Retained antrum syndrome

Q) True about retained antrum syndrome after gastrectomy  are all except

a) It is a persistent hypergastrinemic state

b) It is only seen after Billroth II Gastrectomy

c) Technetium labelled food is not helpful in diagnosing this condition

d) Serum gastrin is usually less than 1000 pg/ml

Answer c

 After billroth II gastrectomy, if a cuff of gastric mucosa remains with duodenum, this entity is called as retained antrum syndrome. This cuff of gastric mucosa is cut off from the proximal stomach and inhibitory effect of hormones such as VIP (Vasoactive Intestinal Peptide)  leading to a persistent hypergastrinemic state. ALso this gastric mucosa is continuously bathed by the alkaline contents of duodenum , which further increases the acid formation.

Both Basal and maximal gastric acid outputs increase but it is not as high as seen in zollinger ellison syndrome. Typically less than 1000 pg/ml

This condition can present as recurrent and persistent ulcerations. Technetium scanning is the diagnostic modality of choice. Treatment is re do surgery and antral excision.

Technetium pertechnate imaging has a sensitivity of 73% and specificity of 100%

More about retained antrum syndrome