Wirsung duct kukulitsa

Udindo wa kapamba ndi wokulirapo. Izi ziwalo zakunja (exocrine) ndi zamkati (endocrine) zobisika zimakhudzidwa ndimatumbo ndimayendedwe a lipid, carbohydrate ndi protein metabolism m'thupi. Mavuto pantchito ya thupi amakhudza mkhalidwe wa Wirsung duct. Kutupa kwachimbudzi kwa chiwonetsero cha thupi kumasonyezedwa ndi kufalikira kwake, ndipo pancreatitis yosatha, kukula kwake kumawonedwa, kusinthana ndi madera a stenosis (kuchepetsa). Ndi matenda a gland mu ma excretory duct, kusintha kumachitika komwe kumapezeka pogwiritsa ntchito njira zamakono zofufuzira.

Wirsung duct

Choyezera chachikulu cha pancreatic chimatalikirana kutalika konse kwa kapamba, mpaka pamwamba pake. Wirsung duct, wopangidwa kuchokera kuphatikizika kwa ducts yaying'ono ya limba lobules, imakhala ndi kutalika kwa masentimita 20. Kanemayo nthawi zambiri amatsirizika mu duodenum, pamalo opangira chiwalo monga sphincter. Kulumikizana kowoneka bwino kwa kutulutsa kwa gland ndi duodenum kumagwira ntchito, zotsatira zake ndikusintha kwamatumbo ndi madzi a pancreatic.

Kukula ndi mawonekedwe a Wirsung duct mwa anthu ambiri sizigwirizana ndipo zimatengera kapangidwe ka thupi. Zambiri, zimaphatikizana ndi wamba bile duct (choledochus) ndikulowa mu duodenum. Ziwerengero zamadipatimenti ake omaliza pamodzi ndi mawonekedwe wamba zimatha kukhala zosiyana. Pali mitundu inayi mwa iyo:

• Kulumikizana konsekonse kwa matumbo onsewo kumadzalowa m'matumbo, pomwe amapanga mtundu wamkati. Kutumphukira kwa Oddi nthawi yomweyo, kuphimba zigawo zonse ziwiri, ndipo mawonekedwe ake amawatseka. Mtundu wofananawo umawonedwa mu 55% ya milandu.
• Kulumikizana kwa mitsitsi yonse pafupi ndi duodenum popanda kupanga wamba. Mtundu uwu umadziwika mu 33.6%.
• Osiyanasiyana otuluka mu duodenum wa aliyense ducts. Uwu ndi mtundu wosowa kwambiri, womwe umapezeka 4%.
• Kuphatikiza kwa ma ducke patali patali ndi nipple ya Vater. Onsewa amatsegulukira mu duodenum ndikugwira makoma awo. Pafupifupi 8.5% ya milandu ikuwonetsa kuti kuphatikiza uku kumasiyana.

Izi mawonekedwe ofunikira ndizofunikira mokwanira kuti zitheke zakukula kwa masanjidwe a Wirsung duct. Chiyanjano cha bile duct yodziwika bwino ndi duct wamkulu komanso mutu wa gland, ubale wawo ndi duodenum umagwira gawo lalikulu pakumvetsetsa ndikupanga zizindikiro zingapo za pathologies ndi khansa ya pancreatic.

Chithunzi cha Ultrasound

Kusintha kwa kapamba (kuphwanya ziwalo parenchyma) kumatha chifukwa cha zifukwa zingapo za causative. Zikuwoneka pakuwunika kwa ultrasound, komwe kumakupatsani mwayi kuti muwone kukula ndi kapangidwe ka parenchyma, kuwona ma contours, kukhalapo kwa pathologies, komanso mkhalidwe wa ma ducts a gland. Zizindikiro za matenda ena omwe adapezeka pa nthawi ya mayeso zikuwonetseranso kupatuka komwe kumatha kuphimba mapangidwe a Wirsung a kapamba.

Mwa njira, ndikofunikira kudziwa kuti anthu ambiri athanzi amatha kuwona zizindikiro zosintha zomwe zimakhudzana ndi zochitika zachilengedwe ndi kugwiritsa ntchito zinthu zomwe zili ndi mankhwala osungirako komanso okhazikika.

