Duodenal motor function in health and some diseases: A hypothesis

Abstract

Aim. To investigate duodenal motor function according to radiological findings. Subjects and methods. Radiological studies of the upper digestive tract were retrospectively analyzed in 116 patients aged 55 to 92 years, including 83 patients in whom the study was conducted using conventional barium suspension (Group 11). Three grams of vitamin C were added to 200 ml of standard barium sulfate suspension in 8 patients (Group 2). Group 3 included 25 patients with primary duodenal diverticula. Group 4 included radiographs from 35 articles on superior mesenteric artery syndrome (SMAS). The width of the duodenum and the length of the sphincters were imaged. Results. Sphincters (bulboduodenal sphincter, sphincter of Kapanci, sphincter of Ochsner) were found to play an important role in the physiology of the duodenum. This could hypothesize that duodenal motor function determines its basic patterns. Conclusion. The proposed hypothesis explains how the duodenum performs its functions and is implicated in the pathogenesis of SMAS, acquired duodenal diverticula and sphincter of Oddi dysfunction.

About the authors

M D Levin

Z Korshun

G Mendelson

References

  1. Маев И.В., Самсонов А.А. Болезни двенадцатиперстной кишки. М.: МЕДпресс-информ; 2005.
  2. Albot G, Kapandji M, Ringenbach J. Physiopathology of timed duodenal intubation. II. Role of Ochsner’s sphincter in the mechanism of normal duodenal intubation and in that of certain prolongations of so-called Oddi’s closed time. Arch Mal Appar Dig Mal Nutr. 1956;45(12):449-457.
  3. Shafik A, El Sibai O, Shafik AA, Shafik IA. Demonstration of a physiologic sphincter at duodeno-jejunal junction. Front Biosci. 2006;11:2790-2794.
  4. Shafik A, Shafik AA, Wahdan M, El Sibai O. Duodeno-jejunal junction: a histoanatomical study with the concept of the existence of an «anatomical» sphincter. Surg Radiol Anat. 2007;29(8):661-665.
  5. Левин М.Д., Мендельсон Г., Троян В.В., Коршун З. К патогенезу первичных дивертикулов двенадцатиперстной кишки. Новости хирургии (Витебск). 2010;18(4):105-112.
  6. Shah D, Naware S, Thind S, Kuber R. Superior mesenteric artery syndrome: an uncommon cause of abdominal pain mimicking gastric outlet obstruction. Ann Med Health Sci Res. 2013;3(Suppl 1):S24-26. doi: 10.4103/2141-9248.121214.
  7. Bhattacharjee PK. Wilkie’s syndrome: an uncommon cause of intestinal obstruction. Indian J Surg. 2008;70(2):83-85. doi: 10.1007/s12262-008-0022-z.
  8. Chan DK, Mak KS, Cheah YL. Successful nutritional therapy for superior mesenteric artery syndrome. Singapore Med J. 2012;53(11):e233-236.
  9. Bandres D, Ortiz A, Dib J Jr. Superior mesenteric artery syndrome. Gastrointest Endosc. 2008;68(1):152-153. doi: 10.1016/j.gie.2007.09.033.
  10. Shafik A. Effect of duodenal distension on the pyloric sphincter and antrum and the gastric corpus: duodenopyloric reflex. World J Surg. 1998;22(10):1061-1064.
  11. Левин М.Д., Фидельман З., Троян В.В. Двигательная функция желудка и двенадцатиперстной кишки в рентгенологическом изображении (гипотеза). Медицина (Минск). 2008;2:7-11.
  12. Витебский Я.Д. Диагностика и оперативное лечение артериомезентериальной компрессии двенадцатиперстной кишки. Хирургия (Москва). 1977;12:22-26.
  13. Lenz K, Buder R, Firlinger F, Lohr G, Voglmayr M. Effect of proton pump inhibitors on gastric pH in patients exposed to severe stress. Wien Klin Wochenschr. 2015;127(1-2):51-56. doi: 10.1007/s00508-014-0637-y.
  14. Dahnert W. Radiology Review Manual. 2-d ed. Williams & Wilkins; 1993:505.
  15. Harii A, Siegelman SS, Hruban RH. Duodenal diverticulum mimicking a cystic pancreatic neoplasm. Br J Radiol. 2005;78;562-564.
  16. Takaaki J, Kadama T, Akaki H et al. Relationship between juxtapapillary duodenal diverticula and biliopancreatic disease — evaluation by endoscopic biliary manometry. Nippon Shokakibyo Gakkai Zasshi. 1992;89(5):1270-1278.
  17. Miyazaki S, Sakamoto T, Miyata M et al. Functuin of the sphincter of Oddi in patients with juxtapapillary duodenal diverticula: evaluation by intraoperative biliary manometry under a duodenal pressure load. World Surg. 1995;19(2):307-312.
  18. Viceconte G, Viceconte GW, Bogliolo G. Endoscopic manometry of the sphincter of Oddi in patients with and without juxtapapillary duodenal diverticula. Scand J Gastroenterol. 1984;19(30):329-333.
  19. Wu S-D, Su Y, Fan Y et al. Relationship between intraduodenal peri-ampular diverticulum and biliary disease in 178 patients undergoing ERCP. Hepatobiliary Pancreat Dis Int. 2007;6(3):299-302.
  20. Corazziari E. Sphincter of Oddi dysphanction. Dig Liver Dis. 2003;35 Suppl 3:S26-29.
  21. Левин М.Д., Мендельсон Г., Троян В.В. Функциональные сфинктеры двенадцатиперстной кишки и их роль в патогенезе синдрома верхней брыжеечной артерии. Здравоохранение (Минск). 2010;8:55-59.
  22. Bennett E, Evans P, Dowsett J, Kellow J. Sphincter of Oddi dysfunction: Psychosocial distress correlates with manometric dyskinesia but not stenosis. World J Gastroenterol. 2009;15(48):6080-6085.
  23. Toouli J, Roberts-Thompson IC, Dent J, Lee J. manometric disorders in patients with suspected sphincter of Oddi dysfunction. Gastroenterolgy. 1985;88:1243-1250.

Statistics

Views

Abstract: 133

PDF (Russian): 32

Article Metrics

Metrics Loading ...

Refbacks

  • There are currently no refbacks.

Copyright (c) 2020 Levin M.D., Korshun Z., Mendelson G.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
 

Address of the Editorial Office:

  • Novij Zykovskij proezd, 3, 40, Moscow, 125167

Correspondence address:

  • Novoslobodskaya str 31c4., Moscow, 127005, Russian Federation

Managing Editor:

 

© 2018-2021 "Consilium Medicum" Publishing house


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies