Hanimann B, Hirsig J
Chirurgische Klinik, Universitäts-Kinderspital Zürich.
Z Kinderchir. 1988 Oct;43(5):315-8. doi: 10.1055/s-2008-1043475.
Between 1982 and 1987 27 Nissen's fundoplications were carried out in our institution. Postoperatively 7 infants showed a typical dumping syndrome. The symptoms were irritability, pallor, sweating, tachycardia, lethargy, diarrhoea and vomiting. In all cases an absolute refusal of feeding was observed. The diagnosis was confirmed by a typical early postprandial hyperglycaemia with hyperinsulinaemia leading to a reactive hypoglycaemia. Additionally, we were able to demonstrate an increased HbA1c as an expression of recurrent hyperglycaemias in 3 infants. In 6 infants the dumping syndrome was of short duration and the symptoms disappeared after application of a so-called dumping diet. In this diet the easily resorbable carbohydrates are replaced by uncooked starch. But in one case we were forced to use continuous enteral nutrition because of persistence of the symptoms 1 year after the Nissen fundoplication. Complete refusal of feeding is an early symptom of the dumping syndrome. If this symptom is observed after a Nissen's fundoplication, a dumping syndrome must be excluded.
1982年至1987年间，我们机构实施了27例尼氏胃底折叠术。术后，7名婴儿出现典型的倾倒综合征。症状包括烦躁、面色苍白、出汗、心动过速、嗜睡、腹泻和呕吐。所有病例均出现完全拒食。典型的餐后早期高血糖伴高胰岛素血症导致反应性低血糖可确诊该疾病。此外，我们还发现3名婴儿的糖化血红蛋白（HbA1c）升高，这是反复出现高血糖的表现。6名婴儿的倾倒综合征持续时间较短，采用所谓的倾倒饮食后症状消失。在这种饮食中，易吸收的碳水化合物被生淀粉取代。但有1例在尼氏胃底折叠术后1年症状持续存在，我们被迫使用持续肠内营养。完全拒食是倾倒综合征的早期症状。如果在尼氏胃底折叠术后出现这种症状，必须排除倾倒综合征。
