Your sphincter ye Oddi (SO) chimwe chinhu chausingazombotauri kufunga - kunze kwekuti chakanga chiri kuita. YAKO ndeye muscular valve iyo inodzora zvipfeko kubva mumaronda ako uye mapapanasi mumukomana wako muduku. Apo iyi valve isiri kushanda sezvainofanira, sphincter yeOdidi dysfunction (SOD) inoonekwa.
SOD chirwere chisingawanzo utano.
MuSOD, tsvina yemasphincter, ichiita kuti igare yakapfigwa. Izvi zvinogona kuguma mukuchengetedza kwe bile uye pancreatic enzyme mumidziyo yavo. Iyi kuchengetedza inogona kukonzera kuvhara kwechiropa uye / kana pancreas.
SOD yakaparadzaniswa mu-sub-types:
- Ita I SOD: Kuvapo kwekutambudzika, yakawedzera bile duct, uye yakakwirira yeropa uye / kana pancreatic enzyme levels.
- Rudzi rwechipiri SOD: Kuvapo kwekutambudzika, pamwe nedhara rakakura kana mazinga enzyme akareba, asi kwete maviri.
- Rudzi rwechitatu SOD: Kuvapo kwekutambudzika, asi hapana kuipa kunowanikwa kuburikidza ne ultrasound kana basa reropa.
Rudzi rwe III SOD rungatumidzwa seSOD functional. Izvi zvinogona kunge zvakaputsika pasi mubasa re biliary SOD uye inoshanda pancreatic SOD.
Njodzi Zviitiko zveSOD
Zviitiko zvakawanda zveSOD zvinowanikwa mushure mekudzingwa kweguruva kana gastric inpass kurasikirwa nekurasikirwa . Kune zviitiko zvinowanzoitika mushure mekutsvaira kwemajeri, SOD inowanikwa kune vakadzi kupfuura varume, asi zvakakosha kuziva kuti SOD inongogadzirisa chikamu chiduku chevanhu.
Zviratidzo zveSOD
Chiratidzo chikuru cheSOD chirwere chinenge chiri pakati nepakati kusvika kumusoro-kurudyi kwemuviri. Marwadzo acho anogona kupararira pamapfudzi kana kuyambuka chifuva. Pain episodes inogona kuva shoma kana kupedza maawa akawanda. Maitiro emarwadzo anogona kusiyana kubva pachiitiko kusvika pachiitiko, uye anotarisa kubva zvinyoro zvishoma kuderedza.
Zviratidzo zvakabatana zvinosanganisira kurasikirwa nechido, kuora mwoyo, uye kuora muviri. Fivha, kurutsa uye jaundice inogonawo kuitika. (Yeuka, zviratidzo zvakakomba zvakadai izvi zvinoda kurapwa nokukurumidza.)
Kuongororwa kweSOD
Kune miedzo yakasiyana-siyana yeSOD. Chinangwa chekuongororwa kuongororwa ndechokuwana kuongororwa kwakajeka kune izvo zvingave zvichikonzera chiratidzo chekurwadziwa kwepamuviri. Heano mamwe maitiro ekuongororwa:
Basa reRopa: Izvi ndizvo zvinowanzoedzwa kutanga. Chiremba wako achange achitsvaga chiropa chepamusoro kana chepencreas enzymes.
Kufananidza: Chiremba wako angada kuedza kuwana mifananidzo pamusoro pezvinoitika mukati mako, kunyanya yako bile duct, chiropa uye pancreas. Izvi zvinogona kuitwa kuburikidza ne X-rays, ultrasound, CT scan kana MRI.
MRCP: Magnetic resonance cholangio-pancreatography inoshandisa dhayi uye magnetti kuti iwane mufananidzo wewa bile uye pancreatic ducts.
ERCP: Endoscopic retrograde cholangio-pancreatography inoshandisa endoscope, dae uye X-rays kuongorora bile uye pancreatic ducts. ERCP yakashata uye saka inokurudzirwa chete kune Vechipiri I kana II. SO manometry inogona kuitika panguva ye ERCP kuti ione kushamiswa kwemitsipa ye sphincter uye inofungidzirwa kuti inopa tsanangudzo yekujekesa yeSOD.
Kurapa kweSOD
Kurapa kweSOD kunoenderana nekuoma kwezviratidzo. Nezviitiko zvinyoro, chiremba wako anogona kupa mutevedzeri wemasumbu, antispasmodics uye / kana mamwe marudzi ehutambudzi huripo.
Mumamiriro ezvinhu akaoma, iyo SO inodzwa panguva ye ERCP, iyo inonzi inozivikanwa se sphincterotomy. Izvi zvinoitwa kuitira kuti kana kubvisa chero matombo angave ari kuvhara mumatope kana kuti kugadzirisa kukwanisa kwematope kubvisa. Iyi nzira inongowanikwa chete kana SO manometry ichiratidza kuvapo kwekumanikidzika mukati mukati meHS uye inofungidzirwa kuti inounza kuponeswa kukuru kwevamwe vanenge 50% yevarwere. Zvisinei, kune zviitiko zvakakosha kune iyi nzira.
Iyo yakaipisisa yakawanda ine ngozi yekukudzikisa kwepakitiriri. Rimwe dambudziko rinogona kuitika nderokuti nzira inogona kukonzera kupera uye nokudaro kudzoka kwezviratidzo.
Sources:
Behar, J., et.al. "Functional Gallbladder uye Sphincter yeOdidi Disorders" Gastroenterology 2006 130: 1498-1509.
"Sphincter yeOdidi Dysfunction" University of Maryland Health Centre Yakasvika July 22, 2105.
"Sphincter yeOdidi Dysfunction" Yunivhesiti yeRochester Health Encyclopedia Yakasvika musi waJuly 22, 2015.