Thirty six patients suffering from continuous upper abdominal pain
complicating gastric surgery for peptic ulcer disease were diagnosed as
alkaline reflux gastritis (ARG). The diagnosis was based on the standard
clinical, endoscopic and histopathological criteria of ARG. Thirteen pa
tients had previous vagotomy and gastrojejunostomy, 12 had Billroth II
gastric reconstruction, 4 had Billroth I gastroduodenostomy, 4 had uagotomy
and pyloroplasty and 3 patients had vagotomy and antrectomy.
Medical treatment was successful in controlling the symptoms in 24
patients 166.7%) who had mild and moderate ARG, but failed in 12 pa
tients (33.3%) with severe incapacitating symptoms. Roux-en-y was the
advocated surgical procedure in these 12 patients. The procedure was fol
lowed by complete relief of pain as well as marked improvement in the
endoscopic and histopathologic evidence of ARG in 100% of cases. Post
operative delayed gastric emptying was noted in 3 patients 125%1 but improued
ujith conservative treatment. |
