Duodenum, duodenum, is the initial section of the small intestine located on the back wall of the abdominal cavity. The length of the duodenum in a living person is 17-21 cm, and in a corpse - 25-30 cm. The intestine begins from the pylorus and then goes around the head of the pancreas like a horseshoe. Four parts are distinguished in it: upper, descending, horizontal and ascending.
Top part,pars superior, starts from the pylorus of the stomach to the right of the XII thoracic or I lumbar vertebra, goes to the right, somewhat posteriorly and upward and forms the upper bend of the duodenum, flexura duode- ni superior, passing to the descending part. The length of this part of the duodenum is 4-5 cm.
Behind the upper part is the portal vein, the common bile duct, and its upper surface is in contact with the square lobe of the liver.
Descending part,pars descendens, starts from the upper bend of the duodenum at level I of the lumbar vertebra and descends along the right edge of the spine downward, where at level III of the lumbar vertebra it turns sharply to the left, resulting in the formation of the lower bend of the duodenum, flexura duodeni inferior. The length of the descending part is 8-10 cm. The right kidney is located posterior to the descending part, the common bile duct runs to the left and somewhat posteriorly. Anteriorly, the duodenum is crossed by the mesentery root of the transverse colon and the liver is adjacent.
Horizontal part,pars horizontalis, starts from the lower bend of the duodenum, goes horizontally to the left at body level III the lumbar vertebra, crosses in front of the inferior vena cava lying on the spine, then turns up and continues v ascending part.
Ascending part,pars ascendens, ends with a sharp bend downward, forward and to the left at the left edge of the body of the II lumbar vertebra - this is a twelve and a hairy-skinny bend, flexura duodenojejunalis, or the junction of the duodenum v skinny. The curvature is fixed to the diaphragm with muscle suspending the duodenum,T.suspensorius duodeni. Behind the ascending part is the abdominal part of the aorta, and at the place of transition of the horizontal part into the ascending one above the duodenum, the superior mesenteric artery and vein pass, entering the mesentery root of the small intestine. Between the descending part and the head of the pancreas there is a groove in which the end of the common bile duct is located. Connected with the pancreatic duct, it opens into the lumen of the duodenum on its large papilla.
The duodenum has no mesentery, it is located retroperitoneally. The peritoneum is adjacent to the intestine in front, except for those places where it is crossed by the root of the transverse colon (pars descendens) and the root of the mesentery of the small intestine (pars hori- sontalis). The initial section of the duodenum is its ampoule ("onion"),ampulla, covered with peritoneum on all sides.
On the inner surface of the duodenal wall are visible circular folds,plicae circuldres, characteristic of the entire small intestine, as well as longitudinal folds that are present in the initial part of the intestine, in its ampulla. Besides, longitudinal fold of the duodenum,plica longitudinalis duodeni, located on the medial wall of the descending part. At the bottom of the fold there is large papilla of the duodenum,papilla duodeni major, where the common bile duct and pancreatic duct open with a common opening. Up from the large papilla is located small papilla of the duodenum,papilla duodeni minor, on which the opening of the accessory pancreatic duct is located. In the lumen of the duodenum open duodenal glands, glandulae duodendles. They are located in the submucosa of the intestinal wall.
Vessels and nerves of the duodenum. The upper anterior and posterior pancreato-duodenal arteries (from the gastroduodenal artery) and the lower pancreatoduodenal artery (from the superior mesenteric artery) are suitable for the duodenum, which anastomose with each other and give the duodenal branches to the intestinal wall. Veins of the same name flow into the portal vein and its tributaries. The lymphatic vessels of the intestine are directed to the pancreatoduodenal, mesenteric (upper), celiac and lumbar lymph nodes. The innervation of the duodenum is carried out by the straight branches of the vagus nerves and from the gastric, renal and superior mesenteric plexuses.
X-ray anatomy of the duodenum. Allocate the initial section of the duodenum called "Onion"bulbus duodeni, which is visible in the form of a triangular shadow, with the base of the triangle facing the pylorus and separated from it by a narrow constriction (contraction of the pylorus sphincter). The top of the "bulb" corresponds to the level of the first circular fold of the duodenal mucosa. The shape of the duodenum varies individually. So, the horseshoe shape, when all its parts are well expressed, occurs in 60% of cases. In 25% of cases, the duodenum is ring-shaped and in 15% of cases, it is in the form of a loop, located vertically, resembling the letter "U". Transitional forms of the duodenum are also possible.