Zizindikiro

Njira zamakono zodziwitsira matenda zimapangitsa kuti athe kuzindikira kusintha kochepa kwambiri m'mimba mwa Wirsung duct, komanso nthawi yomweyo kuwunika boma la kapamba.

Njira yophunzitsira komanso yodziwikiratu yodziwitsa boma la Wirsung duct ndi endoscopic retrograde pancreatocholangiography.

Njira yofufuzira iyi imakupatsani mwayi kuti mufufuze kukula, magwiridwe antchito a ma pancreatic ducts ndi bile ducts.

Panthawi ya ndalamazo, ma ducts amadzazidwa ndi ma sing'anga osiyana (kudzera pakumayambiriro kwake), kenako kuwunika kumachitika kudzera pamakina a X-ray.

Njira zina zodziwira matenda:

• Ultrasound yam'mimba (sonography),
• Zolemba pamakompyuta,
• General zasayansi mayeso magazi, ndowe, mkodzo kuyang'ana magwiridwe antchito am'mimba ndi thupi lonse.

Kukambirana koyambirira kumachitika ndi wodwalayo nthawi yoyambirira atakumana ndi dokotala wa gastroenterologist, pomwe mbiri yatsatanetsatane imapangidwira ndipo tsatanetsatane wa zisonyezo limamveka bwino.

The achire zotsatira zake ndi kukula kwa Wirsung duct chikugwirizana ndi mankhwalawa matenda oyamba - kapamba. Zikondazo zikabwerera wamba, mabatani ake amakhala okhazikika.

Pancreatitis pachimake amathandizidwa ndi chakudya chamagulu, mankhwala a analgesics. Droppers amathandizidwanso kuti ayambitse njira za colloidal ndi saline ndi mankhwala omwe amalepheretsa ntchito za michere.

Nthawi zina, machitidwe othandizira opaleshoni angafunike: kuchotsedwa kwa calculi (miyala), kuchotsa malo omwe ali ndi ziphuphu.

Matenda a kapamba, omwe amayambitsa kuchuluka kwa Wirsung duct, amathandizidwa ndi zakudya, vitamini, kugwiritsa ntchito mankhwala opweteka omwe adalembedwa ndi adokotala, komanso mankhwala a enzyme.

Zakudya ndi kukulitsa kwa duct zimaphatikizapo zoletsa mosamalitsa menyu wazakudya zamafuta ndi chakudya chamagulu ambiri. Ndikofunikira kudya nyama yazakudya ndi chakudya "chopatsa".

Zotsogola ndi kupewa

Kuzindikira kwakanthawi kokwanira komanso koyenera kumakhala koyenera. Njira zoteteza kukula kwa Wirsung duct - kudya wathanzi, kuthetsa mowa, munthawi ya mankhwalawa a bile ducts ndi pathologies a kapamba.

Kodi kapamba amatenga gawo lanji pakupanga chimbudzi, onani pansipa.

Momwe timasungira pazowonjezera ndi mavitamini: mavitamini, ma probiotic, ufa wopanda gluteni, ndi zina zambiri, ndipo timalamula pa iHerb (kulumikiza $ 5 kuchotsera). Kupititsa ku Moscow ndi masabata awiri okha. Nthawi zambiri zotsika mtengo kuposa kugula mgolo la Russia, ndipo zinthu zina, makamaka, sizipezeka ku Russia.

Chophimba chachikulu cha kapamba

Kukwapula komwe kubisala komwe amapititsidwa ku duodenum 12 kumawerengedwa kuti ndi kofunikira kwambiri mu kapamba. Njira yomwe tinthu ting'onoting'ono tambiri timayenderera imakhala tinthu tomwe timalumikizira. Mapeto ake ndi sphincter yomwe imayang'anira kayendedwe kazinthu zachilengedwe.

Mawonekedwewo amangidwa, akubwereza kubowo kwa kapamba. Komabe, kusintha kwina m'thupi kumatha kudzetsa mawonekedwe a bondo kapena mawonekedwe a S. Munthu aliyense amakhala ndi mitundu ingapo ya zothandizira.

Ngati ngalande ya Wirsung imadziwika ndi mtundu waukulu, ndiye kuti munthu ali ndi tubules pafupi 30. Mukamayankhula za mawonekedwe osagwirizana kapena otayirira, ndiye opitilira 50.

