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World J Gastroenterol. Aug 14, 2007; 13(30): 4112-4116
Published online Aug 14, 2007. doi: 10.3748/wjg.v13.i30.4112
Duodeno-jejunal junction dyssynergia: Description of a novel syndrome
Ahmed Shafik, Ismail A Shafik, Olfat El Sibai, Ali A Shafik
Ahmed Shafik, Ismail A Shafik, Ali A Shafik, Department of Surgery and Experimental Research, Faculty of Medicine, Cairo University, Cairo, Egypt
Olfat El Sibai, Department of Surgery, Faculty of Medicine, Menoufia University, Shebin El-Kom, Egypt
Author contributions: All authors contributed equally to the work.
Correspondence to: Ahmed Shafik, 2 Talaat Harb Street, Cairo 11121, Egypt. shafik@ahmedshafik.com
Telephone: +20-2-37498851 Fax: +20-2-37498851
Received: May 9, 2007
Revised: June 3, 2007
Accepted: June 9, 2007
Published online: August 14, 2007
Abstract

AIM: 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.

CONCLUSION: 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.

Keywords: Epigastric distension; Vomiting; Nausea; Dyspepsia; Chyme