Ultrasound Ndiyo Muedzo Wokuona Kukosha
Izwi rokuti "gallbladder" rinosanganisira zvirwere zvehutano zvinokonzera nduru, semapuranga, achirwara kana asingagumi cholecystitis (gallbladder kuvhiringidzika kunobva mumaronda emhepo), uye kenza yeguruva.
Kunyange zvazvo zviratidzo zvichingororwa, kuongorora muviri, neropa zvinoshanda zvose zvinoita basa mukuongororwa kweguruvladder chirwere, kuwana mimba ultrasound (pamwe pamwe nemimwe miedzo yekufungidzira) ndiyo inonyanya kukosha yehutano hwekuongorora.
History Medical
Kana chiremba wako achifungira chirwere chenduru, achabvunza pamusoro pezviratidzo zvako uye iwe kana nhengo dzomumhuri dzakambove nematambudziko emaguru.
Mienzaniso yemibvunzo ingabatanidza:
- Uri kutarisana nemarwadzo emimba, uye kana zvakadaro? Nhamo iri kumusoro kwepamusoro kana kumusoro kwepakati pemubereki inokurudzira dambudziko renduru.
- Ko kurwadziwa kwemuviri kunobatanidzwa nekudya here? Nechipfuva, kurwadziwa kwakakomba, kunorwadza kunogona kuitika imwe kana maawa akawanda mushure mekudya kudya kwemafuta uye kunopedza maminitsi makumi matatu.
- Wati wamboona kurwadziwa kwemuviri pakutanga here? Zvikamu zvehutu zvinorwadza zvinowanzova zvakanyanya kupfuura nguva uye zvinogona kutungamirira kumatambudziko akaita soutachiona hwe bile bile kana kuputika kwepascreas .
- Uri kuona chero humwe zviratidzo kunze kwekutambudzika, semafuta, kushungurudza, kusuruvara, kana kuora kurasikirwa? Izvi zviratidzo zvinobatsira zvinogona kubatsira chiremba kuti aone kana chirwere chenduru uye zvimwe zvinetso zvinogona kuitika.
Kuongorora Kwepanyama
Zvadaro, chiremba wako achaita kuongorora kwepanyama, achitarisa pakutanga pane zviratidzo zvako zvinokosha. Vanhu vane acute cholecystitis vanogona kuva nefivha uye kutengesa kwepamwoyo.
Kuvapo kwejaundice , kunoratidzwa nekuchena kwevatsvene vemaziso uye / kana ganda, kunoshungurudza kwekunyengera kweguruva kunonzi choledocholithiasis umo gorosi rinobuda mumhepo uye inovhara main bile duct (uko yakazara inopinda mumuviri).
Panguva yekuongorora mimba, chiremba wako achacherechedza kana kana kwete chiwanikwa chinonzi "kurinda" chiripo. Munhu ane acute cholecystitis anogona "kurinda" kana kuisa mavoko avo kurutivi rworudyi rwemimba yavo apo gorofu iripo panguva yekuongorora mumuviri.
Pakupedzisira, panguva yekuongororwa kwepanyama, chiremba wako achaita basa rinonzi "chiratidzo chaMurphy." Nechiyero ichi munhu anokumbirwa kutora kufema kwakadzika mukati, achibvumira kuti gomba riende pasi kuitira kuti chiremba anogona kuwedzera. Kana munhu achinzwa kurwadziwa kwakanyanya munguva iyi yechiratidzo (inonzi "yakanaka Murphy"), zvinoratidza kuti angave ane chirwere chenduru.
Labs
Vanhu vane chirwere chenduru vanowanzova nechepamusoro reyero rekuyera ropa . Mucherechedzi eropa rako ndiro maitiro ako ekurwara-mauto uye apo chiratidzo chepamusoro chechimwe rudzi rwekuputika kana utachiona mumuviri. Mukuwedzera kune imwe yeropa rakawanda rekuyera ropa, munhu angangodaro akawedzera chiropa chekushanda kwemashoko .
Nepo pangave nekuwedzera kwechiropa mukati mehutachiona hwechiropa, kukwirira muzinga re bilirubin (uye chikamu chechiropa chekuongorora ropa) rinoratidza kuti zvinogona kuitika kumurwere we gallbladder (somuenzaniso, kana gorosi inopindira mu bile duct uye / kana kune utachiona hweB bile duct).