The mesenteric part of the small intestine, into which the duodenum continues, is located below the transverse colon and its mesentery and forms 14-16 loops, covered in front by a large omentum. Only "1/3 of all loops is on the surface and is visible, and 2/3 lie deep in the abdominal cavity and for their examination it is necessary to straighten the intestine. About 2/3 of the mesenteric part of the small intestine belongs to the jejunum and 3 D to the ileum. Clearly. there is no pronounced border between these parts of the small intestine.
Duodenum, duodenum, - a section of the small intestine that originates directly from the stomach. It got its name due to the fact that its length is, on average, 12 times the diameter of a human finger. Basically, it has a horseshoe shape, but there are also ring-shaped and V-shaped. The length of the duodenum is 25-30 cm, and the width is 4-6 cm, its concave edge wraps around the head.
The duodenum is an important organ in the digestive system, into which the ducts of the large digestive glands (and the pancreas) flow. Hormones are formed in its mucous membrane: secretin, pancreosimin-cholecystokinin, gastric inhibitory peptide, vasoactive intestinal peptide, motilin, enteroglucagon, etc. There are four parts in the duodenum:- Top, pars superior,
- Descending, pars descendens;
- Horizontal, pars horizontalis;
and ascending, pars ascendens.
Top part, pars superior, s. bulbus, - the shortest, its length is
3-4 cm, diameter - up to 4 cm. The goalkeeper starts at level II of the lumbar vertebra, goes back and to the right along the right surface of the spinal column, flexura duodeni superior.
From the gate of the liver to the upper part of the duodenum passes the hepato-duodenal ligament, lig. hepatoduodenal, which contains: the common bile duct, portal vein and the hepatic artery itself, lymphatic vessels and nerves. The ligament is important in surgical practice during operations in the pancreatoduodenal region.
Descending part, pars descendens, - has a length of 9-12 cm, a diameter of 4-5 cm. It originates from the upper bend of the intestine, goes arcuate or vertically and reaches the level of III-IV lumbar vertebrae, where it forms the lower bend, flexura duodeni inferior. In the middle part on the left, the common bile duct and the pancreatic duct flow into the intestine, forming longitudinal folds on the mucous membrane, plica longitudinalis duodeni, large duodenal papilla, papilla duodeni major (Vateri).
Above it there may be a small papilla, papilla duodeni minor; An additional pancreatic duct, ductus pancreaticus ascessorius, opens on it. The outflow of bile and pancreatic juice is regulated by the muscle-closure of the hepato-pancreatic ampulla, m. sphincter ampullae (s. Oddi). The closure [sphincter] is formed by bundles of circular, oblique and longitudinal muscle fibers, which intertwine with each other and function independently of the muscles of the intestine.
Horizontal part, pars horizontalis, - has a length of up to 9 cm, passes at the level of III-IV lumbar vertebrae from right to left below the mesentery of the transverse colon.
The ascending part, pars ascendens, is 6-13 cm long, rises to the left edge of the I-II lumbar vertebrae, where the duodenal hollow bend is formed, flexura duodenojejunalis, the place of transition to the empty intestine. The bend is fixed by suspending the muscle of the duodenum, m. suspensorius duodeni s. m. (Treitzi). Muscle fibers arise from the circular layer of the intestine at the bend and rise up behind the pancreas, where they are woven into the fascia and muscle fibers of the left diaphragm. The duodenal bend, due to its fixation on the left side of the second lumbar vertebra, is a cognitive landmark in surgery that helps to find the origin of the jejunum.
Duodenal topography
The duodenum is in complex topographic and anatomical relationships with neighboring organs. It is located in the retroperitoneal space, mainly behind the stomach. The descending part of the intestine is located to the right of the spinal column, and the horizontal parts intersect its median plane. The ascending part of the duodenum is adjacent to the spine on the left.Skeletotopy. The upper part is located at the level of the second lumbar vertebra (sometimes the XII thoracic vertebra). It crosses its median plane from right to left. The descending part of the intestine is adjacent to the right surface of the bodies of the II-III lumbar vertebrae and reaches the lower edge of the III lumbar vertebra. The horizontal part is located at the level of the III lumbar vertebra, it crosses from right to left in the transverse direction of its median plane. The ascending part reaches level II of the lumbar vertebra on the left and goes into a duodenal-empty bend, flexura duodenojejunalis.