Muzochitika zakapangidwe kapangidwe kake, njira zothandizira zapamtunda zimapezeka pamtunda wa 2 cm kuchokera wina ndi mnzake. Wodwala akakhala ndi mtundu wotayirira, mipata imafupikitsidwa kwambiri.

Mtsuko waukulu wa kapamba umaphatikizika ndi wamba bile duct ndipo kenako umalowa mu duodenum 12. Koma muzochita zamankhwala pamakhala zochitika pamene mawonekedwe a anatomical amasinthidwa. Mwachitsanzo, dambo la Wirsung limayenda mu kachitidwe ka m'mimba, komwe kali pambali pa duct wamba wa bile. Izi zoterezi ndizofanana kwa anthu 15-20%, sizimaganiziridwa kuti ndi matenda.

Pali zosiyana pakamangidwe ka ziwalo zamkati, zomwe, mothandizidwa ndi zina, nthambi zazikulu zomwe zimayikidwa mu nthambi ziwiri, zimagwira ntchito mosiyana, chifukwa chomwe njira ziwiri zimapangidwira.

Kapangidwe kameneka ndi kabadwa mwachilengedwe, kamakhala kocheperako, komwe kumapangitsa kutsekeka kwakukulu kapena kutseka kwathunthu kwa ma ducts.

Kapangidwe ka duct kovuta

Kusintha kwa kapamba, kutsegulira njira zowonjezera, kukulitsa kwa dongosolowedwe kapamba, kupendekera kwache, ndi njirazi njira zowonongeka - zonsezi zimayambitsa kusokonezeka kwa dongosolo logaya chakudya.

Zovuta zakubadwa zimatha kubweretsa kuwoloweka kwa ngalande yayikulu, chifukwa chomwe nthambi zingapo zimapangidwa. Ngalande zikagwera, amalankhula za stenosis - kupendekera kokhazikika kwa ngalande.

Chifukwa cha kusayenda kapena kubisala kwa tubules tating'onoting'ono, mavuto am'mimba amachitika. Kusunthika ndi kusintha kwa madzimadzi kumabweretsa kukula kwa cystic fibrosis, komwe kumayambitsa kusinthika osati mu gland, komanso machitidwe ena a thupi.

Kukula kwabwinobwino, makamaka, m'mimba mwake mwa duct wamkulu ndi 2 mm. Ngati kuchulukitsa kapena kuchepa kwake kumawonedwa, ndiye kuti ntchito ya kapamba imasokonezeka zokha. Wirsung duct wa kapamba ikakulitsidwa, amatsogolera pakupanga miyala, tumor neoplasms.

Mitsempha yamkati yamkati itatsekedwa, mawonekedwe a kapamba amayamba. Zovuta za pachimake, mobwerezabwereza ndimawonekedwe osavuta, nthawi zambiri zimafunikira kuchitapo kanthu pakuchita opaleshoni ndi thunthu lathunthu mkati.

Zomwe zimayambitsa ndi zizindikiro za kukulitsa kwa waukulu

Kukula kwa Wirsung duct kwa kapamba mwa akulu ndi 80% kumagwirizana ndi etiology ya zotupa zina zamkati. Pafupifupi 30% ya zithunzi zachipatala, sizingatheke kukhazikitsa zifukwa zowonjezerazi, chifukwa chomwe pathogenesis imakhala chinsinsi.

Zomwe zimapangitsa kuti pakhale kuchuluka kapena kuchuluka kwakukwanira ndi monga: opaleshoni pamimba kapena m'mimba, matenda a duodenum 12, kuvulala kwamtundu wa peritoneum.

Zomwe zimayambitsa kupsa kwamphamvu mu kapamba zimachitika chifukwa chomwa mowa mwauchidakwa, zomwe zimachitika chifukwa cha mankhwala ena (antibacterial and hormonal drug). Komanso kusowa kwa mahomoni, matenda opatsirana.

Pamene pancreatic duct imatha, nthawi zina pathogenesis imakhazikitsidwa kuchokera kubadwa kwamtsogolo. Pankhaniyi, "genetic" pancreatitis imawonekera, zomwe zimabweretsa kusintha kwa ziwalo zapafupi komanso minofu yofewa.

