Dumping in infancy diagnosed by radionuclide gastric emptying technique

Abstract

Two infants were diagnosed with dumping syndrome by a radionuclide gastric emptying method. Both patients presented with anorexia, weight loss, agitation and diaphoresis following bolus feeding by gastrostomy tube. One had documented hyperglycemia and glycosuria. Symptoms and signs of dumping in one patient were due to a gastrostomy placed in the antrum, whereby bolus tube feedings were inadvertently introduced directly into the duodenum. The second patient developed dumping symptoms after a Waterston colonic interposition was performed to correct a long gap esophageal atresia. Gastric emptying, measured by administering 99mTc-sulfur colloid-labeled formula, demonstrated an initial extremely rapid appearance of isotope in the small intestine, with greater than one-third of the formula leaving the stomach in less than 2 min. The gastric emptying pattern in both patients appeared biphasic; after the initial "dumping" phase, the remaining formula emptied slowly, with monoexponential decay kinetics.