FIELD: medicine.
SUBSTANCE: invention refers to medicine, namely to functional diagnostics and gastroenterology, and can be used for differential diagnosis of organic and functional changes of sphincter of Oddi. That is ensured by direct measurement of pressure in the bile ducts, which is measured before and after four successive infusions of contrast agent 50 % p-p of Ultravist with strictly preset rate and volume, and subsequent calculation of pressure gradient: 4 ml/min for 5 minutes; 8 ml/min – 5 min; 15 ml/min – 3 min; 20 ml/min – 2 minutes. If the initial pressure is higher than 200 mm of water column before the test, the result of the test is considered to be negative and further analysis is not carried out. If intra-lateral pressure gradient exceeds 200 mm of water column during more than one infusion, test result is also considered to be negative. If the pressure gradient after introduction of the solution does not exceed 200 mm of water column, the result of the test is considered to be positive. In case of positive result of direct measurement of pressure in bile ducts, a pharmacological test is additionally carried out by administering 20 mg of buscopan or 5 mg of platiphyllin with subsequent repeated testing in 60 minutes according to above described sequence at threshold level of pressure gradient of 150 mm of water column. If observing stable manometry results accompanying spasmolytics introduction, organic involvement of bile ducts is diagnosed. If the manometry results change taking into account the threshold level of the pressure gradient of 150 mm of water column in response to the introduction of antispasmodic, dyskinesia of bile ducts is diagnosed.
EFFECT: method provides optimizing the choice of therapeutic approach to the patients in this category.
1 cl, 2 ex
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Authors
Dates
2019-05-22—Published
2017-04-03—Filed