Syntopy. The following organs are adjacent to the upper part, pars superior, of the duodenum: from above - the right lobe of the liver, common bile duct, neck of the gallbladder and v. portaer, from below - the head of the pancreas and part of the transverse colon; in front - the left lobe of the liver; behind - hepato-duodenal ligament, lig. hepatoduodenale.
Descending part, pars descendens, the duodenum is limited by such organs: in front - ripples of the transverse colon; behind - by the right kidney and partly by the right ureter. On the posterior surface of the descending part, at its left edge, there is a joint bile duct, ductus choledohus, and a pancreatic duct, ductus pancreatics, which merge in the middle of the descending part. On the left, the head of the pancreas is adjacent to the descending part, and on the right, the loops of the small intestine.
The horizontal part, pars horizontalis, is limited: from above - by the lower edge of the pancreas; from below - loops of the small intestine; behind - the abdominal aorta, on the right - the inferior vena cava; in front - loops of the small intestine.
The ascending part, pars ascendens, is limited: on the right - a. mesenterica superior, from above - the lower surface of the body of the pancreas, the other sides - loops of the small intestine. (The structure of the duodenal wall is examined together with the empty and colon).
Duodenal anomalies
Duodenal anomalies are most often presented in the form of a long and excessively mobile intestine or its separate parts and its reverse location (G.A. Zedgenidze, 1983). At the same time, incomplete lengthening or an increase in the mobility of the intestine can be limited only by the upper horizontal part, and sometimes by capturing the descending part of the intestine. The elongated part of the intestine, due to the presence of its own mesentery, forms bends and loops unusual for it in the norm, which hang down and move within wide boundaries.Bending of the intestine with its atypical location may originate immediately after the bulb or in the area of the lower knee of the duodenum. In this case, the loop of the intestine is deployed not to the left, but anteriorly and to the right, as a result of which the duodenal empty bend is absent.
Blood supply. The blood supply to the duodenum is carried out by the upper and lower pancreato-duodenal artery, aa. pancreaticoduodenals superior et inferior (Branch a. gastroduodenalis and a. mesenterica superior). Venous outflow is carried out through the paired veins of the same name, vv. pancriaticoduodenales superior et inferior, into the superior mesenteric and splenic vein, and then into the portal vein, v. portae.
Lymph flows from the duodenum into the pyloric [portal], right gastric, hepatic, lumbar and superior mesenteric lymph nodes.
Innervation the duodenum is carried out by the branches of the vagus nerves, the hepatic, gastric and superior mesenteric nerve plexus.
Where the duodenum hurts, one wonders who suddenly got a stomach ache. Where is it generally located and what role does it play in the body?
Why is it needed, how and where the duodenum hurts:
Let's look at a simple example:
- You ate at lunch no matter what, just tight. The food you eat will stay in your stomach for about 6 to 8 hours.
- In portions, it begins to accumulate in the upper stomach. Then it is mixed, stacked in layers.
- We must not forget about moderation in food intake. it is possible if you eat your food hastily.
- Then it passes in small portions into the small intestine, which is connected to the stomach. The small intestine begins with the duodenum.
- But in it, with the help of the juices produced by the pancreas, its enzymes, bile from the liver, the breakdown of food begins.
- Carbohydrates, proteins, fats are actively processed.
- All walls of the duodenum are covered with a large number of villi. They all have their own blood vessels, capillaries.
- It is in them that well-decomposed substances are absorbed: such as glucose, amino acids, glycerin.
- Digestion takes place along the entire length of the small intestine.
- Undigested food debris moves into the large intestine, over a period of 12 hours. Most of the water is absorbed into the blood from here.
- In length, it is twelve fingers (fingers). If something does not work in this area, all digestion is disrupted.
Divisions of the duodenum:
- Upper part (level of the first lumbar vertebra). In another way, it is called - a bulb because of its round shape. Length five, six centimeters.
- Descending part (descends to the third lumbar vertebra).
- Horizontal part (level of the third lumbar vertebra).
- The ascending part (ascending to the second lumbar vertebra).
