Detection and quantitative estimation of entero gastric reflux by scintigraphy

Purpose: The aim of the study is detection and quantification of enterogastric reflux (EGR). Patients and Methods: We investigated 162 patients and 10 controls. Dynamic acquisition was performed after i.v. application of 185 MBq 99m-Tc-EHIDA during 90 min (1f/min) with test-meal in 30th min. The stomach was labelled with of 18 MBq 99mTc-S-colloid. Index of enterogastric reflux (EGR%) and reflux duration were calculated from hepatobiliary and stomach curves. Results: The reflux was registered in the controls in small quantity (EGR%=4,4+/-4,2%) exclusively postprandially, shortly (4.3+/-2.0 min) while these values were significantly (p< 0.001) increased in patients after Billroth II resection(68.8+/-43.7%; 58.4+/-4.0min), with duodenal ulcer (36.6+/-33.0%; 40.3+/-22.2 min), cholecystitis (31.0+/-8.7%; 26.5+/-6.8 min), after Billroth I (28.2+/-22.7%; 34.1+/-12.4 min), postcholecystectomy (27.1+/-17.2%; 37.6+/-19.7 min), with gastric ulcer (24.5+/-13.6%; 21.9+/-10.2 min) with GER (24.5+/-14.9; 29.6+/-19.5min) and chronic duodenal disease (17.2+/-5.6%; 27.3+/-8.0 min). EGR% was highly correlated (r=0.580, DF=75, p<0.01) with its duration. In fasting conditions (prior to stimulation), reflux was detected in 28 out of 75 (37.3%) patients with reflux in average quantity of 41.0+/-29.7% which was significantly different (p<0.01) from those postprandially detected (23.26+/-16%). Increased values of EGR index are found in 75 (46.3%) patients: 85.7% and 75% after BII and BI gastrectomy, 60% with gastric and 52.4% with duodenal ulcer, 46.1% with chronic duodenal disease, 41.3% with GER, 39.3% with cholecystectomized patients and 20% in those with cholecystitis. Conclusion: EGR scintigraphy can provide exact data about EGR presence and the quantity