In the case when the pathological saccular protrusion, diagnosed usually in elderly patients, is localized directly behind the stomach, in the first part of the small intestine, specialists diagnose "diverticulum of the 12-colon"( DPC).Appearance in this part of the protrusion is not accompanied by a certain symptomatology, although sometimes it can provoke the development of serious complications, such as perforation of the formation, infection or obstruction in this part of the digestive organ. To suspect the appearance of pathology can be on such signs as discomfort or reflux, which appears immediately after eating. In the case of a prolonged presence of such symptoms of the diverticulum of the 12-colon it is necessary to consult a specialist to find out the cause that caused them and begin adequate treatment.
Diverticula in the duodenum, as well as those in the stomach, are divided into acquired and congenital, false and true, traction and pulsion. These outgrowths are formed in those places where blood vessels enter the wall of the digestive organ and in the place of the healed ulcer. Most experts diagnose false education. The pain in this disease is not seasonal and does not lend itself to antiulcer treatment. Also, during the diagnostic studies conducted for the detection of ulcers, the changes characteristic of it are not revealed.
A distinctive feature of patients with this pathology is the smell of stool. Due to the fact that nutritional remains disintegrate in pathological protrusions, it becomes putrefactive. Another characteristic symptom that occurs with diverticulosis of the duodenum is frequent vomiting. Usually it accompanies a pathology located in the lower third of the descending part, since with such a location of protrusion in the digestive organ there are swelling and cramping, which provokes the pushing of food back. In such cases, the clinical picture of the diverticulosis of the 12th-colon resembles the obstruction that appears in the organs of the gastrointestinal tract.
If the diverticulum of the DPC has developed in the common bile duct entering the duodenum, it is called juxtapapillary, and is a risk factor. Because of this pathology, the person has concrements that interfere with the intake of bile, and also develop diseases such as cholangitis or pancreatitis. Also, the presence of juxtapapillary diverticula, regardless of their presence in the bile ducts of the stones, narrows their diameter, which, accordingly, reduces the entry of bile into the duodenum.
Treatment of diverticulum of the duodenum
Therapy of this pathology is conducted by a conservative method consisting in observance of a strict diet and a diet with constant medical supervision and reception of antibiotics. In addition, the pathological outgrowths located on this site of the gastrointestinal tract suggest treatment of concomitant diseases. In the event that the size of the diverticula in the duodenum has greatly increased, or the inflammatory process that started in them has led to the occurrence of serious complications, urgent surgical intervention is necessary. Pathological protrusion, developed in this part of the digestive tract, is usually difficult to find, so during surgery, air is introduced into the abdominal cavity through a special probe.
If the protrusions are on the outside of the digestive organ, so-called extramural pockets, they are removed with a scalpel. The advantages of surgical intervention in the diverticulosis of the duodenum before therapy with antibiotics is that in the first case the mortality rate is only 30%, whereas in the latter it usually reaches 90% of cases.
With a complicated course of diverticulosis, permanent pain sensations, and also in those cases when pathological protrusions are combined with a ulcer or perforation occurred and internal bleeding has arisen in the duodenum or stomach, this type of surgical intervention, such as excision, is shown. In the process of this operation, the pocket-like outgrowth is excreted at the level of the wall of the digestive organ, is excised, and then the formed defect is sutured. In the postoperative period, patients in order to avoid the development of massive bleeding or pancreatic necrosis should prescribe drugs that inhibit the activity of the pancreas, as well as antispasmodics.
Any method of therapy prescribed by a specialist for diverticulosis of the duodenum should be performed against a background of a special sparing diet that facilitates the work of the digestive organs. In addition, with the help of fluoroscopy, the doctor chooses the position in which the abnormal protrusion located in the patient in the PDK is best emptied and recommends taking it before bedtime in order to avoid contamination of the pathological pocket with food remnants. Also shown in this pathology is a slight massage of the abdomen.