Bends are visible between the sections of the intestine:
- Upper bend.
- Lower bend.
- The place of transition of the duodenum into the jejunum.
Where is the duodenum and how it hurts:
The duodenum is located in the epigastric region, above the navel. Presses on the anterior abdominal wall.
To be precise, it surrounds the pancreas in a horseshoe shape.
Two ducts flow into the intestine from as well as from the pancreas. This place is considered the main one, all digestive enzymes get here. Amylase, lipase, protease begin to break down food.
Based on this, there are five forms of the duodenum:
Forms of the duodenum:
- Up to 60% - horseshoe shape.
- Up to 20% - folded shape.
- Up to 11% - V-shaped.
- Up to 3% - C - shaped.
- Up to 6% - annular.
Duodenal wall structure:
- The mucous membrane itself (absorption of fats, amino acids, glucose).
- Submucosal base.
- Muscular layer (motor-evacuation function).
Where the duodenum hurts, the causes of the pain:
The duodenum is almost the first to pay for our eating disorders, poor water quality, our stress, an eternally driven state of the body.
There are a very large number of different nerve receptors here. They need normal blood supply and nutrition.
In case of failures, everyone suffers, and so does the duodenum.
Bowel diseases can be provoked by:
- Diabetes.
- Cholelithiasis.
- Heredity.
Inflammatory process of the duodenum:
The so-called duodenitis.
Where it hurts with this disease:
- Or on the right side just below the ribs (dull pain).
- Nausea.
- Or in the epigastric region.
- After eating, the stomach is bursting to the sides.
- Vomit.
- Refusal to eat,
- weight loss.
Dangerous development of duodenitis (or inflammation of the gallbladder) or pancreatitis (inflammation). An ulcer often develops.
All these organs are located side by side and communicate with each other. Usually they say - these organs get sick together.
Bowel inflammation can be caused by:
Any viral infection: (Helicobacter pylori) is the most known to us.
When diagnosed, treatment is prescribed:
- Antibiotics (only with a doctor's prescription, taking into account all tests). They are treated with them for two weeks to eliminate the infection.
- Proton pump inhibitors are given along with antibiotics to protect the intestinal and stomach lining.
- Antispasmodics: dratoverin, but - shpa, papaverine.
- Anthracites to reduce pain and acidity in the intestines: almagel, omeprazole.
- Maalox is prescribed for intestinal dysfunction.
- Physiotherapy: magnetotherapy, ultrasound, paraffin therapy, warming up.
Foods that increase the production of stomach acid are removed from the diet.
Food is taken warm. Meals are frequent, in small portions.
Forbidden:
- Fatty, fried foods, broths.
- Sour fruits.
- Spices (pepper, vinegar, salt, mustard).
- Alcohol, nicotine.
- Freshly squeezed fruit and vegetable juices.
- Smoked, salted products.
- Mushrooms.
- Pickled foods.
- Carbonated sweet drinks.
- Coffee Tea.
- Raw vegetables, fruits.
- Legumes.
Allowed:
Steamed or boiled food is prepared.
- Vegetable fats (olive, sunflower oil).
- Slimy, boiled soups.
- Low-fat boiled meat (chicken, turkey).
- Boiled fish.
Bowel cancer:
The disease is not at all rare in our time.
Early symptoms:
The pain is felt immediately on the right side just under the ribs, with spread to other organs.
- You are constipated and have to take laxatives.
- Blood in stool when defecating. Do not disdain, look into the toilet - this is the work of your body.
- Blood should be, if it is present, of red color (black color, cherry color is not excluded).
- Constant urge to defecate. You went to the toilet, and you need to go there again, even though there is no chair.
- There is a narrowing of the anus.
- Gas begins to form, the stomach swells.
- Jaundice, febrile condition.
- Itchy skin (high bilirubin in the blood, irritated skin receptors). Constant itching leads to insomnia, irritation.
If these symptoms appear and bother you, do not postpone the examination. It saves lives.
Treatment begins with surgery, chemotherapy, and radiation therapy. The size and method of surgery depends on the stage of the disease (organ damage) of the sick person.
Duodenal ulcer where it hurts:
Usually develops in the area of the duodenal bulb.
- A clear digestive disorder stands out.
- Frequent, loose stools torment.
- There is an absolute intolerance to dairy products.
