Gastroparesis

Preliminary Diagnosis: Gastroparesis

I. What imaging technique is first-line for this diagnosis?

Contrasted fluoroscopic upper GI examination

II. Describe the advantages and disadvantages of this technique for diagnosis of gastroparesis.

Advantages

• Highly portable examination

Disadvantages

• Has limited sensitivity and is poorly specific in detailing gastroparesis compared to a nuclear medicine gastric emptying test

• May expose patients to a large amount of radiation

• Highly operator dependent

III. What are the contraindications for the first-line imaging technique?

• May be contraindicated in pregnant patients

IV. What alternative imaging techniques are available?

• Nuclear medicine technetium-99m sulfur colloid gastric emptying examination

V. Describe the advantages and disadvantages of the alternative techniques for diagnosis of gastroparesis.

Nuclear medicine technetium-99m sulfur colloid gastric emptying examination

Advantages

• Gold standard for diagnosis of gastroparesis

• Highly sensitive and specific in detailing gastroparesis

Disadvantages

• Time-consuming and must be performed over 4 hours

• Radiopharmaceuticals may not be given to pregnant patients or those breastfeeding

• Offers limited evaluation of the surrounding anatomic structures

VI. What are the contraindications for the alternative imaging techniques?

Nuclear medicine technetium-99m sulfur colloid gastric emptying examination

• May not be given to pregnant patients or those breastfeeding