I-Ultrasound Ngaba yiVavanyo yoLwazi oluPhambili
Ixesha elithi "isifo se-gallbladder" siquka iimeko zonyango ezichaphazela i-gallbladder, njengama-gallstones, i-cholecystitis enomdla okanye engapheliyo (i-gallbladder ukuvuvukala okubangelwa yi-gallstones), kunye nomhlaza we-gallbladder.
Nangona uhlolo lweempawu, ukuhlolwa ngokomzimba, kunye nokusebenza kwegazi bonke badlala indima ekuxilongweni kwesifo se gallbladder, ukufumana isisu esiswini (mhlawumbi nezinye iimvavanyo zengqondo) yinto ebaluleke kakhulu kwinkqubo yokuxilonga.
Imbali Yonyango
Ukuba ugqirha wakho ugxeka isifo se-gallbladder, uya kubuza malunga neempawu zakho nokuba ngaba nawaphi na amalungu entsapho ayenayo ingxaki ye-gallbladder.
Imizekelo yemibuzo enokuthi iquka:
- Ngaba ufumana iintlungu zesisu, kwaye ukuba kunjalo? Ubuhlungu kwinqanaba eliphezulu okanye elingaphakathi lesisu lisikisela inkinga ye gallbladder.
- Ngaba ubuhlungu besisu buhambisana nokutya? Ngama-gallstones, ubuhlungu obukhulu, buhlungu buya kwenzeka emva kweeyure okanye emva kweeyure emva kokutya ukutya okunamafutha kwaye kuthatha ubuncinane imizuzu engamashumi amathathu.
- Ngaba wakha wafumana le ntlungu? Iintlobo zeentlungu zegilongwe ziba zibi nakwixesha kwaye zikhokelela kwiinkathazo ezifana nokusuleleka kwe-bile ducts okanye ukuvutha kwama-pancreas .
- Ngaba unayo nayiphi na enye impawu ngaphandle kweentlungu, njengemfiva, isisongela, ukuhlanza okanye ukulahleka kwesisindo? Ezi zimpawu ezinxulumene nazo zinokukunceda ugqirha ukuba acinge ukuba isifo se-gallbladder kunye nezinye iingxaki ezinokwenzeka.
Uvavanyo lweMvelo
Emva koko, ugqirha uya kwenza uvavanyo lwangaphakathi, ugxininise kuqala kwimpawu zakho ezibalulekileyo. Abantu abane-acute cholecystitis banokuba nomkhuhlane kunye nentliziyo ephezulu.
Ubukho bentambo ye- jaundice , obonakaliswe ngotshani lwabantu abamhlophe kwamehlo kunye / okanye isikhumba, lubuhlungu ngenxa yexilongwe ye-gallstone ebizwa ngokuba yi-choledocholithiasis apho i-gallstone ishiya i-gallbladder kwaye ibimbela i-bile buct (apho ibhala lingena emathunjini).
Ngethuba lokuhlolwa kwesisu, ugqirha wakho uya kuqaphela ukuba okanye akukho ndawo ebizwa ngokuba "ukulinda" ikhona. Umntu onesifo esibi kakhulu se-cholecystitis "unokulinda" okanye abeke izandla zakhe kwicala eliphezulu elingasentla kwesisu sakhe apho i-gallbladder ikhona ngexesha lovavanyo lomzimba.
Ekugqibeleni, ngexesha lovavanyo lomzimba, ugqirha wakho uya kwenza umqhubi othi "uphawu lukaMurphy." Ngolu vavanyo umntu ucelwa ukuba athabathe umoya okhulu, avumele i-gallbladder ukuba ihambe phantsi ngoko ugqirha angayicinezela. Ukuba umntu ufumana intlungu ebudeni beli vavanyo (ebizwa ngokuba ngumqondiso "olungummangaliso" we-Murphy), ucacisa ukuba unokufumana isifo se-gallbladder.
Iilebhu
Abantu abanesifo se-gallbladder kaninzi banesibalo esiphezulu segazi eliphezulu. Amaseli akho amhlophe ayingqambela isifo-iseli kunye nelophawu oluphakanyisiweyo uhlobo oluthile lokuvuvuka okanye unyango kumzimba. Ukongezelela kwibala eliphezulu legazi lamhlophe, umntu unokuthi aphakanyise iimvavanyo zesebe zesibindi .
Nangona kunokunyuka kancinci kwi-enzyme yesibindi, ukuphakama kwinqanaba le-bilirubin (kunye nxalenye yesifo somsebenzi wegazi) kuphakamisa inkcaso enokwenzeka ye-gallbladder disease (umzekelo, ukuba i-gallstone ichaphazeleka kwi-buct kwaye / okanye kukho isifo se-bile duct).
