STUDY OF GASTRIC AND GALL BLADDER EMPTYING USING REAL TIME ULTRASONOGRAOHY IN CASES OF HELICOBACTER PYLORI GASTRITIS

Abstract

Since the discovery of H.pylori in the gastric mucosa. it has been studied as a cause of delayed gastric and gall bladder emptying, gastritis, gastroduodenal ulcers as well as other gastrointestinal and extragastrointestinal diseases. H.pylori has been strongly linked to delayed gastric and gall bladder emptying and non ulcer dyspepsia. which have shown to improve rapidly after eradication of the organism. Many researchers thus tried to discover the exact relation between H.pylori and different conditions and how H.pylori exerts such effects as well as determining accurate methods of detection of the bacteria and its effects.

This study was carried out to evaluate the effect of H.pylori on gastric and gall bladder emptying and how to clarifY this effect using non invasive techniques. For this purpose 20 patients with H.pylori associated gastritis were studied. All patients were subjected to thorough investigations especially barium meal or gastroscopy, H. pylori serology and stool for H.pylori antigen, B-mode real time abdominal ultrasonography using 3.5 MHz probe to study gastric and gall bladder emptying.

Results showed that 7 patients had suffered from delayed gastric emptying and 8 patients had delayed gall bladder emptying. Gastric­ hydrosonography detected antral wall thickness more than 5 mm in 70% of our patients. sludges in 35%, bulbogastric reflux in 35%, nodularity of antral wall in 20%.

Therefore, this study concluded that: I. H.pylori is a cause of delayed gastric and gall bladder emptying and can be evaluated accurately by real time ultrasonography. 2. In all abdominal sonographic examination for dyspeptic patients, the stomach should be assessed through hydro-gastric sonography technique to detect increased antral thickness or other associated signs of gastritis like antral wall nodularity, sludges and bulbogastric reflux. The most common cause of these findings is H.pylori infection. Its detection rate is about 80%. 3. Follow up abdominal ultrasonography may be the easiest method to detect resolution of gastritis after treatment of H.pylori.