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Дисфункции сфинктера Одди: от постановки диагноза к лечению
Дисфункции сфинктера Одди: от постановки диагноза к лечению
Гурова М.М., Кириенко А.И. Дисфункции сфинктера Одди: от постановки диагноза к лечению. Consilium Medicum. Педиатрия (Прил.). 2016; 2: 60–65.
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Аннотация
Дисфункция сфинктера Одди выявлена в 1/2 случаев у детей с повторяющимися эпизодами болей в животе в течение последних 3 мес перед обращением к врачу, в 1/3 (38,7%) случаев они сопровождались нарушениями моторики верхних отделов пищеварительного тракта в виде дуодено-гастрального рефлюкса. Характерными клиническими проявлениям для дисфункции сфинктера Одди являются болевой синдром и синдром диспепсии с преобладанием симптомов кишечной диспепсии (метеоризм, урчание в животе), обусловленные развитием вторичной билиарной и панкреатической недостаточности. Применение в качестве патогенетической терапии ферментных препаратов поджелудочной железы в виде мини-таблеток способствовало эффективной коррекции вторичной панкреатической недостаточности и восстановлению функциональной активности поджелудочной железы.
Ключевые слова: функциональные нарушения поджелудочной железы, дисфункция сфинктера Одди.
Key words: functional disorders of the pancreas, dysfunction of sphincter Oddy.
Ключевые слова: функциональные нарушения поджелудочной железы, дисфункция сфинктера Одди.
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Key words: functional disorders of the pancreas, dysfunction of sphincter Oddy.
Полный текст
Список литературы
1. Drossman DA. The functional gastrointestinal disorders and the Rome III process. Gastroenterology 2006; 130: 1377–90.
2. Римарчук Г.В., Щеплягина Л.А. Заболевания поджелудочной железы. В кн.: Детская гастроэнтерология. Под ред. А.А.Баранова, Е.В.Климанской, Г.В.Римарчук. М., 2002; с. 390–423. / Rimarchuk G.V., Shchepliagina L.A. Zabolevaniia podzheludochnoi zhelezy. V kn.: Detskaia gastroenterologiia. Pod red. A.A.Baranova, E.V.Klimanskoi, G.V.Rimarchuk. M., 2002; s. 390–423. [in Russian]
3. Behar J, Corazziari E, Guelrud M et al. Functional gallbladder and sphincter Oddy disorders. Gastroenterology 2006; 130: 1498–509.
4. Cohen S, Bacon BR, Berlin JA et al. National Institutes of Health State-of-the Science Conference Statement; ERCP for diagnosis and therapy. GIE 2002; 56: 803–9.
5. Волкова М.П., Стецкая Н.А. Взгляд педиатров на функциональные заболевания органов пищеварения. 2013. http://ptcevolution.me/vzglyad-pediatrov-na-funkcionalnye-zabolevaniya-organov-pishhevareniya/ / Volkova M.P., Stetskaia N.A. Vzgliad pediatrov na funktsional'nye zabolevaniia organov pishchevareniia. 2013. http://ptcevolution.me/vzglyad-pediatrov-na-funkcionalnye-zabolevaniya-organov-pishhevareniya/ [in Russian]
6. Rajindrajith S, Devanarayana NM. Functional gastrointestinal diseases in children: Stepping out of the box. Sri Lanka J Child Health 2013; 42: 65–9.
7. Toouli J, Roberts-Thomson IC, Dent J, Lee J. Sphincter of Oddi motility disorders in patients with idiopathic recurrent pancreatitis. Br J Surg 1985; 72: 859–63.
