膵管胆道合流異常における下部胆道の超音波像の検討 : 小児例

概要

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We analyzed the ultrasonograms of the pancreatico-biliary ductal system of 8 cases of PBM (biliary joining type 6, pancreatic joining type 2) diagnosed by ERCP, PTC and Ultrasonography (US). The results are as follows : 1) The junciton of the pancreatic duct and common bile duct (CBD) within the pancreatic parenchyma was cleary visualized in 4 out of 8 cases. This was thought to be a telling feature of PBM. 2) A long narrow segment (LNS) composed of the constricted part of the distal CBD and common channel was demonstrated in J5 cases (biliary joining type 4, pnacreatic joining type 1). 3) The pancreatic portion of the CBD including LNS ran through the deep part of the pancreatic parenchyma in all cases. This finding was thought to be characteristic of PBM. Intraoperative ultrasonography (OUS) deary showed the junction of the pancreatico-biliary ductal system in 7 out of 8 cases. In conclusion, ultrasonographic diagnosis was thought to be especially useful in children for whom it is not easy to perform ERCP or PTC. US and OUS could become a new method for diagnosing PBM based on the anatomical relationship between the pancreatico-biliary ductal system and the surrounding structures.
日本小児外科学会の論文
1992-10-20