technetium-tc-99m-disofenin and Gastroesophageal-Reflux

Reflux is one of the most common sequela after proximal gastrectomy (PG). The aim of this study was to find a predicting factor related to the character of esophageal reflux after PG.. Wireless ambulatory 24-hr pH monitoring (for acid reflux, AR) and diisopropyliminodiacetic acid hepatobiliary scan (for bile reflux, BR) were performed on 24 patients who had reflux symptoms after PG with esophagogastrostomy from July 2008 to March 2009. Endoscopic examination was done and the length of remnant stomach (LoRS) was measure by postoperative UGI series.. Eleven patients (45.8%) had only BR, 7 (29.2%) had AR only, Two patients (8.3%) had both acid and BR, and 3 (12.5%) had neither. The LoRS along greater curvature was significantly shorter in patients with only BR (16.11 +/- 2.87 cm) than in patients with only AR (23.69 +/- 6.15 cm, P = 0.003). Severity of symptoms or esophagitis was not significantly correlated with the content of acid or BR.. Reflux symptom after PG is caused by either bile or acid rather than both. Character of reflux was related to the LoRS.

Topics: Bile Reflux; Esophageal pH Monitoring; Esophagoscopy; Female; Gastric Acid; Gastroesophageal Reflux; Humans; Male; Middle Aged; Postgastrectomy Syndromes; Radionuclide Imaging; Radiopharmaceuticals; Severity of Illness Index; Technetium Tc 99m Disofenin

Topics: Acute Disease; Aged; Cholecystitis; Esophageal Neoplasms; Esophagoplasty; Gastroesophageal Reflux; Humans; Male; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Disofenin

Radionuclide hepatobiliary imaging was performed on a patient with a longstanding history of scleroderma who presented with abdominal pain suggestive of biliary disease. Cystic duct patency was documented after 10 min with tracer accumulation in the second portion of the duodenum which failed to progress consistent with the duodenal hypomotility of scleroderma. The patient was given intravenous Kinevac resulting in gastroesophageal reflux of radionuclide.

Topics: Acute Disease; Biliary Tract; Female; Gastroesophageal Reflux; Humans; Imino Acids; Liver; Middle Aged; Radionuclide Imaging; Scleroderma, Systemic; Technetium; Technetium Tc 99m Disofenin

A new technique to study esophageal reflux by means of hepatobiliary photoscintigraphy using TC-99m DISIDA was examined. The study was undertaken on 19 patients undergoing total gastrectomy without esophageal recurrence or hepatic or pulmonary metastases. The results of hepatobiliary photoscintigraphy were compared with the clinical, endoscopic and radiologic data. From this comparison it was demonstrated that photoscintigraphy is a non-invasive procedure which permits the study of the intestinal loops excluded from the transit of food but not of bile. Hepatobiliary scintigraphy was shown to be a reliable examination and the only one which demonstrates the reflux under physiological conditions, since the 24h. pH test in the absence of the stomach does not clearly prove the presence of alkaline reflux (bile) in an alkaline environment (esophagus). The disadvantages of photoscintigraphy are that the reflux is demonstrated only during the period of examination and in the patients undergoing total gastrectomy it is difficult to identify with accuracy the esophageal anastomosis. In these cases however, the radioactive bolus was used to localize the anastomosis and therefore to assess the esophageal reflux.

Topics: Adult; Aged; Bile Ducts; Gastroesophageal Reflux; Humans; Imino Acids; Liver; Methods; Middle Aged; Postgastrectomy Syndromes; Radionuclide Imaging; Stomach Neoplasms; Technetium; Technetium Tc 99m Disofenin

Biliary and pancreatic juice has been implicated as a cause of regional inflammation or carcinoma after gastric surgery. We studied 38 patients after gastrectomy using a modification of cholescintigraphy (185 mBq 99m-Tc-DESIDA i.v.). As soon as the tracer had reached the duodenum, a dynamic study (30 min, 120 frames) was started. Thereafter a static image of the epigastrium and thorax in the anterior view with more than 1000 cts/cm2 was recorded. This procedure was repeated after a meal. Of 29 patients without complaints only 4 had a reflux into the jejunal loop. By contrast in 7 of 9 patients with suggestive symptoms this examination demonstrated bile reflux which reached the oesophagus in 6 cases. A stenosis of the distal oesophagus prevented oesophageal reflux in one patient. 2 patients with oesophageal reflux had a history of oesophageal stenosis and oesophagitis confirmed by endoscopy. The remaining 2 patients without demonstrable reflux had neither oesophagitis nor radiologically verified reflux. Cholescintigraphy as modified by us may detect clinical relevant bile reflux into the oesophagus. This is important for surgeons selecting patients with potential benefit from a reoperation. Since most patients with complaints after gastrectomy have had demonstrable bile reflux, reflux-reducing surgical techniques should be used in all.

Topics: Bile Reflux; Biliary Tract; Biliary Tract Diseases; Esophagitis, Peptic; Esophagus; Gastrectomy; Gastroesophageal Reflux; Humans; Imino Acids; Postoperative Complications; Radionuclide Imaging; Technetium; Technetium Tc 99m Diethyl-iminodiacetic Acid; Technetium Tc 99m Disofenin; Time Factors

Duodenogastroesophageal reflux is demonstrated using cholescintigraphy in a patient with severe esophagitis.

Topics: Bile Reflux; Biliary Tract Diseases; Esophagitis; Female; Gastroesophageal Reflux; Humans; Imino Acids; Middle Aged; Radionuclide Imaging; Technetium; Technetium Tc 99m Disofenin

Gastroesophageal reflux was a fortuitous finding on a hepatobiliary scan in a patient who had a history of esophagogastrectomy and complained of regurgitation in the supine position.

Topics: Bile Ducts; Gastroesophageal Reflux; Humans; Imino Acids; Liver; Male; Middle Aged; Radionuclide Imaging; Technetium; Technetium Tc 99m Disofenin