De las Heras G, González Bernal A C, García D, Dueñas C, Silván M
Servicio de Aparato Digestivo, Hospital Universitario Marqués de Valdecilla, Santander.
Rev Esp Enferm Dig. 1994 May;85(5):349-53.
The purpose of this study was to assess the role of duodenal diverticula as an etiologic factor in acute pancreatitis.
We have reviewed the records of patients with diverticulum of the second portion of the duodenum diagnosed by gastroduodenal radiology or endoscopy during the period 1991-1992 in our hospital. As a control group we studied patients without duodenal diverticulum. All subjects underwent biliary-pancreatic ultrasonography. Thirty-eight patients had a duodenal diverticulum and gallstones 36 had a duodenal diverticulum but no gallstones; 21 had gallstones alone; and, finally, 42 patients were free of duodenal diverticulum and gallstones.
Patients with duodenal diverticula had a greater prevalence of gallstones than those without (51.3% VS 33.3%, p < 0.005). Of the thirty-eight patients with duodenal diverticula and gallstones 23.7% had acute pancreatitis. None of the 21 patients without duodenal diverticulum and with gallstones had acute pancreatitis, p < 0.05. The median age of patients with duodenal diverticulum without gallstones was 64.25 years, range 34-85, and the age of those with duodenal diverticulum and gallstones was 70.4 years, range 37-87, p < 0.05.
本研究的目的是评估十二指肠憩室作为急性胰腺炎病因的作用。
我们回顾了1991 - 1992年期间在我院经胃十二指肠放射学或内镜检查诊断为十二指肠第二部憩室的患者记录。作为对照组，我们研究了无十二指肠憩室的患者。所有受试者均接受胆胰超声检查。38例患者有十二指肠憩室和胆结石；36例有十二指肠憩室但无胆结石；21例仅有胆结石；最后，42例患者既无十二指肠憩室也无胆结石。
有十二指肠憩室的患者胆结石患病率高于无十二指肠憩室的患者（51.3%对33.3%，p < 0.005）。在38例有十二指肠憩室和胆结石的患者中，23.7%发生了急性胰腺炎。21例无十二指肠憩室仅有胆结石的患者均未发生急性胰腺炎，p < 0.05。无胆结石的十二指肠憩室患者中位年龄为64.25岁，范围34 - 85岁，有十二指肠憩室和胆结石的患者年龄为70.4岁，范围37 - 87岁，p < 0.05。
1）胆结石可能导致十二指肠第二部憩室患者发生急性胰腺炎。2）十二指肠第二部憩室患者常伴有胆结石。3）十二指肠憩室患者年龄低于既有十二指肠憩室又有胆结石患者这一事实表明，十二指肠憩室可能在胆结石的发病机制中起作用。
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