Anomalies of development of duodenal ulcer

As a consequence malformations can change the shape and position of the duodenum. The most common is the so-called "mobile duodenum" (duodenum mobile). The considerable mobility of it is related to the fact that a large part of the colon and sometimes all of it is administered intraperitoneally, while in a healthy person, only the rising part of it lies in the peritoneum. This anomaly is not in itself is of great clinical significance, but can contribute to delays in the content of the duodenum (duodenostasis), chronic gastroduodenitis, peptic ulcer and in the presence of these diseases impairs the effectiveness of therapy.
Megabalanus - idiopathic expansion of the duodenum - is relatively rare. The literature describes 330 cases (Century A. Yefremov and K. D. Eristavi, 1969). Congenital megabalanus associated with congenital underdevelopment intramural nervous system the intestinal wall. This damage may be related to the emergence of expansion duodenal ulcers in the face of chronic duodenitis or pathological condition of the adjacent organs. The clinical picture of megaboom addressbook when duodenostasis. Treatment can be done conservatively, as well as duodenostasis. In the absence of a consistent effect shown operation.
In the field of duodenal ulcer congenital diverticula occur very often (Koelsch, Gulzow, 1969). In most cases it is a congenital anomalies associated with embryological factors. Diverticula are often random radiological finding, therefore, by themselves may not provide clinical symptoms. Over time (the role of age factor) the size and shape of diverticula can change, which is caused by lower tone of the walls of the intestines. Under the influence of stagnation food masses in combination with proteolytic enzymes (restrictinos) in the diverticula duodenal ulcer may be inflammation - diverticulitis. The latter occurs in about 10% (Weisner, 1953) patients with diverticula duodenum. If there diverticulitis half of patients may have pain and constipation, a one-third - nausea and one-fifth, vomiting and bleeding. The presence of diverticula duodenum (diverticulitis) contributes to the development of chronic pancreatitis and the defeat of the biliary tract. Diverticula duodenal ulcers do not require special treatment. If there diverticulitis should be encouraged anti-inflammatory therapy (antibiotics, drugs bismuth), vitamins (pyridoxine, thiamine), anticholinergic drugs (atropine, metazin, geksony), associated power (frequent food in small portions), and diet (to avoid spices, fried foods).