Preparing the patient for duodenal intubation and assessing the results.

in the liver. You will learn about the features of this procedure, as well as the process of preparing for it, from this article.

What is duodenal intubation?

Duodenal intubation is a procedure prescribed to examine the biliary system. The procedure can be used not only for diagnostic purposes: sometimes it is performed to empty the gallbladder if it is impossible to do this naturally due to any pathological processes.

To carry out the manipulation, a special duodenal probe is used, which is a thin tube whose length is about 1.5 m and diameter is 4 mm. At the end of the tube there is a metal nozzle with many holes.

Indications for the procedure

Most often, the main indication for duodenal intubation is chronic pain in the hypochondrium area, which indicate the presence of pathologies of the gallbladder and liver.

Of course, pain in the hypochondrium does not mean serious illness and do not always require duodenal intubation.

Typically, a study is prescribed if the patient has other symptoms, among which special mention should be made:

• digestive disorders;
• nausea and vomiting;
• diarrhea or constipation;
• changes in the color of stool;
• the skin acquires a yellowish tint;
• observed intestinal bleeding. Usually you can see traces of blood in the feces or darkening of the stool, which becomes almost black;
• ascites (accumulation of fluid in the abdominal cavity).

Preparing for probing

Clinical picture

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Duodenal intubation is a procedure that requires careful preparation.

The patient must follow the following rules:

1. Do not eat food 12 hours before the procedure. Typically, probing is carried out in the morning; you should not have breakfast on this day.
2. 48 hours before the procedure, it is important to follow special diet. In particular, the patient is prohibited from eating fruits and vegetables, fatty and meat foods, as well as canned and smoked foods. The diet should exclude hard-to-digest foods that can affect the functioning of the pancreas gall bladder. You can eat light soups, porridges, stewed and boiled dishes.
3. Five days before probing, it is prohibited to take drugs with choleretic properties.

Proper preparation for the study is very important, otherwise the results may be inaccurate. Typically, a nurse or doctor explains to the patient how to behave on the eve of probing.

Immediately before the procedure, the patient is given an atropine solution, which is usually injected subcutaneously, and is also asked to drink a warm solution of xylitol in water.

Execution technique

Two methods of probing are possible: classical and fractional. The classical technique is rarely practiced these days, since the process involves removing the intestinal contents in three stages.

Fractional sounding is carried out in five phases, and the contents of the duodenum are pumped out several times at short time intervals, which makes it possible to monitor the functioning of the bile ducts and glands internal secretion in dynamics.

For functional probing, the procedure algorithm is as follows:

1. Isolation of portion A, taken from the duodenum before the administration of drugs for the secretion of bile.
2. In the second stage, intestinal contents are collected after administering magnesium sulfate to the patient to check the activity of the endocrine glands.
3. At the third stage, secretions from the extrahepatic biliary tract are collected.
4. The fourth stage is taking portion B after emptying the gallbladder. At this stage, thick bile is secreted, which has a dark brown tint.
5. The final phase begins after dark bile with a thick consistency ceases to be secreted and light-colored bile begins to appear. yellow color.

How is the research conducted?

Probing is carried out as follows:

1. The patient takes sitting position, after which he swallows the end of the probe on which the metal olive is located.
2. The patient swallows the probe to a length of about 52 centimeters.
3. A syringe is attached to the probe, which is used to collect gastric juice.
4. The hose is swallowed up to a length of 70 centimeters.
5. The patient is placed on his left side. In this case, under his ribs there should be a heating pad filled with warm water. For the patient's comfort, a small pillow is placed under his pelvis. The patient's position most convenient for the study can be seen in the photo below.
6. A stand with test tubes in which the secretions are collected is installed near the head.
7. The probe is immersed to a length of 90 cm.
8. After the procedure is completed, the probe is carefully removed.

Analysis results and interpretation

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Deciphering the results of duodenal intubation should only be done by experienced doctor. Therefore, before deciding where this procedure can be done, you should find out whether the specialist has a sufficient level of qualifications.

