Is superior mesenteric artery flow increased in patients with early dumping syndrome

Abstract

Dumping occurs in about 10% of patients after gastric surgery. It has been suggested that early dumping is associated with an abnormal increase in postprandial splanchnic blood flow but controlled data are lacking. We have studied basal and postprandial splanchnic blood flow (Doppler ultrasound) in patients with proven early dumping and in two control groups. The dumping group consisted of patients after Billroth II gastrectomy (n=6; age 51 ± 6 yr; body mass index 22 * 1 kg/m2), the surgical control group consisted of patients after Billroth II gastrectomy without dumping symptoms (n=7; age 58 ± 7 yr; body mass index 23 ± 1 kg/m 2) and the third group consisted of healthy controls without previous gastric surgery (n=10; age 52 ± 7 yr; body mass index 23 -+ 1 kg/m2). Blood glucose and heart rate were measured after oral dumping provocation with 50 g glucose in 200 ml. Superior mesenteric artery (SMA) blood flow was measured both basally and 20 min after the glucose ingestion. Basal SMA flow was similar in the three groups 0.36 ± 0.06 l/min (dumping), 0.39 ± 0.05 l/min (surgical controls), 0.43 ± 0.02 l/min (healthy controls). After glucose ingestion SMA flow increased significantly in all groups (p < 0.05). Stimulated SMA flow was not significantly different between dumping patients and surgical controls (1,0 ± 0.2 vs 1.0 ± 0.1 l/rain). However, stimulated SMA flow in both groups after gastric surgery combined was significantly (p < 0.05) higher than in healthy controls (1.0 ± 0.I vs 0.7 ± 0.2 l/min). Conclusion: The systemic symptoms associated with early dumping do not result from increased splanchnic blood flow per se. Patients after gastric surgery have an increased postprandial SMA flow irrespective of the presence of dumping.