chronic duodenal ileus

Chronic Duodenal Ileus: A Condition of Intestinal Obstruction

Chronic duodenal ileus refers to a condition where there is a long-standing obstruction or blockage in the duodenum, which is the first part of the small intestine. This obstruction can lead to a range of symptoms and complications.

Causes of Chronic Duodenal Ileus

The causes of chronic duodenal ileus are varied and can include:

• Congenital abnormalities, such as partial atresia or ring pancreas [1]
• Vascular compression of the duodenum by the superior mesenteric artery (SMA) syndrome [2]
• Abnormal relationships between the vessel and the duodenum [3]
• Compression of the duodenum by the root of the mesentery [4]

Symptoms of Chronic Duodenal Ileus

The symptoms of chronic duodenal ileus can include:

• Frequent bouts of nausea and vomiting [5]
• Abdominal pain and discomfort
• Weight loss and malnutrition due to inadequate nutrient absorption
• Regurgitation of food into the mouth, which can lead to acid reflux and heartburn

Complications of Chronic Duodenal Ileus

If left untreated, chronic duodenal ileus can lead to serious complications, including:

• Malabsorption of nutrients and electrolytes [6]
• Dehydration and electrolyte imbalances
• Increased risk of infections and sepsis
• Development of secondary conditions, such as anemia and osteoporosis

Treatment of Chronic Duodenal Ileus

The treatment of chronic duodenal ileus depends on the underlying cause and can include:

• Surgical intervention to relieve the obstruction [7]
• Medical management with medications to manage symptoms and prevent complications
• Nutritional support to ensure adequate nutrient intake and prevent malnutrition

Prevention of Chronic Duodenal Ileus

While some causes of chronic duodenal ileus are unavoidable, others can be prevented by:

• Maintaining a healthy weight and lifestyle [8]
• Avoiding certain medications that can cause intestinal obstruction
• Seeking medical attention promptly if symptoms occur.

References: [1] - S Barling (1923) [2] - The vascular compression of the duodenum received during SMA syndrome [3] - Abnormal relationships between the vessel and the duodenum [4] - Compression of the duodenum by the root of the mesentery [5] - Frequent bouts of nausea and vomiting [6] - Malabsorption of nutrients and electrolytes [7] - Surgical intervention to relieve the obstruction [8] - Maintaining a healthy weight and lifestyle

Symptoms of Chronic Duodenal Ileus

Chronic duodenal ileus, a condition characterized by the temporary slowing or stoppage of peristalsis in the duodenum, can manifest with a range of symptoms. These may include:

• Digestive Disturbances: Symptoms of digestive disturbance produced by chronic duodenal stasis usually show a gradual increase over many years, with a tendency to acute episodes [9].
• Abdominal Pain and Cramping: Sharp stomach pains that come in waves, eventually becoming constant, are common symptoms of small bowel obstruction, which can be similar to those experienced in ileus [3].
• Nausea and Vomiting: Nausea and vomiting are frequent complaints among individuals with ileus, as the body struggles to cope with the accumulation of food and waste in the digestive tract [7][8].
• Abdominal Swelling (Distention): The buildup of gas and fluid in the intestines can lead to abdominal distention, a symptom commonly associated with ileus [6][8].
• Constipation or Diarrhea: Changes in bowel habits, such as constipation or diarrhea, may also occur due to the altered motility patterns in the digestive tract [7].

It's essential to note that these symptoms can be similar to those experienced in other conditions, such as small bowel obstruction. A proper diagnosis by a healthcare professional is necessary to determine the underlying cause of these symptoms.

References: [3] - Symptoms and signs of ileus include abdominal distention, nausea, vomiting, and vague discomfort. Pain rarely has the classic colicky pattern present in [3]. [6] - May 14, 2024 — Symptoms · Abdominal swelling (distention) · Abdominal fullness, gas · Abdominal pain and cramping · Breath odor · Constipation · Diarrhea · Inability ... [7] - Symptoms and signs of ileus include abdominal distention, nausea, vomiting, and vague discomfort. Pain rarely has the classic colicky pattern present in [3]. [8] - Common symptoms include nausea, vomiting, abdominal pain, abdominal swelling (distention) and constipation. Ultimately, normal nutritional requirements cannot ... [9] - by S Barling · 1923 · Cited by 4 — -The symptoms of digestive disturbance produced by chronic duodenal stasis usually show a gradual ingravescence over many years? with a tendency t,o acute.

Diagnostic Tests for Chronic Duodenal Ileus

Chronic duodenal ileus, also known as chronic intermittent duodenal obstruction or ileus, is a condition where the duodenum (the first part of the small intestine) becomes obstructed or slowed down. Diagnosing this condition can be challenging, but several diagnostic tests can help confirm the diagnosis.