In this case, it is necessary to take into account:

• the time each phase of the study took;
• the amount of discharge, as well as their characteristics;
• microbiological parameters of secretions.

After careful laboratory examination the collected secrets, the indicators are compared with special tables, on the basis of which a conclusion is drawn about the patient’s health status.

Contraindications to the procedure and possible complications

Duodenal intubation should not be performed if patients have the following pathologies:

• V gallbladder there are stones. During the examination, bile production is stimulated, which can cause blockage of the biliary tract and jaundice;
• diseases digestive system in the acute stage;
• cholecystitis;
• varicose veins of the esophagus;
• breastfeeding and pregnancy.

Whether probing can be performed on a child depends on his age: children under three to five years of age do not usually undergo the procedure.

Complications after the procedure are extremely rare, but they are not excluded.

Basic Negative consequences the procedures are as follows:

• damage to the mucous membranes of the esophagus;
• bleeding;
• nausea and vomiting;
• increased salivation causing discomfort to the patient.

Duodenal intubation is a rather unpleasant procedure for the patient, the implementation of which causes significant discomfort. However, you should not give it up. If the results are correctly interpreted by a competent specialist, the accuracy of the diagnosis obtained from the examination results is more than 90%.

Video material with a detailed and visual description in order to identify:

Purpose of manipulation:

Obtaining bile for examination.

Contraindications:

Gastric bleeding, tumors, bronchial asthma, severe cardiac pathology.

Patient preparation:

In the morning, on an empty stomach.

Equipment:

a probe similar to a gastric one, but at the end with a metal olive, having several holes.

Olive is needed for better passage through the gatekeeper.

bottles for gastric juice, a stand with test tubes marked “A”, “B”, “C”.

sterile syringe, capacity 20.0 ml.

irritant: 40 ml of warm 33% magnesium sulfate solution or 40 ml of 40% glucose solution.

gloves, towel, tray, heating pad, roller, direction:

Algorithm of action when introducing a probe:

Explain to the patient the procedure.

seat the patient correctly: leaning on the back of the chair, tilting the head forward.

wash your hands, put on gloves. Place a towel on the patient's neck and chest, if available. removable dentures

, remove them. Use sterile tweezers to remove the probe. Take it in right hand

, and support the free end with your left hand. moisten with warm boiled water

or lubricate with sterile Vaseline.

Invite the patient to open his mouth.

place the end of the probe on the root of the tongue, ask patients to swallow while breathing through the nose.

enter to the desired mark.remember!

there are marks on the probe every 10 cm.

using a 20 ml syringe, obtain a cloudy liquid - gastric juice. This means the probe is in the stomach.

Instruct the patient to walk slowly, swallowing the probe until the 7th mark. Place the patient on the couch on the right side, placing a heating pad under the right hypochondrium and a cushion under the pelvis (facilitates the passage of the olive in 12 duodenum

within 10-60 minutes the patient swallows the probe to the 9th mark.

The outer end of the probe is lowered into a container for gastric juice.

Algorithm for obtaining material for research:

20-60 minutes after placing the patient on the couch, a yellow liquid will begin to flow - this is portion “A” - duodenal bile, that is, obtained from the duodenum and pancreas (its secretion also enters the duodenum ).

Test tube "A".

inject 40 ml of warm stimulus (40% glucose or 33% magnesium sulfate, or vegetable oil) through the probe using a 20.0 ml syringe to open the ODDI sphincter.

tie the probe.

after 5-7 minutes, untie: receive portion “B” - dark olive concentrated bile, which comes from the gallbladder. Test tube "B".

after this, a transparent golden-yellow portion “C” begins to flow - liver bile. Test tube "C". Each portion arrives within 20-30 minutes.

send the bile to the clinical laboratory with a referral.

Gastric lavage.

Contraindications:

Indications: Poisoning: food, drugs, alcohol, etc. Ulcers, tumors, bleeding of the gastrointestinal tract,

Equipment:

bronchial asthma

, severe cardiac pathology.

sterile thick probe, 100-200 cm long, at the blind end there are 2 lateral oval holes at a distance of 45, 55, 65 cm from the blind end of the mark.

a sterile rubber tube, 70 cm long and a sterile connecting glass tube, 8 mm in diameter.

sterile funnel, 1 liter capacity.

sterile petroleum jelly. basin for rinsing water. bucket

clean water

room temperature for 10-12 liters and a liter mug.

rubber gloves, aprons.

