Summary
Following abdominal radiation, a 16-year-old male developed persistent vomitin, metabolic alkalosis, and cachexia secondary to gastric stasis, atony, and dilatation in the absence of mechanical obstruction. Fluoroscopically and manometrically, antral motility was found to be severely impaired. Antral motor activity was not influenced by metoclopramide, but stimulated by carbachol. During oral maintenance carbachol therapy, gastric emptying of food was restored and sufficient oral nutrition could be resumed. The improvement persisted even after termination of therapy four months later. Systematic investigations on the effects of abdominal radiation on gastrointestinal motility appear to be necessary.
Similar content being viewed by others
References
Rundles RW: Diabetic neuropathy. Medicine 24:111–160, 1945
Goyal RK, Spiro HM: Gastrointestinal manifestations of diabetes mellitus. Med Clin North Am 55:1031–1044, 1971
Howland WJ, Drinkard RU: Acute diabetic gastricatony: Gastroparesis diabeticorum. JAMA 185:214–216, 1963
Kassander P: Asymptomatic gastric retention in diabetes (gastroparesis diabeticorum). Ann Intern Med 48:797–812, 1958
Marsak RH, Maklansky D: Diabetic gastropathy. Am J Dis Dis 9:366–370, 1964
Wooten RL, Meriwether TW: Diabetic gastric atony: A clinical study. JAMA 176:1082–1087, 1961
Zitomer BR, Gramm HF, Kozak GP: Gastric neuropathy in diabetes mellitus: Clinical and radiological observations. Metabolism 17:199–211, 1958
Bergin WF, Jordan PH Jr: Gastric atonia and delayed gastric emptying after vagotomy for obstructing ulcer. Am J Surg 98:612–616, 1959
Kraft RO, Fry WJ, DeWeese MS: Postvagotomy gastric atony. Arch Surg 88:865–871, 1964
Browlee M, Kroopf SS: Metoclopramide for gastroparesis diabeticorum. N Engl J Med 291:1256–1258, 1974
Malagelada JR, Rees WDW, Mazzotta LJ, Go VLW: Gastric motor abnormalities in diabetic and postvagotomy gastroparesis: Effect of metoclopramide and bethanechol. Gastroenterology 78:286–293, 1980
Snape WJ Jr, Battle WM, Schwartz SS, Braunstein SN, Goldstein HA, Alavi A: Metoclopramide to treat gastroparesis due to diabetes mellitus. Ann Intern Med 96:444–446, 1982
Longstreth GF, Malagelada JR, Kelly K: Metoclopramide stimulation of gastric motility and emptying in diabetic gastroparesis. Ann Intern Med 86:195–196, 1977
Fox S, Behar J: Pathogenesis of diabetic gastroparesis: A pharmacologic study. Gastroenterology 78:747–763, 1980
Danguechin Dorval E, Mueller GP, Eng R, Durakovic A, Conklin J, Dubois A: Involvement of endogenous opiates in radiation-induced suppression of gastric emptying. Gastroenterol Clin Biol J 7:712, 1983 (abstract)
Dubois A, Facobus JP, Grissom MP, Eng RR, Conklin JJ: Altered gastric emptying and prevention of radiation induced vomiting in dogs. Gastroenterology 86:444–448, 1984
Dozois RR, Kelly KA, Code CF: Effect of distal antrectomy on gastric emptying of liquids and solids. Gastroenterology 61:675–681, 1971
Wilbur BG, Kelly KA: Effect of proximal gastric, complete gastric, and tuncal vagotomy on canine gastric electric activity, motility and emptying. Ann Surg 178:295–303, 1973
Hinder RA, Kelly KA: Canine gastric emptying of solids and liquids. Am J Physiol 233:E355-E340, 1977
Author information
Authors and Affiliations
Additional information
P. Demol was a recipient of a fellowship of the Alexander von Humboldt Stiftung, Bonn, Federal Republic of Germany.
Rights and permissions
About this article
Cite this article
Layer, P., Demol, P., Hotz, J. et al. Gastroparesis after radiation. Digest Dis Sci 31, 1377–1380 (1986). https://doi.org/10.1007/BF01299817
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01299817