title: Total gastrectomy for rare refractory gastroparesis in patient with syringomyelia: A good impact on quality of life.
abstract: Syringomyelia is a chronic progressive disease of the spinal cord. In symptomatic patients, bilateral sensory motor signs and symptoms prevail, moreover they can develop gastrointestinal disorders, although few studies have succeeded in explaining this correlation so far. We report a case of a 67-year-old woman with a history of pain in the back-lumbar spine and lower limbs, paresthesia and urinary incontinence. MRI revealed syringomyelia, extended from T3 to the medullary cone. Neurological picture was worsened by progressive and increasingly debilitating gastrointestinal symptoms refractory to dietary changes and medical treatment. Blood tests, gastrointestinal investigations and imaging were all normal apart from scintigraphy which confirmed delayed gastric emptying. The neurological symptoms disappeared after removal of an hemangioblastoma of the medullary cone. The persistent gastroparesis was treated by total gastrectomy with complete resolution of the patient's gastrointestinal symptoms.
authors.affiliation: Department of General Surgery, C.S. General and Emergency Surgery, Azienda Ospedaliera - IRCCS Arcispedale Santa Maria Nuova, Avenue Risorgimento 80, 42123 Reggio Emilia, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Zizzo
authors.affiliation: Department of General Surgery, C.S. General and Emergency Surgery, Azienda Ospedaliera - IRCCS Arcispedale Santa Maria Nuova, Avenue Risorgimento 80, 42123 Reggio Emilia, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Lanaia
authors.affiliation: Department of Internal Medicine and Medical Specialties, S.S.D. Post-Acute Long-term Care, Extensive Rehabilitation - Palliative Care, Azienda Ospedaliera - IRCCS Arcispedale Santa Maria Nuova, Avenue Risorgimento 80, 42123 Reggio Emilia, Italy.
authors.forename: Aurelio
authors.initials: A
authors.lastname: Negro
authors.affiliation: Department of Internal Medicine and Medical Specialties, C.S. Medicine II - Angiology, Azienda Ospedaliera - IRCCS Arcispedale Santa Maria Nuova, Avenue Risorgimento 80, 42123 Reggio Emilia, Italy.
authors.forename: Rosaria
authors.initials: R
authors.lastname: Santi
authors.affiliation: Department of General Surgery, C.S. General and Emergency Surgery, Azienda Ospedaliera - IRCCS Arcispedale Santa Maria Nuova, Avenue Risorgimento 80, 42123 Reggio Emilia, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Bonilauri
keywords: CT, Computed Tomography; FDA, Food and Drug Administration; GERD, Gastro-Esophageal Reflux Disease; Gastric scintigraphy; MRI, Magnetic Resonance Imaging; MVGS, Modified Visick Grading System; Refractory gastroparesis; Syringomyelia; Total gastrectomy