Biliary Dysfunction Syndrome
Introduction
Introduction to biliary dysfunction syndrome Biliary Tract Dyskinesis Syndrome is also known as Oddi sphincter dysfunction; Oddi sphincter insufficiency; Oddi sphincter relaxation; Vater ampullary insufficiency, intrinsic generally divided into functional, pathological, mechanical, but Cholecystitis, cholelithiasis, biliary ascariasis, etc. are more common. basic knowledge Sickness ratio: 0.5% Susceptible people: no specific population Mode of infection: non-infectious Complications: cholelithiasis pediatric biliary ascariasis
Cause
Causes of biliary motility dysfunction syndrome
It is currently believed that Oddi sphincter dysplasia may be caused by various reasons, leading to functional dysplasia.
Causes
1. Increased gallbladder motor function: This type of dysfunction is generally associated with allergic reactions of the gallbladder or gallbladder inflammation.
(1) gallbladder motor hyperfunction: normal gallbladder tension, but hyperactive movement of the fat meal, so the gallbladder emptying accelerated, 15 minutes after the meal, most of the emptying.
(2) Gallbladder tension is too high: the muscle tension of the gallbladder is too high, but the emptying time is not affected, and it can be normal, accelerated or delayed.
2. Gallbladder motor function is reduced:
(1) Gallbladder motor function decline: normal gallbladder tension, but postprandial contraction is weakened, and emptying is slow.
(2) decreased gallbladder tension and decreased motor function: when the fasting, the gallbladder tension is reduced, the volume is increased, and the emptying after meals is slow.
3. Oddi sphincter dysfunction:
(1) Oddi sphincter tension is too low: gallbladder filling is poor when gallbladder angiography.
(2) Oddi sphincter spasm: mostly due to mental factors, but can also be secondary to adjacent organs such as papillitis, duodenitis, bulbar ulcers, duodenal parasites such as Giardia, Nematode infections, etc.
Prevention
Prevention of biliary dysfunction syndrome
There are no specific preventive measures for this disease, and we should actively participate in physical exercise to improve the body's immunity.
Complication
Complications of biliary dysfunction syndrome Complications cholelithiasis pediatric biliary ascariasis
It is easy to complicated with cholecystitis, cholelithiasis, biliary ascariasis and other diseases.
Symptom
Symptoms of biliary dysfunction syndrome Common symptoms Right upper quadrant pain biliary tract dysfunction limbs cold bloating low fever hypersensitivity gallbladder hypersensitivity anorexia nausea
Most of the patients are high-grade women, with the right flank pain as the main symptom; often accompanied by nausea, abdominal distension, poor appetite, anaesthesia and vomiting and other digestive symptoms, if there are complications, there may be chills, fever, jaundice and other performance .
The disease is more common in women, its clinical manifestations and gallstones are very similar, mainly for abdominal pain, paroxysmal cramps in the upper abdomen or right upper abdomen, some patients may be accompanied by nausea and vomiting, may be induced by eating greasy food, often lasting 2 ~3h, the symptoms are relieved after the antispasmodic drug.
1. Pain: The core symptom of biliary tract disease is pain. Pain can originate from the dilated common bile duct, but the pain is often found in the upper abdomen and right rib, or in the lower sternum, interscapular region, or even under the back. Pain is not related to diet, but can also occur after a meal. Pain may also be caused by Oddi sphincter spasm, its nature and location are very similar to biliary colic, but the attack time is short, only a few minutes to half an hour, the number of episodes is more, more than a day; seizures and mental factors such as anxiety, Nervousness, emotional instability, etc.; inhalation of isoamyl nitrite or sublingual nitroglycerin 0.6mg, the pain can be quickly stopped; morphine 10mg subcutaneous injection can induce pain; no onset of fever or jaundice. Upper right abdominal pain caused by esophagus, small intestine, large intestine or heart disease can also be mistaken for biliary pain. In addition to the presence of acute inflammation, signs do not help to determine biliary motility disorders.
2, dyspepsia symptoms: including loss of appetite, hernia, upper abdominal fullness and other symptoms of upper abdominal discomfort.
3, tired of greasy food: showed a reduced tolerance to fatty foods. Some patients are intolerant of fried foods or high-fat diets, and may have symptoms such as diarrhea and abdominal pain.
4, signs: upper abdominal or upper right abdomen tenderness, Murphy sign can be positive. It is generally thought to be associated with increased pressure in the bile duct and inflammation of the bile duct.
Examine
Examination of biliary dysfunction syndrome
Barium angiography: When the contrast agent enters the intrahepatic bile duct, the extrahepatic bile duct, and the oral gallbladder contrast agent, the contrast agent reaches the end of the common bile duct, suggesting the possibility of high-dynamic dyskinesia.
Diagnosis
Diagnosis and diagnosis of biliary dysfunction syndrome
The diagnosis of this disease is often difficult. If you suspect this disease, you can do cholangiography, barium angiography, B-mode ultrasound and CT to exclude biliary organic diseases.
Should pay attention to the identification of ulcer disease, hepatic syndrome and so on.
