{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T05:29:53Z","timestamp":1790659793939,"version":"4.1.0"},"reference-count":34,"publisher":"American Physiological Society","issue":"2","funder":[{"DOI":"10.13039\/501100001505","name":"Manatu Hauora | Health Research Council of New Zealand (HRC)","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001505","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"HHS | National Institutes of Health (NIH)","doi-asserted-by":"publisher","award":["DK068055"],"award-info":[{"award-number":["DK068055"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"New Zealand Medical Technologies Centre of Research Excellence"},{"DOI":"10.13039\/501100001511","name":"Auckland Medical Research Foundation (AMRF)","doi-asserted-by":"publisher","award":["Edith C. Coan Postdoctoral Fellowship"],"award-info":[{"award-number":["Edith C. Coan Postdoctoral Fellowship"]}],"id":[{"id":"10.13039\/501100001511","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American Journal of Physiology-Gastrointestinal and Liver Physiology"],"published-print":{"date-parts":[[2019,8,1]]},"abstract":"<jats:p> Postsurgical gastric dysfunction is common, but the mechanisms are varied and poorly understood. The pylorus normally acts as an electrical barrier isolating gastric and intestinal slow waves. In this report, we present an aberrant electrical conduction pathway arising between the stomach and small intestine, following pyloric excision and surgical anastomosis, as a novel disease mechanism. A patient was referred with postsurgical gastroparesis following antrectomy, gastroduodenostomy, and vagotomy for peptic ulceration. Scintigraphy confirmed markedly abnormal 4-h gastric retention. Symptoms included nausea, vomiting, postprandial distress, and reflux. Intraoperative, high-resolution electrical mapping was performed across the anastomosis immediately before revision gastrectomy, and the resected anastomosis underwent immunohistochemistry for interstitial cells of Cajal. Mapping revealed continuous, stable abnormal retrograde slow-wave propagation through the anastomosis, with slow conduction occurring at the scar (4.0\u2009\u00b1\u20090.1 cycles\/min; 2.5\u2009\u00b1\u20090.6 mm\/s; 0.26\u2009\u00b1\u20090.15 mV). Stable abnormal retrograde propagation continued into the gastric corpus with tachygastria (3.9\u2009\u00b1\u20090.2 cycles\/min; 1.6\u2009\u00b1\u20090.5 mm\/s; 0.19\u2009\u00b1\u20090.12 mV). Histology confirmed ingrowth of atypical ICC through the scar, defining an aberrant pathway enabling transanastomotic electrical conduction. In conclusion, a \u201cgastrointestinal aberrant pathway\u201d is presented as a novel proposed cause of postsurgical gastric dysfunction. The importance of aberrant anastomotic conduction in acute and long-term surgical recovery warrants further investigation. <\/jats:p><jats:p> NEW &amp; NOTEWORTHY High-resolution gastric electrical mapping was performed during revisional surgery in a patient with severe gastric dysfunction following antrectomy and gastroduodenostomy. The results revealed continuous propagation of slow waves from the duodenum to the stomach, through the old anastomotic scar, and resulting in retrograde-propagating tachygastria. Histology showed atypical interstitial cells of Cajal growth through the anastomotic scar. Based on these results, we propose a \u201cgastrointestinal aberrant pathway\u201d as a mechanism for postsurgical gastric dysfunction. <\/jats:p>","DOI":"10.1152\/ajpgi.00002.2019","type":"journal-article","created":{"date-parts":[[2019,6,6]],"date-time":"2019-06-06T13:51:52Z","timestamp":1559829112000},"page":"G141-G146","source":"Crossref","is-referenced-by-count":38,"title":["Slow-wave coupling across a gastroduodenal anastomosis as a mechanism for postsurgical gastric dysfunction: evidence for a \u201cgastrointestinal aberrant pathway\u201d"],"prefix":"10.1152","volume":"317","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6200-2384","authenticated-orcid":false,"given":"Tim H.-H.","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Surgery, University of Auckland, Auckland, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy R.","family":"Angeli","sequence":"additional","affiliation":[{"name":"Auckland Bioengineering 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