Duodenal stasis

　　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.

　　Five etiologies

　　1, Congenital abnormalities:Such as congenital peritoneal band compression and traction blocking the duodenum; congenital narrowing or occlusion of the distal duodenum, compression of the descending segment of the duodenum by annular pancreas; giant duodenum produced by duodenal dysplasia, and duodenum seriously prolapsed due to congenital variation, which can fold the duodenojejunal angle and close it, thus causing stasis.

　　2, Tumors:Benign and malignant tumors of the duodenum; retroperitoneal tumors such as kidney tumors, pancreatic cancer, lymphoma; metastatic cancer of the duodenum, enlarged lymph nodes (cancer metastasis), mesenteric cysts, or compression of the duodenum by abdominal aortic aneurysm.

　　3, Inflammatory diseases and diseases of the distal or proximal jejunum of the duodenum:Such as progressive systemic sclerosis, Crohn's disease, and inflammatory adhesions or compression caused by diverticulitis, etc.

　　4, Adhesions and traction of the duodenum after cholecystectomy and gastric surgery:Adhesions, ulcers, stenosis, or input loop syndrome after gastrojejunal anastomosis.

　　5, Other congenital malformations:Duodenal inversion, cholecysto-duodenal mesocolic band causing duodenal obstruction; superior mesenteric vein in front of the duodenum; abnormal position of the Vater's ampulla (the common bile duct opens into the third part of the duodenum).

　　It is prone to complications of intestinal obstruction, and long-term vomiting can lead to disordered water and electrolyte metabolism.

　　1, Intestinal obstruction:Duodenal contents are obstructed in the intestines. It is a common acute abdominal condition, which can be caused by various factors. At the initial stage, the obstructed intestinal segment has both anatomical and functional changes, followed by the loss of body fluids and electrolytes, intestinal wall circulation disorders, necrosis, and secondary infection. Finally, it can lead to sepsis, shock, and death.

　　2, Disordered water and electrolyte metabolism:Water and electrolytes are widely distributed in and outside the cells, participating in many important functions and metabolic activities in the body, and play a very important role in maintaining normal life activities. The dynamic balance of water and electrolytes in the body is achieved through the regulation of the nervous and humoral systems. Common disorders of water and electrolyte metabolism in clinical practice include hyperosmotic dehydration, hyposmotic dehydration, isosmotic dehydration, edema, water intoxication, hypokalemia, and hyperkalemia.

　　1, Symptoms

　　Mainly characterized by epigastric pain and fullness, often occurring during or after eating, with nausea and vomiting of bile-like substances. Sometimes, due to epigastric fullness, people may vomit on their own to relieve symptoms. This condition presents with periodic recurrence, gradually worsening, and is often accompanied by constipation.

　　2, Signs

　　Visible gastric shape and peristalsis, positive epigastric tympany, and audible abdominal water lapping sound and increased intestinal sounds.

　　Patients with gastric and duodenal inflammation, tuberculosis, and tumors should try to eat easily digestible foods, and pay attention to avoiding postoperative adhesions after abdominal surgery.

　　Eat easily digestible foods such as congee, noodles, mantou, bun, dumpling, soft cake, soft rice, etc., chew slowly, which is convenient for full digestion and absorption.

　　Eat less legumes, onions, potatoes, sweet potatoes, and other foods that are easy to produce acid and gas, avoid cold and greasy foods, avoid spicy foods, avoid drinking alcohol, and avoid adverse factors stimulating ulcers.

　　Especially recommended for nourishing the stomach and spleen: yam lotus and lily porridge, peanut red bean millet porridge, which can add eggs, minced meat, chicken puree, fish puree, minced vegetables, fruit particles, milk, etc. for seasoning, to increase nutrition.

　　1. Barium meal examination:Visible signs of duodenal stasis and dilatation, or a sudden blockage of barium at some place in the duodenum, sometimes retrograde peristalsis can be seen.

　　2. Gastroscopy:It can be found that there is an obstruction cause in the duodenal cavity and the obstruction site is blocked by gastroscopy.

　　3. Aspiration of duodenal juice on an empty stomach:Food residues and other residues can often be found.

　　1. What foods are good for the body for duodenal stasis?

　　Non-irritating, low in fiber, easy to digest, and nutritionally sufficient diet, with a balanced diet and nutrition.

　　2. What foods should be avoided for duodenal stasis?

　　Quit smoking and drinking, avoid eating stimulating, hard, and other foods in terms of diet.

　　(The above information is for reference only, for detailed information, please consult a doctor)

　　First, non-surgical treatment

　　Rest, elevate the foot of the bed, abdominal massage. Aspirate and flush the duodenum, consume a diet rich in nutrition without residue, and take a left lateral position, prone position, or chest-knee position after eating. The temporary effect can be achieved by taking atropine, phenobarbital, and other drugs orally.

　　Second, surgical treatment

　　1. Duodenojejunostomy:It is suitable for obstruction of the third segment of the duodenum, the operation requires the jejunum to be 10-15cm away from the Treitz ligament, and to anastomose with the dilated third segment of the duodenum, the anastomosis should be at least 5cm to prevent the smooth passage of intestinal contents.

　　2. Gastrojejunostomy:It can be used when there are many adhesions around the duodenum and it is difficult to expose, in order to avoid the occurrence of intestinal fistula.