BDS ke eng? lefu mahareng BDS

Mafu a ba tsamaiso tshilong ya dijo makala - lefu le ka toka neng li tloaelehile tse etsahalang ka batho ba bangata ba baahi ba polanete e. Leha ho le joalo, ha mong le e mong oa tseba hore mafu a mangata a bakoa ke gastrointestinal e re lefu kgolo duodenal papilla. Ho tloha thepa ea sehlooho se reng, 'mali o ithuta hore BDS e, seo mefuta eohle ea mafu a ho tsejoe ke moriana oa sebopeho sena e le hlahloba maemo pathological le phekolo eo tabeng ena e phethahatsoa.

Khopolo BDS

Large duodenal papilla (BNS) emela sebopeho anatomical ya sebopeho hemispherical, e leng e e ratang ka mucosa theoha karolo ea duodenum ena. Ka lingoliloeng tsa bongaka BDS ka fumanoa tlas'a mabitso a fapaneng - kholo duodenal papilla, le papilla tsa Vater. Leha ho le joalo, ke sona seo BDS? Ena ka boholo ho tloha 2 limilimithara ho 2 cm, sebopeho eo o etsa mosebetsi oa bohlokoa haholo - e amahanya ba tloaelehileng bile difapho, ba ka sehloohong pancreatic difapho le duodenum. BDS o laola le phallo ea bile le lero pancreatic ka mantle a tse nyenyane le ho thibela litaba tse ka hare mala ka ducts ka.

Ka sebopeho sa OBD ka etsahala liphetoho pathological tlas'a tšusumetso ea lintlha fapaneng -. Tšoaneng microflora pathogenic, liphetoho khatello le liphetoho tse ka ho leka-lekana acid e-botlaaseng, stagnation ka cavity e, joalo-joalo Ho phaella moo, sebopeho 'mele a ka a qhalana fallela ha bile difapho majoe kapa likarolo tse ling tse tiileng.

bolwetse BDS

Mafu a ya papilla kgolo duodenal e sa tšoaneng haholo. Le tsoelo-pele ea mekhoa ea kajeno ea tlhathoba liqeto ka mafu a tshebetso ka sebopeho sena ke tse ling tse ngata li neng li atile ho feta pele e neng e nahana. Leha ho le joalo, ka lebaka la ho tšohanyetso le ho ena e rarahaneng ka go ikatisetsa tekotshupo tsa bongaka hangata u tobane le palo e khōlō ea sephetho ke ba futsanehileng e ka kalafo ea bakuli le cholelithiasis kapa pancreatitis hore ntshetswa pele ka semelo sa ditlolo ka sebopeho BDS.

BDS tloaelehile hore batho ba bolwetse nkoa tumorous sekame - polyps hyperplastic ho fihlela ho 87% har'a neoplasms nang kotsi. Polyps hangata ha regenerate ka dinama tse nyenyane tse bolaeang. Adenoma - bole seoelo lefu OBD bolaoa ke kankere ka ho fihlela ho 25% ya malignancies tsohle. BDS stenosis fumanoa ka 4-40% ea bakuli. E le busa, ho BDS bolwetse amahanngoa le lefu gallstone (GSD), eo le hlaha mong le o mong moahi ea leshome.

Classification ea Mafu BDS

Mafu a ya papilla kgolo duodenal e classified ka lihlopha tse peli tse ka sehloohong:

• mathomo,
• mahareng.

The mafu mathomo kenyeletsa mafu tseo tse etsahalang tse localized hara sebopeho OBD - papillitis (a hlabang lefu); spastic OBD stenosis, e leng se ka hamorao fetoloa papilloskleroz; OBD lilemo liphetoho; congenital anomalies; nang kotsi le se bolaeang lihlahala - lipoma, melanoma, fibroma, adenoma, polyps, papillomas.

mafu a mahareng BDS - stenosis ho bakoa ke gallstones. Matšoao a boloetse bona a amana ka ho toba hore na ke hobane'ng a ne a bitsa. Kahoo, ha tsamaiso pathological ke lebaka la mafu a ea tsamaiso ea biliary, lefu lena le ke tšoanang le likarolo tsa GSD - bolwetse, tšoauoa ka sebopeho sa majoe ka gallbladder kapa bile ducts, a tsamaea le ba le boikutlo bo boima ka ho e ka holimo quadrant, flatulence, lesokolla, setulo sa tsitsang.

