A 40 years old male underwent Billroth-II gastrectomy for gastric ulcer. After 3 weeks of surgery, when patient was having dinner, patient collapsed within 20 minutes of meals. What is the most probable reason?
Dumping syndrome:- Complication of loop gastrojunostomy / Billroth - II gastrectomy.- Due to dumping of hyperosmotic & hyperosmolar content into proximal pa of jejunum Early dumping Late dumping - 15-30 minutes after meals -Hyperosmotic content | Fluid secretion | Third space loss | Vasomotor symptoms hypovolemia - 2-3 hours after meals - Hyperglycemic content | | release of insulin | Reactive hypoglycaemia Dumping is easy to prevent but difficult to manage Prevention of dumping syndrome: 1. Dietary modification- Small frequent meals- | carbohydrate, | protein, | fat - Avoid liquids during meals- Avoid high calorie drinks2. Octreotide intake3. Sx 1. (B-II - B-I)2. Interposition of anti-peristaltic segment of jejunum.
Hypovolemia
Reactive hypoglycemia
Reactive hyperglycemia
Hypervolemia
GIT