8. Varadarajulu S, Hawes R. Key issues in sphincter of Oddi dysfunction. Gastrointest Endosc Clin N Am 2003; 13: 671–94.
9. Болезни поджелудочной железы у детей. Под ред. С.В.Бельмера, А.Ю.Разумовского, Е.А.Корниенко, В.Ф.Приворотского. М.: Медпрактика-М, 2015. / Bolezni podzheludochnoi zhelezy u detei. Pod red. S.V.Bel'mera, A.Iu.Razumovskogo, E.A.Kornienko, V.F.Privorotskogo. M.: Medpraktika-M, 2015. [in Russian]
10. Evans PR, Bak Y-T, Dowsett JF et al. Small bowel dysmotility in patients with post-cholecystectomy sphincter of Oddi dysfunction. Dig Dis Sci 1997; 42: 1507–12.
11. Corazziari ES, Cotton PB. Gallbladder and sphincter of Oddy disorders. Am J Gastroenterol 2010; 105: 764–9.
12. Desautels SG, Slivka A, Hutson WR et al. Postcholecystectomy pain syndrome: pathophysiology of abdominal pain in sphincter of Oddi type III. Gastroenterology 1999; 116: 900–5.
13. Petersen BT. An evidence-based review of sphincter of Oddi dysfunction: part I, presentations with "objective" biliary findings (types I and II). Gastrointest Endosc 2004; 59: 525–34.
14. Hogan WJ, Geenen JE, Dodds WJ. Dysmotility disturbances of the biliary tract: classification, diagnosis, and treatment. Semin Liver Dis 1987; 7: 302–10.
15. Geenen JE, Hogan WJ, Dodds WJ et al. The efficacy of endoscopic sphincterotomy after cholecystectomy in patients with sphincter-of-Oddi dysfunction. N Engl J Med 1989; 320: 82–7.
16. Семенова О.В. Диагностика билиарной дисфункции у детей. Охрана материнства и детства. 2005; 1 (6): 27–31. / Semenova O.V. Diagnostika biliarnoi disfunktsii u detei. Okhrana materinstva i detstva. 2005; 1 (6): 27–31. [in Russian]
17. Toouli J, Di Francesco V, Saccone G et al. Division of the sphincter of Oddi for treatment of dysfunction associated with recurrent pancreatitis. Br J Surg 1996; 83: 1205–10.
18. Sherman S, Lehman GA. Sphincter of Oddi dysfunction: diagnosis and treatment. JOP 2001; 2: 382–400.
19. Fazel A, Geenen JE, MoezArdalan K, Catalano MF. Intrapancreatic ductal pressure in sphincter of Oddi dysfunction. Pancreas 2005; 30: 359–61.
20. Eversman D, Fogel EL, Rusche M et al. Frequency of abnormal pancreatic and biliary sphincter manometry compared with clinical suspicion of sphincter of Oddi dysfunction. Gastrointest Endosc 1999; 50: 637–41.
21. Guelrud M, Morera C, Rodriguez M et al. Sphincter of Oddi dysfunction in children with recurrent pancreatitis and anomalous pancreaticobiliary union: an etiologic concept. Gastrointest Endosc 1999; 50: 194–9.
22. Laugier R. Dynamic endoscopic manometry of the response to secretin in patients with chronic pancreatitis. Endoscopy 1994; 26: 222–7.
23. Vestergaard H, Kruse A, Rokkjaer M et al. Endoscopic manometry of the sphincter of Oddi and the pancreatic and biliary ducts in patients with chronic pancreatitis. Scand J Gastroenterol 1994; 29: 188–92.
24. Tarnasky PR, Hoffman B, Aabakken L et al. Sphincter of Oddi dysfunction is associated with chronic pancreatitis. Am J Gastroenterol 1997; 92: 1125–9.
2. Rimarchuk G.V., Shchepliagina L.A. Zabolevaniia podzheludochnoi zhelezy. V kn.: Detskaia gastroenterologiia. Pod red. A.A.Baranova, E.V.Klimanskoi, G.V.Rimarchuk. M., 2002; s. 390–423. [in Russian]
3. Behar J, Corazziari E, Guelrud M et al. Functional gallbladder and sphincter Oddy disorders. Gastroenterology 2006; 130: 1498–509.