Action algorithm:

assemble a flushing system: probe, connecting tube, rubber tube, funnel.

Put on aprons for yourself and the patient, and make him sit down. put on gloves. moisten the probe with sterile

Vaseline oil

or warm boiled water.

Place the blind end of the probe on the root of the patient’s tongue and suggest swallowing movements, breathing deeply through the nose.

As soon as the patient makes a swallowing movement, advance the probe into the esophagus.

Having brought the probe to the desired mark (length of the inserted probe: height – 100 cm), lower the funnel to the level of the patient’s knees.

Holding the funnel at an angle, pour in water.

pour the contents into the basin until the water passes through the connecting tube, but remains in the rubber and at the bottom of the funnel.

start filling the funnel again, repeating all the steps.

rinse until the waters are clear.

measure the amount of fluid injected and excreted.

send some of the washing water to the laboratory.

remove the probe.

Perform pre-sterilization cleaning of the entire system.

Note:

If, when inserting the probe, the patient begins to cough or begins to choke, remove the probe immediately, because it went into the trachea, not the esophagus. Duodenal intubation allows you to determine the current state of the liver and biliary tract. You can undergo the procedure in a clinic, hospital, diagnostic center

, and a qualified doctor should decipher the analysis results.

What is duodenal intubation – a diagnostic method with which the biliary tract and liver are examined. Sometimes it is used in medicinal purposes

to empty the gallbladder.

The manipulation is carried out using special equipment - a duodenal probe. It is made in the form of an elastic rubber tube. Its length reaches 1.5 m, and its diameter is 3–5 mm. At the end of the tube, which is inserted into the body, there is a metal olive, the surface of which is covered with holes. This device, which must be completely sterile, collects duodenal contents from the duodenum, consisting of bile, as well as a mixture of juices secreted by the stomach, intestines, and pancreas.

Such diagnostics are prescribed to obtain information about the exocrine activity of the pancreas, as well as the biliary tract and gallbladder capacity. The main indications for the procedure are frequent nausea , pain in the hypochondrium with right side

, congestion in the gallbladder, suspicion of helminthiasis, bitterness in the mouth.

Carrying out duodenal sounding

1. Types of duodenal intubation: Blind probing or tubing
2. – prescribed for therapeutic purposes and performed to remove excessive accumulation of bile from the gallbladder. This allows you to avoid stagnant processes. Multi-moment or fractional probing – collection of duodenal secretions is carried out at intervals of 5 minutes. The procedure involves 5 phases. This is followed by analysis collected material
3. . This is the most modern and frequently used option for the procedure.– before it is carried out, the gallbladder bile is stained, after selection it is examined. For this purpose, the evening before the procedure, the patient drinks a capsule containing methylene blue dye. If there is no colored bile in the material selected during the analysis, duct obstruction is diagnosed.
4. Three-phase or classic version sounding– provides for the collection of 3 portions of bile: A, B and C.
5. Gastroduodenal sounding– to carry it out, a 2-channel probe is used, which simultaneously probes the stomach and duodenum.

To get an accurate result, it is important to properly prepare for the procedure and carry it out correctly. If the examination rules are not followed, the results may be biased.

There are a number of contraindications to the procedure:

• acute form of diseases of the digestive tract;
• the presence of kidney stones;
• acute cholecystitis;
• pregnancy;
• lactation;
• asthma;
• hypertension;
• dilation of the veins of the esophagus.

Duodenal intubation is contraindicated during pregnancy

Algorithm for performing the examination

Let's consider the execution technique fractional sensing, because exactly this option diagnostics provides the opportunity to obtain the most accurate results. The procedure is carried out only on an empty stomach in the morning.

