Onishchenko S V, Darvin V V, Klimova N V, Krasnov E A
Chair of Hospital Surgery of Surgut State University, Surgut, Russia.
Khirurgiia (Mosk). 2018(5):33-39. doi: 10.17116/hirurgia2018533-39.
To develop an optimal diagnostic algorithm in order to the most reliable decrease of inflammatory changes severity in large duodenal papilla in patients with chronic opisthorchiasis.
Medical reports of 384 patients with opisthorchiasis-induced cholangitis have been analyzed. Diagnostic methods were abdominal ultrasound, endoscopic ultrasound of terminal common bile duct, CT scans, MRI of abdominal organs including magnetic resonance cholangiopancreatography and esophagogastroduodenoscopy with biopsy of the papilla, ERCP and PTHC. Comprehensive general and individual analysis of each of them has determined their advantages and disadvantages.
Examination should by comprehensive to evaluate visual appearance of large duodenal papilla, lumen dimensions, state of its walls with histological research. Imaging tests are favorable to determine the diagnosis of papillitis due to possible assessment of lumen dimensions and state of the walls. While making a choice the priority should be given to endoscopic ultrasound examination. It allows visual inspection, assessment of the lumen, the walls of papilla and provides biopsy of deep structures.
制定一种优化的诊断算法，以最可靠地降低慢性后睾吸虫病患者大十二指肠乳头炎症变化的严重程度。
分析了384例由后睾吸虫病引起胆管炎患者的医疗报告。诊断方法包括腹部超声、胆总管末端内镜超声、CT扫描、腹部器官MRI（包括磁共振胰胆管造影）以及食管胃十二指肠镜检查并取乳头活检、内镜逆行胰胆管造影（ERCP）和经皮经肝胆管造影（PTHC）。对每种方法进行综合的总体和个体分析，确定了它们的优缺点。
检查应全面，以评估大十二指肠乳头的外观、管腔大小及其壁的状态，并进行组织学研究。影像学检查有利于诊断乳头炎，因为可以评估管腔大小和壁的状态。在进行选择时，应优先考虑内镜超声检查。它可以进行目视检查、评估乳头管腔和壁，并对深部结构进行活检。