Chowonekera chachikulu cha chipatala chimaphatikizapo kuphwanya kwam'mimba. Pancreatitis imatha kupangitsa kuchepa komanso kuwonjezeka mumkamwa waukulu. Muzochita zamankhwala, matendawa amatchedwa "unyolo wamadzi."

Ma contours a pancreatic ngalande amakhala osagwirizana, mu lumen mumakhala ma inclusions olimba - miyala. Mawonetseredwe azachipatala:

• Zizindikiro zopweteka kwambiri mu hypochondrium. Mankhwala samathandiza kuthetsa ululu.
• Kudzimbidwa, komwe kumawonetsedwa ndi kutsegula m'mimba kwa nthawi yayitali ndi kuchuluka kwa chakudya chosaphikidwa.
• Kusanza, kusanza kosaletseka.
• Kuchepetsa chilakolako cha chakudya, ndi zina.

Zizindikiro zapadera, zomwe zikuwonetsa kupitiliza kwa kupendekera kwakukulu kwa kapamba, kulibe.

Njira zochizira

Matendawa akatsimikizira kukulira kwa duct yayikulu, adotolo, makamaka dokotalayo, amasankha njira zamankhwala ochita opaleshoni. Ndi chifukwa cha mawonekedwe azachipatala, msambo wa wodwalayo, kuchuluka kwake, ndi zina.

Dokotalayo amatha kuyambiranso dera la stenotic kudzera mwa perthaneous arthroplasty. Njira ina, kukonzanso kotseguka kwa Wirsung duct ndi bile ducts kapena kuyambiranso kwa kapamba wam'mimba chifukwa cha opaleshoni yapulasitiki yotsatsira njirayi. Njira yotsatirayi ndiyosowa kwambiri.

Chithandizo cha kukulitsa kwa duct chimagwirizana ndi ma algorithm pochizira matenda akulu - kapamba. Ntchito yamkati yamkati itasintha, kutupa kumayendetsedwa, ndipo milomo imabwezanso.

Mankhwala a pachimake kapamba:

• Kukana chakudya. Kusala kudya ndi kapamba kuyenera kuchitika nthawi yonse ya kukokomeza.
• Kugwiritsa ntchito antispasmodics.
• Intravenous makonzedwe a colloidal ndi saline.
• Kupereka mankhwala omwe amalepheretsa kugwira ntchito kwa michere ya m'mimba.

Nthawi zina opaleshoni imafunika. Mwachitsanzo, kufufutidwa pang'ono kwa gawo la kapamba, kapena kuchotsa miyala m'miyala.

Sluggish pancreatitis, yomwe imayambitsa kupitiliza kwa duct yayikulu, imathandizidwa mothandizidwa ndi chakudya chamagulu, mavitamini ndi ma mineral complexes. Mankhwala opweteka amathandizidwanso, mankhwala othandizira olimbitsa thupi amalimbikitsidwa.

Katsitsimutsidwe komwe kumayambira kumbuyo kwa chithandizo chamankhwala chapanthawi yake komanso chokwanira. Njira zoteteza kufutukuka kwa duct zimaphatikizapo zakudya nambala 5, kukana zakumwa zoledzeretsa, chithandizo chakanthawi ya bile ducts ndi pancreatic pathologies.

Momwe mungapewere zovuta komanso momwe mungathandizire pancreatitis yamatenda akufotokozedwa mu kanema munkhaniyi.

Ichi ndi chiyani

Mudzakhala ndi chidwi: Paul Kalaniti, neurosurgeon waku America: mbiri ya moyo, zaka za moyo, chifukwa cha imfa, mabuku

Wirsung duct wa kapamba amatuluka kulowa wamba duct, kenako ndikulowanso m'matumbo. Ntchito yake yokhudza thupi ndikupereka chikhazikitso cha pancreatic kugaya chakudya. Kapangidwe ka duct kamabwereza kapangidwe ka gland. Imayamba mchira wa chiwalo, kudutsa thupi lonse kupita kumutu, imakhala ndi masentimita makumi awiri mulifupi ndi mamilimita anayi pakatikati.

