Radioisotopic documentation of different solid food transit in gastrectomized patients with dumping syndrome

Scintigraphy was performed on a group of patients following the administration of a solid radiolabelled meal. As a tracer, human albumin microspheres were used with 99mTc, mixed with fresh scrambled eggs, eaten as a sandwich in two slices of white bread. The analysis of transit and emptying-rate of the radiolabelled meal in the gastric or derivate loop areas was performed by means of a medium field (300 mm) gamma camera interfaced with a digital computer; the data were collected at 15'' frames for 90'-120'.Twenty-nine patients were examined who had undergone sub-total gastrectomy: 11 of them were ''dumpers'' and 18 ''non-dumpers''; moreover, 9 volounteers without any history of gastrointestinal diseases and 11 patients with different gastric disorders were checked. In the first group of gastrectomized patients the half-emptying time (T50) was significantly shorter than in the 11 people being checked (Md=27.5±10.8 versus 69.6±19 minutes); in ''non-dumpers'' T50 was even shorter (Md=24.2±13 minutes). There was no significant statistical difference between the two classes of gastroresected patients in both T50 and emptying-rate of the radioactive solid food, which excludes the accelerated transit as a factor in the functional post-prandial symptoms of the dumping syndrome. On the contrary, the dynamic selective analysis of the radiolabelled food transit through derivate afferent and efferent loops showed different patterns in the two groups of gastroresected patients: the prograssion of the propulsive wave was very irregular and constantly hyperperistaltic only in the dumpers