Gastro-duodenal syndrome
Last reviewed: 23.04.2024
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The stomach and 12 duodenum are functionally closely interrelated, and their pathology is accompanied by the development of gastroduodenal syndrome. Survey and treatment of such patients is carried out by therapists or gastroenterologists. The competence of surgeons includes only complicated forms of peptic ulcer, polyps and polyposis, oncoprocesses.
Acute gastro-duodenal syndrome occurs with a clinical picture of food poisoning: nausea, vomiting food without bile, headache, weakness, malaise, hypotension and tachycardia. When palpating the abdomen, there is a moderate tension in the abdominal wall in the upper abdominal floor, without symptoms of irritation of the peritoneum, pain in epigastrium and right hypochondrium (painful symptoms of Kocher, Boas, Oppenkovsky). When such a patient arrives to the surgeon, it is necessary to call for an infectious disease doctor (for the elimination of food poisoning and botulism) and to perform emergency FGS for differential diagnosis of pathology: acute ulcers, extensive erosive gastritis, acute ulcers, which are dangerous for bleeding. In acute gastritis and duodenitis endoscopically revealed signs of acute inflammation, often found deserosized areas of the mucosa, which often bleed (there may be massive bleeding).
Chronic gastro-duodenal syndrome occurs in the form of periodic exacerbations, often of a seasonal nature.
Exacerbations are accompanied by pain in the upper abdomen, usually immediately after meals or after 1-2 hours, often night and night "sucking" pain, nausea, heartburn, hiccough, regurgitation, less often vomiting that brings relief. Often there are hidden bleedings. The patient gradually pales, and grows thin, weakness and fatigue develop. Basically such a picture, give pylorospasm and pyloric stenosis, peptic ulcer of stomach and duodenum, polyps, chronic gastritis and duodenitis, reflux syndrome.
Of course, in the presence of such a syndrome, the patient should be fully examined, first of all, with the use of FGS and fluoroscopy of the stomach, with observance of the principle of on-care.
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