Stomach Probe

STOMACH PROBE (Fig. 4).

A. Prokin. Stomach probes are used for extracting gastric contents during functional examinations and for therapeutic purposes, such as gastric lavage. They were introduced into practice by Kussmaul in 1867. Instead of the hard and elastic probes used initially, soft rubber ones were gradually adopted (following the suggestion of Jürgensen in 1870). A distinction is made between the so-called thick and thin stomach probes. The thick probe consists of an elastic rubber tube 75–100 cm long, with a diameter of 12–15 mm and a lumen of 7–8 mm. The tube has a blind, rounded lower end, and near it are 2 or 3 side openings; other modifications include probes with a single round opening at the very end, as well as probes equipped with a whole series of side openings arranged obliquely opposite each other over a significant length. (Regarding the technique of using the probe, see Stomach - methods of examination.) The introduction of a thick probe into the stomach is contraindicated in cases of severe dyspnea, aortic aneurysm, severe heart failure, varicose veins of the esophagus in patients with liver cirrhosis, shortly after gastric or pulmonary hemorrhages, and in patients prone to cerebral hemorrhages. The thin probe was introduced into clinical practice by Einhorn in 1910 for the examination of duodenal contents (see Duodenal probe); it was first used for gastric examination by Ehrenreich in 1912, and in the USSR by Gorshkov in 1922. In terms of design principle, the thin stomach probe does not differ from the duodenal one; it consists of a narrow rubber tube (diameter 3–5 mm, lumen 1.5–3 mm, length 100 cm) equipped at the end with a metal olive with openings. Individual modifications of the probe, intended to adapt it to the special tasks of functional gastric examination, differ from one another in the diameter of the rubber tube, the shape and size of the olive, and the size of its openings. Probes without olives (an open tube end with side openings) were also used; instead of olives, small rubber balloons with openings were also employed. The most suitable for the purpose is a rubber tube with a diameter of 5 mm and a lumen of 3 mm, which is elastic and not too soft (to avoid the tube coiling in the stomach and the walls collapsing during suction). Among olives, it is advisable to use the pear-shaped olive recommended by Katsch, 3 cm long, with a maximum width of 1 cm and a weight of 8.5 g. At the wide end, the olive is equipped with an opening 4 mm in diameter, in addition to ten side openings 2 mm in diameter. The introduction of the thin probe into clinical practice opened up broad possibilities for the development and improvement of methods for the functional examination of the stomach.