Department of Gastroenterology, S.M.S. Medical College, Jaipur, Rajasthan, India.
Endosc Ultrasound. 2013 Oct;2(4):204-7. doi: 10.4103/2303-9027.121247.
Asymptomatic dilatation of bile duct and symptomatic sphincter of Oddi dysfunction have been reported in opium addicts. Except one case report, there is no report in the literature on endoscopic ultrasound (EUS) study of pancreato-biliary system in opium addicts. The aim of the present study was to report the EUS features of pancreato-biliary system in opium addicts presenting with abdominal pain.
A total of 15 opium addicts presenting with upper abdominal pain and dilated common bile duct (CBD) and or pancreatic duct (PD) on abdominal ultrasound were included in this study. EUS findings of pancreato-biliary system were analyzed in these patients.
All the 15 patients were males (mean age 53.3 years) presented with upper abdominal pain. Mean duration of opium addiction was 20.1 years. On EUS CBD was dilated in all the patients while PD was dilated in six patients. Gall bladder, liver and pancreatic parenchyma was normal in all these patients. Surface area of papilla of Vater (SPV) was increased in 12 patients.
Opium addiction causes obstruction at ampulla and produces dilatation of bile duct and PD. Bile duct dilatation was seen in all the patients while PD dilatation was seen in few patients. Increase in SPV was a peculiar finding and appears to be as a result of direct effect of opium on ampulla.
据报道，阿片类药物成瘾者会出现无症状胆管扩张和症状性 Oddi 括约肌功能障碍。除了一例报告外，文献中尚无关于阿片类药物成瘾者胰胆管系统内镜超声（EUS）研究的报道。本研究旨在报告腹痛的阿片类药物成瘾者胰胆管系统的 EUS 特征。
本研究纳入了 15 例以上腹部疼痛和腹部超声显示胆总管（CBD）和/或胰管（PD）扩张的阿片类药物成瘾者。分析这些患者的胰胆管系统 EUS 检查结果。
所有 15 例患者均为男性（平均年龄 53.3 岁），表现为上腹痛。阿片类药物滥用的平均时间为 20.1 年。EUS 显示所有患者 CBD 均扩张，6 例患者 PD 扩张。所有患者的胆囊、肝脏和胰腺实质均正常。12 例患者 Vater 乳头表面面积（SPV）增加。
阿片类药物成瘾会导致壶腹阻塞，引起胆管和 PD 扩张。所有患者均出现胆管扩张，少数患者出现 PD 扩张。SPV 增加是一种特殊发现，似乎是阿片类药物对壶腹的直接作用所致。
