Zaloga G P, Chernow B
Gastroenterology. 1983 Apr;84(4):840-2.
The motility of the stomach is modulated by the complex interplay of muscular, humoral, and neuronal factors. Rapid gastric emptying has been described after gastrectomy, gastrojejunostomy, vagotomy with pyloroplasty, and with active peptic ulcer disease. Rapid emptying may result in "dumping" syndrome and in postprandial hypoglycemia. We report a patient who developed postprandial hypoglycemia after a Nissen fundoplication for reflux esophagitis. This is the first report of this complication after this surgical procedure. The hypoglycemia was secondary to a combination of rapid gastric emptying, rapid absorption of glucose causing hyperglycemia, and excessive insulin secretion. This syndrome should be considered in patients who develop hypoglycemic symptoms after fundoplication. Treatment with a low carbohydrate diet and anticholinergic agents may offer symptomatic relief.
胃的运动受肌肉、体液和神经因素复杂的相互作用调节。胃切除术后、胃空肠吻合术后、迷走神经切断术加幽门成形术后以及患有活动性消化性溃疡病时，均有胃排空加速的描述。快速排空可能导致“倾倒”综合征和餐后低血糖。我们报告一例因反流性食管炎行nissen胃底折叠术术后发生餐后低血糖的患者。这是该手术术后出现这种并发症的首例报告。低血糖继发于胃排空加速、葡萄糖快速吸收导致高血糖以及胰岛素分泌过多的共同作用。对于胃底折叠术后出现低血糖症状的患者，应考虑到这种综合征。采用低碳水化合物饮食和抗胆碱能药物治疗可能会缓解症状。