Ukuba ugqirha wakho ugxeka umdlavuza we-gallbladder ngokusekelwe kwiimvavanyo ze-imaging (umzekelo, i-ultrasound, i-CT scan, okanye i-MRI), unokuhlawula ukuhlolwa kwegazi, njenge-CEA okanye i-CA 19-9. Noko ke, aba makishi, nokuba kunjalo, banokuphakanyiswa ebusweni bezinye i-cancer, ngoko awanalo uphawu olucacileyo lomhlaza we-gallbladder. Ngokugqithiseleyo kunokuba kunjalo, abaphawuli bamathambo asetyenziswa ukulandela impendulo yomntu kwonyango lomhlaza (ukuba luphakanyisiwe ekuqaleni).
Ukucinga
Nangona imbali yonyango, ukuhlolwa kwempilo, kunye neelabhu kunokuxhasa ukuxilongwa kwesifo se-gallbladder, ukucinga okufunekayo ukuqinisekisa ukuxilongwa. Ngamanye amagama, i-gallbladder idinga ukuboniswa, kwaye oku kudlalwa rhoqo nge-ultrasound.
Ultrasound
I-ultrasound yiyo vavanyo esheshayo nesingenabuhlungu yokucinga esisebenzisa amaza omsindo ukuvelisa umfanekiso we gallbladder. Ukongeza kwimizimba yamathambo, ukuqina kwodonga lwe-gallbladder okanye ukuvuvukala kunye ne-polybladder polyps okanye izixuku zingabonwa.
Ngethuba le-ultrasound, uchwepheshe usenokwenza "uphawu lwe-Murphy uphawu". Ngethuba le ndlela, i-ultrasound transducer igxininiswe kwi-gallbladder ngelixa isigulane sithatha umoya. Ukuba i-positive, umntu uya kuba neentlungu xa i-gallbladder ixinzezelwe.
HIDA Scan
Ukuba ukuxilongwa kwesifo se-gallbladder akuqinisekanga emva kwe-ultrasound, i-scan ye-HIDA ingenziwa. Olu vavanyo luvumela ukubonakala kwesebe ye-bile ngokusebenzisa inkqubo ye-bile. Ngethuba lokuskena kweHIDA, i-traceeractiveactive traject ijojowe ngesisu somntu. Le nkunkuma ithathwa yileli yesibindi kwaye isuswa kwi-bile.
Ukuba i-gallbladder ayikwazi ukuboniswa ngolu vavanyo "i-positive" kuba ithetha ukuba kukho uhlobo olunqandekileyo (ngokuphindaphindiweyo ukusuka kwilongwe, kodwa mhlawumbi ukusuka kwidumbu) kwi-cystic duct, eyona yimboyi ehambisa i-bile kwi-gallbladder ukuya i-buct ye-bony efanayo.
CT Scan
I-CT scan yakho esiswini isenokubonakalisa iimpawu zesifo se-gallbladder, njenge-gallbladder udonga ukuvuvukala okanye ukugqithisa kwamafutha. Ingaba luncedo ngokukhethekileyo ukufumanisa iingxaki ezinqabileyo, ezisongela ubomi be-cholecystitis, njenge-gallbladder perforation (xa umgodi ukhula kwi-gallbladder) okanye i-chophycystitis emphysematous (apho kukho ukusuleleka kwindonga ye-gallbladder kwi-bacterial-forming bacteria).
I-Magnetic Resonance Cholangiopancreatographyography (MRCP)
Olu vavanyo lokungcamango olungenangxamnye lugqirha ugqirha ukuba ahlolisise i-bile idonsa ngaphakathi nangaphandle kwesibindi. Ingasetyenziselwa ukuxilonga ilitye kwi-buct ye-bison efanayo (imeko ebizwa ngokuba yi-choledocholithiasis).
I-Endoscopic Retrograde i-Cholangiopancreatographyography (ERCP)
I-ERCP yobabini uvavanyo lokuhlola kunye nolunokuthi lube luvavanyo. Ngexesha le- ERCP , i-gastroenterologist (ugqirha ogxininisa kwizifo zendlela yokutya) uza kufaka ikhamera encinci, eguquguqukayo ebizwa ngokuthi i-endoscope emlonyeni womntu, phantsi kwe-esophagus, idlule kwisisu, kwaye ibe kwisisu esincinci.
Umntu uyakuncenga ngexesha le nkqubo ukwenzela ukuba akukho nto ibuhlungu ngayo. Emva koko, ngokusebenzisa i-endoscope, ityhubhu encinci idluliselwa kwi-buct evamile. Idayi yokuphambana ifakwe kwisibhubhe esincinci ukuze kukhanyiswe inkqubo ye-bile, ebonakalayo nge-x-ray.
