Kuyini BDS? Secondary BDS isifo

Izifo wokugaya ukudla uhlelo izitho - isifo lalivamile ezenzeka iningi lezakhamuzi kule planethi. Nokho, akubona bonke uyazi ukuthi izifo eziningi zibangelwa emathunjini isifo uthi papilla ezinkulu duodenal. Kusukela izinto esihloko umfundi ethola ukuthi BDS okungukuthi, iziphi izinhlobo izifo ezaziwayo emkhakheni wezokwelapha lokhu isakhiwo njengoba ukuxilonga izimo zokucabanga okubangelwa isifo futhi ukwelashwa okuyinto kuleli cala wenziwa.

Umqondo BDS

Elikhulu papilla duodenal (BNS) limelela isakhiwo yokwakheka ukuma hemispherical, okuyinto ngokufanele kwi mucosa ukwehla ingxenye duodenum. Esikhathini izincwadi zezokwelapha ezisekelwe ekwazisweni BDS kungatholakala ngaphansi amagama ahlukene - papilla ezinkulu duodenal, futhi papilla ka Vater. Nokho, yini BDS? Lo sayizi kusukela 2 mm 2 cm isakhiwo esingagcina eyenza umsebenzi obalulekile kakhulu - lebhokisi ezivamile Bile imbobo, main imbobo pancreatic kanye duodenum. BDS ulawula ukugeleza Bile futhi juice pancreatic ku wamathumbu ezincane iphinde ivimbele okuqukethwe emathunjini phakathi mapayipi.

Ngo isakhiwo OBD singenzeka izinguquko sokugembula bedle izici ezahlukene -. Microflora pathogenic Zihlukahlukene ingcindezi iyehla iyenyuka futhi izinguquko acid-base balance, yokujama tsi kule komgodi, njll Ngaphezu kwalokho, isakhiwo umzimba kungase kuphazanyiswe yokufuduka Bile imbobo amatshe noma ezinye izakhiwo eziqinile.

zokugula BDS

Izifo papilla ezinkulu duodenal wehlukile kakhulu. With ukuthuthukiswa yezindlela zesimanje ukuhlola iziphetho mayelana iziyaluyalu ukusebenza kulesi sakhiwo zivamile kakhulu kunalokho okwake kwacatshangwa. Nokho, ngenxa kwezokwelapha zokuxilonga kwesikhathi futhi kunalokho kuyinkimbinkimbi it is babhekana lenqwaba Imiphumela ompofu nokwelashwa kweziguli cholelithiasis noma pancreatitis ukuthi lakhula ngemuva ukwephulwa e isakhiwo BDS.

BDS ezivamile zokugula kubhekwe neziqu tumorous - polyp hyperplastic kuze kufinyelele 87% phakathi neoplasms kungavamile ukuba ingozi. Polyp ngokuvamile musa sikhiqize kwezicubu ebulalayo. Adenoma - bole ezingavamile isifo OBD umdlavuza-25% azo zonke komdlavuza. BDS stenosis kutholakala 4-40% eziguli. Njengoba umthetho, zokugula BDS exhumene isifo gallstone (GSD), okuyinto eyenzeka kuwo wonke owakhileyo yeshumi.

Ukwahlukanisa Diseases BDS

Izifo papilla ezinkulu duodenal libhekwa ngamaqembu amabili amakhulu:

• eyinhloko,
• lesibili.

Izifo eyinhloko zihlanganisa nalabo iziyaluyalu ezenzeka kuthiwa yenziwe yaba yasendaweni ngaphakathi OBD isakhiwo - papillitis (isifo ukuvuvukala); spastic OBD stenosis, ezingasetshenziswa kamuva siguqulelwa papilloskleroz; izinguquko yobudala OBD; anomalies azalwa naso; ingozi nesibulalayo izimila - lipoma, i-melanoma, fibroma, adenoma, ama-polyp, papillomas.

izifo Secondary BDS - stenosis kubangelwa amatshe atholakala enyongweni. Izimpawu zesifo zihlobene ngokuqondile isizathu sokuthi kungani ayekade mema. Ngakho, uma inqubo sokugembula is phetho of izifo kohlelo biliary, lesi sifo singumbulali efana izici GSD - zokugula, libhekene kumiswa amatshe e-gallbladder noma Bile Amapayipi, ephelezelwa umuzwa ukusinda elingenhla quadrant, ukubuyisa, isilungulela, situlo azitholakali kalula.

