Biliary ọbara mgbali: Description, akpatara, Mgbaàmà na Ọgwụgwọ

Dị ka n'ihu ọha dị data, ugbu a mụbara ọnụ ọgụgụ nke ọrịa nke biliary usoro. Nke a bụ n'ihi na omume nke na-adịghị mma si ebi ndụ, erighị ezigbo nri, na butere n'aka pụrụ ịrịa. Kwa afọ, e nwere ihe na-abawanye nke ọrịa so site na mmepe nke biliary ọbara mgbali. Nke a oké ọrịa na a ga-atụle isiokwu anyị.

Atụmatụ nke ọrịa

Biliary ọbara mgbali bụ ihe kasị nkịtị ngosipụta nke etuto ahụ na-agba malignancy na edemede na umeji gallbladder. Ọtụtụ mgbe, nke a daa ọrịa na-esonyere okpo jaundice. Pụtara na isi nke pancreas akpụ amalite pịa na opi mgbailu, na e nwere nkume ma ọ bụ polyps akwalite omume nke mgbali nke adịghị enye nkịtị bile eruba. Ọbara mgbali emeso ma ọ bụrụ bụ benign, na-enyemaka nke ịwa ahụ endoscopy.

akpata

Biliary ọbara mgbali bụ enwe ike ịzụlite ndị na-esonụ-enweghị nchịkwa na ọnọdụ:

• Benign na ịza aza etuto ahụ ịda na otu nke biliary tract, na-eduga na-emeghasịkwa nke outflow. Ke adianade do, ọdịdị nke a daa ọrịa n'ihi mkpakọ nke onye nke ducts ghọọ a dị nso ngwa neoplasm.
• Cholelithiasis na calculous cholecystitis. Ọrịa ndị dị na-ji guzobe unyi anaghị agbasa na nkume dị iche iche nke ndị hepatobiliary usoro na ọdịdị jaundice.
• Ọnụnọ nke nje na ducts - helminths.

Ọzọkwa, a na ọrịa nwere ike ịzụlite n'ihi congenital malformations biliary tract, nke nwere ihe gbanwere udi na dayameta nke lumen. Na nke a, ihe mgbaàmà nke ọrịa egosipụta onwe ha na nwata.

mgbaàmà

Mgbaàmà nke biliary ọbara mgbali na mbụ ogbo nke ya mmepe, nnọọ na ụzọ adịghị adịghị na-egosi onwe ha, nke bụ ya mere ọtụtụ ndị ọrịa na-akpalite ọrịa. Otú ọ dị, ọ ga-eche nche na ndị na-esonụ mgbaàmà:

• n'adịghị ike anyị;
• flatulence;
• afọ ọsịsa;
• mgbu na nri elu quadrant.

Isi mgbaàmà bụ n'ụzọ doro anya indicative nke biliary ọbara mgbali syndrome, bụ onye na-abawanye na olu nke splin metụtara na mgbali na portal usoro. Na a gasịrị ogbo emee anaemia, thrombocytopenia, leukopenia.

N'ihi ya e jaundice dị ka a n'ihi nke n'ibu nsogbu na gallbladder. mmiri mmiri nwere ike akpọkọtara na abdominal oghere (ascites), nke mma bụ ya iguzogide na-aga n'ihu ọgwụ. Iji tufuo ya na-emekarị na-ewe ogologo oge. Onye ọrịa na-amalite ka iwelie olu nke afo, fụrụ akpụ ụkwụ, mmụba na-ewe ebe na n'ihu nke veins nke abdominal mgbidi.

The kacha njọ ngosipụta nke ọrịa a ọbara ọgbụgba na afo, colon ma ọ bụ na nkọlọ. All a na-esonyere na-agbọ ọbara. Ọ bụrụ na ọbara na-agba pụtara na nkọlọ, ifịm ga-ọbara.

nchọpụta nsogbu

Instrumental ụzọ nke research a rụrụ na-esonụ mgbe:

• iji gosi na ọnụnọ nke biliary ọbara mgbali;
• ka ọrịa, nke mere ka omume nke ndị dị otú ahụ daa ọrịa.

The kasị ihe ọmụma na-atụle ga-n'okpuru depụtara ụzọ.

ultrasound

Otu n'ime ihe ndị dị mkpa ihe na ị na-ahọrọ a ọgwụgwọ plan biliary ọbara mgbali bụ iji chọpụta na ọkwa nke na-egbochi opi mgbailu. Na nke a, isi-abụghị invasive usoro a na-ewere ultrasound nnyocha nke abdominal uji eze na retroperitoneal ohere. N'ihi dị otú ahụ nchoputa ekpughe mgbasa extra- na intrahepatic opi mgbailu, nke bụ mgbaàmà nke a daa ọrịa.

