Advertisement

Must duodenal diversion be reserved for alkaline reflux?

  • H. Viard
Conference paper

Abstract

In answering this question, it is important to note that two populations may be opposed in our series: those of esophagitis after UPG (Uppen Polar Gastrectomy) (8 cases), where the result of duodenal diversion is regularly good and long-lasting, and those of esophagitis after recurrence of hiatus hernia (5 cases) or after Heller’s operation (3 cases), which include the 2 poor results. This contrast is probably linked to the nature of the reflux. In UPG the reflux is alkaline, since there has been a TV (Truneal Vagotony) and an extensive gastric resection; the esophagitis is then early and severe. In recurrences after hiatus hernia or Heller operations the reflux is acid and the esophagitis develops later. But when there is no anatomic explanation to arouse suspicion of alkaline reflux, its diagnosis may encounter technical difficulties. In fact, endoscopy and scintigraphy with technetium-99 can diagnose duodenogastric reflux [3] but pH measurement cannot prove alkaline esophageal reflux since the esophageal pH is normally elevated and the recording is disturbed by the alkaline saliva [4].

Keywords

Hiatus Hernia Peptidic Hormone Duodenogastric Reflux Uneven Quality Gastric Reflux 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Jebira A, Benamor N, Ayachi K, Ben Younes MA, Gargouri M, Fourati M (1986) La diversion duodénale totale: à propos de 4 cas. Me Chir Dig 15:559–562Google Scholar
  2. 2.
    Malagelada JR, Phillips S, Shorter RG, Higgins JA, Magrina C, Van Heerden JA, Adson MA (1985) Post-operative reflux gastritis: pathophysiology and long term outcome after Roux en Y diversion. Ann Intern Med 103:178–183PubMedCrossRefGoogle Scholar
  3. 3.
    Ritchie WP Jr (1986) Alkaline reflux gastritis: late results on a controlled trial of Diagnosis and treatment. Ann Surg 203:537–544PubMedCrossRefGoogle Scholar
  4. 4.
    Schlesinger PK, Donahue PE, Schmid B, Layden TJ (1985) Limitations of 24-hour intra- oesophageal pH-Monitoring in the hospital setting. Gastroenterology 80:797–804Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1989

Authors and Affiliations

  • H. Viard
    • 1
  1. 1.DijonFrance

Personalised recommendations