Transient severe distributive shock due to early dumping syndrome: a case report

J Med Case Rep. 2018 Sep 13;12(1):259. doi: 10.1186/s13256-018-1800-2.

Abstract

Background: Early dumping syndrome characterized by palpitation, dizziness, cold sweat, feebleness, and abdominal symptoms, occurs within 30 minutes after meals in patients who have undergone gastrectomy. This case report describes the case of a patient who presented with severe distributive shock due to early dumping syndrome; he recovered within a few hours after massive fluid infusion and vasopressor administration.

Case presentation: Our patient was a 68-year-old Japanese man who underwent total gastrectomy for gastric cancer and was diagnosed as having late dumping syndrome. On admission, he developed severe shock and was treated with massive fluid administration. Based on the history of the present illness, past medical history, normal findings of blood chemistry test, transient course, and Sigtad score, which helps diagnose dumping syndrome, early dumping syndrome was considered the cause of severe distributive shock.

Conclusions: Early dumping syndrome can cause severe shock requiring massive fluid infusion and vasopressor administration. It should be considered a cause of severe distributive shock in patients who have undergone gastrectomy.

Keywords: Early dumping syndrome; Gastrectomy; Hyperlactatemia; Hypotension; Norepinephrine.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Blood Pressure
  • Dumping Syndrome / diagnosis*
  • Dumping Syndrome / etiology
  • Dumping Syndrome / physiopathology
  • Dumping Syndrome / therapy
  • Fluid Therapy
  • Gastrectomy / adverse effects*
  • Humans
  • Male
  • Shock / diagnosis*
  • Shock / physiopathology
  • Stomach Neoplasms / surgery*
  • Vasoconstrictor Agents / therapeutic use

Substances

  • Vasoconstrictor Agents