- Plaque on the tongue, yellow (biliary tract spasm).
- The right side hurts, the pain is sharp to an exhausting aching character. It happens in seizures or vice versa for a long time.
- Gives to the lower back or thoracic spine. In some patients, pain is felt in the area of the collarbone.
- Salvation from pain is eating. Such pains are called "hungry".
- The skin is yellowish.
- Scars appear on the sore spots of the mucous membranes.
- Nauseous, vomiting appears.
The treatment is very serious and long-term. Appointed after a full examination for life.
- In order to destroy Helicobacter pylori, antibiotics (erythromycin, metranidazole) are taken.
- To reduce the formation of hydrochloric acid - omeprazole.
- The administration of anthracites reduces pain.
Where the duodenum hurts, diagnosis:
- A gastroscopy endoscope with a small television camera at the end is prescribed. Enter through the mouth into the stomach, then into the duodenum.
- The intestinal mucosa is examined with an endoscope, sore areas are found, and a small piece is taken for analysis (biopsy).
- Determine the cause of the disease for adequate treatment.
Diet food is of great importance in the treatment and recovery of the patient. A significant reduction in the incidence of exacerbations of the disease, improvement of the patient's well-being.
Get diagnosed in time to identify Helicobacter pylori and be treated. Without treatment, you can.
Observe the daily routine, rest in moderation. Try not to eat harmful foods, the body will thank you.
And I wish you and your family health!
Come and see me more often.
Watch the video, all about the duodenum:
The human intestine begins with the duodenum- it is located just behind the stomach and is relatively small compared to other parts of this organ (see photo above). Also called KDP for short.
Why was it called that: Medieval scientists - anatomists did not have modern measuring instruments, and, having measured the length of this organ with their fingers, they received an indicator of 12 fingers in diameter - 25 - 30 cm.
Duodenal functions
The duodenum plays an important role in the entire digestive process. Since it is the initial link of the intestine, the processes of absorption of nutrients from the incoming food and liquid are actively proceeding here. It brings the acid-base index of food to a level that will be optimal for the subsequent stages of digestion in the intestine. It is in this organ that the stage of intestinal digestion begins.
Another integral phase of the work of this part of the intestine is the regulation of pancreatic enzymes secreted by the pancreas, as well as bile, depending on the acidity of the food bolus and its chemical composition.
The duodenum affects the proper functioning of the gastric secretory function, since there is a reverse interaction. It consists in opening and closing the pylorus of the stomach and in humoral secretion.
Evacuation and motor functions.
12 the duodenum carries the functions of further advancement of food gruel, processed with enzymes, into the following section of the small intestine. This is due to the massive muscle layer of the duodenal wall.
Features of the structure of the organ (shape, location, attachment)
The shape of most people is diverse, and even for one total person, both the shape and location of the duodenum can change during life. It can be V-shaped, and resemble a horseshoe, loop and other shapes. In old age, or after weight loss, it is lowered compared to where the duodenum is in young and middle-aged people and overweight. But most often it originates at the level of the seventh thoracic or first lumbar vertebra, located from left to right. Then there is a bend with a descent to the third lumbar vertebra, another bend with an ascent parallel to the upper part, and the intestine ends in the region of the second lumbar vertebra.
It is attached by connective fibers located on the walls to the organs of the abdominal cavity. The least of these attachments is in the upper part of the duodenum, so it is mobile - it can move from side to side.
Duodenal wall structure:
- the serous outer layer performs mechanical protective functions.
- the muscle layer is responsible for the organ's peristalsis during the digestion of food.
- the submucosal layer contains nerve and vascular nodes.
- the inner layer is a mucous membrane, strewn with a large number of villi, folds and depressions.
Bodies adjacent to the KDP
This part of the intestine is in contact with other organs of the abdominal cavity from all sides:
- and the main duct;
- right kidney and ureter;
- the ascending part of the colon.
This anatomical arrangement of the organ has a huge impact on the characteristics and course of diseases that arise in it.
The most common diseases of the duodenum.
- - the most common ailment of the duodenum of an acute or chronic type, manifested in the form of inflammation of the mucous membrane.
- Ulcer- develops as a result of chronic duodenitis. Chronic damage to the duodenum, in which ulcers form in the mucous layer.
- Cancer tumor- malignant neoplasm localized in different layers of the duodenal wall.