Sequential algorithm for conducting research:

• the patient sits down, the end of the probe with the olive is placed in his mouth, and he must swallow it;
• after this, its slow swallowing begins;
• when the hose reaches 40 cm, it is swallowed for about another 12 cm, and then a syringe is connected to it to remove the incoming gastric juice;
• then the hose is immersed to the 70 cm mark;
• when the probe is immersed to the indicated mark, the patient should lie on his right side, while a warm heating pad is placed under his rib, and it is advisable to place a pillow under the pelvis;
• a stand with test tubes for collecting secretions is placed at the head of the head; the outer end of the hose is lowered into them;
• V supine position The probe continues to gradually immerse until the 90 cm mark is reached, this process takes 20–60 minutes;
• when the olive of the probe enters the duodenum, the test tube is filled with yellow duodenal secretion;
• After passing through all 5 probing phases, the hose is carefully removed.

Duodenal sounding can take up to 2 hours

The duration of the procedure is on average 1.5–2 hours.

Probing phases:

1. First phase– within 10–20 there is an active release of duodenal contents. It is labeled as portion “A”, consisting of a mixture of bile secretions, gastric, intestinal and pancreatic juice. This portion has practically no significance for diagnosis. This phase continues from the moment the probe penetrates the duodenum until the introduction of the cholecystokinetic substance. It can be played by 75 units. cholecystokinin administered intravenously, or 30-0 ml of magnesium sulfate solution 33%, which is infused through a tube.
2. Second phase– under the influence of a cholecystokinetic substance, a spasm of the sphincter of Oddi occurs, and bile completely ceases to be secreted. The normal duration of this phase is 4–6 minutes. If bile begins to be released earlier again, this indicates sphincter hypotension, and if the spasm continues longer, then it indicates increased tone.
3. Third phase– the sphincter spasm passes and within 3-4 minutes juice is released from the extrahepatic bile ducts. It has a yellow-golden color and is labeled as portion “A” or “A1”.
4. Fourth phase– at this stage, the gallbladder is emptied and portion “B” begins to be released. This is vesicular bile, it is dark yellow, closer to brown, and thick. It contains bilirubin, cholesterol and bile acids.

This process occurs due to contraction of the gallbladder, provoked by the introduction of a cholecystokinetic agent against the background of relaxation of the sphincters of the gallbladder and Oddi. The normal period for continuing the phase is 20–30 minutes. During this time, 20–30 ml of thick secretions should enter the test tube.

If 30 minutes after the cholecystokinetic substance was administered, the secretion of dark bile does not begin, an antispasmodic is administered. This can be a subcutaneous injection of 0.5 ml of atropine 0.1% solution or 30 ml of novocaine 20% solution directly through a probe. When this does not help, cholecystokinin is reintroduced.

If this does not provoke a bladder reflex, we can assume blockage of the ducts. Obstruction of the ducts can be caused by stones, tumors or helminths.

1. Fifth phase– the final stage, which lasts 30 minutes. During this period, light yellow-golden bile begins to be released again. This is portion "C". It is collected in a test tube, maintaining an interval of 10 minutes.

Duodenal intubation is an unpleasant procedure. It is accompanied by vomiting. In some people they are so strong that muscle spasm makes it impossible to diagnose.

This procedure is especially difficult for children. To do it, the child needs to be prepared not only physiologically, but also mentally. The depth of insertion of the probe depends on the age of the child. For newborns it is inserted to 25 cm, from 6 months - to 30 cm. For babies who have reached one year, the hose is inserted to 35 cm, from 2 to 6 years the depth increases to 40-50 cm. After 6 years - from 45 cm. These are approximate options. The doctor determines the exact depth of insertion individually.

It is important to know that throughout the entire procedure there is increased secretion saliva. It should not be swallowed.

You can watch the video to see how duodenal analysis is performed. The price of the procedure is from 950 rubles.

Preparation for duodenal intubation

Before undergoing the procedure, you will need proper preparation. At least 5 days before the scheduled test, you must completely stop taking enzyme and choleretic medications, antispasmodics, laxatives, and vasodilators.

It is also important to start following a diet 5-7 days before the procedure. It is necessary to exclude legumes, dairy and fatty foods, and fried foods from the diet.