Biliary ọbara mgbali distal ngọngọ larịị e ji mmụba nke hepaticocholedochus, ma mgbe oge ụfọdụ ịgbasa intrahepatic ducts, na e nwere onye na-abawanye na size nke gallbladder. The duct n'obosara bụ karịa 10 mm bụrụ na nke neoplasms. N'ihi na elu nnweta unit ịchọpụta na-ehi ụra gallbladder na mmụba intrahepatic ducts. The akpụ a hụrụ na 51,3% nke ikpe.

agbakọrọ tomography

CT nke afo na retroperitoneal ohere na-enyere aka iji anya nke uche na atụmatụ nke ihe owuwu nke ọtụtụ akụkụ. Nke a na-amụ na-enye ohere na-ezi ihe megide nnukwu formations na-amata otú ha Germination mere na n'akụkụ Ọdịdị.

Radiopaque research ụzọ

Ọ bụrụ na e enyo n'ịmụ banyere ọrịa ndị dị otú ahụ dị ka biliary ọbara mgbali elu, ndị ọkachamara na-eji retroholangiopankreatografiyu ma ọ bụ endoscopic cholangiography. Okwu Mmalite nke radiopaque ihe maka ndị dị otú ahụ ụzọ rụrụ n'ụzọ dị iche iche, ma nke nwere a mmetụta yiri. N'ihi dị otú ahụ a umi ke radiograph nwere ike na-eme atụmatụ ogo patency nke duct usoro.

biopsy

Nnyocha dị otú ahụ na-atụle ga invasive, na-eme ya naanị na mgbagwoju ikpe, ya bụ na ikpe nke-enyo enyo na ịza aza akpụ. A rụrụ aiming trepanobiopsy imeju n'okpuru ultrasound nduzi. A obere ego nke anụ ahụ e si na isi iyi nke daa ọrịa, nke a na-doro histopathological nyochaa. Nke a n'ihi na-eme ka o kwe omume na-ekpe ikpe na uwa nke a neoplasm.

achọpụta ọrịa laparoscopy

Ọ bụrụ na ndị n'elu-achọpụta ọrịa ụzọ nwere ike mata ihe kpatara nke biliary ọbara mgbali elu, nke na-emezu ihe ọrụ. Ọ nwere ike na-rụrụ site laparoscopy ma ọ bụ laparotomy, na ohere na a oge na-eji dị ka a na-achọpụta ọrịa na ọgwụgwọ usoro ịwa ahụ. Iji nchọpụta nsogbu rụrụ kpọmkwem intraoperative Onyonyo na biopsy. Usoro ịwa ahụ na-rụrụ dị ka ọdịdị nke daa ọrịa okosobode.

ọgwụgwọ

Ọ bụrụ na ị na-chọpụtara na biliary ọbara mgbali elu, ọgwụgwọ bụ mgbanwe ma ọ bụ ịwa ahụ n'aka.

Conservative ọgwụgwọ a na-emekarị rụrụ na ọtọ-anaghị ekwe, mkpochapu nke na-emepụta dị otú ahụ ọgwụ ọjọọ eme ihe dị ka "Atenolol" "nitroglycerin", "Monopril," "Inderal", "Nitrosorbide" "Sulodexide", "ednit".

Ịwa ahụ ọgwụgwọ a rụrụ naanị ma ọ bụrụ na e depụtara na ọgwụ ọjọọ na-adịghị amịghịkwa ọ bụla N'ihi. The ọrụ a rụrụ site nchọpụta nke ascites, nsia agba ọbara, afo na nkọlọ, nakwa dị ka mmepe nke gipersplenicheskogo syndrome. Modern ụzọ na-agụnye ojiji nke ịwa ahụ laparoscopy, nke bụ minimally invasive ịwa ahụ na nwayọọ iwebata site na obere incisions mkpa tube na a igwefoto na ọkụ micromanipulators. Na ileba anya, e nwere a picture, ilekwasị anya dibịa na-eme ka mwepụ nke ihe mgbochi.

Na ọ bụrụ-onwe-medicate na ịṅụ ọgwụ ọjọọ na chemical wepụ akpụ, na-ebelata ibu nke afo na wepụ nkume enweghị a ọgwụ. Ọzọkwa, ọ bụrụ na achọpụtara biliary ọbara mgbali elu, imeju na-na-elu ilu eriri afo, rụrụ na-esonụ omume nzọụkwụ:

• Ha na-enye a dropper ịnọgide na-enwe ezigbo ọmụmụ etoju na electrolyte;
• eji ọgwụ na mma ọbara eruba na oriri na-edozi imeju mkpụrụ ndụ;
• rụrụ antibacterial ọgwụ;
• emefu biliary decompression ụzọ.

ọgwụgwụ

N'ihi ya, biliary ọbara mgbali na-atụle ga a nnọọ oké ọrịa. Ọwọrọ ọrịa na-eduga ọrịa a na-emeso surgically. Ma atụla egwu, n'ihi na-adọ ọgwụgwọ na nke dọkịta nwere ike iwepụ ihe ndị na-akpata nke a ọbara mgbali na daa ọrịa onwe ya.