Kukhona umqondo stenosis kuhlanganiswe - ukuhlukumeza BNS imisebenzi ukuthi iphakame ngokumelene isizinda isilonda we duodenum. Kulokhu, akukho ukuntuleka BNS.

pancreatitis

Uma izinqubo sokugembula e isakhiwo kubangelwa ukuvuvukala OBD isifo pancreatic ukubonakaliswa zifana izimpawu pancreatitis.

Pancreatitis - kuyinto ukuvuvukala e kwamanyikwe. Kuyaphawuleka ukuthi isithombe lesi sifo zingase zihluke - zokugula iyakwazi ukuthuthukisa ngokushesha, ethatha ifomu acute, noma musa ubonise ngokwabo isikhathi eside, okuyinto ejwayelekile ifomu njalo ukugeleza.

Uphawu oyinhloko pancreatitis acute kuyinto ubuhlungu enamandla kakhulu ukunqamula elingenhla endaweni esiswini - kwesokunene noma kwesobunxele quadrant engenhla. Ubuhlungu singase sithwale herpes kanye abayekanga ngisho nangemva kokuthatha antispasmodics noma analgesics. Yilokho BDS kanye nemiphumela okuholela ukwephulwa imisebenzi yawo ngokupheleleko.

Ngaphezu yobuhlungu pancreatitis zenzeka reflex Gag, ukuba buthakathaka kwezicubu, isiyezi. Izimpawu eyinhloko pancreatitis by ultrasound Ushintsha ukuma maholoholo ka emaphethelweni kwamanyikwe. Ngo sitholakele izinhlumba kungatholakala emzimbeni. Mangisho ukuthi lesi sifo kunzima. Futhi kokungenela okungazelele kungaholela ekufeni.

stenosis spastic BDS

Stenosis OBD - zokugula ingozi le ndima, okuyinto kubangelwa ukuvimbela uvule imbobo pancreatic nenyongo ngenxa yezinguquko ukuvuvukala futhi nokuminyaniseka cicatricial papillae. Indlela kwenzeka? itshe Sicephu nilimaza papilla futhi ukutheleleka asebenzayo emphethweni kuholela ukuthuthukiswa kwezicubu fibrous futhi izifunda stenotic ampoules OBD.

Njengoba yaziwa, isakhiwo BDS oluthinta ngqo iminyaka yobudala bomuntu. Abantu zeminyaka sezihambile cholelithiasis basithole-sclerotic ifomu atrophic ka papillita ezingamahlalakhona. I akuxhomekile, okuyinto engazange efinyelela eminyakeni yobudala engamashumi ayisithupha phesheya, kuncike izinguquko hyperplastic e BDS (adenomatous, adenomiomatoznye).

Eminyakeni yamuva, ngenxa yokuthi, e izifo asetshenziswa BDS endoscopes, kungenzeka ukuhlukanisa ngokucacile phakathi constrictive futhi catarrhal (nestenoziruyuschy) papillitis. Ifomu yokuqala zokugula ezihambisana ne cholelithiasis. Uma umzimba ingeyona amatshe, ukuthuthukiswa lesi sifo singumbulali lesi sifo singalapheki ukuthi usabalala wamanje lymph.

Amafomu stenosis BDS

Kuye izinhlamvu morphological kukhona izinhlobo ezintathu stenosis:

• stenosis ukuvuvukala-sclerotic - a zokugula ukuthi libhekene lamadigri cystic obuhlukahlukene;
• stenosis fibrocystic - ukuphazamiseka lapho kumiswa cystic nge izinhlumba kwakhiwa encane - akungenxa nezindlala kakhulu sithuthukiswe ecindezela imisipha Imicu yotshani;
• Stenosis adenomiomatozny - zokugula, lapho adenomatous Hyperplasia nezindlala, kanye fibre hypertrophy imisipha bushelelezi futhi overgrowth fibrous zemicu, ukuhlukumeza ngokuvamile kakhulu kwenzeka kubantu abadala.

Ngaphezu kwalokho, BDS isibanda stenosis oluthathwa:

• eyinhloko,
• lesibili.

stenosis Primary akakubangeli izinguquko Amapayipi Bile. Pathology kubangelwa izinguquko esiwohlozayo we papilla, okuyinto avele yoma ungqimba kwemisipha. Kwesinye isikhathi stenosis eyinhloko Inesici azalwa nako.

stenosis Secondary is phetho izinguquko ezikhona e isakhiwo ngenxa yokulimala papillae kufuduka amatshe noma ukuhlinzwa.

