Duodeno-jejunal junction dyssynergia: description of a novel syndrome.
OBJECTIVE
To investigate the hypothesis that duodeno-jejunal dyssynergia existed at the duodeno-jejunal junction.


METHODS
Of 112 patients who complained of epigastric distension and discomfort after meals, we encountered nine patients in whom the duodeno-jejunal junction did not open on duodenal contraction. Seven healthy volunteers were included in the study. A condom which was inserted into the 1st duodenum was filled up to 10 mL with saline in increments of 2 mL and pressure response to duodenal distension was recorded from the duodenum, duodeno-jejunal junction and the jejunum.


RESULTS
In healthy volunteers, duodenal distension with 2 and 4 mL did not produce pressure changes, while 6 and up to 10 mL distension effected significant duodenal pressure increase, duodeno-jejunal junction pressure decrease but no jejunal pressure change. In patients, resting pressure and duodeno-jejunal junction and jejunal pressure response to 2 and 4 mL duodenal distension were similar to those of healthy volunteers. Six and up to 10 mL 1st duodenal distension produced significant duodenal and duodeno-jejunal junction pressure increase and no jejunal pressure change.


CONCLUSIONS
Duodeno-jejunal junction failed to open on duodenal contraction, a condition we call 'duodeno-jejunal junction dyssynergia syndrome' which probably leads to stagnation of chyme in the duodenum and explains patients' manifestations.
Shafik
Ahmed
A
Department of Surgery and Experimental Research, Faculty of Medicine, Cairo University, Cairo, Egypt. shafik@ahmedshafik.com
Shafik
Ismail A
IA
El Sibai
Olfat
O
Shafik
Ali A
AA
D000328:Adult; D001259:Ataxia / Q000175:diagnosis / Q000503:physiopathology*; D016022:Case-Control Studies; D004378:Duodenal Diseases / Q000175:diagnosis / Q000503:physiopathology; D004386:Duodenum / Q000503:physiopathology*; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000503:physiopathology; D005769:Gastrointestinal Motility / Q000502:physiology*; D006801:Humans; D007579:Jejunal Diseases / Q000175:diagnosis / Q000503:physiopathology; D007583:Jejunum / Q000503:physiopathology*; D008297:Male; D013577:Syndrome
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