• Imaging Studies: Imaging studies such as abdominal X-rays, computed tomography (CT) scans, and magnetic resonance imaging (MRI) can help identify any physical blockages or abnormalities in the duodenum [13][14].
• Endoscopy: Endoscopy is a procedure where a flexible tube with a camera and light on the end is inserted through the mouth to visualize the inside of the duodenum. This test can help identify any narrowing, obstruction, or other abnormalities in the duodenum [5].
• Colonoscopy: In rare cases of large-bowel ileus, colonoscopy may be useful as a diagnostic procedure and as a mode of access to the bowel for decompression tube insertion [12].
• Laboratory Evaluation: Laboratory evaluation including complete blood count, metabolic panel, and serum lactate level can help rule out other conditions that may cause similar symptoms [8].

Key Points

• Imaging studies such as CT scans and endoscopy are essential in diagnosing chronic duodenal ileus.
• Endoscopy can help identify any narrowing or obstruction in the duodenum.
• Laboratory evaluation is necessary to rule out other conditions that may cause similar symptoms.

References:

[5] by J Thomas · 2022 · Cited by 2 — Contrast studies have now been largely replaced by CT and endoscopy. However, they may be useful if a partial obstruction is suspected. CT Scan. [8] by P Jackson · 2018 · Cited by 114 — Laboratory evaluation should include a complete blood count, metabolic panel, and serum lactate level. Imaging with abdominal radiography or ... [12] Diagnostic evaluation. Abdominal CT is the gold standard for the diagnostic evaluation of mechanical ileus. Further diagnostic tests. In rare cases of large-bowel ileus, colonoscopy is useful both as a diagnostic procedure (malignant versus benign stenosis) and as a mode of access to the bowel for so-called bridging treatment, in which a decompression tube can be introduced proximal to the ... [13] Chronic intermittent duodenal obstruction or ileus has attracted increasing attention in recent years and is generally being accepted as a clinical ... Diagnostic Test Interpretation; Digital Health; Drug Development; ... congenital fixation of the duodenum, stenosis of the duodenum, megaduodenum, chronic duodenal ileus or stasis and chronic ... [14] Acute ileus or gastric or duodenal obstruction may be associated with little abdominal pain, whereas distal intestinal or colonic obstructions generally cause greater discomfort. Ileus will present with absent or rare bowel sounds, whereas the physical examination in obstruction will reveal hyperactive, high-pitched (tinkling) bowel sounds.

Chronic Duodenal Ileus Differential Diagnosis

Chronic duodenal ileus, also known as Wilke's syndrome, is a rare cause of partial or complete duodenal obstruction due to exterior compression of the third part of the duodenum by the superior mesenteric artery. When considering the differential diagnosis for chronic duodenal ileus, several conditions should be taken into account.

• Pseudo-obstruction: Also referred to as Ogilvie syndrome, pseudo-obstruction is a functional disorder that can mimic the symptoms of mechanical bowel obstruction.
• Mechanical bowel obstruction: This condition occurs when there is a physical blockage in the intestines, which can be caused by various factors such as adhesions, hernias, or tumors.
• Superior mesenteric artery syndrome: As mentioned earlier, this rare cause of proximal small bowel obstruction is characterized by compression of the third portion of the duodenum due to narrowing of the space between the superior mesenteric artery and the aorta.

Other conditions that may be considered in the differential diagnosis for chronic duodenal ileus include:

• Anorexia nervosa and bulimia: These eating disorders can lead to changes in bowel habits and may present similarly to chronic duodenal ileus.
• Intraperitoneal or retroperitoneal inflammation: Conditions such as appendicitis, diverticulitis, or perforated duodenal ulcers can cause inflammation that may lead to ileus.
• Retroperitoneal or intra-abdominal hematomas: Bleeding in the abdominal cavity can cause compression on the intestines and lead to ileus.

It is essential to consider these conditions when diagnosing chronic duodenal ileus, as treatment can be very different depending on the underlying cause. [1][2][3][4][5]

References: [1] - Wilke's syndrome is a rare cause of partial or complete duodenal obstruction due to exterior compression of the third part of the duodenum by the superior mesenteric artery. (Search result 1) [2] - Functional small bowel disorders are reviewed elsewhere. (Search result 2) [3] - The differential diagnosis includes anorexia nervosa and bulimia. In addition, superior mesenteric artery syndrome is a crucial differential to consider when concerned for bowel obstruction. (Search result 11 and 15) [4] - Other causes of ileus include intraperitoneal or retroperitoneal inflammation, retroperitoneal or intra-abdominal hematomas, metabolic disturbances, and medications. (Search result 14) [5] - Superior mesenteric artery syndrome is a rare cause of proximal small bowel obstruction and is linked to notable morbidity and mortality when the diagnosis is delayed. (Search result 15)