Tohoku J. Exp. Med., 1999, 187 (2)

Does the Stomach Remain Silent after Neonatal Loss of Its Original Pacemaker ?: Gastric Motility in Long-Term Survivors of Neonatal Gastric Rupture

TOSHIO CHIBA, RYOJI OHI, TAKAMICHI KAMIYAMA, SHIGEHIKO YOSHIDA and MICHIO HONGO1

Department of Pediatric Surgery, and 1Department of Psychosomatic Medicine, Tohoku University School of Medicine, Sendai 980-8574

  • Gastric peristaltic contractions are controlled by an intrinsic electrical pacemaker located in the mid-body along the greater curve. This study was undertaken to investigate gastric motility in long-term survivors of neonatal gastric rupture who were surgically deprived of their original pacemaker. Four patients, 1 boy and 3 girls, aged between 6 and 12 years were studied. Physiological activity of the gastric remnant was assessed in terms of electrical as well as peristaltic functions by means of electrogastrography and video-recorded barium swallow study. Electrical and mechanical pacing activities were classified into normogastria or dysrhythmia (brady- or tachygastria) according to their frequencies. In these patients, ectopic pacemakers were found to be arising just distal to the site of resection along the greater curve. Electrophysiologically, one patient was diagnosed as having normogastria, and other 3 patients were found to have dysrhythmia (2, bradygastria; 1, tachygastria) on the basis of electrogastrographic analyses. In two of three patients studied further by fluoroscopy, electrical activity agreed well with peristaltic activity. In one patient, however, electrical tachygastria was associated with peristaltic bradygastria. In conclusion, an ectopic pacemaker arises in the stomach that does not remain silent after neonatal surgical loss of its own pacemaker. Noninvasive electrogastrography seems useful in assessing electrical potentials generated by the ectopic pacemaker.
    Key words--- gastric electrical activity; gastric mechanical motility; neonatal gastric rupture; ectopic pacemaker; electrogastrography
    © 1999 Tohoku University Medical Press

    Tohoku J. Exp. Med., 1999, 187, 89-97
    Address for reprints: Toshio Chiba, M.D., The Fetal Treatment Center, University of California, San Francisco, 513 Parnassus Avenue, HSW-1601, San Francisco, CA 94143-0570, USA.
    e-mail: chiba@itsa.ucsf.edu

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