Gastroparesis - very severe

Case contributed by Dachani Kansan Naider
Diagnosis certain

Presentation

Reflux symptoms.

Patient Data

Age: 70 years
Gender: Female

Gastric emptying study

Nuclear medicine

Tracer migration is noted from the stomach to the small bowels within 30 minutes.

The half clearance time is 267 minutes (normal 60 -105 minutes).

The % of retained activity is recorded at the following time points.

  • 30mins : 95 % retention (normal>70%)

  • 60mins : 90 % retention (normal 30- 90%)

  • 120mins : 79 % retention (normal <60%)

  • 240mins : 54 % retention (normal <10%)

There is curvilinear activity identified in the esophagus, reflecting gastro-esophageal reflux.

Case Discussion

A patient with a history of hiatus hernia repair a few years ago presented with reflux symptoms. Endoscopy showed residual fluid in stomach.

This corresponds to the nuclear medicine gastric emptying study which showed scintigraphy features of very severe gastroparesis with gastro-esophageal reflux.

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