Benign duodenal stasis syndrome

　　There are many causes of this disease, and the most common is the compression of the duodenum by the superior mesenteric artery (accounting for 50%), which is also known as superior mesenteric artery syndrome.
　　Other causes include:
　　① Congenital abnormalities: such as congenital peritoneal band compression and traction blocking the duodenum; congenital narrowing or obstruction of the distal duodenum, annular pancreas compressing the descending segment of the duodenum; giant duodenum produced by duodenal maldevelopment, and the duodenum due to congenital variation seriously prolapsed, which can cause the duodenal jejunal angle to be folded and closed, thus producing an accumulation.
　　② Tumors: benign and malignant tumors of the duodenum; retroperitoneal tumors such as renal tumors, pancreatic cancer, lymphoma; metastatic cancer of the duodenum, enlarged lymph nodes (cancer metastasis), mesenteric cysts, or abdominal aortic aneurysm compressing the duodenum.
　　③ Duodenal distal or proximal jejunal infiltrative diseases and inflammation: such as progressive systemic sclerosis, Crohn's disease, and inflammatory adhesion or compression caused by diverticulitis leading to stricture.
　　④ Adhesion and traction of the duodenum after gallbladder and stomach surgery: adhesion, ulcer, stricture, or input loop syndrome after gastric jejunal anastomosis.
　　⑤ Other congenital malformations: duodenal inversion, biliary duodenal colonic cord caused by duodenal obstruction; abnormal position of the prehepatic portal vein and Vater's ampulla (bile duct opening at the third part of the duodenum).

　　If benign duodenal stasis cannot be relieved and occurs chronically, it can lead to weight loss, dehydration, and malnutrition throughout the body. It has a negative impact on the patient's daily life, threatens health, and it is necessary to receive timely treatment.
　

　　1. Symptoms
　　Mainly manifested as upper abdominal pain and fullness, usually occurs during or after eating, with nausea and vomiting of bile-like substances, and sometimes vomiting on purpose due to upper abdominal fullness to alleviate symptoms. This condition presents periodic recurrence, gradually worsens, and is often accompanied by constipation.

　　2. Signs and symptoms
　　Visible gastric shape and peristaltic waves; positive upper abdominal tympany, can hear the sound of water in the abdomen and the loud bowel sounds.

　　It is advisable to have small meals frequently in daily life, perform the knee-to-chest position for half an hour after meals, and also strengthen the abdominal muscle exercise.
　　Methods to strengthen the abdominal muscle strength:
　　First, side bending waist exercise Stand upright, spread the legs apart, extend the arms to the sides, bend the upper body forward, reach the right foot with the left hand while the right arm is naturally raised, do not bend the legs and arms, inhale, and then return to the original position, exhale. Repeat in the opposite direction once, and do 8 times in total.
　　Second, leg bending exercise Lying on the back, place both arms flat on the ground with the palms facing down, extend the legs straight and then simultaneously bend the knees to lift them, inhale and bring the thighs close to the abdomen, then exhale and slowly return to the original position. Repeat 8 times.
　　3. Leg Lift and Abdominal Draw-in Mainly to exercise the lower abdominal muscles. Lie flat on the back, extend the legs straight and as high as possible, then slowly lower them. After completing this exercise, bend the knees and continue the same action. Repeat 8 times.
　　4. Seated Bending Body Mainly to exercise the muscles of the upper and lower abdomen. Lie on the back, extend the legs straight, arch the back to maintain body balance, then bend the knees and pull in the abdomen to make the abdominal muscles extremely flexed. During the exercise, the feet should not touch the ground or bed.
　　5. "Bicycle Riding" Exercise Lying on the back, flex and extend the two legs alternately, imitating the movement of riding a bicycle, with quick and flexible movements, and the range of flexion and extension should be as large as possible. Last for 20 to 30 seconds.
　　6. Twisting Waist Hold the handle or pull a heavy object of a certain weight, and perform various twisting and turning exercises in various postures to exercise the external oblique muscles and lumbar muscles.
　　The above exercises can be chosen according to individual conditions, and the amount of exercise should be gradually increased from less to more, twice a day.

　　Endoscopic Examination:The stasis phenomenon of the duodenum can be clearly seen.
　　X-ray Barium Meal Examination Characteristics:The horizontal part of the duodenum shows a broken barium column (suddenly vertically cut off); the near segment of the obstructed intestinal tract shows strong forward and backward peristalsis forming a pendulum movement; when in prone position, the barium passes smoothly and the backward peristalsis disappears.
　　If necessary, selective superior mesenteric artery angiography can be performed to show the anatomical relationship between the duodenum and the superior mesenteric artery.

　　Rest, fasting, gastric lavage, fluid replacement, and other treatments should be given during the attack of benign duodenal stasis. After symptoms subside, semi-liquid food, less eating and more meals, and prone or left lateral position after meals should be adopted. Pay attention to healthy diet and nutrition in daily life.

　　Individuals without obvious symptoms do not need to be treated. During the acute attack, intravenous nutrition including fat emulsion, nasogastric tube decompression, and antispasmodic drug treatment for acute gastric dilatation should be given. In daily life, it is advisable to eat small and frequent meals, perform knee-chest position for half an hour after meals, and strengthen abdominal muscle exercises. If conservative internal medicine treatment is not obvious, surgical treatment can be adopted. The surgical methods that can be chosen include: ① Freeing the duodenal ligament; ② Duodenal-jejunal anastomosis; ③ Duodenal reduction surgery.