Madzi am'mimba amapangidwa mu kapamba. Imalowa kudzera munthaka yamayendedwe omwe ali mu dambo la Wirsung, ikuchita nawo mbali pakudya chimbudzi. Katemera wa pancreatic amakonzedwa ndi minofu yapadera yosalala. Matenda a gland amadzetsa kuchepetsedwa kwa kupanga juwisi kapena kuchitapo izi pamatumbo a chiwalo. Zotsatira zake, chitsulo chimayatsidwa, duct imasintha m'mimba mwake, ndikugaya kwambiri. Dongosololi limatchulidwa ndi a Johann Georgia Wirsung, katswiri wazinthu zaku Germany amene adazipeza. Chifukwa chake, tsopano tikutembenukira kuzinthu zomwe zimapangitsa kukula kwa dambo la Wirsung.

Zomwe zimayambitsa matendawa

Zomwe zimayambitsa matenda a pathology zimagwirizana makamaka ndi zomwe zimayambitsa kukula kwa kapamba ndi zotupa zina za kapamba. Popeza ndizotheka kudziwa zomwe zimayambitsa kutupa kwa chiwalochi mwa magawo makumi asanu ndi awiri okha a milandu yonse yazachipatala, nthawi zina mawonekedwe a kusintha kwa pathological amakhala chinsinsi. Zifukwa zakukula kwa dambo la Wirsung ziyenera kutsimikiziridwa ndi dokotala.

Zinthu zomwe zimapangitsa kukula kwa njira yolakwika ndiy:

• Opaleshoni yam'mimba bile.
• Matumbo amkati komanso kuwonongeka kwa m'mimba.
• Kumwa kawirikawiri anthu.
• Zochita zamankhwala ena mwanjira yothandizira maantibayotiki, komanso estrogens.
• Zotsatira za matenda opatsirana.
• Maonekedwe a kusokonezeka kwa mahomoni.

Nthawi zina, kuchulukana kopanda mulingo wa duct kumafotokozeredwa ndi kupangika kwa majini, ndiko kuti kukula kwa chibadwa cha chibadwa, komwe kumabweretsa kusintha kwa minofu yolumikizana ndi ziwalo.

Mudzakhala ndi chidwi: Lactobacillus Lactobacillus spp: mawonekedwe, kutanthauzira ndi chizolowezi

Kodi chizolowezi chotani cha ultrasound cha Wirsung duct?

Pofuna kumveketsa bwino matendawa, zonse zomwe zimadziwika pakamayeso a sonographic, madokotala amafanizira ndi manambala wamba. Pokhala ndi kusiyana kwakukulu pamalingaliro, zimafotokozedwa za kukhalapo kwa nthendayi. Kwa odwala akuluakulu, kukula kwa dambo la Wirsung ndikwabwino motere: kutalika kuyambira 14 mpaka 23, m'lifupi 9, ndi mainchesi 3 cm. Kenako, timvetsetsa zomwe zimayendera limodzi ndi kupatuka komwe kukufunsidwa.

Zizindikiro zamatsenga

Chizindikiro chachikulu cha chitukuko cha matenda a m'mimba ndicho kuphwanya njira zogaya chakudya. Pancreatitis imatha kuyambitsa pamodzi ndi kuchepetsa kwa dambo la Wirsung. Chithunzichi chimatchedwa ndi akatswiri matenda a unyolo wamadzi. Ma strange a channel amakhala osagwirizana, mu ma lumen awo mumakhala ma inclusions olimba, omwe ndi ma calcified kapena miyala. Zizindikiro zowonjezera za matendawa ndi:

• Maonekedwe a ululu waukulu mu hypochondrium (chowonadi ndichakuti ululu, monga lamulo, suyimitsidwa ndi antispasmodics ndi analgesics).
• Kupezeka kwa kutsekula m'mimba ndi chimbudzi cha mushy.
• Maonekedwe a nseru, kusanza, ndi kuchepa thupi.
• Kuchepa kwa chilakolako cha kudya komanso zizindikiro zina zosonyeza kukula kwa ngalande.

Njira zina

Njira zina zodziwikitsa matenda:

• Kuyesa kwa Ultrasound kwam'mimba dera (i.e. sonography).
• Kuchita zowerengera zowerengera.
• Kutumiza kwa ambiri mayeso a labotale magazi, mkodzo, ndowe kuyesa magwiridwe antchito am'mimba ndi chamoyo chonse.

