histologic examination revealed a submucosal neoplastic proliferation of fusiform cells variably arranged in irregular bundles and scattered whorls. Fusiform cells strongly reacted to antibodies against vimentin, S100, and neuron-specific enolase; glial fibrillary acidic protein was moderately and multifocally expressed. Pancytokeratin, KIT, α–smooth muscle actin, and desmin were nonreactive. Histologic and immunohistochemical findings suggested a diagnosis of gastric sarcoma with features referable to a non-GIST (gastrointestinal stromal tumor), non–smooth muscle NIMT (non-angiogenic, non-lymphogenic intestinal mesenchymal tumor). The overlying gastric mucosa was thickened by elongated and dilated gastric glands, predominantly lined by intensely periodic acid-Schiff–stained mucous cells. This altered mucosal architecture was suggestive of Ménétrier-like disease. Although this disease has been hypothesized to predispose to gastric adenocarcinoma in dogs, an association with gastric sarcoma has not been documented previously in the veterinary literature, to our knowledge.

Ultrasonographic estimation of gastric volume in patients after overnight fasting and after ingestion of clear fluids two hours before surgery

2020 ◽  
Vol 24 (3) ◽  
Author(s):  
Manjunath C. Patil ◽  
B. Prajwal
Keyword(s):  
Gastric Volume ◽  
Pulmonary Aspiration ◽  
Gastric Aspirate ◽  
Two Dimensional ◽  
Non Invasive ◽  
The Past ◽  
Gastric Contents ◽  
Overnight Fasting ◽  
Risk Of Aspiration

Pre-operative fasting aims to decrease the volume and increase the pH of gastric contents, hence reducing the risk of aspiration. According to the past literature gastric contents of 25 ml (0.4 ml/kg) and with pH ≤ 2.5 predisposes the patient to pulmonary aspiration hence pre-operative fasting was recommended. Use of two-dimensional ultrasonography is an accurate non-invasive tool to determine gastric volume. We compared the gastric volume using ultrasonography and pH of gastric aspirate by pH strip in patients after overnight fasting and after ingestion of 200 ml clear fluids (water) 2 h prior to surgery.

Ingestion, gastric fill, and gastric emptying before and after withdrawal of gastric contents

1994 ◽  
Vol 267 (5) ◽  
pp. R1257-R1265 ◽  
Author(s):  
Joel M. Kaplan ◽  
William Siemers ◽  
Harvey J. Grill
Keyword(s):  
Gastric Emptying ◽  
Gastric Volume ◽  
Additional Contribution ◽  
Initial Test ◽  
Gastric Emptying Rate ◽  
Solute Content ◽  
Gastric Contents ◽  
Before And After ◽  
Food And Water Intake ◽  
Do So

The notion that satiation signals are derived from the stomach with no additional contribution of postgastric sources (J. A. Deutsch. In: Handbook of Behavioral Neuroscience. Food and Water Intake. 1990, vol. 10, p. 151–182) was evaluated in two experiments. In experiment 1, the gastric contents were withdrawn after the rat met the satiety criterion for an initial intraoral intake test (12.5% glucose delivered at 1.0 ml/min). Ten minutes later, the intraoral infusion was continued until the rat again met the satiety criterion. We found that rats reingested an amount closely corresponding to the amount withdrawn, in agreement with previous studies using spout-licking tests. Despite a lower gastric emptying rate during reingestion than during the initial test, the amount recovered from the stomach (both volume and solute content) after reingestion was significantly less (gastric volume 16% less; gastric glucose 18% less) than that withdrawn initially. In experiment 2, a portion (8 ml) of the gastric contents was removed after the end of an initial intraoral intake test and, after 10 min, rats were again given an opportunity to ingest to satiety. The procedure was repeated for a total of three withdrawals (24 ml) and three reingestion opportunities. Rats accurately replaced the amounts withdrawn such that net intake at the end of the experiment did not differ from that ingested during the initial test. In addition, the amount recovered from the stomach after the terminal test was considerably less (gastric volume 25% less; gastric glucose 29% less) than that recovered at the end of single-test control sessions. Both experiments show that gastric feedback cannot alone account for the termination of intraoral intake. The results suggest that rats defend total intake and do so via the integration of signals derived from postgastric as well as gastric sources. stomach; satiation Submitted on November 15, 1993 Accepted on May 12, 1994

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