Duodenitis
More than 90% of patients develop chronic duodenitis. It can develop due to many factors, including:
- consumption of low-quality products;
- alcohol abuse;
- smoking;
- ingress of foreign bodies and toxic substances;
- other chronic bowel ailments.
This disease manifests itself in the form of epigastric pain of moderate intensity, weakness, belching, heartburn, nausea, turning into vomiting. The symptoms are often accompanied by a fever.
A variation of this inflammatory phenomenon is in which the pathological process takes place only in the bulb of the duodenum. This form of duodenitis does not arise just like that - it is a consequence of other pathologies of the intestine or stomach. Bulbit can be caused by:
- or KDP.
If the disease is at an acute stage, then the person feels pain and nausea and suffers from repeated vomiting. Acute bulbitis develops against the background of prolonged use of a large group of drugs, or poisoning. In the chronic form, there is also a aching pain syndrome, sometimes it can be accompanied by nausea.
Patients also have chronic duodenal obstruction, which occurs against the background of tumor processes, developmental anomalies and other disorders in the duodenum. It is expressed in a violation of the motor and evacuation function in this part of the intestine and is characterized by the following symptoms:
- decreased appetite;
- feeling of heaviness and discomfort in the epigastric region;
- constipation;
- gurgling and gurgling.
The manifestation of this ailment is influenced by the reasons that caused duodenal obstruction, the stage of the course and how long ago the disease arose.
Peptic ulcer
The main reason for this dangerous disease is the reflux of acid from the gastric contents and its destructive effect on the mucous membrane of this part of the intestine. But this pathological process develops only when the surface layers of the intestine cannot cope with their protective functions. The ulcer is localized in the initial part of the duodenum and in the bulb, that is, in the zone of the intestine that is at a minimum distance from the stomach.
Many gastroenterologists unanimously repeat about the negative effect of frequent intake of anti-inflammatory drugs, which lower the protective barrier of the mucous layer of the duodenum. These drugs are aspirin and dosage forms based on it, ibuprofen, diclofenac, etc.... Therefore, if there is such an opportunity, you should limit the intake of drugs in this group as much as possible.
Poorly treated or neglected duodenitis, alcohol abuse and the use of products harmful to the body can also become duodenal ulcer.
It also tends to affect not only the stomach, but also the mucous membrane of the 12 duodenal ulcer. It is a fairly common cause of ulcerative pathology, opening the way for acid in the mucous layers of the intestine. In 19 out of 20 cases of development of an ulcer of this organ, it is the bacterium Helicobacter that is to blame.
Symptoms:
Since this ailment is very common in gastroenterological practice, you should know what kind of symptomatic picture it manifests itself in. This is a paroxysmal pain syndrome in the upper abdomen just below the sternum. during a feeling of hunger or, conversely, immediately after a meal. After eating, symptoms such as:
- nausea;
- urge to use the toilet.
The main dangerous complications of this disease of the duodenum are bleeding or perforation, which require emergency surgical assistance. Bleeding is fraught with dangerous blood loss and filling the abdominal cavity with it. Perforation is when food with all the enzymes and acids enters the abdominal cavity through the ulcer formed in the intestine.
If medical assistance is not provided on time, then such complications can lead to the death of the patient. There are cases in medical practice when a peptic ulcer also turns into a cancerous state.
An ulcer, like other duodenal lesions, is diagnosed by an endoscopy procedure. With this procedure, a gastroenterologist can visually assess the condition of all organs of the digestive system. A blood test may also be needed, especially when it comes to duodenal ulcer caused by the bacterium Helicobacter. Comprehensive diagnostics may include biopsy of the affected area of the intestine - it is carried out directly during the endoscopic examination (a procedure for taking a small volume of the affected tissue for laboratory examination).
Duodenal cancer
, bladder;
According to research by scientists, the components of coffee in combination with nicotine can also affect the development of cancer of the duodenum 12. Therefore, doctors do not recommend getting carried away with coffee: you should limit yourself by making the maximum for a day 2 - 3 cups. Continuous ingestion of carcinogens and chemicals that have a detrimental effect on the entire gastrointestinal tract can also cause duodenal cancer. The unfavorable ecological situation in the region of residence undoubtedly affects the development of many groups of diseases, including oncological ones. Both men and women over 50 are at risk.