Amayankhulanso wodwalayo mwachangu ngati mbali yoyamba kucheza ndi gastroenterologist, pomwe amapanga mbiri mwatsatanetsatane, ndikupeza tsatanetsatane wazizindikirozo.

Mudzakhala ndi chidwi: Coloproctology: ndi chiyani, njira zodziwira matenda ndi chithandizo

Kusamalira achire pakukulitsa kwa Wirsung duct kumatha kugwirizana ndi chithandizo cha matenda oyamba, ndiye kuti kapamba. Zikondazo zikakhala zabwinobwino, nsuzi zake zonse zimakhazikika.

Acute pancreatitis amathandizidwa ndi kudya mwachangu, mankhwala, ndi analgesics. Kuphatikiza apo, omwe akutsikira amapatsidwa jekeseni wa saline ndi colloidal solution ndi mankhwala omwe amalepheretsa ntchito ya enzymatic. Nthawi zina, opaleshoni ingafunike mwanjira yochotsa miyala ya calculi (i.e.) ndi kuyikanso kwina komwe kumadzetsa chithokomiro.

Matenda a kapamba, omwe amayambitsa kuchuluka kwa Wirsung duct, amathandizidwa ndi zakudya zowonjezera, komanso ndi mankhwala a vitamini, kumwa mankhwala opweteka omwe adalembedwa ndi adokotala, komanso mankhwala a enzyme. Kudya motsutsana ndi maziko a kukulitsa kwa duct kumaphatikizapo kukhazikitsidwa kwa malamulo okhwima pa menyu wazakudya zamafuta ndi chakudya chamagulu ambiri. Ndikofunikira kudya nyama yazakudya komanso zopatsa mphamvu pang'onopang'ono.

Kodi chithandizo chamankhwala ichi chimatanthauzanji?

Monga gawo la mankhwalawa a kapamba, dokotala amatha kukupatsani mankhwala otsatirawa:

• Kugwiritsa ntchito kashiamu.
• Chithandizo cha mankhwala a choleretic.
• Chithandizo cha mankhwala a mahomoni.
• Kugwiritsa ntchito mankhwala osokoneza bongo.
• Kugwiritsa ntchito mitundu ya metabolite.
• Kugwiritsa ntchito mankhwala okhala ndi zotsatira zake.

Kuchiza kwa mitundu yosiyanasiyana ya kapamba kumaphatikizira kugwiritsa ntchito mavitamini, komanso mankhwala a choleretic ndi enzyme mu mawonekedwe a "Creon", "Festal", "Digestal" ndi "Pancitrate". Ngati matumbo ali ndi vuto m'matumbo, mankhwalawa omwe ali ngati "Cisapride" ndi "Domperidone" akhoza kutumikiridwa.

Matenda obwera ndi matenda

Momwe matendawa amaperekera nthawi yake komanso chithandizo chokwanira amakhala abwino nthawi zonse. Njira zoteteza kufutukula kwa dambo la Wirsung ndizopatsa thanzi, kuphatikiza ndi mowa, chithandizo cha nthawi ya bile ducts ndi matenda a kapamba.

Kupewa kufalikira kwa ziwalo

Kuti mudziteteze ku matenda amtundu uliwonse omwe amalumikizidwa ndi kuphwanya kwa ntchito ya Wirsung duct, muyenera:

• Chotsani machitidwe onse oyipa.
• Makonda ayenera kuperekedwa ku zakudya zotsika mu shuga, mafuta, mchere ndi cholesterol.
• Ndikofunikira kutsatira zakudya zosiyanasiyana, zomwe zimakhala ndi masamba ambiri atsopano, zipatso ndi zipatso.
• Muyenera kumwa tsiku lililonse pafupi malita awiri amadzi.
• Nthawi ndi nthawi, muyenera kukonzekera masiku akusala.
• Ndikofunikira kwambiri kuchita nawo masewera aliwonse.
• Nthawi zonse pamafunika kupumula kwathunthu (ndiko kuti, kugona osachepera maola asanu ndi atatu patsiku) komanso kupewa mavuto.
• Ndikofunikira kuchitira panthawi yake matenda opatsirana komanso ma virus.
• M'dzinja ndi nthawi yachisanu, ndikofunikira kutenga mavitamini ovuta.

