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What causes decrease in the size of duodenum in an elderly person?

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Posted on Sat, 13 Feb 2016
Question: What can cause the deudonal to be small? My husband had a endoscope and they said it is the diameter of a pencil lead. In 2013 it was the size of a nickel. What is normal size ? They suggested stint which doesn't last a long time, or gastric surgery . He is 72 years old.
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Answered by Dr. T Chandrakant (39 minutes later)
Brief Answer:
Bypass preferably. To rule out cancer

Detailed Answer:
Hi.
Thanks for your query and an elucidate history.
Noted the history related to your husband about colectomy for diverticulitis and and stricture of the duodenum.
The commonest cause is stricture after an ulcer which on healing causes fibrosis and permanent small size.
Another most important reason to be ruled-out is a cancer of the area considering the age of 72.
Hence I would advise you the following:
First of all to confirm that this is benign. This is possible by Endoscopic biopsy and CT scan.
As you already know the stent will have its own complications, it is always better to go for Gastrojejunostomy, this again gives the chance to prove or disprove the presence of malignancy and act accordingly.

I hope this answer helps you getting the correct diagnosis and the proper treatment. Please feel to ask for further relevant queries if you feel tat there is a gap of communication.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. T Chandrakant (1 hour later)
I ask the internist doctor if there was cancer he said no. Can he tell by looking. I don't know if a biopsy was done. Going to family doctor Friday. What kind of surgeon should we go to. General surgeon or a gastric speacialist? He is on a soft diet now no fiber, no meats, no raw vegs, He will follow diet.
doctor
Answered by Dr. T Chandrakant (7 minutes later)
Brief Answer:
To make the diagnosis certain

Detailed Answer:
Since the scope can not be passed through the stricture, how can one be sure about what is lying distally?
Hence it is necessary to be sure before going for further actions.

Your Family Doctor will let you know which Specialist will be the correct choice in your country, whether the General Surgeon or Gastro Surgeon or even the Onco-Surgeon if there is suspicion on CT and/or Biopsy.




Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. T Chandrakant

General Surgeon

Practicing since :1984

Answered : 19176 Questions

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What causes decrease in the size of duodenum in an elderly person?

Brief Answer: Bypass preferably. To rule out cancer Detailed Answer: Hi. Thanks for your query and an elucidate history. Noted the history related to your husband about colectomy for diverticulitis and and stricture of the duodenum. The commonest cause is stricture after an ulcer which on healing causes fibrosis and permanent small size. Another most important reason to be ruled-out is a cancer of the area considering the age of 72. Hence I would advise you the following: First of all to confirm that this is benign. This is possible by Endoscopic biopsy and CT scan. As you already know the stent will have its own complications, it is always better to go for Gastrojejunostomy, this again gives the chance to prove or disprove the presence of malignancy and act accordingly. I hope this answer helps you getting the correct diagnosis and the proper treatment. Please feel to ask for further relevant queries if you feel tat there is a gap of communication.