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Gastro-duodenal syndrome
Last reviewed: 07.07.2025
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The stomach and duodenum are functionally closely interconnected, and their pathology is accompanied by the development of gastroduodenal syndrome. Examination and treatment of such patients are carried out by therapists or gastroenterologists. The competence of surgeons includes only complicated forms of peptic ulcer disease, polyps and polyposis, oncological processes.
Acute gastroduodenal syndrome occurs with a clinical picture of food toxicoinfection: nausea, vomiting of food masses without bile, headache, weakness, malaise, hypotension and tachycardia. When palpating the abdomen, moderate tension of the abdominal wall in the upper abdomen is noted, without symptoms of peritoneal irritation, pain in the epigastrium and right hypochondrium (pain symptoms of Kocher, Boas, Oppenhovsky). When such a patient is admitted to a surgeon, it is necessary to call an infectious disease specialist for consultation (to exclude food toxicoinfection and botulism) and perform an emergency FGDS for differential diagnostics of pathology: acute ulcers, extensive erosive gastritis, acute ulcers that are dangerous due to bleeding. In acute gastritis and duodenitis, signs of acute inflammation are revealed endoscopically; deserotic areas of the mucosa are often found, which often bleed (there may also be massive bleeding).
Chronic gastroduodenal syndrome occurs in the form of periodic exacerbations, often seasonal in nature.
Exacerbations are accompanied by pain in the upper abdomen, usually immediately after eating or after 1-2 hours, often evening and night "sucking" pain, nausea, heartburn, hiccups, regurgitation, less often vomiting, which brings relief. Hidden bleeding is often noted. The patient gradually turns pale and loses weight, weakness and fatigue develop. Basically, such a picture is given by pylorospasm and pyloric stenosis, gastric ulcer and duodenal ulcer, polyps, chronic gastritis and duodenitis, reflux syndrome.
Of course, if such a syndrome is present, the patient should be fully examined, first of all, using FGDS and X-ray examination of the stomach, observing the principle of oncovigilance.
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