Gastrojejunal input loop syndrome
Introduction
Brief introduction of gastrojejunal sputum syndrome Gastrojejunal sputum syndrome refers to a series of symptoms caused by dilatation of sputum and retention of contents after gastrojejunostomy. Mostly related to the input of a low Zhang, too long kinks or output obstruction, resulting in obstruction of duodenal emptying. Often occurs within 24 hours after surgery. Pay attention to the identification of other diseases of the gastrointestinal, such as: gastritis, peptic ulcer, postprandial syndrome. basic knowledge The proportion of illness: 0.002% Susceptible people: no specific population Mode of infection: non-infectious Complications: acute peritonitis intestinal obstruction shock
Cause
Gastrointestinal enterosis syndrome
Mostly related to the input of a low Zhang, too long kinks or output obstruction, resulting in obstruction of duodenal emptying.
It usually occurs within 24 hours after surgery, but it can also be caused by partial or complete intermittent or permanent Billroth II type of postoperative obstruction within a few days or even years after surgery. Obstruction occurred. Where the pre-colon anastomosis is more common than the posterior colon anastomosis, the strangling obstruction occurs because the input sputum is too long to be inserted behind the output when the space between the mesorma and the transverse mesenteric membrane is output through the jejunum; If the gastrojejunostomy or duodenal jejunum is in the intersection, enter . After the output of the sputum, the latter enters the sacral intestine and causes the closed obstruction of the jejunum to enter the colon. The sputum may be obstructed by retraction to the transverse mesenteric orifice.
Prevention
Gastrojejunal sputum syndrome prevention
The prevention of this disease is mainly in the case of gastric jejunostomy, paying attention to the details of the operation, such as the adhesion of the input fistula and the surgical suture.
Complication
Gastrojejunal sputum syndrome complications Complications acute peritonitis intestinal obstruction shock
The disease is secondary to gastrojejunostomy, and more complicated with gastric or jejunal diseases, acute peritonitis, intestinal obstruction, shock and so on. Acute jejunal sputum obstruction, no bile in vomit, symptoms are not relieved after vomiting, severe obstruction may occur in the duodenum, intestinal wall necrosis, perforation, leading to acute peritonitis. Chronic input syndrome. In patients with chronic illness, duodenal and jejunal input fistula can be significantly dilated, and the abdomen can reach the mass.
Symptom
Gastrointestinal sputum syndrome symptoms Common symptoms Pain and painful duodenal hypertonic peritonitis intestinal wall necrosis upper abdominal discomfort blood pressure drop shock
1 Acute jejunal input sputum obstruction: Sudden upper abdominal pain, frequent vomiting, no bile in vomit, symptoms are not relieved after vomiting, severe obstruction may occur in the duodenum, intestinal wall necrosis, perforation, leading to acute peritonitis.
2 Chronic sputum syndrome, 15-30 minutes after a meal, there is right upper abdominal discomfort, pain, sudden vomiting a lot of bile, the symptoms can be alleviated.
Examine
Examination of gastrojejunal sputum syndrome
Physical examination: Acute jejunal input sputum obstruction: tenderness in the upper abdomen, can touch suspicious mass or dilated intestinal fistula, followed by increased pulse rate, decreased blood pressure and other shock performance. Chronic input syndrome. In patients with chronic illness, duodenal and jejunal input fistula can be significantly dilated, and the abdomen can reach the mass.
X-ray examination: the abdominal plain film can be seen in the right upper abdomen to expand the intestinal fistula, and has a giant liquid level.
Barium meal check: A barium meal test can prove a giant expansion of the duodenum and the input jejunum.
Diagnosis
Diagnosis and differentiation of gastric jejunal sputum syndrome
diagnosis
Medical history questions:
1 Acute jejunal input sputum obstruction: Sudden upper abdominal pain, frequent vomiting, no bile in vomit, symptoms are not relieved after vomiting, severe obstruction may occur in the duodenum, intestinal wall necrosis, perforation, leading to acute peritonitis.
2 Chronic sputum syndrome, 15-30 minutes after a meal, there is right upper abdominal discomfort, pain, sudden vomiting a lot of bile, the symptoms can be alleviated.
Physical examination found:
Acute jejunal sputum obstruction: upper abdominal tenderness, can touch suspicious mass or dilated intestinal fistula, followed by increased pulse rate, decreased blood pressure and other shock performance, chronic sputum syndrome, chronic disease, duodenum and jejunal input Can be significantly expanded, the abdomen can touch the mass.
Differential diagnosis
Pay attention to the identification of other diseases of the gastrointestinal, such as: gastritis, peptic ulcer, postprandial syndrome.
