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Endoscopic signs of duodenostasis
Last reviewed: 06.07.2025
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Chronic duodenal obstruction (duodenostasis) is a polyetiological process leading to a violation of passage through the duodenum and accompanied by duodenogastric reflux. These disorders exist for a long time and are not the result of inflammatory changes. The disease was first described in 1901. Chronic duodenal obstruction can be:
- Primary.
- Secondary. Occurs against the background of duodenal ulcer, chronic liver and pancreas diseases.
Classification of duodenostasis.
- Functional nature. Disorders of the autonomic innervation of the duodenum.
- Mechanical nature. Congenital anomalies, arterio-mesenteric obstruction, massive cicatricial periduodenitis and unusual fixation of the intestine with a violation of its shape at the transition to the jejunum.
During endoscopy, the diagnosis of "Chronic duodenal obstruction" can be made based on 3 criteria:
- Presence of duodenogastric reflux.
- Condition of the gastric mucosa (reflux gastritis).
- Diameter and shape of the duodenum.
Duodenogastric reflux. Characteristic endoscopic signs of duodenogastric reflux:
- Pyloric gape. Occurs in 82%.
- The flow of bile from the duodenum into the stomach.
- The presence of inflammatory changes in the gastric mucosa, especially in the antral section along the lesser curvature. There may be reflux gastritis and reflux esophagitis. The condition of the gastric mucosa: hyperemia and edema, mainly in the antral section.
Biopsy in reflux gastritis: a decrease in mucus formation in the cells of the superficial epithelium, alveolar hyperplasia of the glandular pits, the appearance of corkscrew-shaped glands, invasion of leukocytes of the interstitial tissue up to the formation of microabscesses, foci of intestinal metaplasia are determined.
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