bubble_chart Overview

Gastric retention, also known as delayed gastric emptying, refers to the accumulation and delayed emptying of stomach contents. If vomiting occurs with food ingested 4 to 6 hours prior, or if the gastric residual volume exceeds 200ml after fasting for more than 8 hours, it indicates the presence of gastric retention. This condition is divided into organic and functional types. The former includes pyloric obstruction caused by peptic ulcers, as well as primary or secondary tumors in the gastric antrum or adjacent organs that compress or block the pylorus, which will not be discussed in this article.

bubble_chart Etiology

Functional gastric retention is mostly caused by gastric atony. Additionally, gastric motility disorders resulting from gastric or other abdominal surgeries, central nervous system diseases, diabetic neuropathy, and vagotomy can also lead to this condition. Uremia, acidosis, hypokalemia, hypocalcemia, systemic or intra-abdominal infections, severe pain, severe anemia, as well as the use of antipsychotic and anticholinergic drugs may also contribute to the disease.

bubble_chart Clinical Manifestations

Vomiting is the main manifestation of this disease and can occur day or night, ranging from once to several times a day. The vomitus often consists of retained food and generally does not contain bile. Epigastric fullness and pain are also common. Abdominal pain may present as dull pain, colicky pain, or burning pain. Symptoms may temporarily improve after vomiting. Acute cases can lead to dehydration and electrolyte imbalances, while chronic cases may result in malnutrition and weight loss. Severe or prolonged vomiting can cause alkalosis due to the significant loss of gastric acid and potassium ions, leading to tetany.

Physical examination may reveal signs of dehydration, epigastric distension, and tenderness in the mid-upper abdomen accompanied by a succussion splash. The presence of a gastric outline with enhanced peristaltic waves moving from left to right often suggests gastric outlet obstruction. If only a gastric outline is observed without peristaltic waves, it may indicate gastric atony.

bubble_chart Auxiliary Examination

Varying degrees of anemia, hypoalbuminemia, electrolyte and acid-base imbalances, and prerenal azotemia may be observed.

bubble_chart Diagnosis

If there is vomiting of retained food or a splashing sound in the abdomen when fasting, it indicates gastric retention. Confirmation can be obtained by aspirating food from the stomach cavity through a gastric tube 4 hours after eating.

During a gastrointestinal barium meal examination, if 50% of the barium remains after 4 hours or if it has not been emptied after 6 hours, these findings serve as evidence for this condition. It is important to differentiate between organic and functional gastric retention. The former is characterized by increased gastric motility, while the latter involves reduced gastric tone and decreased gastric motility.

bubble_chart Treatment Measures

Remove the cause of the disease, administer Motilium, and implement fasting and gastrointestinal decompression if necessary.