Immediately on the day of the procedure, you should avoid physical and emotional stress. They may negatively affect the objectivity of the analysis.

You must follow a special diet before undergoing the procedure.

To confirm or refute the diagnosis of helminthiasis, duodenal secretions are subjected to bacteriological research and examination under a microscope. To do this, part of the secretions is collected into sterile tubes. Their edges are pre-treated with fire. The material must be delivered to the laboratory within a few hours.

To get objective results, diagnostic procedure should be repeated at intervals of 5–7 days. This is due to the fact that if the helminths did not lay eggs on the day the material was collected for analysis, a false negative result can be obtained.

For objective results, probing must be repeated after a few days.

Analysis results and interpretation

A competent doctor should interpret test results.

It takes into account:

• time of occurrence of each phase;
• volume and characteristics of duodenal secretions;
• microbiological indicators of duodenal secretions (their norms are presented in the table).

Table normal indicators duodenal secretions

All portions of discharge should be transparent and free of mucus. A small amount of it is permissible only in portion “A”.

A gastroenterologist will be able to correctly decipher the results of a duodenal examination. At correct implementation the effectiveness of this complex diagnostic method is 90%. This procedure used to clarify many diagnoses associated with impaired functioning gastrointestinal tract. With its help, it is often possible to determine the presence of helminthiases that cannot be detected by other laboratory methods.

Classical and fractional duodenal intubation are procedures in which bile secretions are taken from the patient for analysis using a probe. Proper collection of fluids helps to identify pathologies and detect helminthiasis inside the gallbladder and liver with an accuracy of 90%. The probing procedure for the patient involves a number of uncomfortable sensations, so you need to strictly follow the doctor’s instructions.

, and a qualified doctor should decipher the analysis results.

The duodenal sounding procedure is a diagnostic method that is used to examine the liver and biliary tract. For medicinal purposes medical event used to drain the contents of the gallbladder. Carrying out such diagnostic manipulation becomes possible thanks to special equipment - a duodenal tube, which appearance is a tube made of flexible material 150 cm long and 3-5 mm in diameter. At the tip of the device there is a metal olive with holes on the surface.

A duodenal tube can enter the body through the digestive system, so the tube and other parts must be completely sterile. Using the device, doctors select required amount bile, gastric, intestinal and pancreatic juice from the duodenum. Duodenal method diagnostics is required if it is necessary to obtain information about the activity of the pancreas, the condition of the liver, biliary tract and gallbladder capacity.

Indications for duodenal intubation

The main indications for probing the liver and gallbladder are the following symptoms:

Proper preparation of the patient for duodenal intubation is very important. The process is a set of measures consisting of the following actions:

• discontinuation of choleretic, laxative, antispasmodic and enzyme medications medicines 5 days before the expected sounding;
• a diet that you need to start following 2-3 days before the study;
• refusal to eat 12 hours before the procedure - probing is carried out on an empty stomach;
• bowel cleansing in the evening before duodenal examination.

Diet before probing

Preparation for duodenal intubation involves following a diet. Dietary restrictions are not strict - on the eve of the study, the patient is allowed to eat his usual food. Experts recommend limiting consumption large quantity products that stimulate the biliary system. You should eat less fatty and fried foods, vegetable oil, dishes that include eggs, soups based on rich fish and meat broths, sour cream, cream, sweets.

It is not recommended to drink strong tea, coffee, carbonated drinks, or alcohol. Fruits, vegetables and berries have a strong stimulating effect on the gallbladder. When consuming these products, the secretory function organ. You should not combine vegetables with vegetable oils. Such a union provokes bile secretion. The diet must be followed by the patient for 2-3 days before duodenal examination.

Execution technique

Duodenal examination using a probe can be carried out in two versions: classical and fractional. The first technique, consisting of three phases, is practically not used because it is considered obsolete. As a result of the procedure, the specialist receives three types of bile for study: duodenal, hepatic, and cystic. These fluids are taken from the duodenum, bile ducts and bladder, liver.

