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Endoscopic Diagnosis of Lesions in the Papillary Area of the Duodenum: Endoscopic and biopsy findings and pancreatocholangiogram T. Kasugai 1 , N. Kuno 1 , I. Aoki 1 , M. Kizu 1 1Department of Medicine, Aichi Cancer Center Hospital pp.1455-1465
Published Date 1972/11/25
DOI https://doi.org/10.11477/mf.1403109017
  • Abstract
  • Look Inside

 Fiberduodenoscopy with JF type B was performed in 1,900 cases clinically suspected to have diseases in the duodenum, pancreatic or biliary systems. Biopsy of the papilla of Vater in 543 instances and endoscopic pancreatocholangiography (EPCG) in 310 cases were studied.

 Shape of the normal papilla of Vater was endoscopically classified into four groups; hemispherical, he-miellipsoid, flat and special types. The hemispherical type was most commonly seen.

 Shape of the orifice of the pancreatic and biliary ducts was classified endoscopically into four types; round, puckered, slit-like and elongated.

 Marked swelling, redness, visible dilated blood vessels in the submucosal layer, edema, bleeding, erosslon, ulcerations, granular, nodula and cauliflowerlike appearances of the papilla of Vater were listed as endoscopical, pathological findings of the papilla as well as a markedly swollen longidudinal fold of the duodenum in the papillary area.

 Inflammation at the papilla was usually demonstrated by biopsy in the cases in which endoscopic findings of inflammation were observed in the papillary area, and a correlation between the both findings was observed in the majority of the cases studied.

 Endoscopic and biopsy examination of the papilla of Vater is one of the most reliable methods to detect a malignancy of the papilla.

 Pressure of injecting dye in the EPCG was controlled with a manometer developed by us.

 Inflammation at the papilla of Vater in biopsy and endoscopical, inflammatory findings in the papillary area were observed in the majority of the cases revealing inflammation in the pancreatic and biliary ducts with chronic pancreatitis, pancreatic carcinoma, stone of the common bile duct, carcinoma of the gall bladder and the common bile duct, and liver tumor diagnosed by EPCG.

 It seems that the inflammatory findings in the papillary area would be signs suggesting the presence of inflammation in the pancreatic and biliary tracts.


Copyright © 1972, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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