Studies on the Functional Disorder in the Papillary Region

Abstract

The functional and organic narrowing of the papillary region which may complicate chronic inflammatory disease taking place in the biliary tract and pancreas, or after removal of a diseased gallbladder has long been known. Clinically we have often experienced cases of reversible narrowing resulting from edema or functional disorder in the papillary region.
We presume not only that the functional disorder in the papillary region is a secondary outcome, but also that it may produce primary effects upon such surrounding organs as the liver and the pancreas.
The functional disorder in the papillary region may lead to various symptoms such as, jaundice and nausea.
It is essential for the diagnosis of a functional disturbance in the papillary region to make minute observations on pictures of the bile duct obtained by endoscopic retrograde cholangio-pancreatography (ERCP).
Keenly feeling the necessity for more objective estimation of pathological conditions in the papillary region, we have developed a pressure sensor based on a semi-conductor. When the function of the terminal part of the choledochus was examined by the use of the pressure sensor, the wave type in the patients free from biliary disease showed a regular pattern, whereas the wave type in the patients with choledocholithiasis showed an irregular pattern. An irregular-wave pattern was seen in 50% of the 20 patients with duodenal ulcer.
These findings suggest that there is a close correlation between the functional disorder in the papillary region and pathologic manifestation of the surrounding organs. In the diagnosis of the functional disorder in the papillary region, the pressure sensor method will be worthy of trial along with other clinical and laboratory examinations.