gastroduodenal ulcer cicatricial pyloric obstruction
Introduction
Brief introduction of scarring pyloric obstruction in gastroduodenal ulcer Pyloric obstruction is caused by scar contracture after healing of gastroduodenal ulcer near the pylorus. The clinically prominent symptoms are severe vomiting, which is a separate meal and does not contain bile, which can lead to severe malnutrition and water-electrolyte disorders. The incidence of pyloric obstruction is about 10%. More common in patients with duodenal ulcer, early often with pyloric fistula, inflammation, can be relieved by medical treatment, and permanent stenosis must be treated surgically. basic knowledge Proportion of disease: about 5 to 10% of patients with ulcer disease complicated with pyloric obstruction Susceptible people: no special people Mode of infection: non-infectious Complications: duodenal ulcer gastric ulcer
Cause
Causes of scarring pyloric obstruction in gastroduodenal ulcer
Cause:
Pyloric obstruction can be caused by local inflammation of the ulcer or pyloric sphincter spasm, or by the scar formed during the repair of the ulcer. These two factors can exist at the same time, but most of them are based on one factor.
Prevention
Gastric duodenal ulcer scar pyloric obstruction prevention
A reasonable diet can take more high-fiber and fresh vegetables and fruits, balanced nutrition, including essential nutrients such as protein, sugar, fat, vitamins, trace elements and dietary fiber, with a combination of vegetarian and vegetarian foods. The complementary role of nutrients in food is also helpful in preventing this disease.
Complication
Gastroduodenal ulcer scar pyloric obstruction complications Complications duodenal ulcer gastric ulcer
It is usually the most common complication of ulcer disease.
Symptom
Gastroduodenal ulcer scar pyloric obstruction symptoms common symptoms upper abdominal pain upper abdominal discomfort weight loss vomiting ball ulcer
1. Upper abdominal fullness and deep feeling.
2. Vomiting and eating, without bile.
3. The stomach and peristaltic waves are visible in the upper abdomen, and there is a water sound.
4. Chronic patients may have malnutrition, weight loss, anemia, dry skin and so on.
Examine
Examination of scarring pyloric obstruction in gastroduodenal ulcer
1. Stomach volume aspiration is a simple and reliable method to determine the presence or absence of gastric retention. For example, 4 hours after the meal, the gastric juice can still be extracted more than 300ml, or 200ml or more of the gastric juice can be taken out in the morning after fasting, suggesting that the gastric sputum remains. If the stomach juice is mixed with food, it supports the diagnosis of pyloric obstruction.
2. Saline load test After pumping the gastric juice, inject 750ml of isotonic saline, and then extract all the stomach contents after 30min. If it reaches 400ml or more, it can be considered that there is pyloric obstruction.
3. X-ray examination of the abdominal X-ray film can be seen in the swelling of the stomach bubble. Such as the upper digestive tract barium meal examination, can confirm the diagnosis, and can understand the nature of obstruction, but for patients with severe obstruction, because there is a large amount of food in the stomach, affecting the filling of the tincture, it is often impossible to determine the nature of obstruction. For such patients, gastrointestinal decompression can be performed first. After the stomach is exhausted, the barium meal examination is performed, which is often helpful for diagnosis.
4. Fiber endoscopy Fiberoptic examination can not only determine the presence or absence of obstruction, but also determine the nature of obstruction, and can do a scrub cell examination or biopsy to confirm the diagnosis, such as gastric retention effect examination, can be attracted under direct vision Check again.
Diagnosis
Diagnosis and differentiation of scarring pyloric obstruction in gastroduodenal ulcer
diagnosis
1. There is often a history of longer gastroduodenal ulcer.
2. The upper abdomen is full, deep and heavy, vomiting a large number of meals, without bile.
3. There are stomach and peristaltic waves in the abdomen, and there is a water sound. Chronic patients may have malnutrition, weight loss, anemia, dry skin and relaxation.
4. X-ray barium meal examination showed that the stomach was enlarged, there was a large amount of retention fluid, and the emptying was slow (the tincture residue was still visible for 24 hours). Or see the pyloric tube thinning, irregular shape, deformation of the duodenal bulb.
Differential diagnosis
It is differentiated from gastritis and gastric ulcer.
