A 40 years old male underwent Billroth-II gastrectomy for gastric ulcer. After 3 weeks of surgery, when patient was having dinner, patient collapsed within 20 minutes of meals. What is the most probable reason?
**Core Concept**
The patient underwent Billroth-II gastrectomy, which involves the removal of the lower portion of the stomach and the creation of a gastrojejunostomy. This type of surgery can lead to complications related to the altered anatomy and physiology of the gastrointestinal tract.
**Why the Correct Answer is Right**
The most probable reason for the patient's collapse after meals is **dumping syndrome**. Dumping syndrome occurs when food, especially sugar, moves too quickly from the stomach to the small intestine. This rapid movement of food can cause a sudden drop in blood sugar levels, leading to hypoglycemia. The symptoms of dumping syndrome can include abdominal cramps, nausea, vomiting, diarrhea, and, in severe cases, hypoglycemic shock.
In the context of Billroth-II gastrectomy, the creation of a gastrojejunostomy can lead to the formation of a short gastric stump, which can increase the risk of dumping syndrome.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because it does not directly relate to the complications associated with Billroth-II gastrectomy. While hemorrhage is a potential complication of surgery, it is not directly related to the patient's symptoms of collapsing after meals.
**Option B:** This option is incorrect because it is not a direct consequence of Billroth-II gastrectomy. While anastomotic leak is a potential complication of surgery, it would typically present with symptoms such as abdominal pain, fever, and abdominal tenderness, rather than sudden collapse.
**Option C:** This option is incorrect because it is not a direct consequence of Billroth-II gastrectomy. While gastritis can occur after surgery, it would typically present with symptoms such as abdominal pain and nausea, rather than sudden collapse.
**Option D:** This option is incorrect because it is not a direct consequence of Billroth-II gastrectomy. While small bowel obstruction can occur after surgery, it would typically present with symptoms such as abdominal pain, vomiting, and constipation, rather than sudden collapse.
**Clinical Pearl / High-Yield Fact**
Dumping syndrome is a common complication of Billroth-II gastrectomy, and it is essential to educate patients about the symptoms and management of dumping syndrome to prevent severe complications.
**Correct Answer:** C. Dumping syndrome.