Upper GI Results are in... can someone translate?

kjaccaud
on 3/5/09 11:35 pm - San Carlos, CA
So, my upper GI results are in.... and they are in a foreign language!

Can someone help?

"The gastric remnant is unremarkable in appearance.  The gastrojejunostomy is widely patent.  The visualized segments of mesenteric small bowel are grossly unremarkable.  Barium reaches the colon within 30 - 60 minutes after initial ingestion.  The terminal ileum is unremarkable."

"Impression: 1. Status post gastric bypass with widely patent gastrojejunostomy. 2. Intermittent very small herniation of a portion of the gastric remnant throughout the diaphragmatic hiatus."

Does any of this mean anything to anyone?

It's all a totally foreign language to me. :-)
charleston-mom
on 3/6/09 4:04 am
Essentially - everything is fine, normal, with slight hernia. Part of your stomach is intermittently (just at times) herniating (going up through) the opening at your diapraghm. You're okay.

If it's the esophageal hiatus at the diaphragm, then you have a small hiatal hernia.
kjaccaud
on 3/6/09 4:11 am - San Carlos, CA
Normal for someone that's had a Roux-en-y or normal for someone without a Roux-en-y? 

This was a test to see what was going on since the roux-en-y to see where things were, why I had gained back all of my weight, etc.

Does this give any hints?

Sorry for the questions :-(

I'm sure you can imagine, I'm quite anxious.
LosingSally
on 3/6/09 11:31 am

Your gastric bypass is normal. Your stoma is open and unobstructed. Your small bowel is normal, with nothing remarkable about it. Meaning nothing abnormal in the appearance.

You seem to have a small hiatial hernia. This is normal for those with or without RNY. It is a defect, but many people have it.

Nothing in the report shows any problem with your RNY. It would seem your gain was from something other than failure of your surgery.

mipo1
on 3/6/09 12:23 pm - Lowell, MA
Gastrojejunostomy widely patent= no restriction.   Restriction is a big part of how the RNY works.
Probably your Dr will want an upper endoscopy which is the only reliable way to measure the opening. I think fresh post op RNY the opening is somewhere around 15 mm  and I recall them saying in the study I was in at Brigham and Womens that most who regain weight for this reason the opening was 25-30 mm and people were not feeling much if any restriction 
LosingSally
on 3/7/09 2:05 pm
The words " widely patent" in a EGD report regarding a stoma after RNY means exactly this: "open and unobstructed".It does NOT mean WIDE as in too big. The report is saying she has a typical RNY. If it meant to say her stoma was enlarged, it would say " remarkable for enlarged stoma" or " remarkable for 10cm stoma or 40mm stoma" or words similiar. A new post-op would have about a 2cm opening, which is about an .8 inch wide.
This is the language that would also be used if a blockage of the small intestines were suspected, and ruled out. It would also say widely patent. Widely patent does not mean no restriction, in fact her report doesn't mention restriction at all.
My last EGD indicated I had a typical RNY stoma, unremarkable and widely patent. Size was about the size of a nickle, larger than immediately post-op, but not considered enlarged.
mipo1
on 3/8/09 12:25 am - Lowell, MA
However we disagree in the wording, the only way to accutately tell the size of the opening in by measuring it during an upper endoscopy.  The Contrast barium x ray is not exact enough
LosingSally
on 3/8/09 12:46 am
You are correct, a Barium swallow wouldn't measure a stomal opening.
But the term widely patent has the same meaning in any surgical report or EGD or barium swallow or barium follow-through. It would mean in this case the stoma is unobstructed, and the barium flowed through. The word " patent" in and of itself means " of no clinical significance'!
Widely patent therefore means as I said open and unobstructed, and nothing remarkable was found.  I think if the barium had fallen through the stoma in 2 minutes, or in less time than was to be expected for a RNY stoma, it would have been noted, since that was the purpose of the test, to see why she was regaining weight.
The reason for her gain could be many things including too little intestine bypassed in the first place. Or her stoma could be intact, but her stomach pouch could have been made too big to begin with.
mipo1
on 3/8/09 9:03 am - Lowell, MA
 You know much more than I do about this it appears
pepsi98
on 3/6/09 10:31 pm - Norwich, CT
On March 6, 2009 at 7:35 AM Pacific Time, kjaccaud wrote:
So, my upper GI results are in.... and they are in a foreign language!

Can someone help?

"The gastric remnant is unremarkable in appearance.  The gastrojejunostomy is widely patent.  The visualized segments of mesenteric small bowel are grossly unremarkable.  Barium reaches the colon within 30 - 60 minutes after initial ingestion.  The terminal ileum is unremarkable."

"Impression: 1. Status post gastric bypass with widely patent gastrojejunostomy. 2. Intermittent very small herniation of a portion of the gastric remnant throughout the diaphragmatic hiatus."

Does any of this mean anything to anyone?

It's all a totally foreign language to me. :-)
"the gastrojejunostomy is widely patent"---in other words the opening into your intestine is very wide probably allowing you to eat more because the food leaves your pouch quickly.
 "The Joy of the Lord is your strength."  Nehemiah 8:10


START:  330         CURRENT:  274.5 lbs         GOAL:  190          TOTAL:  55.5 lbs

 



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