4. Cohen S, Bacon BR, Berlin JA et al. National Institutes of Health State-of-the Science Conference Statement; ERCP for diagnosis and therapy. GIE 2002; 56: 803–9.
5. Volkova M.P., Stetskaia N.A. Vzgliad pediatrov na funktsional'nye zabolevaniia organov pishchevareniia. 2013. http://ptcevolution.me/vzglyad-pediatrov-na-funkcionalnye-zabolevaniya-organov-pishhevareniya/ [in Russian]
6. Rajindrajith S, Devanarayana NM. Functional gastrointestinal diseases in children: Stepping out of the box. Sri Lanka J Child Health 2013; 42: 65–9.
7. Toouli J, Roberts-Thomson IC, Dent J, Lee J. Sphincter of Oddi motility disorders in patients with idiopathic recurrent pancreatitis. Br J Surg 1985; 72: 859–63.
8. Varadarajulu S, Hawes R. Key issues in sphincter of Oddi dysfunction. Gastrointest Endosc Clin N Am 2003; 13: 671–94.
9. Bolezni podzheludochnoi zhelezy u detei. Pod red. S.V.Bel'mera, A.Iu.Razumovskogo, E.A.Kornienko, V.F.Privorotskogo. M.: Medpraktika-M, 2015. [in Russian]
10. Evans PR, Bak Y-T, Dowsett JF et al. Small bowel dysmotility in patients with post-cholecystectomy sphincter of Oddi dysfunction. Dig Dis Sci 1997; 42: 1507–12.
11. Corazziari ES, Cotton PB. Gallbladder and sphincter of Oddy disorders. Am J Gastroenterol 2010; 105: 764–9.
12. Desautels SG, Slivka A, Hutson WR et al. Postcholecystectomy pain syndrome: pathophysiology of abdominal pain in sphincter of Oddi type III. Gastroenterology 1999; 116: 900–5.
13. Petersen BT. An evidence-based review of sphincter of Oddi dysfunction: part I, presentations with "objective" biliary findings (types I and II). Gastrointest Endosc 2004; 59: 525–34.
14. Hogan WJ, Geenen JE, Dodds WJ. Dysmotility disturbances of the biliary tract: classification, diagnosis, and treatment. Semin Liver Dis 1987; 7: 302–10.
15. Geenen JE, Hogan WJ, Dodds WJ et al. The efficacy of endoscopic sphincterotomy after cholecystectomy in patients with sphincter-of-Oddi dysfunction. N Engl J Med 1989; 320: 82–7.
16. Semenova O.V. Diagnostika biliarnoi disfunktsii u detei. Okhrana materinstva i detstva. 2005; 1 (6): 27–31. [in Russian]
17. Toouli J, Di Francesco V, Saccone G et al. Division of the sphincter of Oddi for treatment of dysfunction associated with recurrent pancreatitis. Br J Surg 1996; 83: 1205–10.
18. Sherman S, Lehman GA. Sphincter of Oddi dysfunction: diagnosis and treatment. JOP 2001; 2: 382–400.
19. Fazel A, Geenen JE, MoezArdalan K, Catalano MF. Intrapancreatic ductal pressure in sphincter of Oddi dysfunction. Pancreas 2005; 30: 359–61.
20. Eversman D, Fogel EL, Rusche M et al. Frequency of abnormal pancreatic and biliary sphincter manometry compared with clinical suspicion of sphincter of Oddi dysfunction. Gastrointest Endosc 1999; 50: 637–41.
21. Guelrud M, Morera C, Rodriguez M et al. Sphincter of Oddi dysfunction in children with recurrent pancreatitis and anomalous pancreaticobiliary union: an etiologic concept. Gastrointest Endosc 1999; 50: 194–9.
22. Laugier R. Dynamic endoscopic manometry of the response to secretin in patients with chronic pancreatitis. Endoscopy 1994; 26: 222–7.
23. Vestergaard H, Kruse A, Rokkjaer M et al. Endoscopic manometry of the sphincter of Oddi and the pancreatic and biliary ducts in patients with chronic pancreatitis. Scand J Gastroenterol 1994; 29: 188–92.