This disease is considered insidious, because it is difficult to diagnose at the initial stages of development. The first signs of the disease can be easily confused with common gastrointestinal disorders. Later, pains are added to these sensations with the development of oncology, especially when a person feels hunger, heaviness. The patient feels weak, his appetite disappears and depressive syndrome is observed. This symptomatology is associated with the intoxication process.
A person with duodenal cancer is much more likely to have a normal outcome if the tumor is found in the early stages of development. To make an accurate diagnosis, endoscopy and biopsy of the affected area of the intestine are performed, a complex of laboratory studies (OAK, etc.) is also connected to them. After that, an operation to remove the tumor and the lymph nodes closest to it should be urgently performed.
From all of the above, a simple and logical conclusion can be drawn. The duodenum is, like all organs, a very important part of our body. It performs complex and important functions in the digestive system, so each person should be attentive to their food addictions - if possible, exclude unhealthy foods from their diet and give up bad habits. After all, it is much easier to prevent diseases than to go to doctors and stay in the hospital, hoping to overcome them.
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Interesting
The human body is prone to various diseases. Ailments can affect any internal organ. Duodenal ulcer is no exception. The most famous ailment of this part of the digestive system is a peptic ulcer. For many people, it is associated with the stomach, but in fact, it is associated not only with it. The duodenum is often involved in the pathological process. What is this ailment? What other diseases can affect the duodenum? Before looking for answers to these questions, it is worth considering the structure of the named section of the digestive system.
The structure of the duodenum
The human digestive system is complex. One of its components is the duodenum. It is considered the initial section of the small intestine. The duodenum originates from and ends with the duodenal bend, which passes into the next section of the small intestine (into the jejunum).
Several constituent elements are distinguished in the duodenum:
- the upper part, the length of which is from 5 to 6 cm;
- the descending part, which is 7-12 cm in length;
- the horizontal part, which is 6-8 cm in length;
- the ascending part, equal in length to 4-5 cm.
Duodenal functions
The duodenum performs several important functions:
- This is where the process begins. Food from the stomach is brought here to an alkaline pH that does not irritate other parts of the intestine.
- The duodenum regulates the production of bile and pancreatic enzymes, depending on the chemical composition and acidity of food coming from the stomach.
- The initial one also performs an evacuation function. From it, food gruel from the stomach is sent to other parts of the intestine.
Some diseases that can be associated with the duodenum
One of the diseases that occurs in the duodenum is duodenitis. This term refers to inflammatory and dystrophic changes in the mucous membrane. They arise due to the impact on the body of harmful factors: food toxicoinfections, toxic substances that cause poisoning when they enter the digestive system, spicy food, alcoholic beverages, foreign bodies. With duodenitis, pain is felt in the epigastric region, nausea, vomiting, weakness, body temperature rises.
Diseases of the duodenum also include chronic duodenal obstruction. This is a process that leads to a violation of the passage through the duodenum, i.e., motor and evacuation activity in this part of the digestive system is disrupted. The disease occurs for many different reasons (for example, the presence of tumors, congenital anomalies, etc.). Signs depend on the causes of chronic duodenal obstruction, on the stage of the disease and on how long the duodenum has been affected. Symptoms sick people note in themselves such as discomfort and heaviness in the epigastric region, heartburn, impaired appetite, constipation, gurgling and transfusion in the intestines.
Treatment of duodenitis and chronic duodenal obstruction
Treatment of diseases should be prescribed by a doctor. In order for duodenal ulcer to restore its functions during duodenitis, the following measures may be required:
- hunger for 1 or 2 days;
- gastric lavage;
- appointment of a special diet (No. 1, 1a, 1b);
- the appointment of astringent, enveloping, antacid, antispasmodic, anticholinergic, ganglion-blocking agents, vitamins;
- in some cases, surgery and antibiotic therapy are required.
In chronic duodenal obstruction, treatment of the duodenum 12 requires an individual approach. If the disease provoked a mechanical obstacle, then surgery is performed. In other cases, prokinetics may be prescribed. These drugs have a stimulating effect on the muscles of the gastrointestinal tract, increase the contractile activity, tone of the stomach and duodenum, and make the evacuation of gastric contents faster.
What is meant by a peptic ulcer?
