Hypergastrinemia, gastric endocrine cell hyperplasia, and intractable diarrhea.

A patient with pernicious anemia developed severe intractable diarrhea night and day. Investigation revealed chronic atrophic gastritis and a markedly elevated level of serum gastrin. No obvious explantation for the diarrhea was found, but after antrectomy, the gastrin level returned to normal and the diarrhea subsided.

Use of secretin in the roentgenologic and biochemical diagnosis of duodenal gastrinoma.

The use of secretin in the biochemical and roentgenologic diagnoses of a duodenal gastrinoma has been described. Preoperatively, the secretin test indicated that a gastrinoma and not a retained antrum was the cause of hypergastrinemia in a patient who had previously undergone Billroth II gastrectomy. Intravenous infusion of secretin during selective angiography resulted in greatly enhanced visualization of the tumor which allowed it to be localized to the duodenal stump.

Metoclopramide for gastroparesis diabeticorum.

Three patients with uncontrolled diabetes mellitus and with symptoms due to gastric retention proved to have gastroparesis diabeticorum. The diagnosis was established by the beefsteak-barium meal. After the administration of metoclopramide, gastric emptying improved and the diabetes was easily controlled.

The butterfat absorption test in adults.

The usefulness of the butterfat absorption test in assessing fat absorption has been studied in 89 adult patients. In 42 patients who were shown to have steatorrhea by the criteria of the fat balance studies, 33 patients (78.6%) had abnormally low serum optical density values following butterfat ingestion.

Fecal chymotrypsin and trypsin determinations.

Trypsin and chymotrypsin concentrations were determined in 180 spot stool specimens from 110 control patients in hospital. The lower limit of normality for each enzyme was placed at the 5% level: 95% of this population excreted feces containing more than 100 mug. of chymotrypsin and 30 mug.

The pancreozymin-secretin test after partial gastrectomy.

The administration of pancreozymin and secretin to eight control patients and 18 patients after partial gastrectomy caused no rise in serum amylase levels above normal. Four postgastrectomy patients had unexplained elevations of basal serum lipase levels but in only one did the lipase increase above the basal level after stimulation.Duodenal aspirates from the control group and from one patient with a Billroth I gastrectomy showed a wide range of values for volume, bicarbonate and amylase content.

Microscopic examination of stools after partial gastrectomy.

The present study was undertaken to determine the frequency with which undigested meat fibres in the stool could be found after partial gastrectomy. A sample of stool was examined in 61 patients who had undergone a partial gastrectomy and in 92 control patients. The age ranges and average ages of both groups were similar.

THE EFFECTS OF THIETHYLPERAZINE DIMALEATE (TORECAN) ON NAUSEA AND VOMITING.

A double-blind study of thiethylperazine dimaleate (Torecan) and a placebo, given intramuscularly, was carried out on 40 patients with nausea and/or vomiting due to a variety of causes. No effect on these symptoms was noted in five patients who received the drug and in six who received the placebo. Thiethylperazine dimaleate was judged to have a good effect in 14 patients and the placebo in five patients.

IDIOPATHIC STEATORRHEA PRESENTING WITH DIFFERENT MANIFESTATIONS IN SISTERS.

Although it is well known that the incidence of idiopathic steatorrhea is much higher in relatives of patients with this disease than it is in the general population, there has been little comment on the variability of symptoms in familial cases. Two sisters with this disease are reported. One presented with a relatively acute history of diarrhea, weight loss, fatigue and peripheral edema and was found to have a normal hemoglobin, hypocalcemia and a markedly decreased prothrombin activity.

Gastritis of the herniated stomach in patients with esophageal hiatus hernia.

Seven illustrative cases of gastritis of the herniated stomach in patients with sliding esophageal hiatus hernia are reported. Five had superficial gastritis (three mild, one moderate and one severe); two had atrophic gastritis. Gastritis was present in two patients whose mucosa appeared normal at esophagoscopy.