WordNet

washing out a hollow organ (especially the stomach) by flushing with water
relating to or involving the stomach; "gastric ulcer" (同)stomachic, stomachal
rock that in its molten form (as magma) issues from volcanos; lava is what magma is called when it reaches the surface

PrepTutorEJDIC

(特に胃などの)洗浄
胃の,胃に発生する
(火山から噴出する高温の)溶岩;(すでに冷えた)火山岩

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/12/04 06:28:34」(JST)

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Gastric lavage, also commonly called stomach pumping or gastric irrigation, is the process of cleaning out the contents of the stomach. It has been used for over 200 years as a means of eliminating poisons from the stomach. Such devices are normally used on a person who has ingested a poison or overdosed on a drug such as alcohol. They may also be used before surgery, to clear the contents of the digestive tract before it is opened.

Apart from toxicology, gastric lavage (or nasogastric lavage) is sometimes used to confirm levels of bleeding from the upper gastrointestinal tract.^[1] It may play a role in the evaluation of hematemesis. It can also be used as a cooling technique for hyperthermic patients.^[2]

Technique

Gastric lavage involves the passage of a tube (such as an Ewald tube) via the mouth or nose down into the stomach followed by sequential administration and removal of small volumes of liquid. The placement of the tube in the stomach must be confirmed either by air insufflation while listening to the stomach, by pH testing a small amount of aspirated stomach contents, or x-ray. This is to ensure the tube is not in the lungs. In adults, small amounts of warm water or saline are administered and, via a siphoning action, removed again. In children, normal saline is used, as children are more at risk of developing hyponatremia if lavaged with water. Because of the possibility of vomiting, a suction device is always on hand in case of pulmonary aspiration of stomach contents. Lavage is repeated until the returning fluid shows no further gastric contents. If the patient is unconscious or cannot protect their airway then the patient should be intubated before performing lavage. The person must be put to sleep for a period of time during the operation due to its high risk of shock and hyponatremia.

Indications

Gastric lavage is used infrequently in modern poisonings and some authorities have suggested that it not be used routinely, if ever, in poisoning situations.^[3] Lavage should only be considered if the amount of poison ingested is potentially life-threatening and the procedure can be performed within 60 minutes of ingestion.^[4] Lavage is also the initial treatment for duodenal atresia in newborns, a condition where the small intestine is closed distal to the stomach, causing food and fluid to accumulate in the stomach.

Contraindications

Lavage is contraindicated when patients have a compromised, unprotected airway and in patients at risk of gastrointestinal hemorrhage or perforation. Relative contraindications include when the poisoning is due to a corrosive substance (T54), hydrocarbons (T53), or for poisons that have an effective antidote.

Complications

Many complications have been reported, although it appears serious complications are uncommon. The most dangerous risk is aspiration pneumonia, which is more likely to occur if hydrocarbons are ingested or in patients without a protected airway. Other complications include laryngospasm, hypoxia, bradycardia, epistaxis, hyponatremia, hypochloremia, water intoxication, or mechanical injury to the stomach.

References

^ Gary R. Fleisher; Stephen Ludwig; Benjamin K. Silverman (2002). Synopsis of pediatric emergency medicine. Lippincott Williams & Wilkins. pp. 409–. ISBN 978-0-7817-3274-1. Retrieved 4 August 2010.
^ Laura W Kates; Erik D Schraga (12 December 2008). "Cooling Techniques for Hyperthermia: Treatment & Medication". eMedicine. Omaha, Nebraska, USA: Medscape. p. 2. Retrieved 3 Nov 2010.
^ Vale JA, Kulig K; American Academy of Clinical Toxicology; European Association of Poisons Centres and Clinical Toxicologists. (2004). "Position paper: gastric lavage". J Toxicol Clin Toxicol 42 (7): 933–43. doi:10.1081/CLT-200045006. PMID 15641639.
^ "BestBets: Method of gut decontamination".

External links

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UpToDate Contents

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1. 成人の中毒患者における胃洗浄 gastrointestinal decontamination of poisoned adults
2. 成人における急性上部消化管出血へのアプローチ approach to acute upper gastrointestinal bleeding in adults
3. 経鼻胃管と経鼻腸管 nasogastric and nasoenteric tubes
4. 中毒の小児に対する汚染除去 decontamination of poisoned children
5. 成人における薬物中毒への一般的アプローチ general approach to drug poisoning in adults

English Journal

Clinical Significance of Cytological Status of Peritoneal Lavage Fluid During Intraperitoneal Chemotherapy for Gastric Cancer with Overt Peritoneal Dissemination.

Emoto S1, Kitayama J, Ishigami H, Yamaguchi H, Watanabe T.
Annals of surgical oncology.Ann Surg Oncol.2014 Sep 13. [Epub ahead of print]
BACKGROUND: A positive cytology of peritoneal lavage fluid (CY1) is a poor prognostic factor in patients with gastric cancer (GC). We have recently reported that CY1 often changes to negative (CY0) following combination chemotherapy including intraperitoneal (IP) paclitaxel (PTX), which results in m
PMID 25216603

Alleviation of Dermatophagoides microceras-induced allergy by an immunomodulatory protein, FIP-fve, from Flammulina velutipes in mice.

Chang YC1, Hsiao YM, Hung SC, Chen YW, Ou CC, Chang WT, Lue KH, Ko JL.
Bioscience, biotechnology, and biochemistry.Biosci Biotechnol Biochem.2014 Sep 11:1-9. [Epub ahead of print]
Asthma is a major public health concern. Its greatest risk factor is house dust mite (HDM). Dermatophagoides microceras (Der m) is a type of HDM, and in central Taiwan, there is approximately 80% prevalence of sensitization to Der m. FIP-fve is a fungal immunomodulatory protein (FIP) isolated from t
PMID 25209380

Extracellular Histones Play an Inflammatory Role in Acid Aspiration-induced Acute Respiratory Distress Syndrome.

Zhang Y1, Wen Z, Guan L, Jiang P, Gu T, Zhao J, Lv X, Wen T.
Anesthesiology.Anesthesiology.2014 Sep 3. [Epub ahead of print]
BACKGROUND:: Systemic inflammation is a key feature in acid aspiration-induced acute respiratory distress syndrome (ARDS), but the factors that trigger inflammation are unclear. The authors hypothesize that extracellular histones, a newly identified inflammatory mediator, play important roles in the
PMID 25188000

Japanese Journal

症例報告超音波観察下の胃洗浄を行った大量服薬の1症例

鈴木昭広,丹保亜希仁,稲垣泰好 [他]
救急医学 36(9), 1116-1118, 2012-09
NAID 40019436843

Immunological milieu in the peritoneal cavity at laparotomy for gastric cancer

Yoneda Akira,Ito Shinichiro,Susumu Seiya,Matsuo Mitsutoshi,Taniguchi Ken,Tajima Yoshitsugu,Eguchi Susumu,Kanematsu Takashi,Nagata Yasuhiro
World Journal of Gastroenterology 18(13), 1470-1478, 2012-04-07
… AIM: To investigate the immunological repertoire in the peritoneal cavity of gastric cancer patients. … However, the role of lymphocytes in the peritoneal cavity of gastric cancer patients is unclear. … We observed 64 patients who underwent gastrectomy for gastric cancer and 11 patients who underwent laparoscopic cholecystectomy for gallstones and acted as controls. …
NAID 120004754246