The Possible Effect Of Gastric Endoscopy In Refractory Diabetes Mellitus Gastroparesis (One Case Report)

Background : Diabetes mellitus gastroparesis is defined as adiabetes mellitus patient with the impaired transit of intraluminal contents from the stomach to the duodenum in the absence of mechanical obstruction. It is a disorder of delayed gastric emptying: vomiting gastric contents which were taken 4-6 hours before or having more than 200ml gastric contents left at fasting 8 hours later. It is often occurred in the patients whose levels of fasting plasma glucose are not well controlled, and may be more companied in 1 type diabetes mellitus than 2 type diabetes mellitus. Symptoms of gastroparesis include early satiety, nausea, vomiting, anorexia, gastric emptying delayed, bloating, and weight loss. Generally, gastrokinetic agents could increase gastric fundic or antral contractions and eradicate gastric dysrhythmias. But some patients are refractory to pharmacological therapy, it generally called refractory diabetes mellitus gastroparesis.Clinical Material: This case was a patient with long-term diabetesmellitus, and the level of plasma glucose is not well controlled. The patient subsequently felt nausea and vomit severely. The diagnosis of diabetes mellitus gastroparesis was given after a series of examinations. The gastrointestinal symptoms of patient were refractory topharmacological therapy, but disappeared after the examination of gastric endoscopy.Discussion: In this report, we described a case of refractorydiabetes mellitus Gastroparesis. It was difficult to deal with in practice. Recently, some research considered gastric electrical stimulation (GES) a good way to treat refractory Gastroparesis. Gastric electrical stimulation could activate the gastric pacemaker, and normalize the gastric dysrhythmias and entrain gastric slow waves and accelerate gastric emptying. In this case, we found that gastric endoscopy can relieve the symptoms of nausea and vomiting in the patient by chance. We surmised that gastric endoscopy might have the similar mechanism of gastric electrical stimulation in this case. The report was unusual in clinical practice, so summing up more cases should be done to evaluate the effects of gastric endoscopy in refractory diabetes mellitus gastroparesis. It maybe benefit for medical practice.