PATHOPHYSIOLOGICAL STUDY ON DUMPING SYNDROME

A questionaire was answered by post-gastrectomy patients, and 150m1 of 50% glucose solution was given to 42 of these patients with suspected dumping syndrome. As a result, in 20 patients, early dumping syndrome was induced. To clarify the involvement of changes in circulatory dynamics, biochemical changes and changes in the circulatory system in dumping syndrome, blood serotonin, blood catecholamines, serum potassium, acid-base balance, changes in ECG and ventricular work load were all studied and following results were obtaine. 1) Significant increases in blood serotonin and blood catecholamines were observed, and a parallel relationship was suggested between serotonin and catecholamines. 2) Serum potassium was decreased by dumping syndrome. This was considered to have been induced by increase in blood insulin as a result of a temporary increase in blcod sugar level. 3) As an acid-base balance in PaO₂ and an increase in PaCO₂ were observed, a decrease in espiratory function was suggested. 4) From an overall standpoint, the pathological condition of dumping syndrome closely resembles that of reversible shock. That is it is considered that various symptoms of circulatoty system disorders appear because a decrease in cardiac output and increase in ventricular work load are present, and peripheral circulatory insufficiency is induced. 5) It is believed that peripheral circulatory insufficiency, observed after glucose loading, activates catecholamines and also acclerates peripheral circulatory insufficiency and an increase in ventricular work load. According to these considerations, the presence of catecholamines like serotonin, is an indispensable factor in the onset of dumping syndrome.