24. Tarnasky PR, Hoffman B, Aabakken L et al. Sphincter of Oddi dysfunction is associated with chronic pancreatitis. Am J Gastroenterol 1997; 92: 1125–9.
2. Римарчук Г.В., Щеплягина Л.А. Заболевания поджелудочной железы. В кн.: Детская гастроэнтерология. Под ред. А.А.Баранова, Е.В.Климанской, Г.В.Римарчук. М., 2002; с. 390–423. / Rimarchuk G.V., Shchepliagina L.A. Zabolevaniia podzheludochnoi zhelezy. V kn.: Detskaia gastroenterologiia. Pod red. A.A.Baranova, E.V.Klimanskoi, G.V.Rimarchuk. M., 2002; s. 390–423. [in Russian]
3. Behar J, Corazziari E, Guelrud M et al. Functional gallbladder and sphincter Oddy disorders. Gastroenterology 2006; 130: 1498–509.
4. Cohen S, Bacon BR, Berlin JA et al. National Institutes of Health State-of-the Science Conference Statement; ERCP for diagnosis and therapy. GIE 2002; 56: 803–9.
5. Волкова М.П., Стецкая Н.А. Взгляд педиатров на функциональные заболевания органов пищеварения. 2013. http://ptcevolution.me/vzglyad-pediatrov-na-funkcionalnye-zabolevaniya-organov-pishhevareniya/ / Volkova M.P., Stetskaia N.A. Vzgliad pediatrov na funktsional'nye zabolevaniia organov pishchevareniia. 2013. http://ptcevolution.me/vzglyad-pediatrov-na-funkcionalnye-zabolevaniya-organov-pishhevareniya/ [in Russian]
6. Rajindrajith S, Devanarayana NM. Functional gastrointestinal diseases in children: Stepping out of the box. Sri Lanka J Child Health 2013; 42: 65–9.
7. Toouli J, Roberts-Thomson IC, Dent J, Lee J. Sphincter of Oddi motility disorders in patients with idiopathic recurrent pancreatitis. Br J Surg 1985; 72: 859–63.
8. Varadarajulu S, Hawes R. Key issues in sphincter of Oddi dysfunction. Gastrointest Endosc Clin N Am 2003; 13: 671–94.
9. Болезни поджелудочной железы у детей. Под ред. С.В.Бельмера, А.Ю.Разумовского, Е.А.Корниенко, В.Ф.Приворотского. М.: Медпрактика-М, 2015. / Bolezni podzheludochnoi zhelezy u detei. Pod red. S.V.Bel'mera, A.Iu.Razumovskogo, E.A.Kornienko, V.F.Privorotskogo. M.: Medpraktika-M, 2015. [in Russian]
10. Evans PR, Bak Y-T, Dowsett JF et al. Small bowel dysmotility in patients with post-cholecystectomy sphincter of Oddi dysfunction. Dig Dis Sci 1997; 42: 1507–12.
11. Corazziari ES, Cotton PB. Gallbladder and sphincter of Oddy disorders. Am J Gastroenterol 2010; 105: 764–9.
12. Desautels SG, Slivka A, Hutson WR et al. Postcholecystectomy pain syndrome: pathophysiology of abdominal pain in sphincter of Oddi type III. Gastroenterology 1999; 116: 900–5.
13. Petersen BT. An evidence-based review of sphincter of Oddi dysfunction: part I, presentations with "objective" biliary findings (types I and II). Gastrointest Endosc 2004; 59: 525–34.
14. Hogan WJ, Geenen JE, Dodds WJ. Dysmotility disturbances of the biliary tract: classification, diagnosis, and treatment. Semin Liver Dis 1987; 7: 302–10.
15. Geenen JE, Hogan WJ, Dodds WJ et al. The efficacy of endoscopic sphincterotomy after cholecystectomy in patients with sphincter-of-Oddi dysfunction. N Engl J Med 1989; 320: 82–7.
