The purpose: to study the peculiarities of motor and evacuation functions of the stomach and duodenum in patients with peptic ulcer with associated chronic duodenal insufficiency (СDI). Materials and methods. The complex examination was carried out by 160 patients with ulcer disease (UD) with concomitant CDI (group 1) and 104 patients with no concomitant CDI (2nd group). The verification of UD was carried out by clinical and fibrogastroduodenoscopy studies. In the definition of CDI contrast duodenography and fibrogastroduodenoscopy were used. The evaluation of the motor-evacuation function (MEF) of the stomach and duodenum was carried out with the help of the peripheral electrogastroenterograph. Results of the study. In patients with UD with associated HDI before meals were identified bradygastria (75%) and hypertension (67%) of the stomach, and after eating the parameters of the electrical activity of the stomach in frequency and amplitude were decreased. We revealed hypokinesia (74%) and hypertension (52%) of duodenum on an empty stomach, postprandial frequency of it decreases compared with a thorough examination. The duodenogastric reflux is revealed in the fasting phase of the study. A segmenting and peristaltic contractions of the duodenum are slowed down, which is manifested in a decrease in the evacuation function of stomach and duodenum. Before meals in patients with UD without accompanying HDI were identified hypertension of the stomach (15%) and duodenum (68,95%), after a meal the indices of electrical activity of the stomach and duodenum were increased. In patients with duodenum ulcer of 1 group the electrical activity of duodenum before meals was corresponded to hyperkinetic (98.2%) and hypertensive (62.3%) type of the curve. The eating in patients of this group increases the peristaltic contractions of the longitudinal muscle layer of the duodenum, thereby accelerating the evacuation of the chyme without mixing it and disrupting the digestion process. In patients with duodenal ulcer without accompanying HDI before meals were identified the hypertension of the stomach (15%) and duodenum (68.95%), coordinated work of stomach and duodenum, as well as evacuation of food chyme were preserved. The conclusion. In patients with ulcer disease of stomach and duodenum with accompanying duodenal insufficiency, there was a violation of motor and evacuation activity of the stomach and duodenum both on an empty stomach and after eating, which adversely affects the course of ulcer disease.
Read full abstract