奥狄氏括约肌闭锁不全症的影像学诊断

The Radiology Diagnosis of the Oddi′s Sphincter Insufficiency

目的 :探讨奥狄氏括约肌闭锁不全症的影像诊断、鉴别诊断问题。材料与方法 :回顾性分析我院自 1990年至2 0 0 3年累积 5例奥狄氏括约肌闭锁不全症 (成人 4例 ,婴儿 1例 )的临床资料 (临床表现与实验室检查结果 )及影像学检查资料 (X线表现、B超表现与十二指肠内镜检查结果 )。结果 :5例经丝造影检查 ,奥狄氏括约肌闭锁不全返流均发生于胆道系统 ,X线表现为胆系管道扩张或不规则狭窄、管壁边缘毛糙、模糊、负性结石。成人 4例经B超检查为胆道系统感染合并结石 ,十二指肠内镜检查为十二指肠乳头炎 ,其中 1例乳头增大。临床以上腹部疼痛伴高热畏寒为主要症状。婴儿 1例为先天性十二指肠盲端式闭锁行结肠后空肠十二指肠吻合术后胆道返流。结论 :结石、炎症、黏连牵拉、十二指肠明显逆蠕动、手术创伤。

Purpose:To study the oddi′s sphincter insufficiency,including its pathogeny,pathology,physiology and clinical diagnosis.Materials and Methods:Review the clinical and radiology data of 5 patients with oddi′s sphincter insufficiency,including clinic,X-ray,B ultrasonic and duodenum endoscop.Results:Bile duct backflow was showed by X-ray with contrast media in all cases.4 adults had symptom of bellyache,high fever and chill.1 infant was after a anastomose of jejunum and duodenum.And stones in bile duct were found by duodenum endoscop in 4 cases.Conclusion:Stone and inflammation of the bile duct,operation of abdomen,abnormality of bile duct system etc can induce oddi′s sphincter insufficiency.