X-ray diagnostics of postbulbar suprapapillary duodenal stenoses

Abstract

Conventional X-ray examination, widely used to detect pathology in the gastroduodenal zone, is insufficient to obtain an anatomical representation of the duodenum. In our opinion, its full-fledged study can be carried out by the method of probe-free duodenography, which in our modification is as follows. After an overview X-ray of the thoracic and abdominal cavities, the patient drinks two or three sips of barium suspension, and the esophageal and stomach mucosa is examined by serial sighting radiography. If the barium suspension also enters the duodenum, we perform a series of images of its contrasting sections. Next, the patient drinks the rest of the barium suspension and takes two aeron tablets under the tongue (taking aeron inside is impractical due to the presence of barium suspension in the stomach, especially since aeron when taken under the tongue, as our observations have shown, acts almost the same as when taken orally). After examining the stomach with its tight filling with a contrast agent, we proceed to the study of the duodenum. To do this, we lay the patient on his right side for 15 minutes, transfer the tripod to the trochoposition and perform a series of sighting and survey images in straight and oblique projections with compression of the anterior abdominal wall in the projection of the duodenal horseshoe. We finish the study with a picture in a lateroposition on the left side in conditions of double contrasting of the bulb and the upper horizontal with the upper knee (in this position, the patient's air from the stomach passes into the duodenum). This technique slightly lengthens the study time, is not burdensome for patients and does not require additional manipulations (probing, injections), but it makes it possible to get a more complete picture of the topographic anatomical characteristics of duodenum. The use of this technique allowed us to identify and clarify a number of pathological conditions of duodenum that were observed in patients diagnosed with pyloric stenosis or duodenal ulcer.

Keywords

Kazan Medical archive

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