幽门部异位的 Vater 乳头伴胆管炎：一例报告并文献复习
Ectopic papilla of Vater in the pylorus presenting with cholangitis: A case report with literature review.
作者信息
Alkarboly Taha, Gharib Dana T, Salih Karzan M, Mustafa Shevan M, Salih Abdulwahid M, Kakamad Fahmi H
机构信息
College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq.
Kurdistan Center for Gastroenterology and Hepatology, Sulaimani, Kurdistan, iraq; Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq.
出版信息
Int J Surg Case Rep. 2022 Apr;93:106887. doi: 10.1016/j.ijscr.2022.106887. Epub 2022 Mar 1.
INTRODUCTION
The papilla of Vater is situated in the second part of the duodenum. The current study aims to report a rare occurrence of an ectopic papilla of Vater in the pyloric region presenting with cholangitis.
CASE REPORT
A 59-year-old male patient presented with right upper quadrant pain, anorexia, nausea, and jaundice. He was feverish and exhibited tenderness in the right upper quadrant. Endoscopic retrograde cholangiopancreatography revealed an ectopic papilla of Vater on the pyloric canal. A gastroscope was used instead of a duodenoscope for better visibility of the opening, easier cannulation, and a less risky sphincterotomy. He returned one year after his last procedure with no symptoms and no recurrence of acute cholangitis.
DISCUSSION
It has been suggested that developmental defects are acquired during embryogenesis. If subdivision happens early in embryogenesis, leaving the pars hepatica above the zone of proliferation that divides the stomach from the duodenum, the pars hepatica will develop into a duct that empties into the pylorus area.
CONCLUSION
It is preferable to use a gastroscope rather than a duodenoscope to visualize and manipulate the common bile duct in the case of an ectopic papilla of Vater in the pylorus.
引言
十二指肠乳头位于十二指肠第二部。本研究旨在报告一例罕见的位于幽门区的异位十二指肠乳头伴胆管炎病例。
病例报告
一名59岁男性患者出现右上腹疼痛、厌食、恶心和黄疸。他发热，右上腹有压痛。内镜逆行胰胆管造影显示幽门管有异位十二指肠乳头。使用胃镜而非十二指肠镜以更好地观察开口、更易于插管且括约肌切开术风险更低。上次手术后一年他复诊，无症状且急性胆管炎未复发。
讨论
有观点认为发育缺陷是在胚胎发生过程中获得的。如果在胚胎发生早期发生细分，使肝部位于将胃与十二指肠分开的增殖带上方，肝部将发育成一条排入幽门区的导管。
结论
对于幽门区异位十二指肠乳头的情况，使用胃镜而非十二指肠镜来观察和操作胆总管更佳。
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