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X-RAY DIAGNOSIS OF PARS DESCENDENS OF THE DUODENUM Junichi Takase 1 1Dept. of Radiology, National Chiba Hospital. pp.1373-1381
Published Date 1969/11/25
DOI https://doi.org/10.11477/mf.1403110918
  • Abstract
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 By combining hypotonic duodenography with percutaneous transhepatic cholangiography, x-ray diagnosis of diseases of the duodenum and its adjacent organs can now be made exactly. In this paper are described the technics of both procedures together with such diseases as are within reach of diagnosis by these maneuvers.

 The mucosal relief of the duodenum obtained by hypotonic duodenography is a little coarse but usually not to such an extent as to be beyond its conception; the papilla of Vater can be recognized normally in about 60 per cent as and almost circular, protruded silling defect. It swells up according as it is affected by inflammation in the regions of the bile duct and the pancreas. When the muscle of Oddi is ruined by long-standing inflammation, contents of the duodenal lumen may regurgitate up into the bile duct.

 Discrimination between benign and malignant tumors of the duodenum is roentgenologically not difiicult, and percutaneous transhepatic cholangiography is of great diagnostic significance because the papilla of Vater is the predilection site of malignant tumors.

 Lesions of the pancreas affect direct or indirect changes on the duodenum. Pancreatitis presents itself as dilatation or deformation of the duodenal loop. It may also cause Winding or narrowing of the terminal part of the choledochus followed by dilatation of its upper part. For early detection of pancreatic cancer, deformity of the duodenal loop is less important than findings in the terminal part of the common bile duct visalized by percutaneous transhepatic cholangiography.

 Duodenal diverticula, because of the location of their predilection sites, greatly affect the bile duct as well as the pancreas. Of greater impoptance are secondary changes caused by the presence of duodenal diverticula rather than their clinical significance itself. It also has been presented in this paper that lesions in the bile duct and the pancreas can be diagnosed by observation of the duodenal diverticula themselves.


Copyright © 1969, 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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