キンジヨウ　タカヒコ   KINJIYOU Takahiko   金城　貴彦    所属   医学部 医学科（東京女子医科大学病院）    職種   助教
論文種別	症例報告
言語種別	英語
査読の有無	査読あり
表題	Hypotensive Dumping Syndrome in Hypertrophic Obstructive Cardiomyopathy
掲載誌名	正式名：JMA Journal ISSNコード：2433-328X/2433-3298
掲載区分	国内
出版社	Japan Medical Association
巻・号・頁	8(1),pp.295-297
総ページ数	2
著者・共著者	Takahiko Kinjo†*, Shogo Hamaura, Hirofumi Tomita
担当区分	筆頭著者,責任著者
発行年月	2025/01/15
概要	A 79-year-old woman with hypertrophic obstructive cardiomyopathy (HOCM) (Figure 1) was admitted for pneumonia (Figure 2) and require intubation and mechanical ventilation. Severe hypotension with restlessness was reproducibly induced 30 min after feeding using a nasogastric tube. We diagnosed the patients with early dumping syndrome because gastrointestinal radiography revealed that the nasogastric tube tip was positioned at the gastric pylorus (Figure 3), whereas the duodenum was immediately contrasted. Post-feeding hypotension no longer occurred after the tube tip was pulled back into the gastric body. Dumping syndrome without previous gastric surgery was also reported when a nasogastric tube (1) or gastrostomy tube (2) was positioned in the duodenum. Reduction of preload and vasodilation exacerbates left ventricular outflow obstruction in patients with HOCM (3). Early dumping syndrome, which is characterized by rapid flushing of the hyperosmolar feed into the intestine and subsequent fluid distribution and vasodilation, may cause severe hypotension in patients with HOCM.
DOI	DOI: 10.31662/jmaj.2024-0194