- 期刊
利用鎝—99m—DISIDA膽道閃爍造影診斷因輸膽管囊腫破裂所引起之膽汁性腹膜炎：病例報告
Diagnosis of Bile Peritonitis Caused by Rupture of Choledochal Cyst via 99mTc-DISIDA Cholescintigraphy: A Case Report
摘要
輸膽管囊腫(choledochal cyst)是一種罕見先天性的構造異常。臨床上的症狀輕如右上腹痛或黃疸，重則破裂導致膽汁性腹膜炎。診斷膽管囊腫的方法很多，包括超音波、電腦斷層攝影、穿皮經肝膽道造影(percutaneoustranshepatic cholangiography,PTC)、內視鏡回溯性膽管胰臟造影(endoscopic retrograde cholangiopancreatography,ERCP)及核醫的膽道閃爍造影(cholescintigraphy)。超音波通常是用來初步篩檢疑似病例，而電腦斷層攝影、穿皮經肝膽道造影、內視鏡回溯性膽管胰臟造影或核醫膽道閃爍造影則是用來做進一步診斷。但在懷疑囊腫破裂導致膽汁性腹膜炎時，由於穿皮經肝膽道造影或內視鏡回溯性膽管胰臟造影具侵犯性，所以有一些臨床醫師改采核醫的閃爍膽道造影來進一步確定診斷。本文報導一例利用鎝-99m-DISIDA膽道閃爍造影診斷因輸膽管囊腫破裂導致腹膜炎之病例。
並列摘要
Choledochal cyst is a rare congenital anomaly, occurring in approximately 1:100,00-150,00 live birth. Clinical manifestations include right upper quadrant pain or jaundice, but bile peritonitis may occur due to rupture in severe cases. There are many diagnostic methods such as sonography, computed tomography, percutaneous transhepatic cholangiography (PTC), endoscopic retrograde cholangiopancreatography (ERCP) and cholescintigraphy. Sonography is usually used for primary survey in suspected cases, while CT, PTC, ERCP, or cholescintigraphy are for further confirmation. However, because of invasive nature of PTC and ERCP, many clinicians start to choose cholescintigraphy in cases of suspected bile peritonitis caused by rupture of choledochal cyst. We report a case of bile peritonitis caused by rupture of choledochal cyst, which was diagnosed by 99mTc-DISIDA cholescintigraphy.
延伸閱讀
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