Kuye kube sezingeni ukusabalala kwezifo stenosis BNS ukwabelana:

• ku elingalodwa,
• ezivamile.

ukuhlola

Kuze kube yimanje, imithi isetshenziswa izindlela abaningana ngempumelelo izifo ukuhlola OBD. Ake sicabangele ezinye zazo. ultrasonography endoscopic - inqubo lapho esebenzisa idivayisi optical - the endoscope - ucwaningo olwenziwe OBD isakhiwo. Photography papilla, enziwe isifundo esifanayo, esicashunwe ngenhla.

ultrasonography Transabdominal - ukuhlolwa luhlolo indlela usebenzisa ultrasound, okuvumela kakhulu ukubona ngokunembile tingucuko tekuhleleka gallbladder, isibindi, amanyikwe, futhi mapayipi. Ngaphezu kwalokho, indlela inquma homogeneity we umgodi futhi nenyongo sesinye motility, khona / ukungabikho inclusions intracavitary.

Indlela esilandelayo ekuxilongweni pathologies BDS - cholecystography ultrasonic - zokukhwabanisa, nge okuyinto bahlola motor-ukuthuthwa kwabantu ngenxa yengozi umsebenzi esinyeni nenyongo amahora amabili ngemuva kokuthola ibhulakufesi choleretic.

Dynamic scintigraphy hepatobiliary - inqubo, ogxile - Kuhlola absorptive-excretory umsebenzi kwesibindi. Fractional chromatique duodenal kumba ukucacisa ithoni gallbladder; ukuzinza colloidal hepatic Bile ingxenyenamba futhi ngezithako zawo bacteriological. Lapho gastroduodenoscopy Uhlaziya isimo BDS, kanye nokuqaphelisisa ubunjalo Bile itholakala. Ngaphezu kwalezindlela zokudlulisela kukhona tomography computer nokuhlola laboratory.

BDS: ukwelashwa

Ngesisekelo ekwelapheni stenosis we BDS babe umsebenzi ukubuyisela ukugeleza of Bile futhi juice pancreatic phakathi duodenum. Ngaphakathi accordance nga lo mgomo kukhona eziningi izimiso, ukugujwa ozokusiza impumelelo ekwelapheni:

• ukuvala abacaphuni abangobe, ekwelapheni nezifo zengqondo, ekulinganiseni amazinga hormone, ukunciphisa ukucindezeleka, ukuphumula, ukudla okufanele;
• Ukwelashwa nokuvikelwa pathologies we ingaphakathi lesisu,
• nokuqedwa izici dyspeptic.

Ukuze kuqedwe izifo ezibangelwa Neurotic esetshenziswa sedatives infusions noma Iziphungo amakhambi ahlukahlukene. Ngaphezu kwalokho, iziguli yabonisa ukwelashwa kwengqondo.

Ebalulekile yokwelapha ngempumelelo kuyinto Ukudla:

• ukudla wamaqhuzu;
• ekuzileni utshwala carbonated iziphuzo kanye ukudla ngibhema futhi ethosiwe;
• nokukhawulela yokuvuma amaqanda izikhupha, ukubhaka, ukhilimu, ikhofi eqinile futhi itiye;
• njalo ukudla iklabishi, kakolweni bran kanye nokunye okufana nokolweni,
• ethola antispasmodics, okuyinto ukususa ukuhlaselwa ubuhlungu.

BDS stenosis ngokuvamile ziphatha izindlela kuhlinzwa. Hlukanisa nekorrigiruyuschie kanye nokusebenza ilungiswe. Isigaba sokuqala sihlanganisa endoscopic PST, kumba BDS.

Esikhathini inkathi ukuthethelelwa iziguli ngaphezu ekudleni Kunconywa yokwelapha yesondlo - izinzuzo ukuhamba nsuku zonke, yokuzijwayeza ekuseni, ukubhukuda.

Kafushane, kungashiwo ngokufingqiwe ukuthi abaningi izifo wokugaya ukudla zenzeka ngokumelene isizinda ukungasebenzi eyodwa isakhiwo esincane. ukwephulwa okunjalo kungaholela ezinkingeni ezingathi sína emzimbeni futhi ngokuvamile amenable ukusolwa kuphela ukuhlinzwa. Yilokho BDS.