Ukusuka kwi-ERCP, i-gallstone evimbela i-bile ducts ingabonwa kwaye isuswe ngexesha elinye. Ukugqithisa kwee-bin ducts kuya kubonakala kunye ne-ERCP, kwaye i-stent ingafakwa ukuba igcine ivule. Ekugqibeleni, ngexesha le-ERCP, ugqirha unokuthatha isampuli yesishubhu (ebizwa ngokuba yi-biopsy) nayiphi na iipolps okanye izixuku ezixhasayo.
Ukuxilongwa ngokungafani
Nangona kunengqiqo ukukrokra isifo se-gallbladder ukuba umntu unentlungu ephezulu kwinxalenye yesisu, ezinye iingxaki (ezininzi iingxaki zesibindi) maziqwalaselwe. Oku kungenxa yokuba isibindi sakho sisekwe kwicala elingasentla lesisu sakho kwaye sixhumeke kwi-gallbladder ngoluhlu lweedayili zebhiliyari.
Imizekelo yeengxaki zesibindi ezingabangela intlungu kwinqanaba eliphezulu elingasese kwesisu esisithi:
- I-hepatitis (umzekelo, i-virus ye-hepatitis) : Ngaphandle kwentlungu, ezinye iimpawu zesifo se-hepatitis zingabandakanya i-jaundice, izitulo ezinobumba , kunye nomchamo omnyama.
- I-Fitz-Hugh-Curtis Syndrome (perihepatitis): Esi sifo sibhekisela ekuvukeleni kwesibindi sentsholongwane esenzeka kubasetyhini abafumana izifo ezivuthayo.
- Ukungena kwesibindi: Abantu abanesifo sikashukela, abaye bafumana ukufakelwa kwesibindi, okanye abanesifo sesibindi, i-gallbladder, okanye i-pancreatic isifo esichengeni sokwenza i-abscess.
- I-portal vein thrombosis: Esi sifo sibhekisela kwi-clot yegazi kwi-veal vein, ephethe isitya segazi esithwala igazi kwisibindi emathunjini.
- Isifo seBudd-Chiari: Esi sisifo esingavamile kakhulu esenzeka xa kukho ukuvinjelwa kweemvini ezikhupha isibindi.
Ngaphandle kwentlungu engxenyeni ephezulu yesisu, umntu onesifo se-gallbladder unokufumana intlungu kwisigaba esiphakathi esiswini (esibizwa ngokuthi intlungu ye-epigastric).
Ezinye izizathu ezinokubangela ubuhlungu be-epigastric ziquka:
- Isifo se-reflux ye-Gastroesophageal (GERD): Ukongeza kwintlungu yesifo se-epigastric, umntu oneGERD unokuphawula ukukhwabanisa kunye neengxaki zokugwinya.
- Isifo sesilonda se-Peptic: Le meko ichaza izilonda eziphuhliswa kwisibilini sesisu okanye inxalenye yokuqala yamathumbu amancinci. Ukubandezeleka esiswini ngumqondiso oqhelekileyo.
- I-Gastritis: Le meko ibhekisela ekuvukeleni kwesisu esiswini kwaye sinokubangela ubuninzi bezinto ezinjenge-alcohol, nonsteroidal anti-inflammatories, okanye intsholongwane.
- I-Pancreatitis: Abantu abane-pancreatitis bafumana amava e-epigastric okanye asemacaleni angasemva aphuma emva kwaye adibaniswa nesicathulo kunye nokuhlanza.
- Intsholongwane Yentliziyo (i-myocardial infarction): Intlungu yesifo se-epigastric ingaba yimboqo yokuqala yokuhlaselwa intliziyo . Umntu unokufumana ukuphefumula okufutshane kunye nezinto ezinobungozi bomzimba.
> Imithombo:
> Abraham S, Rivero HG, Erlikh IV, Griffith LF, Kondamudi VK. Ukuphanda kunye nolawulo olungapheliyo lweempawu ze-gallstones. > Am Fam Physician . 2014 Meyi 15; 89 (10): 795-802.
> I-American Cancer Society. (2016). I-Gallbladder Cancer Diagnosed?
> Sanders G, Kingsnorth AN. Ukuhlaziywa kwezonyango: iGallstones. > BMJ . 2007 Aug 11; 335 (7614): 295-99.
> Zakko SF, Afdhal NH. (2016). I-cholecystitis enobuchule: i-Pathogenesis, iimpawu zekliniki kunye nokuxilongwa. I-Chopra S, (ed). UptoDate, Waltham, MA: UpToDate Inc.