Considering the ailments of the duodenum, special attention should be paid to peptic ulcer disease. This term denotes a serious illness that proceeds in a chronic form with alternating periods of remission and exacerbation. The etiology of this disease is not well understood. It used to be thought that peptic ulcer disease is provoked by substances such as pepsin and hydrochloric acid, which are produced in the digestive system. However, studies have shown that Helicobacter pylori microorganisms play an important role.
Statistics show that the prevalence is between 6 and 15%. This is not to say that a representative of a particular sex is sick less often or more often. Men and women are equally susceptible to this ailment.
Features of duodenal ulcers
Ulcers are damage to the duodenum. They can be compared to erosion. However, these two types of damage have significant differences. Erosion only affects the mucous membrane that lines the duodenum. The ulcer penetrates into the submucosal and muscle layers.
Research shows that ulcers are in most cases at the top. They are localized near the pylorus. Damage diameter varies. Most often, there are ulcers in which this parameter does not exceed 1 cm. In some cases, large ulcers are found. Doctors in their practice met damage to the duodenum, which reached 3-6 cm in diameter.
Clinical manifestations of peptic ulcer
In some people, the disease proceeds imperceptibly, while in others, peptic ulcer disease of the duodenum is manifested with suspicious signs. Symptoms are most often observed as follows:
- recurrent pain localized in the upper abdomen;
- digestive disorders;
- deterioration in a sick person of appetite and weight loss;
- tarry stools;
- bleeding due to erosion of the walls of a blood vessel by gastric juice;
- pain in the back (they arise due to the germination of an ulcer into the pancreas);
- intense pain in the abdomen (they are observed with the perforation of the ulcer, the development of peritonitis).
Of these, the most common symptom is pain. By its nature, it can be different - sharp, burning, aching, vague, dull. Pain usually occurs on an empty stomach (in the morning after waking up). They can also appear after eating in about 1.5-3 hours. Unpleasant sensations are stopped by antacids, food and even a glass of milk or warm water. The fact is that food and drinks, when ingested, partially neutralize the effect of hydrochloric acid. However, after a short period of time, the pain returns again.
Diagnostic procedures for peptic ulcer disease
The diagnosis of "duodenal ulcer" cannot be made only by symptoms and external examination of a sick person, because the above symptoms are characteristic of a wide range of diseases. The listed symptoms may hide not only a duodenal ulcer, but also gallstone disease, pancreatitis, benign tumors, etc.
A suitable and reliable method for diagnosing peptic ulcer disease is fibrogastroduodenoscopy. During this study, a special instrument with a light source and a camera is inserted through the mouth into the stomach to examine the mucous membrane of the digestive system. The image is formed on the monitor. The doctor assesses the stomach and duodenum. Diseases are diagnosed by the observed pathological changes. If necessary, a specialist takes a sample of the mucous membrane for examination for the presence of microorganisms that provoke the onset of peptic ulcer disease.
Drug treatment of duodenal ulcer
A peptic ulcer can be treated with medication or surgery. In the first method, doctors prescribe drugs to sick people that neutralize hydrochloric acid. They are called antacids. Also, drugs help with illness, helping to suppress the production of hydrochloric acid in the human body. For example, Omeprazole may be prescribed.
If during the diagnosis Helicobacter pylori microorganisms are detected, then the appointment of a three-component therapy is possible. "Omeprazole" or "Ranitidine" are prescribed in combination with antibiotics ("Amoxicillin" and "Clarithromycin").
Surgical intervention for peptic ulcer disease
When the diagnosis of duodenal ulcer is too late, surgical treatment is prescribed. It is carried out under certain indications:
- with perforation of the ulcer or profuse bleeding;
- frequent exacerbations of the disease that occur despite ongoing drug treatment;
- narrowing of the outlet of the stomach, which arose due to cicatricial deformity of the duodenum;
- chronic inflammation that does not respond to drug therapy.
The essence of surgical treatment is removal. During the operation, that part of the internal organ, which is responsible for the secretion of gastrin in the body, is excised. This substance stimulates the production of hydrochloric acid.
In conclusion, it is worth noting that in the event of suspicious symptoms characteristic of diseases of the duodenum, it is worth seeking help from a polyclinic to specialists. Self-medication for ailments is inappropriate, because improper drug therapy, its absence or unnecessary folk remedies can cause serious harm to your body, worsen your well-being.
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