The fractional technique of duodenal intubation consists of 5 phases of pumping out bile secretion, which change every 5-10 minutes:

• The first phase is the release of portion A. Liquid is taken at the stage of the probe entering the duodenum before the use of cholecystokinetic agents. The duration of the probing phase is 20 minutes, during which the duodenal contents, consisting of pancreatic, gastric and intestinal juices, and bile, are pumped out.
• At the second stage of duodenal examination, the specialist introduces magnesium sulfate, the release of bile from the spasm of the sphincter of Oddi stops. The duration of this phase varies between 4-6 minutes.
• The third stage of sounding is characterized by sampling the contents of extrahepatic biliary tract, lasts 3-4 minutes.
• The fourth phase of the duodenal examination consists of isolating portion B: the contents of the gallbladder, the secretion of thick bile of a dark yellow or brown hue.
• At the final stage of probing, specialists begin to pump out bile, which has a golden hue. The process takes about half an hour.

Algorithm

Duodenal examination by probing involves a sequential algorithm:

1. The patient must take sitting position straightening your back. The specialist places the subject in oral cavity the tip of the probe, on which the olive is located, must be swallowed.
2. The umbrella then begins to sink deeper through slow swallowing.
3. When the hose for duodenal examination drops inward by 40 cm, it is necessary to advance it another 12 cm. At this stage, a syringe is attached to the device, which helps to collect gastric juice.
4. Next action the rubber tube for probing must be swallowed to the 70 cm mark.
5. When the duodenal tube is immersed to this depth, the patient should lie on the right side. In this case, the specialist places a pillow under the pelvis of the person undergoing probing, and places a warm heating pad.
6. The outer free end of the duodenal hose is lowered into a test tube on a stand designed to collect secretions.
7. Immersion of the probe continues until the 90 cm mark. From 20 to 60 minutes are allotted for this stage of duodenal sounding.
8. After the olive enters the duodenum, the tube is filled with yellow duodenal fluid;
9. When all phases of the procedure have completed, the probing hose is removed with gentle movements.

How to swallow a tube correctly

Probing of the liver and gall the bubble will pass successful if the patient can swallow the tube correctly. The doctor must carefully move the device through the esophagus and stomach to the required marks that are on the hose. Sudden swallowing can cause the probe to curl up, requiring repeated immersion, so the process must be carried out progressively. As the tube is inserted into the digestive system, the patient should breathe through the nose to relieve discomfort.

Patient's feelings

Duodenal examination is an unpleasant process for the patient. Swallowing the tube may cause nausea and aspiration due to salivation. Therefore, it is necessary to use a position lying on your side - saliva will flow into a special tray or onto a diaper. The patient's condition may worsen when drugs are administered - diarrhea or a feeling of fermentation in the intestines occurs. An unpleasant symptom Often there is a drop in blood pressure and a change in heart rate.

Complications during the procedure

The occurrence of complications during probing can be caused by insufficient qualifications of the doctor and an unforeseen reaction of the patient. Experts highlight the following possible negative consequences:

• intense salivation;
• education internal bleeding;
• injuries of the larynx, esophagus and other organs;
• constant vomiting;
• fainting and collapse are rarely possible.

Analysis results and interpretation

Only a competent doctor can evaluate the results of a duodenal examination. In this case, the specialist must take into account the following indicators:

• duration of each phase;
• quantity and characteristics discharge;
• microbiological indicators of liquids, which take into account the normal concentration ranges of leukocytes, cholesterol, bilirubin, bile acids, protein, pH in duodenal samples.

The results of the study of the secretions of the digestive organs make it possible to see the presence of pathologies in the bile ducts, pancreas, and liver. The study is carried out if gastroenterological diseases and the development of liver pathologies are suspected. It shows the presence of foci of inflammation and helminths in the organs of the digestive system.

• accumulation of sputum in the gallbladder;
• bitter taste in the mouth;
• frequent attacks of nausea of ​​unknown etiology;
• pain near the right hypochondrium;
• increase in urine concentration.

Important! For helminthic infestations duodenal examination prescribed for suspected giardia cholecystitis, infection with cat or liver fluke.