Kana chiremba wako achishungurudza kenza yegorosi yakabva pamagetsi ekufungidzira (somuenzaniso, ultrasound, CT scan, kana MRI), anogona kuronga tumor marker blood test, zvakadai se CEA kana CA 19-9. Aya mavara, zvisinei, angavewo akakwidziridzwa pamberi peimwe kenza, saka haisi kuratidzwa kwakananga kwekenza yeganda. Kazhinji pane zvisiri izvo, izvi zvinokonzera maronda zvinoshandiswa kutevera mhinduro yemunhu kune kurapwa kwekenza (kana yakasimudzwa pakutanga).
Imaging
Kunyange zvazvo nhoroondo yezvokurapa, kuongororwa kwenyama, uye mabhizimusi anogona kutsigira chirwere chenduru, chirwere chinofanirwa chinofanirwa kusimbisa kuongororwa. Mune mamwe mazwi, ganda rinoda kuonekwa, uye izvi zvinowanzoitwa ne ultrasound.
Ultrasound
An ultrasound inokurumidza uye isina kurwadza kuedza kufungidzira inoshandisa mazai ezwi kuti ibudise chifananidzo chenduru. Mukuwedzera kune maronda, ganda remadziro rinoputika kana kuvhara uye nduru yegorosi kana masasa zvinogona kuonekwa.
Munguva ye ultrasound, nyanzvi inogonawo kuita "chiratidzo chaMonical Murphy." Munguva iyi yekufambisa, iyo transducer ye-ultrasound inomanikidzwa pamusoro peguruva apo murwere anotora kufema kwakadzika. Kana zvakakosha, munhu wacho acharwadziwa apo gorosi rinomanikidzwa pasi.
HIDA Scan
Kana kuongororwa kweguruvladder chirwere hakusi chokwadi pashure pekushandiswa kwe ultrasound, HIDA scan inogona kuitwa. Uyu muedzo unobvumira kutarisa kwebe bile kufamba nenzira yeB bile duct system. Munguva yeHIDA scan, muchengeti we-radioactive inoyirwa kuburikidza nemutsipa wemunhu. Izvi zvinotorwa kumusoro nemasero eropa uye zvakabviswa kuva bile.
Kana chirwere chisingaiti kuonekwa, chirwere ichi "chine" nokuti zvinoreva kuti kune chimwe chinhu chekudzivirira (kazhinji kubva kune gorosi, asi zvichida kubva mumarara) mu cystic duct, iyo inotakura bhati iyo inotakura bile kubva ku-gallbladder kusvika the common bile duct.
CT Scan
I-CT scan yebonde rako inogonawo kuratidza zviratidzo zvehutachiona hwehutachiona, hwakaita senyere yeguru rinoputika kana kuti mafuta anonyorera. Inogona kunyanya kukosha pakutsvaga kushaya njodzi, zvinotyisa zvinotyisa zvehupenyu hwechilecystitis, segurubladder perforation (apo gomba rinowedzera mumaronda) kana kuti emphysematous cholecystitis (umo mune chirwere chenduru yeguruva kubva kumagetsi anogadzira gasi).
Magnetic Resonance Cholangiopancreatography (MRCP)
Ichi chisingaenzaniswi chiyero chekufungidzira chinobvumira chiremba kuti aongorore b bile inopinza mukati uye kunze kwechiropa. Inogona kushandiswa kuongororwa ibwe muine yakawanda bile duct (chirwere chinonzi choledocholithiasis).
Endoscopic Retrograde Cholangiopancreatography (ERCP)
An ERCP inosanganisira kuongororwa uye kunogona kurapa. Munguva ye ERCP , gastroenterologist (chiremba anonyanya kugadzirisa zvirwere zvezvirwere) achaisa kamera yakaoma, yakashandurwa inonzi endoscope mumuromo wemunhu, pasi pasi, inopera mudumbu, uye mumukomana muduku.
Munhu anonyoreswa panguva iyi, saka hapana chakaipa. Zvadaro, kuburikidza ne endoscope, duku duku inopfuurirwa munharaunda yakazara bile duct. Kusiyanisa dhayi kunoshandiswa mumuchina uyu muduku kuti uone bhodhi yegwayo, iyo inogona kuonekwa kuburikidza ne x-rays.