16. Семенова О.В. Диагностика билиарной дисфункции у детей. Охрана материнства и детства. 2005; 1 (6): 27–31. / Semenova O.V. Diagnostika biliarnoi disfunktsii u detei. Okhrana materinstva i detstva. 2005; 1 (6): 27–31. [in Russian]
17. Toouli J, Di Francesco V, Saccone G et al. Division of the sphincter of Oddi for treatment of dysfunction associated with recurrent pancreatitis. Br J Surg 1996; 83: 1205–10.
18. Sherman S, Lehman GA. Sphincter of Oddi dysfunction: diagnosis and treatment. JOP 2001; 2: 382–400.
19. Fazel A, Geenen JE, MoezArdalan K, Catalano MF. Intrapancreatic ductal pressure in sphincter of Oddi dysfunction. Pancreas 2005; 30: 359–61.
20. Eversman D, Fogel EL, Rusche M et al. Frequency of abnormal pancreatic and biliary sphincter manometry compared with clinical suspicion of sphincter of Oddi dysfunction. Gastrointest Endosc 1999; 50: 637–41.
21. Guelrud M, Morera C, Rodriguez M et al. Sphincter of Oddi dysfunction in children with recurrent pancreatitis and anomalous pancreaticobiliary union: an etiologic concept. Gastrointest Endosc 1999; 50: 194–9.
22. Laugier R. Dynamic endoscopic manometry of the response to secretin in patients with chronic pancreatitis. Endoscopy 1994; 26: 222–7.
23. Vestergaard H, Kruse A, Rokkjaer M et al. Endoscopic manometry of the sphincter of Oddi and the pancreatic and biliary ducts in patients with chronic pancreatitis. Scand J Gastroenterol 1994; 29: 188–92.
24. Tarnasky PR, Hoffman B, Aabakken L et al. Sphincter of Oddi dysfunction is associated with chronic pancreatitis. Am J Gastroenterol 1997; 92: 1125–9.
________________________________________________
2. Rimarchuk G.V., Shchepliagina L.A. Zabolevaniia podzheludochnoi zhelezy. V kn.: Detskaia gastroenterologiia. Pod red. A.A.Baranova, E.V.Klimanskoi, G.V.Rimarchuk. M., 2002; s. 390–423. [in Russian]
3. Behar J, Corazziari E, Guelrud M et al. Functional gallbladder and sphincter Oddy disorders. Gastroenterology 2006; 130: 1498–509.
4. Cohen S, Bacon BR, Berlin JA et al. National Institutes of Health State-of-the Science Conference Statement; ERCP for diagnosis and therapy. GIE 2002; 56: 803–9.
5. Volkova M.P., Stetskaia N.A. Vzgliad pediatrov na funktsional'nye zabolevaniia organov pishchevareniia. 2013. http://ptcevolution.me/vzglyad-pediatrov-na-funkcionalnye-zabolevaniya-organov-pishhevareniya/ [in Russian]
6. Rajindrajith S, Devanarayana NM. Functional gastrointestinal diseases in children: Stepping out of the box. Sri Lanka J Child Health 2013; 42: 65–9.
7. Toouli J, Roberts-Thomson IC, Dent J, Lee J. Sphincter of Oddi motility disorders in patients with idiopathic recurrent pancreatitis. Br J Surg 1985; 72: 859–63.
8. Varadarajulu S, Hawes R. Key issues in sphincter of Oddi dysfunction. Gastrointest Endosc Clin N Am 2003; 13: 671–94.
9. Bolezni podzheludochnoi zhelezy u detei. Pod red. S.V.Bel'mera, A.Iu.Razumovskogo, E.A.Kornienko, V.F.Privorotskogo. M.: Medpraktika-M, 2015. [in Russian]
10. Evans PR, Bak Y-T, Dowsett JF et al. Small bowel dysmotility in patients with post-cholecystectomy sphincter of Oddi dysfunction. Dig Dis Sci 1997; 42: 1507–12.