The procedure for duodenal examination for children does not differ from probing for adults. But the child needs to be mentally prepared for the study.

Preparation for duodenal examination begins 5 days in advance. In order for the analysis results to be reliable, it is necessary to exclude the use of certain pharmaceuticals:

• choleretic;
• antispasmodics;
• vasodilators;
• laxatives;
• medications that improve the digestion process.

24 hours before the study, the patient is shown atropine - a 0.1% solution is administered subcutaneously. Or take a mixture of 8 drops of the drug, 30 g of xylitol and a small amount of warm water.

Before a chromatic duodenal examination, you must take methylene blue in a gelatin capsule. The product should be consumed 3-4 hours after dinner.

Important! The evening meal should be light: you need to completely eliminate foods that cause gas - milk, brown bread, legumes, potatoes.

On preparatory stage A throat smear is taken from the patient on the eve of probing. This procedure is done in order to see the presence of pathogenic microflora and prevent its penetration into the bile samples being studied.

The procedure is carried out in the morning, on an empty stomach. Before probing antiseptics treat the pharynx and oral cavity.

Duodenal sounding - complicated and not very pleasant procedure. For research, use a probe with a tip made of plastic or metal (olive). The olive has holes into which samples of the material being tested penetrate.

Before starting the diagnosis, marks are applied to the probe that will help determine the location of the probe. The distance between the start and end marks is equal to the length between the front teeth and the navel.

How it is carried out:

1. The tip of the probe is lubricated with glycerin and placed as close as possible to the root of the tongue.
2. The patient should breathe calmly and make uniform swallowing movements.
3. The first mark was at the level of the teeth - the probe reached the stomach.
4. The person needs to lie on his right side and continue to swallow the probe until the second mark.
5. The second mark means that the tip has reached the pylorus - after opening it will be able to penetrate the duodenum.
6. The third mark indicates that the olive has penetrated the duodenum - a golden liquid appears from the hose.

On average, the examination takes approximately 1.5 hours.

Duodenal intubation can be classical or fractional. The classical method is somewhat outdated, since it allows you to take only samples of duodenal, cystic and hepatic bile.

Important! Fractional research consists of 5 phases, which are taken after a strictly defined time.

Portion A appears immediately after the tip of the probe enters the duodenum and is released within 20 minutes. After this, magnesium sulfate is administered - bile from the spasm of the sphincter of Oddi ceases to be released. The phase lasts approximately 5 minutes.

In the third phase, the contents of the extrahepatic bile ducts are released within 3–4 minutes. In the next phase, portion B of bile is released directly from the gallbladder - the thick liquid is dark yellow or Brown color. This type of biomaterial is the most important for research.

Portion C includes light bile, which appears after the gallbladder is completely empty.

Due to the complexity of the procedure, probing is not performed on children under 3 years of age. The main contraindications are asthma, jaundice, hypertensive crisis, varicose veins veins of the esophagus. Duodenal examination is not performed when stomach bleeding, peptic ulcer in the acute stage, the presence of gallstones. This type of examination is contraindicated for expectant and nursing mothers.

Complications during the procedure and research results

Duodenal examination is extremely unpleasant for people. The main problem is the occurrence of strong urges of nausea when swallowing the probe and tip. In some people, the gag reflex is so strong that the muscles spasm, making the examination impossible.

Important! Throughout the procedure, increased salivation is observed - saliva cannot be swallowed, it must be spat into a special tray.

If magnesium sulfate is used as an irritant, it may begin severe diarrhea. When using xylitol, sorbitol, or glucose solution, the patient's condition may worsen if there were strong fermentation processes in the intestines.

People who undergo probing often fall arterial pressure, changes in pulse rhythm are observed. After completing the procedure, you should not jump up suddenly - you must lie down for at least an hour under the supervision of a doctor.

All portions of bile undergo microscopic and bacteriological examination.

Duodenal diagnostics is one of the most informative types of research for many diseases of the gastrointestinal tract and helminthic infestations. The procedure requires preliminary preparation: It is necessary to strictly follow all doctor’s instructions.