Duodenal sounding

Duodenal sounding is a diagnostic procedure which is appointed for a duodenum contents research – bile mix with intestinal, gastric and pankteratichesky juice. The similar research gives the chance to estimate a condition of bile-excreting system, secretory function of a pancreas and appoint it at the inflammation of a gall bladder, diseases of bile-excreting channels and a liver proceeding with such symptomatology: a stagnant phlegm in a gall bladder, feeling of bitterness in a mouth, nausea, pain in right hypochondrium, the concentrated urine.

Preparation for duodenal sounding

Carry out diagnosis on an empty stomach, in the morning. The dinner the day before has to be a lung, at the same time potatoes, milk, black bread and other products increasing gas generation are excluded. In 5 days prior to carrying out sounding it is necessary to stop reception of cholagogue drugs (Cycvalonum, барберин, Allocholum, Flaminum, a holenizm, Cholosasum, liv-52, Cholagolum, Barbara's salt, sulfate magnesia, sorbite, xylitol), anti-spastic (Nospanum, Tifenum, bellalgin, a papaverine, Bispanum, Belloidum, a belladonna), vasodilating, laxative and such that improve digestion (панзинорм, абомин, Pancreatinum, festal, etc.).

In the course of preparation for duodenal sounding the patient is given the day before 8 drops of atropine – 0,1% of solution (the drug can also be administered subcutaneously), allow to drink warm water from 30 g of xylitol.

Technology of duodenal sounding

For carrying out a research two technicians use: duodenal sounding classical and fractional. A classical method call still three-phase and consider a little outdated since duodenal contents are selected in only three phases: from a duodenum, bilious channels, a bubble and a liver, receiving, thus, bile duodenal, vesical and hepatic.

Fractional duodenal sounding includes five phases and contents pump out each 5-10 minutes that gives the chance to fix its dynamics and type of biliary secretion:

• the first phase – is allocated a portion And which is selected when the probe gets into a duodenum, before introduction of holetsistokinetichesky means. Duodenal contents at this stage consist of bile, pancreatic, intestinal and partially gastric juice. The phase lasts about 20 minutes.
• The second phase – comes after administration of magnesium of sulfate and the termination of biliation from a spasm of a sphincter of Oddi. The second phase of fractional duodenal sounding of 4-6 minutes lasts.
• The third phase – allocation of contents of extrahepatic bilious ways. 3-4 minutes last.
• The fourth phase – allocation of a portion In: devastation of a gall bladder, secretion of vesical dense bile of brown or dark yellow color.
• The fifth phase – begins after dark vesical bile ceased to be emitted and again there is a bile of golden yellow color (a portion C). Collect bile for half an hour.

For carrying out classical and fractional duodenal sounding the rubber probe on which end there is a plastic or metal olive with openings for sampling is used. It is more preferable to use the double probe since one of them pumps out stomach contents.

By preparation for duodenal sounding on the probe note distance from foreteeth of the patient to a navel (in a standing position) and put three tags which give the chance to understand where there is a probe. After this patient seat, put to him for a language root the olive greased with glycerin ask it to breathe and do the deglutitory movements deeply. When at the level of cutters there is the first tag, so the probe presumably got into a stomach. The patient lays down on the right side and continues to swallow the probe. It is necessary to do it to the second tag designating that the olive of the probe approached the gatekeeper and after his next disclosure it will be able to get into a duodenum (the third tag on a rubber tube of the probe). There is it usually through one or an hour and a half and from the probe golden liquid – a portion And which is collected in test tubes begins to arrive.

The portion In is received in 20-30 minutes after a portion And yes it plays the greatest diagnostic value.

Such technology of duodenal sounding gives the chance to determine the capacity of a gall bladder, feature of department of bile, to find organic and functional frustration of bile secretion. All tests of bile received in the course of sounding subject to a microscopic and bacteriological examination.