It has been difficult to diagnose the disease of the duodenum, pancreas and biliary system because of anatomical vicinity each other, almost clinical similar symptoms and signs and radiological overlaping shadow.
Various diagnostic procedures were devised for early diagnosis and better prognosis.
Radiologically, conventional U.G.I. study was not content to diagnosis of periampullary region because of rapid peristalsis and overlaping shadow, for the better precise diagnosis.
The author analysed 25 cases clinically who received hypotonic duodenography in S.N.U.H. from Jan. 1971. to Oct. 1972 about 2 years duration and examined differences between radiologic diagnosis and that of operation and biopsy, and made conclusion about clinical diagnostic value of the hypotonic duodenography.
1) Average age of cases was 52.4 years and male was predominant to female, about 2 times.
2) Frequency of symptoms was as follows: epigastric pain 96%, icterus 60%, chilling and fever 52%, nausea 32%, and vomiting 24%.
3) Frequency of the signs was: epigastic tenderness 80%, weight loss 72%, mass 60%, hepatomegaly 56%, diarrhea 16%, and splenomegaly 8%.
4) About half of patients had occult blood in stool.
5) For laboratory examinations, elevation of the serum bilirubin, alkaline phosphatase, transaminase was observed 72%, 64%, 52% respectively in the cases.
6) Operability of 20 operated cases was 43%.
7) In 80% of the cases, the diagnosis of hypotonic duodenography was confirmed to be correct by surgery and biopsy.
8) For the better prognosis of the patient who has equivocal clinical symptoms and signs and, "FALSE NEGATIVE" findings by hypotonic dnodenography, the patient should be traced by the more meticulous aggressive diagnostic procedures and follow up studies.
|