Hepato Gastroenterol
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Hepato Gastroenterol · Dec 1992
Randomized Controlled Trial Clinical TrialProtecting against the acid aspiration syndrome in adult patients undergoing emergency surgery.
This paper has studied the effect of i.v. cimetidine and ranitidine, given 1 h prior to anesthesia, on gastric volume and pH in three homogeneous groups undergoing emergency surgery. Group I (10 patients) received placebo, group II (20 patients) cimetidine 400 mg in saline solution, and group III (20 patients) ranitidine 150 mg in saline. Standardised premedication was administered and anesthesia induced. ⋯ There were no significant differences in gastric volume among the three groups. However, treated patients had significantly elevated pH as compared with the control group and the number of patients at risk (pH < 2.5 and volume > 25 ml) was significantly smaller at 20% and 15%, respectively, than in the control group (40%). It is concluded that cimetidine 400 mg, and ranitidine 150 mg i. v., given about 70 min. prior to induction of anesthesia may decrease the risk of the acid aspiration syndrome in emergency operations.
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Myotonic dystrophy is an autosomal inherited disorder of both striated and smooth muscle, and is considered to be a rare cause of gastrointestinal dilatation and abnormal peristalsis. We report on a patient with myotonic dystrophy complicated by gastric volvulus. A 57-year-old female with myotonic dystrophy suddenly developed abdominal pain, nausea and vomiting. ⋯ The patient underwent successful emergency gastrectomy. Gastric volvulus is often an unrecognized surgical emergency, but its clinical and radiographic features are so characteristic that accurate diagnosis is possible if the condition is kept in mind. Thus, the clinician should consider the possibility of gastric volvulus when evaluating gastrointestinal complaints in patients with myotonic dystrophy.