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Gastric Emptying in Male Neurologic Trauma

Department of Nuclear Medicine, Taichung Veterans General Hospital, Taichung; Department ofNuclear Medicine, Chung-Shan Medical and Dental College Hospital, Taichung; Department ofNuclear Medicine, National Taiwan University Hospital and Chang Gung Memorial Hospital, Taipei, Taiwan, Republic of China

Correspondence: For correspondence or reprints contact: Chia-Hung Kao, MD, Department of Nuclear Medicine, Taichung Veterans General Hospital, 160 Taichung Harbor Road, Section 3, Taichung 40705, Taiwan, Republic of China.

ABSTRACT

Prolonged gastric emptying half-time (GET1/2) has been observed in several neurological disorders. Most patients with moderate to severe neurologic trauma (NT) initially do not tolerate enteral or nasogastric feedings. However, previous findings of altered gastric emptying (GE) in patients with NT have been questionable. Quantitative measurements of GE, to determine a possible mechanism for intolerance to enteral feeding, are lacking. In this study, we measured GET1/2 sec of solid and liquid meals by radionuclide imaging in men who were neurologic trauma patients. Methods: A prospective study was conducted to assess GET1/2 in 30 men who were patients with spinal cord injuries (SCIs) and 20 men who were patients with head injuries (HIs) using radionuclide-labeled solid and liquid meals, respectively. Meanwhile, 18 and 14 male control subjects underwent the same imaging technk@ues for solid and liquid meals, respectively, to evaluate the normal ranges of solid and liquid GET1/2 sec (84.5 ± 16.7 and 29.2 ± 3.7 min). Results: In the 30 SCI patients, GET1/2 of solid meals was significantly prolonged (138.3 ± 49.2 min, p < 0.05), and 53% (16/30) of patients had abnormal GET1/2. A more prolonged GET1/2 and a higher incidence of abnormal GET1/2 were observed in patients with high level injury, when compared with patients with low-level injury (p < 0.05). In the 20 HI patients, GET1/2 of lk@uidmeals was prolonged significantly (51 .7 ± 24.8 min, p < 0.05), and 65% (13/20) of patients had abnormal GET1/2. Coma, as indicated by the Glasgow Coma Scale score, was not a Statistically sigflificant factor influencing GET1/2 (p >0.05). Conclusion: NT can cause significantly prolonged GE, especially in patients with high-level SCI.

Key Words: gastric emptying • neurologic trauma • head injury • spinal cord injury