Special examination and care of biliary system

Biliary system examination and diagnosis of biliary tract disease, the following methods are commonly used for B-mode ultrasound, X-ray examination, duodenal drainage, CT examination, and radionuclide scanning. Basic Information Specialist classification: Digestive examination classification: other examinations Applicable gender: whether men and women apply fasting: fasting Tips: Do not eat greasy food the day before the B-ultrasound examination. It should be fasted for 12 hours and for 4 hours before the examination. Normal value Observed without any abnormalities. Clinical significance Abnormal results: 1. X-ray examination, l0%-15% of gallstones are developed due to the presence of sufficient calcium. Small lesions on the duodenal mucosa are shown to help identify cancerous and calculus obstruction at the lower end of the bile duct. 2. Duodenal drainage. Check for bile outflow and the color is yellow. 3. CT examination and B-ultrasound examination can observe malignant changes of hepatobiliary. 4. Radionuclide scanning has jaundice. Need to check the crowd: patients with liver and gallbladder disease. Precautions Taboo before inspection: 1. Do not eat greasy food one day before the B-ultrasound examination. Before the examination, you should fast for 12 hours and for 4 hours, to ensure that the gallbladder and bile duct are filled with bile and reduce the interference of gastrointestinal contents and gases. 2. Give sedatives one hour before angiography, but morphine is forbidden to avoid confusion caused by Oedic sphincter spasm. As an iodine allergy test. Taboo when checking: 1. B-ultrasound, such as gallbladder does not show need to review, must fast food fat food 24-48 hours. 2. Pay attention to the concentration and uniformity of the contrast agent in the bile. The contrast agent is too thick to cover up the small stones; when it is too light, the display is unclear and can be misdiagnosed. Inspection process First, B type ultrasonic inspection It is a non-invasive examination with clear images and high resolution. It is a safe, fast, simple, economical and accurate method of examination. It is the first choice for biliary diseases. Second, X-ray examination 1. Abdominal plain film cholesterol stones are not developed, and about 10%-15% of gallstones are developed because they contain enough calcium. 2. Oral cholecystography: oral administration of the triiodide iopanoic acid as a contrast agent, film examination. 3. Percutaneous transhepatic cholangiography (PTC) and percutaneous transhepatic catheter drainage (PTCD) PTC is a direct injection of choledochal contrast into the intrahepatic bile duct through the needle, which can clearly show the entire biliary system (including intrahepatic bile duct) The situation, can understand the location, extent and extent of lesions in the bile duct, and help to identify the jaundice. 4. Endoscopic retrograde cholangiopancreatography (ERCP): The lesions in the duodenal papillary area were observed by fiberoptic duodenoscopy, and inserted into the bile duct or pancreatic duct through the nipple opening, and then injected into the catheter through the catheter. Retrograde angiography was performed to show the biliary and pancreatic system, to identify the location of the intrahepatic and extrahepatic bile duct obstruction and the extent of the lesion. 5. Low-tension duodenal barium meal examination: anti-cholinergic drugs are used to inhibit duodenal peristalsis. When it is relaxed, the gas-filled double contrast test is performed. Third, duodenal drainage Place the catheter into the duodenum, inject magnesium sulfate, relax the common bile duct 0ddi sphincter, and contract the gallbladder to collect the bile in the common bile duct, gallbladder and bile duct. Check the color, transparency, and concentration of bile, and check for cholesterol crystals, pus cells, abnormal cells, eggs, and bacteria. Fourth, CT examination V. Radionuclide scanning Intravenous injections such as 99m锝-EHIDA and continuous photography with a sputum camera can dynamically observe the lesions of the intrahepatic and extrahepatic biliary system and the liver, and contribute to the differential diagnosis of jaundice. Not suitable for the crowd Unsuitable for people: Iodine allergy patients are not suitable for drainage. Radiation scanning is not allowed for sensitive radioactive elements. Adverse reactions and risks No complications or hazards.