胆路系疾患における十二指腸ファーター乳頭部のX線学的・臨床的研究

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タイトル別名
  • タンロケイ シッカン ニ オケル ジュウニシチョウ ファーター ニュウトウブ ノ Xセンガクテキ リンショウテキ ケンキュウ
  • Radiologic and Clinical Studies on the Papilla of Voter in Biliary Tract Diseases
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  • Original Article

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The papilla of Vater of the duodenum showed various reactive changes in pancreatic and biliary tract diseases. The author studied the radiologic signs of the papilla of Vater by hypotonic duodenography, referring to clinical signs and symptoms, laboratoric data and operative findings. 1. The duodenum was opacified clearly by hypotonic duodenography. The results obtained by this method were valuable for the diagnosis of disease of the duodenum, pancreas and biliary tract. 2. The inflammatory changes were indicated by swelling of the papilla of Vater or functional insufficiency of the sphincter of Oddi. a) The X-ray findings of swelling of the papilla of Vater: i) Smooth, round or oval filling defect, ii) Slight elevation of the surface, iii) Rigidity of the small patch of the inner duodenal wall, iv) Normal surrounding mucosa, v) The regressing filling defect with recovery from inflammation of the biliary tract. b) Functional insufficiency of the sphincter of Oddi: Reflux of duodenal contents through the papilla of Vater into the biliary tract. 3. The X-ray findings of the benign tumor: i) Sharply demarcated filling defect, ii) Translucency with non-specific surface change, iii) Less irregularity of the surrounding mucosa, iv) No rigidity of the duodenal wall. 4. The X-ray findings of the malignant tumor: i) Irregular, large filling defect, ii) Granulated, small round or polymorphic elevation of the surface of irregular excavation (ulcer formation), iii) Thickening, defect, irregularity, widening or narrowing of the surrounding mucosa (complicated mucosal patterns), iv) Diffuse rigidity of the duodenal wall. As other indirect signs, v) Filling defect of the duodenal cap due to delatated common bile duct, vi) Inverted 3-sign of the duodenal loop.

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