Ho na le ke khopolo ea ho kopantswe stenosis - ho tlōla BNS mesebetsi hore ba ipotsa khahlanong le semelo sa seso sa duodenum ena. Tabeng ena, ho na le ho hloka BNS.

pancreatitis

Ha dithulaganyo pathological ka sebopeho sa e bakoang ke ho ruruha OBD liponahatso pancreatic lefu tse tšoanang le matšoao a pancreatitis.

Pancreatitis - ke ruruha ka manyeme le. Hoa hlokomeleha hore le setšoantšo sa lefu lena ka 'na ba e fapaneng - bolwetse ke khona ho ntshetsa pele ka potlako, ho nka foromo a hlobaetsang le, kapa u se ke ua bontša ho bona ka bobona ka nako e telele, e leng ke tloaelehileng bakeng sa mofuta o le sa foleng la phallo ea.

The letšoao ka sehloohong sa pancreatitis hlobaetsang ke matla haholo ho itšeha bohloko sebakeng sena holimo mala - le letona kapa le letšehali ka holimo quadrant. Bohloko e ka etsa herpes le aa ka a khaotsa esita le ka mor'a ho nka antispasmodics kapa analgesics. Ke eng BDS le liphello sephetho le tlōlo ea mesebetsi ea eona.

Ho phaella tabeng ea ho isa bohlokong ba pancreatitis etsahala gag reflex, bofokoli mesifa, ho tsekela. Matšoao o ka sehloohong oa pancreatitis ke tsa ultrasound li fetola sebōpeho le roughness ea metshetshe ea manyeme le. Ka phumano ya cysts ka lemoha ka 'mele. Ke lokela ho bolela hore lefu lena ke ho le thata. 'Me ka ho kenella ha tšohanyetso ho ka etsa hore lefu.

Spastic stenosis BDS

Stenosis OBD - nang kotsi bolwetse ea temana eo, eo ho bakoa ke obstruction tsa difapho pancreatic le nyooko e loketseng ho liphetoho a hlabang le cicatricial constrictions papillae. Kamoo e se etsahala? Temana Lejoe e qetellong papilla le tšoaetso ea mafolofolo lemenong le isang ntshetsopele ya dinama tse nyenyane tse fibrous le libaka stenotic OBD ampoules.

E le o tsejoa, sebōpeho sa BDS kotloloho ama lilemo ea motho. Batho ba lilemo tse tsoetseng pele ka ho cholelithiasis utloa bohloko-sclerotic atrophic foromo ya papillita foleng. The contingent, eo ha e e-ba lilemo tsa lilemo tse mashome a tšeletseng linaheng tse ling, ho liphetoho hyperplastic ka BDS (adenomatous, adenomiomatoznye).

lilemong tsa morao tjena, ka lebaka la 'nete ea hore, ho fumanoe mafu a BDS endoscopes di a sebelisa, ho ka etsahala hore ba ka ho hlaka khetholla pakeng tsa constrictive le catarrhal (nestenoziruyuschy) papillitis. Mofuta oa pele oa bolwetse amanang le cholelithiasis. Haeba 'mele ha e theha majoe, ntshetsopele ya lefu lena le ke tšoaetso e sa foleng hore ata ka ho lisele tsa mmele jwale.

Liforomo stenosis BDS

Ho itšetlehile ka batho ba hlahang ka morphological ke liforomo tse tharo tsa stenosis:

• hlabang-sclerotic stenosis - ya bolwetse e tšoauoa ka sa tšoaneng likhato tsa fibrosis;
• fibrocystic stenosis - e hloka taolo eo sebopeho sa fibrosis le cysts thehoa tse nyenyane - ka lebaka la litsoelesa haholo ntlafatsoa pepeta likhoele mesifa;
• adenomiomatozny Stenosis - bolwetse, moo ba adenomatous hyperplasia litsoelesa, hammoho le faeba hypertrophy tsa mesifa le boreleli le fibrous overgrowth tsa likhoele, tlōlo e hangata haholo le hlaha ka batho ba hōlileng.

