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Pathology - Gastroparesis
Pathophysiology
Although it can also be idiopathic, diabetes and surgery are the most prevalent causes of gastroparesis. Normal stomach motility requires the sympathetic and parasympathetic (vagal) neural systems to work in concert with the enteric nervous system. Neuronal or GI smooth muscle loss of function is possible. Although the exact process relating to diabetes is unknown, it is consistent with other signs of advanced diabetic disease, such as nephropathy (see the patient's elevated serum creatinine level) and neuropathy (notice the patient's sensory loss). In this instance, nutritional anemia, brittle hair and skin, and fat loss are signs of malnutrition brought on by gastroparesis. There is dehydration, as evidenced by tachycardia and low blood pressure. Hypokalemia and metabolic alkalosis have been caused by prolonged vomiting. The use of a feeding tube or prokinetic medication may be part of the therapy. Based on the broad intestinal gas shown on the radiograph, this patient may also have weak intestinal motility.
Pathophysiology
Although it can also be idiopathic, diabetes and surgery are the most prevalent causes of gastroparesis. Normal stomach motility requires the sympathetic and parasympathetic (vagal) neural systems to work in concert with the enteric nervous system. Neuronal or GI smooth muscle loss of function is possible. Although the exact process relating to diabetes is unknown, it is consistent with other signs of advanced diabetic disease, such as nephropathy (see the patient's elevated serum creatinine level) and neuropathy (notice the patient's sensory loss). In this instance, nutritional anemia, brittle hair and skin, and fat loss are signs of malnutrition brought on by gastroparesis. There is dehydration, as evidenced by tachycardia and low blood pressure. Hypokalemia and metabolic alkalosis have been caused by prolonged vomiting. The use of a feeding tube or prokinetic medication may be part of the therapy. Based on the broad intestinal gas shown on the radiograph, this patient may also have weak intestinal motility.
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