壶腹周围十二指肠腔外憩室与急性胰腺炎：一种被低估的病因关联。

Periampullary extraluminal duodenal diverticula and acute pancreatitis: an underestimated etiological association.

作者信息

Uomo G, Manes G, Ragozzino A, Cavallera A, Rabitti P G

机构信息

Department of Internal Medicine, Cardarelli Hospital, Napoli, Italy.

出版信息

Am J Gastroenterol. 1996 Jun;91(6):1186-8.

PMID:8651168

Abstract

OBJECTIVES

The aim of this study was to investigate the etiological role of periampullary extraluminal duodenal diverticula (PEDD) in acute pancreatitis (AP).

METHODS

The study included 433 consecutive patients who underwent successful ERCP during the period 1992-1994; PEDD were discovered in 58 cases (13.4%); patients without PEDD (n = 375) were considered the control group. Indication for ERCP and final diagnosis were recorded in each case.

RESULTS

The age of patients with PEDD was significantly higher (p < 0.0001) than that of controls. The incidence of biliary lithiasis was 65.5% in PEDD and 40.8% in controls (p = 0.0001). A recent episode or acute phase of AP constituted the indication for ERCP in 62% of PEDD and 24.8% of controls (p < 0.0001); idiopathic AP was found more often (p = 0.04) in PEDD patients (13.7%) than in controls (1.8%).

CONCLUSIONS

PEDD should be included in the list of possible etiological factors of AP. The presence of PEDD should be verified, mainly in elderly patients, before defining an AP episode as idiopathic.

摘要

目的

本研究旨在探讨壶腹周围十二指肠腔外憩室（PEDD）在急性胰腺炎（AP）中的病因学作用。

方法

该研究纳入了1992年至1994年间连续接受成功内镜逆行胰胆管造影（ERCP）的433例患者；58例（13.4%）发现有PEDD；无PEDD的患者（n = 375）被视为对照组。记录每例患者的ERCP指征和最终诊断。

结果

PEDD患者的年龄显著高于对照组（p < 0.0001）。PEDD患者的胆石症发生率为65.5%，对照组为40.8%（p = 0.0001）。在PEDD患者中，62%的患者ERCP的指征为近期发作的AP或AP急性期，而对照组为24.8%（p < 0.0001）；PEDD患者中特发性AP的发生率（13.7%）高于对照组（1.8%）（p = 0.04）。