Oesophageal Strictures after Gastric Surgery and Naso-gastric Intubation

Bingham, J. A. W.

doi:10.1136/bmj.2.5100.817

Cited by 39 publications

(10 citation statements)

References 3 publications

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“…However, several authors reported since the beginning of last century, cases of esophageal stenosis caused by prolonged use of NGI in clinical and surgical patients 6,11,12,21 . Douglas 11 (1956) 4,7,29 . Its use is not innocuous and is related to some complications, such as nasal and oro-pharyngeal lesions, bronchial infection and esophageal stenosis 4,16 , with great morbidity.…”

Section: Discussionmentioning

confidence: 99%

“…The mechanism involved is multifactorial. The nasogastric probe interferes with the physiological barrier against gastroesophageal reflux, while keeping open the lower esophageal sphincter and aligning the esophageal-gastric junction 4,5,7,8 . Pre-existing predisposing factors also contribute, such as hiatal hernia or gastroesophageal reflux disease 4,16,21 .…”

Section: Discussionmentioning

confidence: 99%

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Estenose esofágica por uso de sonda nasogástrica: reflexão sobre o uso indiscriminado

Ribeiro¹,

Lopes²,

Souza-Neto³

et al. 2011

ABCD, arq. bras. cir. dig.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Estenose esofágica por uso de sonda nasogástrica: reflexão sobre o uso indiscriminado

Ribeiro¹,

Lopes²,

Souza-Neto³

et al. 2011

ABCD, arq. bras. cir. dig.

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“…Furthermore, the restoration of a normal manometric pattern in the sphincteric area in a patient who was completely achlorhydric after a partial gastrectomy and vagotomy is conclusive evidence that gastrin can act on the lower oesophageal sphincter. Whether these increases in pressure have relevance to the preservation of normal oesophageal competence is still conjectural but it is interesting that several workers have reported a higher incidence of oesophageal reflux after partial gastrectomy where the gastric antrum, the source of endogenous gastrin, is removed (Bingham, 1958;Cox, 1961;Windsor, 1964).…”

Section: Discussionmentioning

confidence: 99%

Action of gastrin on the lower oesophageal sphincter in man

Giles¹,

Mason²,

Humphries³

et al. 1969

Gut

122

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suMMARY Both hog gastrin and synthetic gastrin stimulate the cardiac sphincter to increase tone and augment the resistance to reflux. Endogenous gastrin has a similar effect, and gastrin also stimulates the secretion of acid which has also been found to increase the resistance of the sphincter, but the effect of gastrin appears to be independent of the secretory stimulus.Now that the role of gastrin in the control of gastric acid secretion has become clearer, attention has turned to the subsidiary action of this hormone on the smooth muscle of the gastrointestinal tract. Early studies by Blair, Harper, Lake, Reed, and Scratcherd (1961) showed that an extract of antral mucosa produced a marked pressor response in the stomach and upper small intestine of anaesthetized cats. Similar results were later reported by Gregory and Tracy (1964) using an extract of hog antral mucosa to produce stimulation of intestinal motility in dogs.In an earlier study (Giles, Humphries, Mason, and Clark, 1968) we found that the intraluminal pressure of the cardiac sphincter increased when the gastric aspect of the sphincter mucosa was perfused with acid. This suggested a physiological response to gastric secretion such as after eating, and perhaps designed to increase the barrier pressure preventing gastrooesophageal reflux. Following this hypothesis it seemed reasonable to examine whether circulating gastrin, induced during eating, might have a similar effect.In the experiments to be described, the pressures exerted by the lower oesophageal sphincter have been measured before and after the injection of hog gastrins I and II in varying doses, and also after injection of synthetic gastrin (ICI 50,123). The effect of release of endogenous gastrin can be studied in man using the technique of meat extract stimulation (Giles and Clark, 1967; Giles, Buchan, and Clark, 1967). This technique has been adopted to study the effect on the cardiac sphincter in an attempt to ascertain the events likely to occur during digestion. MATERIALS AND METHODSThe methods used to measure the sphincteric pressures in these experiments were similar to those used previously (Giles et al, 1968) and measurements were made of the mean gastric pressure, maximum sphincteric pressure, and the oesophageal pressures, all calculated from the end expiratory measurements. After the sphincteric profile had been determined under resting control conditions, an injection of gastrin was given slowly intravenously and the sphincter profile was repeated after 15 minutes. The gastrin (Leo Labs) was given in a bodyweight dose which carried from 0.005 units to 1.0 units/kg.In five subjects a continuous infusion of pentagastrin (ICI 50,123) was given at a rate of 0-06 tg/kg/hr and sphincter profiles were obtained in the usual way after five and again after 25 minutes of infusion. In a further three subjects, pressure tracings were made before and 15

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“…The LES pressure follow ing gastric resection has not been systematically determined. However, the literature contains several reports of gastroesophageal reflux, esophagitis and stricture formation following gastric resection [2,12,19,28,33]. These clinical observations are limited and are certainly not universally observed in all post gastrectomy patients.…”

Section: The Genesis O F Resting Lower Esophageal Sphincter Competencementioning

confidence: 99%

The Hormonal Regulation of Lower Esophageal Sphincter Competence

Cohen¹

1972

Digestion

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Oesophageal Strictures after Gastric Surgery and Naso-gastric Intubation

Cited by 39 publications

References 3 publications

Estenose esofágica por uso de sonda nasogástrica: reflexão sobre o uso indiscriminado

Estenose esofágica por uso de sonda nasogástrica: reflexão sobre o uso indiscriminado

Action of gastrin on the lower oesophageal sphincter in man

The Hormonal Regulation of Lower Esophageal Sphincter Competence

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