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[胆管引流在微结石症诊断中的应用。对急性特发性胰腺炎及右季肋部持续性疼痛的价值]

[Biliary drainage in the diagnosis of microlithiasis. Value in acute idiopathic pancreatitis and in persistent pain in the right hypochondrium].

作者信息

Bel F J, Aparisi L, García-Tell G, Roselló J V, Rodrigo J M

机构信息

Servicio de Aparato Digestivo, Hospital Clínico Universitario, Valencia.

出版信息

Rev Esp Enferm Dig. 1994 May;85(5):343-7.

PMID:8049104
Abstract

We present a microscopic study of bills obtained via biliary drainage from 33 patients with the diagnosis of acute idiopathic pancreatitis, 33 subjects with pain in the epigastrium and U.Q. with the suspicion of biliary origin, but not revealed by means of routine techniques, and 14 patients with confirmed biliary lithiasis. Duodenal intubation under radiological control was used in all cases, with the administration of 2 UI/kg of CCK IV, in order to study bile A and B under polarized light microscopy. We found cholesterol crystals in 12 cases (36.3%) of acute idiopathic pancreatitis, 5 cases (15.1%) of right hypocondrial pain, and 14 (100%) of biliary lithiasis. Calcium bilirubinate granules were obtained in 15 cases (45.4%) of acute idiopathic pancreatitis, 8 cases (24.4%) of pain in the right hypocondrium and 7 (50%) of biliary lithiasis. We detected giardia in one case of acute idiopathic pancreatitis and an other with pain in the right U.Q. In conclusion, biliary drainage reveals its diagnostic importance in the study of biliary pathology in patients diagnosed of acute idiopathic pancreatitis as well as in cases of chronic right U.Q. al pain suggestive of biliary pathology.

摘要

我们对33例诊断为急性特发性胰腺炎的患者、33例上腹部疼痛且怀疑有胆源性但常规检查未发现的患者以及14例确诊为胆石症的患者通过胆汁引流获取的胆汁进行了显微镜研究。所有病例均在放射学控制下进行十二指肠插管,并给予2 UI/kg的CCK IV,以便在偏光显微镜下研究胆汁A和胆汁B。我们在12例(36.3%)急性特发性胰腺炎患者、5例(15.1%)右季肋部疼痛患者和14例(100%)胆石症患者中发现了胆固醇结晶。在15例(45.4%)急性特发性胰腺炎患者、8例(24.4%)右季肋部疼痛患者和7例(50%)胆石症患者中发现了胆红素钙颗粒。我们在1例急性特发性胰腺炎患者和1例右季肋部疼痛患者中检测到贾第虫。总之,胆汁引流在诊断急性特发性胰腺炎患者以及慢性右季肋部疼痛提示胆源性病变的病例中的胆道病理学研究中显示出其诊断重要性。

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