Kubva kuE ERCP, gorozi rinodzivirira bile ducts rinogona kuonekwa uye rakabviswa panguva imwe chete. Kuwedzereka kwe-bile ducts kunogona kuonekwa neE ERCP, uye stent inogona kuiswa kuitira kuti duct isvhurwe. Pakupedzisira, munguva yeE ERCP, chiremba anogona kutora sampu yemaoko (inonzi biopsy) yemhando ipi neipi inoshungurudza kana masasa.
Kusiyanisa Kuziva
Kunyange zvazvo zvakanakira kunyungira chirwere chenduru kana munhu ane marwadzo mune chikamu chepamusoro chemuviri wavo, mamwe etiologies (kunyanya zvinetso zveropa) inofanira kufungwa. Izvi ndezvokuti chiropa chako chinowanikwawo kumusoro kwekweshure kweropa rako uye chinosanganiswa ne gallbladder neruzhinji rwebiliary ducts.
Mienzaniso yezvinetso zvechiropa zvinogona kukonzera marwadzo muchepamusoro kwepamusoro kwemuviri zvinosanganisira:
- Hepatitis (somuenzaniso, viral hepatitis) : Kunze kwekunzwa kurwadziwa, zvimwe zviratidzo zvehupatachi zvinogona kusanganisira jaundice, zvidhori zvevhu , uye mumvuri werima.
- Fitz-Hugh-Curtis Syndrome (perihepatitis): Chirwere ichi chinoreva kuvhiringidza kwekuvhara kwechiropa kunoitika kuvakadzi vane chirwere chinoputika cheplavic.
- Chiropa chisingaiti: Vanhu vane chirwere cheshuga, avo vane chirwere chekuvhara chiropa, kana vane vane chiropa chechiropa, gallbladder, kana pancreatic vane mungozi yekugadzira bundu.
- Chirwere chechirwere chepachirwere: Chirwere ichi chinoreva ropa rinoputika mumutsipa wemasuo, iro ndiro ropa rinotakura ropa kuchiropa kubva mumatumbo.
- Chirwere cheBudd-Chiari: Ichi chirwere chisingawanzoitiki chinowanikwa apo kune kuvhiringidzwa kwemitsipa inodzinga chiropa.
Zvimwe kunze kwokurwadziwa mune chikamu chepamusoro chemuviri, munhu ane chirwere chinonzi gallbladder chirwere chinogona kurwadziwa mukati memucheto wepakati penzvimbo yedumbu (inonzi chirwere chepigastric pain).
Zvimwe zvinokonzera kukonzera kurwadziwa kwepamuviri zvinosanganisira:
- Gastroesophageal reflux chirwere (GERD): Mukuwedzera kune kurwadziwa kwepamuviri, munhu ane GERD angaona kuora mwoyo uye zvinetso zvichimedza.
- Peptic Chirwere chechirwere: Ichi chiitiko chinorondedzera maronda anowanikwa pamakamuri emudumbu kana kuti chikamu chokutanga chematumbo maduku. Kupisa kurwadziwa kwepamuviri chiratidzo chakakurumbira.
- Gastritis: Mamiriro aya anoreva kuvhiringidzika kwemuviri wechipfu uye inogona kukonzerwa nezvimwe zvinhu zvakasiyana zvakadai sewaini, nonsteroidal anti-inflammatories, kana chirwere.
- Pancreatitis: Vanhu vane pancreatitis vanowanzoona kurwadziwa kwepagastric kana kuti kuruboshwe kunobhururuka kumashure uye kunobatanidza kushungurudza uye kurutsa.
- Heart Attack (myocardial infarction): kurwadziwa kwepigastric kunogona kuva chiratidzo chokutanga chekurwadziwa kwepfungwa . Munhu angave anewo nguva shomanana yekufema uye yepfungwa zvinokonzera ngozi.
> Sources:
> Abraham S, Rivero HG, Erlikh IV, Griffith LF, Kondamudi VK. Kuvhiya uye kusagadzikana kwekutonga kwezvinyorwa. > Am Phys Physician . 2014 Mbudzi 15; 89 (10): 795-802.
> America Cancer Society. (2016). Ko Gallbladder Cancer Inozivikanwa Sei?
> Sanders G, Kingsnorth AN. Clinical Review: Gallstones. > BMJ . 2007 Aug 11; 335 (7614): 295-99.
> Zakko SF, Afdhal NH. (2016). Acute cholecystitis: Pathogenesis, zvipatara, uye kuongororwa. Chopra S, (ed). UptoDate, Waltham, MA: UpToDate Inc.