HYPERGASTRINEMIA, DYSURIA-HEMATURIA AND METABOLIC ALKALOSIS - COMPLICATIONS ASSOCIATED WITH GASTROCYSTOPLASTY

Purpose: To help determine the etiology and most appropriate treatment regimen for hypergastrinemia, dysuria-hematuria and metabolic alkalos is following augmentation gastrocystoplasty. Materials and Methods: Tw o patients who presented with refractory metabolic alkalosis (1 with d ysuria-hematuria) underwent extensive laboratory evaluation, complete upper gastrointestinal evaluation and intravesical pH probe placement. Results: Both patients eventually required high dose oral potassium c hloride supplementation. Bladder mucosal pH was not reflected by buffe red urinary pH. Both patients demonstrated significant gastroesophagea l reflux and diminished overall gastric acid output. Conclusions: Outp atient maintenance on potassium chloride supplementation may be warran ted in select patients and appears to be preferable to histamine block ade or omeprazole. Postoperative screening esophagogastroscopy and an additional surgical maneuver might be indicated to prevent possible ad verse sequelae of reflux esophagitis. Gastrocystoplasty may be an inap propriate operation in children with renal insufficiency who have not had metabolic acidosis.