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Non-ulcer dyspepsia is a frequent clinical entity characterized by chronic upper gastrointestinal symptoms without organic lesions by radiology, sonography or endoscopy. We studied simultaneously the rate of gastric emptying and gallbladder contraction in 10 patients with non-ulcer dyspepsia and in 10 healthy controls after ingestion of 500 cc of isotonic saline, and 500 cc of a liquid mixed meal, hypercaloric and hyperosmotic. The measurements were done by direct real-time ultrasonic imaging in fasting and were repeated at regular intervals (15-30 minutes) after the liquid meal, until complete gastric emptying was established. We found with the liquid mixed meal, the patients with non-ulcer dyspepsia had a significant delay in gastric emptying and gallbladder hypokinesis with faulty contraction and slow refilling. Dynamic ultrasonographic studies are useful in patients with non-ulcer dyspepsia.

The rate of gastric emptying of different liquid solutions was measured in 80 voluntary normal young male subjects (mean age 19.9 +/- 1.6 years) by direct real-time ultrasonic imaging. Multiple US scans were repeated at regular intervals (15-30 minutes) until complete gastric emptying was established, after ingestion of 500 cc of 8 different liquid test meals: isotonic saline, 50% glucose, 5% glucose, 40 g of proteins, 20 g of protein, 40 g of fat, 20 g of fat and mixed (carbohydrates, proteins and fat). Eight groups of ten subjects were studied, each one with a different test meal. Three types of gastric emptying were identified: slow (177 +/- 12 minutes) in subjects receiving 50% glucose, 40 and 20 grs of proteins and mixed test meals; intermediate (83 +/- 9 minutes) with 5% glucose, 40 and 20 g of fat; rapid (40 +/- 6 minutes) with isotonic saline. The mixed diet had the slowest emptying time (210 +/- 6 min). Our results are in accordance with published data regarding gastric motor physiology and demonstrates the usefulness of ultrasound in the study of gastric emptying of fluids.

This paper reports a case of an histological non aggressive thymoma with myasthenic symptoms as the first clinical manifestation. Three years after its complete surgical resection liver metastases appeared without evidence of intrathoracic neoplastic disease. The extrathoracic metastases are uncommon and the thymomatous myasthenia gravis is present in 25 to 50% of cases. We reviewed the literature and analyzed its clinical pathological characteristics and therapeutics approach.