11. Corazziari ES, Cotton PB. Gallbladder and sphincter of Oddy disorders. Am J Gastroenterol 2010; 105: 764–9.
12. Desautels SG, Slivka A, Hutson WR et al. Postcholecystectomy pain syndrome: pathophysiology of abdominal pain in sphincter of Oddi type III. Gastroenterology 1999; 116: 900–5.
13. Petersen BT. An evidence-based review of sphincter of Oddi dysfunction: part I, presentations with "objective" biliary findings (types I and II). Gastrointest Endosc 2004; 59: 525–34.
14. Hogan WJ, Geenen JE, Dodds WJ. Dysmotility disturbances of the biliary tract: classification, diagnosis, and treatment. Semin Liver Dis 1987; 7: 302–10.
15. Geenen JE, Hogan WJ, Dodds WJ et al. The efficacy of endoscopic sphincterotomy after cholecystectomy in patients with sphincter-of-Oddi dysfunction. N Engl J Med 1989; 320: 82–7.
16. Semenova O.V. Diagnostika biliarnoi disfunktsii u detei. Okhrana materinstva i detstva. 2005; 1 (6): 27–31. [in Russian]
17. Toouli J, Di Francesco V, Saccone G et al. Division of the sphincter of Oddi for treatment of dysfunction associated with recurrent pancreatitis. Br J Surg 1996; 83: 1205–10.
18. Sherman S, Lehman GA. Sphincter of Oddi dysfunction: diagnosis and treatment. JOP 2001; 2: 382–400.
19. Fazel A, Geenen JE, MoezArdalan K, Catalano MF. Intrapancreatic ductal pressure in sphincter of Oddi dysfunction. Pancreas 2005; 30: 359–61.
20. Eversman D, Fogel EL, Rusche M et al. Frequency of abnormal pancreatic and biliary sphincter manometry compared with clinical suspicion of sphincter of Oddi dysfunction. Gastrointest Endosc 1999; 50: 637–41.
21. Guelrud M, Morera C, Rodriguez M et al. Sphincter of Oddi dysfunction in children with recurrent pancreatitis and anomalous pancreaticobiliary union: an etiologic concept. Gastrointest Endosc 1999; 50: 194–9.
22. Laugier R. Dynamic endoscopic manometry of the response to secretin in patients with chronic pancreatitis. Endoscopy 1994; 26: 222–7.
23. Vestergaard H, Kruse A, Rokkjaer M et al. Endoscopic manometry of the sphincter of Oddi and the pancreatic and biliary ducts in patients with chronic pancreatitis. Scand J Gastroenterol 1994; 29: 188–92.
24. Tarnasky PR, Hoffman B, Aabakken L et al. Sphincter of Oddi dysfunction is associated with chronic pancreatitis. Am J Gastroenterol 1997; 92: 1125–9.
Авторы
М.М.Гурова1, А.И.Кириенко2
1 ФГАОУ ВО Белгородский государственный национальный исследовательский университет. 308015, Россия, Белгород, ул. Победы, д. 85;
2 ОГБУЗ Городская детская больница г. Белгорода. 308014, Россия, Белгород, ул. Садовая, д. 1а
1 Belgorod State National Research University. 308015, Russian Federation, Belgorod, ul. Pobedy, d. 85;
2 Belgorod City Children Hospital. 308014, Russian Federation, Belgorod, ul. Sadovaia, d. 1a
1 ФГАОУ ВО Белгородский государственный национальный исследовательский университет. 308015, Россия, Белгород, ул. Победы, д. 85;
2 ОГБУЗ Городская детская больница г. Белгорода. 308014, Россия, Белгород, ул. Садовая, д. 1а
________________________________________________
1 Belgorod State National Research University. 308015, Russian Federation, Belgorod, ul. Pobedy, d. 85;
2 Belgorod City Children Hospital. 308014, Russian Federation, Belgorod, ul. Sadovaia, d. 1a
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