Mkhalidwe wabwinobwino wa duct ndiwofunikira kwambiri njira zambiri zomwe zimachitika mthupi la munthu. Muzochitika pamene njira zopatuka kuchoka pa chizolowezi, chiwerengero chachikulu cha matenda opweteka kapena owopsa amatha. Chifukwa chake, chofunikira kuyang'anira thanzi, m'njira iliyonse yomwe ingatheke kuthandizira magwiridwe antchito amkati.

Mapeto ndi mawu omaliza pam nkhaniyi

Wirsung duct ndiye pancreatic ngalande yayikulu, yokhala ndi kutalika kwathunthu kutalika konse kwa kapamba. Imabwera mwachindunji kumbuyo kwake. Amapangidwa kuchokera kuphatikiza zing'onozing'ono za ubules wa chiwalo ichi ndipo ali ndi kutalika pafupifupi masentimita makumi awiri. Kukula kwake ndi mawonekedwe ake ndiosiyana ndi anthu ena, chifukwa chamoyo chilichonse chimakhala ndi kapangidwe kake.

Cholinga chachikulu cha duct yofotokozedwayo ndikuyendetsa chimbudzi, chomwe chimakhudza chimbudzi cha chakudya m'mimba. Kupititsa patsogolo kwa katulutsidwe ka pancreatic kumayendetsedwa ndi minofu yosalala. Pankhani ya chiwopsezo cha pancreatic, kupanga juwisi kumachepa. Potengera maziko awa, imayamba kugwira ntchito ngati minofu ya chiwalo. Zotsatira zake zonsezi, chitsulo mwa munthu chimayamba kupsa, m'mimba mwake mumakhala kusuntha, ndipo chimbudzi chimalephera. Matenda ofala kwambiri a chithokomiro ndi kapamba.

Ngati Wirsung duct imakulitsidwa, zomwe zikutanthauza tsopano ndi zomveka.

Zizindikiro za pathologies ndi ultrasound

Nthawi zambiri, matenda monga acute komanso pancreatitis yayikulu, kapamba, cysts ndi ma pathologies ena amapezeka.

Kuchulukana kwamankhwala kumayambitsa matenda a m'matumbo kumapangitsa kuti pakhale pancreatitis yayikulu. Pa nthawi ya mayeso, zopindika za ziwalozi zimachita khungu, mawanga akhungu atha kupezeka munjira yake, zomwe zitha kukhala chifukwa cha zotupa m'mimba kapena necrosis ya gland. Kukula kwa dambo la Wirsung ndi ma ducts ena a gland atsimikiza.

Mu mawonekedwe a kapamba, kukula kwa ziwalo sangasinthe. Mphepete zake sizikhala zopanda phokoso komanso zosagwirizana. Gland minofu ikamachepa. Pamaso pa fibrosis, kuphatikizika kwa parenchyma kumawonedwa, dambo la Wirsung limakhala lopindika ndikuchepera, ndipo makhoma ake amatsekeka. Nthawi zambiri kuphwanya patency ya zonyansa za gland amapezeka. Kusintha koteroko ndizotsatira zamapangidwe a cysts ndi kuwerengera.

Mapangidwe a miyala mu parenchyma, kapena pancreolithiasis, ndimomwe amachititsa kutupa kwa gland kapena kuwonongeka kwa michere. Poyamba, kusunthika kwamkati mwa limba kumawonedwa, zomwe zikuwonetsedwa ndi kufutukuka kwa dambo la Wirsung. Pa gawo lotsatira lachitukuko cha pathological mkhalidwe, mapuloteni amakhazikitsidwa mu madzi a pancreatic ndikuwerengera amayikidwa, omwe mu kuwunika kwa ultrasound akuwonetsedwa ngati akuwonjezera kuwonjezereka kwa echogenicity ya parenchyma. Mtundu wonyalanyaza wa matendawa umabweretsa pancreolithiasis.

Kapangidwe ka gland kamatha kukhudzidwa ndi matenda a ziwalo zina zamkati (kuperewera kwa mtima, hepatitis, cirrhosis).

Kupatuka komwe kwapezeka mu kapamba kumatha kukhala chifukwa cha nthenda zake zosiyanasiyana, koma nthawi zambiri kapamba ndi kapamba zimayambitsa.

