METHOD FOR SETTING DIFFERENTIAL DIAGNOSIS OF ODDI SPHINCTER DYSFUNCTION

摘要

FIELD: medicine.;SUBSTANCE: method involves recording choledochus diameter changes in carrying out Oddi sphincter relaxation with isosorbide dinitrate in combination with nutrient loading by means of ultrasonography. Diagnosis is carried out in two stages. Maximum choledochus diameter is determined in the morning with empty stomach at the first day at the beginning of the study. The value is taken as the initial value (D_in). Then, standard breakfast is given to the patient like 200 ml creamy yogurt containing 10% fat and choledochus diameter (d_xi,j) is measured twice with 40 min long pause. Diameter variation (δD_ij) is measured at 40 and 80 min relative to initial value using formula δD_ij = (D_in - d_xi,j)/D_in*100%, where i is the parameter values at 40 min of study; j the parameter values at 80 min of the study. At least one δD_ij value becoming greater than 25%, the second study stage is carried out the next day. 10 mg of isosorbide dinitrate is given to the patient with empty stomach in the morning. 40 min later, the first choledochus diameter D₁ value is measured and standard breakfast is given to the patient like at the first day study. Maximum choledochus diameter (d_xi,j) is once more measured twice with 40 min long pause at 40 and 80 min, respectively. Diameter variation (δD_ij) is measured relative to the first measurement using formula δD_ij = (D₁ - d_xi,j)/D₁*100%, where i is the parameter values at 40 min of study; j the parameter values at 80 min of the study. At least one δD_ij value becoming greater than 25%, organic change of Oddi sphincter is to be diagnosed. At least one δD_ij value becoming equal to or less than 25%, functional disorder is diagnosed.;EFFECT: high reliability of diagnosis.;2 dwg