Duodenal sounding

Description:

Duodenal sounding — the method applied at diseases of a liver and biliary tract with the diagnostic and medical purposes. Or in a duodenum, or parenterally — enter various irritants for the purpose of stimulation of reductions of a gall bladder and sphincteri incontinence of the general bilious channel that leads to a bile exit in a duodenum. The emitted bile is aspirated via the probe entered into a duodenum.

Inside apply such irritants as 30 — 50 ml of warm 25% of solution of magnesium of sulfate, 20 ml of olive oil, 10% solution of peptone, 10% solution of sodium of chloride, 40% solution of xylitol, 40% glucose solution, etc. Parenterally use such drugs as 2 ml of Pituitrinum, 0,5 — 1 mg of a histamine intramusculary, atropine, etc.

The probe for duodenal sounding — a rubber tube. Diameter is 3 — 5 mm, length — 1,5 m. On its end (what is entered into a stomach) the hollow metal olive with a number of openings is strengthened. Sizes of an olive of 2x0,5 cm. Tags on the probe: at distance of 40 — 45 cm from an olive; at distance of 70 cm, at distance of 80 cm. The last tag approximately corresponds to distance from teeth of the nipple (a big nipple of a duodenum) investigated to a faterov.

Preparation of the probe for a research: boiling and cooling in boiled water.

Additional equipment for a research: a clip for the probe, a support with test tubes, the syringe with a capacity of 20 ml, sterile test tubes for crops, a tray.

Medicines: Pituitrinum, atropine, 25% sulfate magnesium solution, olive oil or other irritants of secretion, 200 ml of 2% of solution of hydrosodium carbonate.

Training of the patient for a research: on the eve of the research — reception or in 8 drops of 0,1% of solution of atropine, or enter atropine subcutaneously. Allow to drink a little warm water with dissolved in it 30 g of xylitol. A dinner — easy; gas-forming products, such as potatoes, milk, black bread are excluded.

Technique of implementation of the procedure.
On the probe the distance from a navel to foreteeth of the patient in a standing position is noted.
To seat the patient, to give him in hands a tray with the probe.
The olive is put to the patient deeply for a language root, suggest to breathe and do the deglutitory movements deeply. The olive presumably is in a stomach if the probe reached the first tag. In case of desires on vomiting — the patient has to clamp the probe lips and make several deep sighs.
After hit of an olive in a stomach of the patient stack on the right side, having enclosed the roller (from above which — the hot hot-water bottle wrapped in a towel) on the level of the lower edges — hypochondrium.
The patient has to continue to swallow the probe slowly. It is at the same time necessary to aspirate stomach contents that has to promote opening of the gatekeeper and transition of an olive to a duodenum.
Most often the olive passes in a duodenum in 1 — 2 hour during periodic opening of the gatekeeper. If the probe was curtailed in a stomach — investigated delays it to the first mark then again slowly swallows. For definition of location of an olive it is possible to use roentgenoscopy. It is possible to apply such method also: the syringe enter air into the probe if the patient feels bubbling — an olive in a stomach if is not present — in a duodenum.
In case of a delay of opening of the gatekeeper — to enter subcutaneously 1 ml of 0,1% of solution of atropine, 2 ml of 2% of solution of a papaverine or to allow to drink 100 — 200 ml of 1% of solution of Natrii hydrocarbonas then for 10 — 15 minutes to close the probe a clip.
Portia A. Vydelyaetsya from the probe after hit of an olive in a gut. For the analysis — take a test tube with the most transparent contents.
For collecting a portion of B enter one of irritants then close the probe for 5 — 10 minutes then dark and olive bile — the concentrated contents of a gall bladder is emitted. If it does not occur, then in 15 — 20 minutes repeat introduction of an irritant.
Portia C — is allocated after full emptying of a gall bladder. Liquid transparent, without impurity is a mix of bile from intra hepatic bilious ways and intestinal juice.
After receiving a portion the C probe is taken.