Pancreatitis

Kuchokera pamankhwala, pancreatitis (njira yotupa ya kapamba) imatha kuoneka ngati yovuta kwambiri. Zomwe zimayambitsa matendawa ndikutha kuchepa kwa madzi omwe amatuluka kuchokera mthupi kulowa mu duodenum chifukwa chotchinga duct. Ndi kutupa kwa nthawi yayitali, michere ya m'mimba imayamba kugaya maselo awo. Zomwe zimayambitsa kutupa zimathanso kuwonongeka chifukwa cha kutaya kwake chifukwa cha edema yake.

Acute pancreatitis nthawi zambiri amayamba chifukwa cha kupezeka kwa ndulu zomwe zimatchinga ma ducts, kapena ndi uchidakwa, zomwe zimapangitsa kutsekeka kwa milomo yaying'ono ya chiwalo.

Pancreolithiasis

Pancreatolithiasis ndi njira yodziwika bwino yopangidwa ndi miyala mu Wirsung duct gland kapena nthambi zake. Zizindikiro za matendawa ndi kupweteka kwapamapazi m'dera la epigastric, ndipo zimafalikira ku dera lumbar.

Kukhalapo kwa miyala, kulepheretsa kutuluka kwa pancreatic madzi, kumayambitsa kugaya kwam'mimba. Ndi kusasunthika kotere ndi ultrasound, zikuwululidwa kuti Wirsung duct imasungunuka, ndipo makoma amadzala ang'onoang'ono amachepetsa.

Komabe, ndikofunikira kukumbukira kuti chithunzi cha ultrasound sichimapereka chidziwitso chokwanira pakuzindikira. M'pofunika kuchita zowonjezera. Popeza nthawi zambiri mukazindikira kusintha kwa kapamba kapena chiwindi, mwachitsanzo, dambo la Wirsung silikuwoneka. Njira zina zodziwira matenda zimathandizira kuti aphunzire mwatsatanetsatane.

Kuzindikira kovuta

Kuvuta kwazidziwitso za ma pathologies omwe mukuwunikira kumalumikizidwa ndi komwe kupezeka kwa kapamba. Ili mkati mozama mthupi la munthu. Kafukufuku wake akuyenera kuchitika kokha ndi akatswiri oyenerera ndipo aphatikizire luso la zida zotsogola ndi zapamwamba. Uku ndikuwerengera kokwanira mwazinthu za ma pancreatic enzymes (pancreatic isoamylase, lipase, trypsin mu mkodzo, m'magazi, muzinthu za duodenal). Kuti akhazikitse kusakwanira kwa gland, ndikofunikira kudziwa fecal elastase mu ndowe. Kuunika magazi kofunikira, kuwunika kwa glycemia, sonography yam'mimba, dopplerography ndiyofunikanso.

Kuti mupeze zigawo za axial zam'mimba, MRI imayikidwa.

M'malo ovuta, kupatsirana kwa laparoscopy kumachitidwanso. Monga ma pancreatic ducts ndi bile duct pathologies nthawi zambiri amakhudzanso kapamba, ERCP ndiyofunikira.

MR cholangiography

Magnetic resonance cholangiopancreatography yokhala ndi mawonekedwe a pancreatitis amalola kafukufuku watsatanetsatane wa boma la Wirsung duct. Iyi ndi njira imodzi yamakono kwambiri yophunzirira ndulu, ndulu zake ndi ma pancreatic duct. Zimapangitsa kupeza chidziwitso chokwanira chokhudza momwe ziwalozi zimakhalira, kudziwa kupezeka kwa ma polyp, miyala, masitepe, kuwona kusintha kwa zotengera ndi ma lymph node.

Chithandizo cha kusinthasintha kwakumveka komwe kaphatikizidwe ka kapamba kitha kuchitika ndi njira zopumira komanso za opareshoni. Kusankhidwa kwa njira zoyenera zamankhwala kumadalira mtundu wa matenda, kupezeka kwa matenda olimba ndi momwe wodwalayo alili.

Nthawi zambiri, chifukwa chazindikiritso komanso chithandizo chosayembekezereka, zizindikiro za echogenic sizingasinthe, sizipitilira kukula.

Kubwezeretsa kapangidwe kabwino ka chiwalo kungatheke pokhapokha ngati mutachira mokwanira ndikuyang'ana malingaliro onse a katswiri.