E Tloaelehileng bile difapho - ke eng? litšobotsi tse fisioloji le dithulaganyo pathological

Mang kapa mang ea tsebang moo sebete, ka karolo hae ka physiology ba iphelisa phelang. Empa moo ke choledoch hore eona? Ho ke ke mong le e mong ea tsebang. Tlaasana makala a tshilo ya dijo ke gallbladder. The narrowest karolo (molaleng) e fetoleloa difapho cystic le merges le sebete. Thehoa ducts choledochus tloaelehile hore batho ba bile difapho, kapa e le feela ho bua, choledoch.

Ho fetela le hammoho bohale e ka ntle ea sebete, pakeng tsa maqephe ho ka peritoneal ligament hepatoduodenal, tebang fatše pakeng tsa hlooho ea manyeme le duodenum (12PK). Ebe o fetela ho tswa ho lehlakoreng le ka hare, ka morao leboteng 12PK le a tšela ka lumen ka papilla tsa Vater.

entsprechen fisioloji le sebōpeho sa e tloaelehileng bile difapho

Itseng melao-motheo ea ho ba le bohloeki e le choledoch. ntho e tloaelehileng le e emeloang ke litsupa latelang: bolelele e lokela ho ba 2-12 cm, o ile a re ho itšetleha ya litšobotsi tsa confluence ea difapho cystic .. Ha e amanang le sebete difapho lengthened, ho tla ba e khutsoanyane choledoch. E bolela eng? Feela taba ea hore bolelele ba phallo motho. bophara le fapana ho ea ka e kholoanyane ho mokhabo nyenyane ka tsela ea ho pheta-pheta. Qalong o ke 5-8 limilimithara. Joale ho na le phetoho e sa lumen, 'me monyako ka intestine difapho sesefatsa ho led 3mm. Leboteng botenya ba limilimithara 0.5 ho 1.5. Ka maemo a pathological ka lebaka la keketseho ea dinama tse nyenyane tse connective choledoch ka 'na thicken ho fihlela ho 3-4 limilimithara.

Kakaretso bile difapho na le likarolo tse 4.

1. Supraduodenal. Bolelele -. Fetisa ho cm, 4 hammoho bohale le ka ntle ya e amanang le sebete-duodenal ligament karolo e itseng ea difapho cystic ho e ka holimo bohale 12PK.
2. Retroduodenalny. Bolelele -. Fetisa cm, 1-2 bakeng sa 12PK retroperitoneal ho fihlela e ama manyeme.
3. Pancreatic. Bolelele -. 3 cm, a kopana le hlooho ea manyeme le e pota-potiloe ke eona.
4. Intraduodenally. Bolelele ba -. Cm, 12 Located leboteng 12PK.

liphetoho pathological

Ho na le a 'maloa a liphetoho pathological tšoana bile difapho. E mong oa bona ke dilatation e akaretsang bile difapho. Dilation tsa Latin dilatation - atolosoa ha lumen tsa difapho ena. Ke ka lebaka la thibelo phetha molao oa karolo tlaase ho linoka tsa lekala la.

Etsa dilation:

1. Congenital le fumaneng malformations (hypoplasia, cysts).
2. Nang kotsi gallbladder lefu (cholelithiasis, strictures tsa ducts bile).
3. dithulaganyo hlabang (cholecystitis, cholangitis, pancreatitis).

Ho na le lipotso tse ngata tse utloahalang. Kaha sena se fapana choledoch? Le hore se ka akarelletsa eng? Maemong a joalo a abeloa palo e liteko litleleniki tsa ho fumana hore na sesosa sa ho fetola lumen le khetha mokhoa kalafo ka ho eketsehileng.

mekhoa phuputso e entsoeng

Mokhoa o tloaelehileng haholo le o tšepahalang oa hlahloba sebete ke SPL. disebediswsa morao-rao lumella oa ultrasound ho fumana setšoantšo hlakileng ea ducts e amanang le sebete. Ka bomalimabe, boholo ba se senyenyane sa calculi ka kakaretso difapho ultrasound tse hangata e ke ke visualized. Maemong a joalo ho ke ke ho hlokahala hore ho retelehela ho mekhoa e meng ea tepelletse maikutlong, ho hlahloba choledoch kaofela. na le mekhoa e tsena ke life?

1. Bontša phapang pakeng tsa X-ray hlahloba.
2. Mekhoa ea ho staining otlolohileng (duodenoscopy catheter, puncture e akaretsang bile difapho ke tsa ultrasound).

Mekhoa ena e etsa hore ho be bonolo ho theha sesosa sa ho tloaelehile hore batho ba difapho obstruction mokhoa o nepahetseng haholoanyane 'me ho le thata ho finyella libaka.

Re lokela ho hlokomela hore ke habohlokoa ho liteko kakaretso le skeletal mali. lithuto tsena li bontša ho ba teng ha dithulaganyo a hlabang.

Lisosa tsa mafu a ea gallbladder le tloaelehileng le sebelisoang malapeng bile difapho

Liphetoho ka ba tloaelehileng bile difapho bontsha ho ba teng ha dithulaganyo pathological ka sebete 'me gallbladder. From eo ho hlaha lefu le sebete? Motso ke kamehla e le tsela ea bophelo le phepo e nepahetseng, ha le lula tšebeliso ea joala, ho tsuba. Rata ho mafura, halikiloeng dijo, hape, ho phetha karolo ea, hammoho le sa laoleheng, ahloloe ka leeme tšebeliso ea meriana. Ka linako tse ling mathata a ho li bakoa ke litšobotsi tse tlhaho motho. Ha nako e ntse ona o isa ho ruruha, sebopeho sa majoe. Blockage qala le katoloso ea ho tloaelehile hore batho bile difapho. Ha dithulaganyo pathological ke asymptomatic, boemo e a feteletsoang le isang liphello tse tebileng, ho fihlela ho necrosis pancreatic.

phekolo

Phekolo e lokela ho ba akaretsang. Ha sesosa ke ho ba teng ha ho tloaelehile hore batho bile difapho majoe, ho phekola a tsitsinkela tlang hangata ho fihlela ho buoa. The menyetla ea phekolo ea kajeno etsa ho ka khoneha ho sebelisa mekhoa ea ho tsosolosa ya ba tloaelehileng bile difapho senya, ka tlase e sithabetsang ho buoa.

Ha mafu parasitic le a hlabang le phekolo le lithibela-mafu le duodenal intubation, ikemiseditse ho ho lokolloa ha ba tloaelehileng bile difapho ke stagnation. The mokhoa o atlehang ka ho fetisisa ke thibelo. ho ja bophelo bo botle, ho ikoetlisa ho ke kahlolo e molemo, ka nako e loketseng hlahlojoa thibelang ya kalafi thusa ka lilemo tse ngata ho boloka ho loketse.