It manifests as frequent or intermittent stagnation of duodenal contents, leading to duodenal dilation and its characteristic clinical symptoms. The causes include inflammation, subcutaneous nodes, tumors, congenital anomalies, and compression of the duodenum by the mesenteric artery, among others. Occasionally, it is seen in cases of gastric or duodenal ulcers, biliary tract diseases, or functional duodenal obstruction following abdominal surgery.

bubble_chart Clinical Manifestations

The main symptoms are epigastric pain and bloating, which often occur during or after eating, accompanied by nausea and vomiting of bile-like substances. Sometimes, patients may induce vomiting on their own to relieve symptoms due to severe epigastric bloating. This condition recurs periodically and gradually worsens. Constipation is common.

Signs may include visible gastric peristalsis and waves, a positive succussion splash in the upper abdomen, as well as audible splashing sounds and hyperactive borborygmi.

bubble_chart Auxiliary Examination

1. Barium meal examination may reveal signs of duodenal stagnation and dilation, or sudden obstruction of barium at a certain point in the duodenum, sometimes accompanied by reverse peristalsis.
2. Gastroscopy can identify the cause of obstruction within the duodenal lumen and detect resistance at the obstruction site during the procedure.
3. Fasting duodenal fluid extraction often reveals food residues and other debris.

bubble_chart Treatment Measures

Non-surgical treatment

Rest, elevate the foot of the bed, and perform abdominal tuina. Aspirate and rinse the duodenum, consume a residue-free but nutrient-rich diet, and adopt a left lateral, prone, or knee-chest position after meals. Oral administration of atropine, phenobarbital, and other medications may provide temporary relief.

1. Duodenojejunostomy. Suitable for obstruction of the third segment of the duodenum. The procedure requires the jejunum to be 10–15 cm from the ligament of Treitz and anastomosed to the dilated third segment of the duodenum, with an anastomotic opening of at least 5 cm to prevent poor passage of intestinal contents.
2. Gastrojejunostomy. This method should only be used when there is extensive adhesion around the duodenum and exposure is difficult, to avoid the occurrence of intestinal fistula.