Retained antrum syndrome

Retained antrum syndrome is a medical condition that occurs when a portion of the gastric antrum is inadvertently left behind after a surgical procedure, typically a gastrectomy or Billroth II procedure. This retained antrum can continue to produce gastrin, a hormone that stimulates the secretion of gastric acid, leading to complications such as peptic ulcers and gastritis.

Pathophysiology

The gastric antrum is the lower portion of the stomach that plays a crucial role in the regulation of gastric acid secretion. It contains G cells that secrete gastrin. When a part of the antrum is left behind after surgery, it can lead to excessive gastrin production, resulting in increased gastric acid secretion. This hyperacidity can cause recurrent peptic ulcers and inflammation of the gastric mucosa.

Causes

Retained antrum syndrome is most commonly associated with incomplete surgical resection during procedures such as:

• Gastrectomy
• Billroth II procedure
• Partial gastrectomy

Symptoms

The symptoms of retained antrum syndrome are similar to those of peptic ulcer disease and may include:

• Epigastric pain
• Nausea
• Vomiting
• Gastrointestinal bleeding
• Weight loss

Diagnosis

Diagnosis of retained antrum syndrome typically involves a combination of clinical evaluation, laboratory tests, and imaging studies. Common diagnostic methods include:

• Endoscopy
• Gastrin level measurement
• CT scan or MRI

Treatment

The primary treatment for retained antrum syndrome is surgical resection of the retained antrum. This may involve:

• Revision surgery to remove the remaining antrum
• Medications to reduce gastric acid secretion, such as proton pump inhibitors or H2 receptor antagonists

Prognosis

With appropriate surgical intervention, the prognosis for patients with retained antrum syndrome is generally good. However, if left untreated, the condition can lead to severe complications such as recurrent peptic ulcers and gastrointestinal bleeding.

Related Pages

• Gastrectomy
• Billroth II
• Peptic ulcer
• Gastritis
• Gastrin
• G cells
• Proton pump inhibitors
• H2 receptor antagonists