The article highlights the current views on the famous long ago, but until now little studied issue of long-term effects on gastric resection caused by peptic gastro-duodenal disease. The problem of complications that occur after gastrectomy is widely represented in modern literature, but, unfortunately, it does not explain the origin of various hormonal disorders that underlie at the appearance of hormone-metabolic syndrome – one of the manifestations of postgastroresection disease. Ascertaining the nature of postgatroresection complications that should be the key to successful treatment of postgastroresection disease, is complicated with the fact that until now there is still not fully understood question of the role of genetic, constitutional, emotional, immune, endocrine, infectious agents and metabolic and vegetative characteristics of the organism in the etiology and pathogenesis of ulcer disease.

In this article we want to describe the clinical case of a patient who was hospitalized to the Gastroenterology Department of the Lviv Regional Clinical Hospital during the period of 03.04.2013 till 04.18.2013.

The patient had atypical for such patients survey, including measured hormone levels in the serum: growth hormone, parathyroid hormone, testosterone (anabolic action) and triiodothyronine, thyroxine, cortisol, glucagon (catabolic action).

Based on clinical signs, results of laboratory and instrumental examinations the following clinical diagnoses was diagnosed: postgastroresection disease, II severity; hormonal-metabolic syndrome; early dumping syndrome: II severity, episodic form. Chronic hyperacid gastritis of gastric stump, acute phase; chronic anastomositis, acute phase; chronic duodenitis of duodenal stump, acute phase. Postgastroresection dystrophy: II severity. Digestive failure: III severity. Multiple dental caries.

The data showed that in the later periods after surgery on complicated peptic ulcer of gastro-duodenal zone resistant dyshormonemy was observed. Only two of the seven studied hormones were within normal limits: parathyroid hormone (anabolic action) and thyroxine (catabolic action). Levels of all other hormones were significantly reduced. Also decreased levels of cyclic nucleotides of the studied serum were observed. The correction of stable dyshormonemy may be the key to solving the problem of the treatment of long-term effects of gastric resection.

Today, it is obvious that the concept of treating of postgastroresection disease need to be improved, as wide represented in modern literature studies, unfortunately, did not explain the origin of various hormonal disorders that underlie the development of hormone-metabolic syndrome – one of the manifestations of postgastroresection disease.

So, perspective studies on hormonal homeostasis characteristics of patients in later periods after gastrectomy, due to peptic ulcer of gastro-duodenal zone, in order to increase the efficiency of the diagnosis and treatment. A detailed study of the characteristics of endocrine homeostasis disorders in these patients could allow us to correct the identified deviation and thus, prevent serious consequences of gastrectomy.

Ключові слова: peptic ulcer, gastrectomy, postgastroresection disease, hormonal homeostasis

Повний текст: PDF (Ukr)