A 45-year-old man undergoes proximal gastric vagotomy for treatment of
intractable duodenal ulceration. What physiologic alterations might be
anticipated as a consequence of the operation?
A. Reduction of basal acid secretion by approximately 25%
B. Accelerated gastric emptying of liquids
C. Accelerated gastric emptying of solids
D. Fasting hypergastrinemia
E. Postprandial hyperinsulinemia
A. Reduction of basal acid secretion by approximately 25%
B. Accelerated gastric emptying of liquids
C. Accelerated gastric emptying of solids
D. Fasting hypergastrinemia
E. Postprandial hyperinsulinemia
Ans. B, D. Division of cholinergic vagal fibers
directly affects parietal cell acid secretion by reducing stinrulatory input.
Basal acid secretion is diminished by approximately 80% and maximal acid output
in response to pentagastrin stimulation is reduced by about 70%. Fasting
hypergastrinemia and an exaggerated gastrin response to meal ingestion is
observed due to loss of feedback inhibition of gastrin release and gastrin cell
hyperplasia. Release of pancreatic polypeptide, secretin and cholecystokinin
may be decreased.
Proximal gastric vagotomy accelerates gastric emptying of liquids due to a loss of receptive relaxation. In contrast, gastric emptying of solids is usually not affected by proximal gastric vagotomy.
Proximal gastric vagotomy accelerates gastric emptying of liquids due to a loss of receptive relaxation. In contrast, gastric emptying of solids is usually not affected by proximal gastric vagotomy.
