Endocrine Abstracts

Introduction: Dumping syndrome is a phenomenon produced by the alteration of the pyloric sphincter. It occurs in 20% of pyloroplasty or distal gastrectomies. The syndrome is attributed to the rapid emptying of the chyme in the intestine. The osmotic gradient attracts fluid to the intestine, and this releases vasoactive hormones, such as serotonin or vasoactive intestinal polypeptide.

Case report: We present a 82-year-old woman with gastric intervention in 1985 with pyloroplasty and vagotomy with early and late dumping syndrome. This situation was refractory to nutritional and medical treatment conditioning with frequent and severe hypoglycemia events. A hypoglycemia study was performed with a fasting test, anti-insulin antibodies and C-peptide that were normal. The possibility of home parenteral nutrition was ruled out because of the risk of infection and also surgical intervention because her comorbidities. The placement of a nasoyejunal catheter was chosen. Given the good tolerance it was decided to perform a radiological yejunostomy to definitely avoid hypoglycemia.

Discussion: Dumping syndrome is defined by a group of symptoms caused by rapid emptying of nutrients from the stomach into the small intestine. First line of the treatment includes dietary modifications. A small group of patients may require medical therapy with acarbose or octreotide. Nevertheless is extremely rare the use of continuous enteral feeding to avoid hypoglycemia symptoms.

Ethical aspects

The case has the informed consent of the patient.