A 46 year old female presented with a chief complaint of post-prandial vomiting containing food particles 2-3 hours after meals, for two months. She also complained of post-prandial fullness that had lasted five years. She had no history of significant weight loss, abdominal pain or altered bowel habits. She was previously diagnosed with Type 2 Diabetes (Controlled , HBA1c 6.7 %) and hypertension, for which she is receiving regular treatment.
The patient was evaluated in the hospital previously and her OGD, contrast enhanced CT abdomen and colonoscopy results were normal. There was partial relief with oral prokinetics.
A 99m Tc Sulphur colloid Solid gastric emptying study showed negligible emptying from the stomach into the intestine during Dynamic study. Significant retention of tracer was noted in the stomach at the end of the study. Emptying at 60 min was 4 %. She was diagnosed with gastroparesis and underwent Gastric POEM after informed consent.
Dr Mohan Ramchandani,
Director of Interventional Endoscopy
Asian Institute of Gastroenterology,
Hyderabad, India