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Endoscopic signs of duodenosis
Last reviewed: 23.04.2024
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Chronic duodenal obstruction (duodenostasis) is a polyethological process leading to a violation of the passage through the duodenum and accompanied by duodenogastric reflux. These violations exist for a long time and are not the result of inflammatory changes. The disease was first described in 1901. Chronic duodenal obstruction occurs:
- Primary.
- Secondary. It occurs against the background of peptic ulcer of the duodenum, chronic liver and pancreas diseases.
Classification of duodenosis.
- Functional nature. Violations of autonomic innervation of the duodenum.
- The mechanical nature. Congenital anomalies, arterio-mesenteric obstruction, massive cicatricial periduodenitis and unusual fixation of the intestine with a violation of its shape at the site of the transition to the jejunum.
With endoscopy, the diagnosis of "Chronic duodenal obstruction" can be made based on 3 criteria:
- The presence of duodenogastric reflux.
- The condition of the gastric mucosa (reflux gastritis).
- Diameter and shape of the duodenum.
Duodenogastric reflux. Characteristic endoscopic signs of duodenogastric reflux:
- The gaze of the gatekeeper. It is noted in 82%.
- Entry of bile from the duodenum into the stomach.
- The presence of inflammatory changes in the gastric mucosa, especially in the antrum part of the small curvature. There may be reflux gastritis and reflux esophagitis. The state of the gastric mucosa: hyperemia and edema, mainly in the antrum.
Biopsy with reflux gastritis: a decrease in mucus in the cells of the superficial epithelium, alveolar hyperplasia of glandular pits, the appearance of corkscrew glands, the invasion of leukocytes of interstitial tissue, up to the formation of microabscesses, foci of intestinal metaplasia.
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