متلازمة الإغراق المتأخرة مع نقص السكر التفاعلي الذي يحدث بعد 1–3 ساعات من تناول الوجبة

References

• Late dumping syndrome usually occurs 1–3 h after a meal and is characterized by (reactive) hypoglycaemia.
• The modified OGTT is considered positive for late dumping syndrome based on the development of late (60–180 min after ingestion) hypoglycaemia (<50 mg/dl).
• Constant enteral nutrition via a feeding jejunostomy can be effective for the management of refractory dumping syndrome.
• Continuous enteral feeding via a gastrostomy tube can be effective for the management of dumping syndrome after Nissen fundoplication.
• Patients with severe hypoglycaemia after RYGB who do not respond adequately to dietary modification and pharmacologic intervention should be considered for surgical re-intervention.
• The association between hypoglycaemia after RYGB and nesidioblastosis that might result in serious and refractory neuroglycopenic symptoms might be resolved with pancreatic resection (distal, subtotal and total pancreatomies — distal pancreatectomy with or without splenectomy is the most common).