Ho phaella moo, lebali stenosis BDS classified:

• le ka sehloohong,
• mahareng.

stenosis mathomo ha bakela liphetoho ka ducts bile. Bolwetse bakoa ke liphetoho tse holofatsang tsa papilla, e leng hlaha ka felloa ke matla ha lera mesifa. Ka linako tse ling stenosis ka sehloohong ke le sekoli congenital.

stenosis mahareng ke ka lebaka la liphetoho tse teng ka sebopeho sa e loketseng ho majoe a ho falla ho lemala papillae kapa ho buuoa.

Ho itšetlehile ka boholo ba ho ata ha lefu stenosis BNS dishere:

• ka thōko,
• tloaelehileng.

tlhathoba

Ho fihlela joale, moriana sebelisa mekhoa e 'maloa e atlehang ea mafu tlhathoba OBD. A re ke re hlahlobeng tse ling tsa tsona. Endoscopic ultrasonography - mokhoa oo ka sesebediswa sa Optical - the endoscope - thuto ea etsoa OBD sebopeho. Photography papilla, se entsoeng ka ho ithuta e tšoanang, a qotsitsoeng ka holimo.

Transabdominal ultrasonography - screening mokhoa tlhlahlobo sebelisa ultrasound maemong, eo dumella haholo ka tsela e nepahetseng hlwaya liphetoho mehaho ka gallbladder, sebete, manyeme le ducts. Ho phaella moo, mokhoa o etsang qeto ea pathomorphology ea cavity le senya nyooko motility, ho ba teng / sieo ha inclusions intracavitary.

The mokhoa latelang ea diagnosing pathologies BDS - galena cholecystography - mellwane, ka tsela eo ba hlahloba dilenaneo-sebakeng seo mosebetsi oa nyooko senya ka lihora tse peli ka mor'a ho amohela choleretic lijo tsa hoseng.

Matla hepatobiliary scintigraphy - mokgwa wa, e leng e thehiloe - Tekolo ya absorptive-excretory mosebetsi sebete. Palophatlo chromatic duodenal ntse a botsolotsa a ho fumana hore na molumo oa ho senya nyooko; colloidal botsitso e amanang le sebete bile karoloana le sebopeho lona bacteriological. Ha gastroduodenoscopy e lekola puso ea BDS, hammoho le hlokomela la mofuta wa bile e ba teng. Ho phaella ho mekhoa tsena ho na le k'homphieutha tomography le tlhathoba laboratoring.

BDS: kalafo

Motheong oa kalafo ya stenosis tsa BDS na le mosebetsi ho tsosolosa phallo tloaelehileng bile le lero pancreatic ka duodenum ena. Ho latela sepheo sena ho na le tse 'maloa ea melao-motheo, moketeng oa eo ho tla u thusa ho finyella katleho ea ho phekola ba:

• a tlhaloganyo, kalafo ea neuroses, tsitsisa maemo hormonal, fokotsa khatello ea kelello, boikhathollo, lijo e loketseng;
• Phekolo ea pathologies ea cavity ka mpeng,
• ho felisoa ha mabaka a dyspeptic.

E le hore ho felisa mafu a neurotic sebediswa sedatives infusions kapa decoctions ea litlama tse sa tšoaneng. Ho phaella moo, bakuli o ile a bontša a kelello.

E karolo ea bohlokoa ea kalafo atlehileng ke lijo:

• palophatlo lijo;
• teloe joala le carbonated dino, hammoho le lijo tse tsuba le halikiloeng;
• fokotsa yolks kenoa lehe, ho baka, tranelate, kofi le matla le tee;
• ja khafetsa k'habeche, koro matlapi a korong le buckwheat;
• kamohelo antispasmodics, eo tlosa litlhaselo tse bohloko.

BDS stenosis e atisa ho tšoaroa ka mekhoa ea ho buoa. Khetholla nekorrigiruyuschie le ho e lokisa tshebetso. Sehlopha sa pele se akarelletsa endoscopic PST, ntse a botsolotsa a BDS.

Ka nako ya ho leballa motho bakuli ho phaella ho ho ja ho kgothaletswa tokiso phekolo - Melemo ea ho tsamaea letsatsi le letsatsi, hoseng gymnastics, ho sesa.

Ka kakaretso, e ka akaretsa hore ba bangata ba mafu a tshilong ya dijo ea hlaha khahlanong le semelo sa ka sebetse hantle ya sebopeho le leng tse nyenyane. ditlolo joalo lebisa mathata a tebileng a ka 'mele' me hangata amenable ho khalemelo feela ke etsa opereishene. Hore 's seo e BDS.