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英文誌(2004-)

Journal of Medical Ultrasonics

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1989 - Vol.16

Vol.16 No.06

Case Report(症例報告)

(0588 - 0592)

超音波検査法により診断し得た膵管胆道合流異常の1例

A Case of Anomalous Union of the Pancreatico-Biliary Ductal System Diagnosed by Ultrasonography

遠藤 正章1, 棟方 博文1, 羽田 隆吉1, 須貝 道博1, 井上 茂章1, 小野 慶一1, 栗田 武彰2, 加藤 智2

Masaaki ENDOH1, Hirofumi MUNAKATA1, Ryukichi HADA1, Michihiro SUGAI1, Shigeaki INOUE1, Keiichi ONO1, Takeaki KURITA2, Satoru KATO2

1弘前大学医学部第二外科, 2木造成人病センター外科

1The Second Department of Surgery, Hirosaki University School of Medicine, 2Department of Surgery, Kizukuri Adult Disease Center Hospital

キーワード : Anomalous union of the pancreatico-biliary ductal system, Ultrasonography

We examined a case of anomalous union of the pancreatico-biliary duct system (AUPBDS) with fusiform dilatation of the common bile duct diagnosed using ultrasonography (US) before cholangiography.
The patient was a 9 year-old boy with recurring abdominal pain. An ultrasonogram obtained by first filling the stomach and duodenum with water revealed the junction of the pancreatico-biliary duct system to be located in the pancreatic parenchyma. This was pathognomonic for AUPBDS. We also found that the long narrow segment, composed of the constricted part of the common bile duct and the common channel, ran deep in the pancreatic parenchyma to the papilla of Vater. This was also characteristic of AUPBDS. A subsequent cholangiography via the PTCD tubing clearly showed AUPBDS, confirming the diagnosis established using US.
We believe that US can be an useful method for imaging the extramural junction of the pancreatic and biliary duct in AUPBDS patients.