Acute Diabetic Gastric Atony

THE PUBLISHED OBSERVATIONS of gastric atony occurring in diabetic patients leave one confused as to the significance and clinical course of this condition. The standard reference books¹on diabetes mellitus refer to gastric atony only in connection with diabetic coma or precoma states. Kassander²in a recent article used the term "gastroparesis diabetacorum" to describe cases ofasymptomaticgastric dilatation and retention occurring in patients with peripheral diabetic neuropathy. Kassander, and Gould and McAfee³have theorized that this condition is due to visceral diabetic neuropathy involving the vagus nerve, since the clinical and radiographic findings are similar to those seen in patients who have undergone vagotomy. More recently, Wooten and Meriweather⁴have described gastric atony which, in some instances, was abrupt in onset and associated with considerable difficulty of diabetic control. However, some of their cases were patients in diabetic acidosis. The gastric atony which they