Duodenal sounding is a study that allows to analyze the contents of the lumen of the duodenum, including bile, the fluids produced by the pancreas and the intestine, as well as a certain amount of gastric juice. This technique has been used in medicine for a long time, but in recent years it has been modified and improved.
Indications for duodenal sounding
This study can be scheduled for:
- liver diseases (hepatitis, hepatosis, etc.);
- pathologies of the gallbladder (cholecystitis, cholelithiasis);
- diseases of the biliary tract (dyskinesia, cholangitis)
- disease of the duodenum (gastroduodenitis);
- disease of the pancreas (pancreatitis).
To complaints, in the presence of which patients are recommended duodenal sounding, are:
- pain in the right hypochondrium;
- disorders of stool (constipation, diarrhea, changes in color of faeces);
- eructation;
- heartburn;
- bitter taste in the mouth ;
- frequent nausea;
- flatulence.
The method is also used to diagnose and control the effectiveness of lambliosis and some helminthiases. In addition, with a therapeutic purpose, duodenal sounding is performed to extract bile from the gallbladder during stasis, to introduce drugs into the gut with parasitic diseases.
Preparation for duodenal sounding
Before duodenal sounding, patients are carefully examined to exclude contraindication to the procedure. Also, patients themselves are required to conduct a simple training, which provides:
- the abolition of medicinal preparations for 5 days before the study (enzyme, choleretic, laxatives, spasmolytic, etc.);
- compliance with the diet for 2-3 days before the procedure with the exception of gas-producing products (confectionery, legumes, black bread, milk, etc.), as well as fatty, fried and spicy dishes;
- refusal to eat 12 hours before the study (a light supper is recommended overnight);
- cleansing of the intestine on the eve of the procedure.
Technique of carrying out duodenal sounding
The method of duodenal sounding involves the use of a thin rubber probe, at the end of which there is a plastic or metal olive with holes for sampling.
After special treatment of the probe and rinsing the mouth with an antiseptic solution, the patient slowly swallows the probe in the sitting position until the end reaches a certain distance.
Then the patient is placed on the couch on the right side, a roller with a warmer is placed under his side, and continues to swallow the probe until his end reaches the duodenum.
Then, the material for syringe analysis from the probe begins, which can be carried out in three or five phases to obtain contents of different compositions.
To activate the contractions of the gallbladder and relax the sphincter of the bile duct, various stimulant preparations (atropine, histamine, magnesium sulfate solution, etc.) are used.
Portions of the selected duodenal contents are subjected to microscopic and bacteriological examination, also during the procedure the amount of material and the rate of its evacuation are estimated. Pathological signs are:
- Change in the amount of secret and its transparency;
- detection of a large number of leukocytes, mucus, epithelial cells, cholesterol crystals, etc.
Contraindications for duodenal sounding:
- varicose veins of the esophagus;
- bleeding tumors, stomach and duodenal ulcers;
- cholecystitis and cholelithiasis in the acute stage;
- oncology of the stomach or esophagus;
- angina pectoris;
- aortic aneurysm;
- myocardial infarction, etc.