Korean Journal of Gastrointestinal Endoscopy 2004;29(2): 70-74.
당뇨병성 위마비증 환자에서 유문륜내 보툴리눔독소의 주사 치험 4예
김민수·이용찬·박효진·이정은·정연수·박종관·안철우·이현철
연세대학교 의과대학 내과학교실
Pyloric Injection of Botulinum Toxin for Treatment of Diabetic Gastroparesis: A Report of Four Cases
Min Su Kim, M.D., Yong Chan Lee, M.D., Hyojin Park, M.D., Jung Eun Lee, M.D., Yon Soo Jeong, M.D., Jong Kwan Park, M.D., Chul Woo Ahn, M.D. and Hyun Chul Lee, M.D.
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
Abstract
Gastroparesis is a disorder of gastric motility that results in delayed gastric emptying. Up to 58% of patients with diabetes mellitus may have diabetic gastroparesis, a syndrome characterized by nausea, vomiting, early satiety, and bloating. The pathophysiology of this disorder is not completely understood, but it is believed to include fundic dysaccommodation, a decrease in gastroduodenal pressure gradient and antral hypomotility. In addition to antral and fundic dysfunction, patients with diabetes may typically have pyloric dysfunction or spasm. Treatment consists of a change in diet to small volume, frequent meals and the use of the prokinetic agents. This case report describes the four patients with severe diabetic gastroparesis whose symptoms persisted despite of dietary changes and the use of prokinetic agents in high doses. All of them were treated with pyloric injection of botulinum toxin and three had significant symptomatic and scintigraphic improvement. (Korean J Gastrointest Endosc 2004;29:7074)
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