Short bowel syndrome: Difference between revisions
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*Rapid post-prandial gastric emptying, release of gastric hormones, splanchnic vasodilation | *Rapid post-prandial gastric emptying, release of gastric hormones, splanchnic vasodilation | ||
*Hyperinsulinemic and hypoglycemic state | *Hyperinsulinemic and hypoglycemic state | ||
==Clinical Features== | ==Clinical Features== | ||
*Nausea | *[[Nausea/vomiting]], bloating, [[abdominal pain|abdominal cramps]], [[diarrhea]], diaphoresis | ||
**Early dumping= symptoms 30-60min after a meal | **Early dumping= symptoms 30-60min after a meal | ||
**Late dumping= symptoms 1-3 hours after a meal | **Late dumping= symptoms 1-3 hours after a meal | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Abdominal Pain DDX Diffuse}} | |||
== | ==Evaluation== | ||
*See [[Abdominal Pain]] | |||
* | |||
*Diagnosis of exclusion | *Diagnosis of exclusion | ||
==Management== | ==Management== | ||
| Line 21: | Line 20: | ||
**Avoid highly concentrated foods | **Avoid highly concentrated foods | ||
**Separate eating and drinking | **Separate eating and drinking | ||
*Octreotide | *[[Octreotide]] | ||
**Positive case reports | **Positive case reports | ||
==Disposition== | ==Disposition== | ||
*Home if other diagnoses excluded and able to tolerate oral intake | *Home if other diagnoses excluded and able to tolerate oral intake | ||
==See Also== | ==See Also== | ||
[[Gastric bypass surgery]] | [[Gastric bypass surgery]] | ||
Latest revision as of 00:12, 30 September 2019
Background
- Well-recognized complication of gastric bypass
- Rapid post-prandial gastric emptying, release of gastric hormones, splanchnic vasodilation
- Hyperinsulinemic and hypoglycemic state
Clinical Features
- Nausea/vomiting, bloating, abdominal cramps, diarrhea, diaphoresis
- Early dumping= symptoms 30-60min after a meal
- Late dumping= symptoms 1-3 hours after a meal
Differential Diagnosis
Diffuse Abdominal pain
- Abdominal aortic aneurysm
- Acute gastroenteritis
- Aortoenteric fisulta
- Appendicitis (early)
- Bowel obstruction
- Bowel perforation
- Diabetic ketoacidosis
- Gastroparesis
- Hernia
- Hypercalcemia
- Inflammatory bowel disease
- Mesenteric ischemia
- Pancreatitis
- Peritonitis
- Sickle cell crisis
- Spontaneous bacterial peritonitis
- Volvulus
Evaluation
- See Abdominal Pain
- Diagnosis of exclusion
Management
- Dietary Modifications
- Avoid highly concentrated foods
- Separate eating and drinking
- Octreotide
- Positive case reports
Disposition
- Home if other diagnoses excluded and able to tolerate oral intake
See Also
External Links
References
O'Brien M. Acute Abdominal Pain In: Tintinalli's Emergency Medicine. 7th ed. McGraw-Hill. 2011:Chapter 74