Matombo

Matombo akaomarara akaomeswa anoumba mukati meguruva. Izvi zvinogona kuve zvidiki segorosi rejecha kana kukura sebhora regorofu.

Chikonzero chenduru dzinosiyana. Kune maviri epamhando mikuru yematombo:

• Matombo akagadzirwa necholesterol - Iyi ndiyo mhando yakajairika. Cholesterol gallstones haina hukama necholesterol muropa. Muzviitiko zvakawanda, hazvioneke paCT scan.
• Matombo akagadzirwa ne bilirubin - Aya anonzi matombo e pigment. Zvinoitika kana masero matsvuku eropa aparadzwa uye bilirubin yakawandisa iri munyuchi.

Matombo ematombo anowanzoitika mu:

• Bonde rechikadzi
• MaIndia ekuAmerica nevanhu verudzi rweSpain
• Vanhu vanopfuura makore makumi mana
• Vanhu vakafuta zvakanyanya
• Vanhu vane nhoroondo yemhuri yematombo

Izvi zvinotevera zvinhu zvinoitawo kuti iwe uwedzere kugadzira maturu.

• Bone mwongo kana yakasimba nhengo kuisazve
• Chirwere cheshuga
• Kukundikana kweguropa kubuda bile zvakanaka (izvi zvinowanzoitika panguva yekuzvitakura)
• Chiropa cirrhosis uye biliary chirwere chetachiona (pigmented matombo)
• Mamiriro ekurapa anokonzeresa akawanda maseru matsvuku eropa kuti aparadzwe
• Kukurumidza kurasikirwa uremu kubva pakudya yakaderera-koriori chikafu, kana mushure mekurema kwekuremerwa kuvhiya
• Kugamuchira kudya kunovaka muviri kuburikidza netsinga kwenguva yakareba (intravenous feedings)
• Kutora mapiritsi ekudzivirira kubereka

Vanhu vazhinji vane gallstones havana chero zviratidzo. Izvi zvinowanzo kuwanikwa panguva yechinyakare x-ray, kuvhiyiwa mudumbu, kana imwe nzira yekurapa.

Nekudaro, kana dombo hombe rikavharidzira chubhu kana dhayeti iyo inodurura nduru, unogona kunge uchirwadziwa nepakati nepakati padumbu repamusoro chaipo. Izvi zvinozivikanwa se biliary colic. Marwadzo anoenda kana dombo richipfuura muchikamu chekutanga chemukati mudumbu.

Zviratidzo zvinogona kuitika zvinosanganisira:

• Marwadzo ari mudumbu repamusoro kana epakati kumusoro padumbu kwemaminitsi makumi matatu. Marwadzo anogona kunge achigara kana kupwanya. Inogona kunzwa yakapinza kana kusviba.
• Kupindwa nechando.
• Yero yeganda uye chena yemeso (jaundice).

Zvimwe zviratidzo zvinogona kusanganisira:

• Zvigaro zvine ruvara rwevhu
• Kusvotwa uye kurutsa

Kuyedza kunoshandiswa kuona maturu kana gallbladder kuzvimba kunosanganisira:

• Ultrasound, mudumbu
• CT scan, dumbu
• Endoscopic kudzokorora cholangiopancreatography (ERCP)
• Gallbladder radionuclide scan
• Endoscopic Ultrasound
• Magnetic resonance cholangiopancreatography (MRCP)
• Percutaneous transhepatic cholangiogram (PTCA)

Mubatsiri wako wehutano anogona kuraira zvinotevera kuongororwa kweropa:

• Bilirubin
• Chiropa basa bvunzo
• Yakazara kuverenga ropa
• Pancreatic enzyme

Kuvhiya

Kazhinji yenguva, kuvhiyiwa hakudiwe kunze kwekunge zviratidzo zvatanga. Nekudaro, vanhu vanoronga kuvhiya uremu vangangoda kubviswa nduru vasati vaitwa maitiro. Muzhinji, vanhu vane zviratidzo vachada kuvhiyiwa ipapo ipapo kana nguva pfupi dombo rawanikwa.

• Imwe nzira inonzi laparoscopic cholecystectomy ndiyo inowanzoshandiswa. Maitiro aya anoshandisa zvidiki zvekuvhiya, izvo zvinobvumidza kukurumidza kupora. Murwere anowanzo enda kumba achibva kuchipatara mukati mezuva rimwe rekuvhiyiwa.
• Munguva yakapfuura, yakavhurika cholecystectomy (kubvisa nduru) yaiwanzoitwa. Nekudaro, iyi nzira haina kujairika zvino.

Endoscopic retrograde cholangiopancreatography (ERCP) uye maitiro anonzi sphincterotomy anogona kuitwa kutsvaga kana kurapa matombo eguroni mune yakajairwa bile duct.

MISHONGA

Mishonga inogona kupihwa mupiritsi fomu kuputsa cholesterol matombo. Zvisinei, mishonga iyi inogona kutora makore maviri kana kupfuura kuti ishande, uye matombo anogona kudzoka mushure mekurapwa kwapera.

Kazhinji, makemikari anopfuudzwa muguruva kuburikidza necatheter. Iyo kemikari inokurumidza kuputsa cholesterol mabwe. Kurapa uku kwakaoma kuita, saka hazviitwe kazhinji. Makemikari anoshandiswa anogona kunge aine chepfu, uye matombo anogona kudzoka.

LITHOTRIPSY

Shock wave lithotripsy (ESWL) yeguruva rave kushandiswawo kuvanhu vasingakwanise kuvhiyiwa. Mushonga uyu haushandiswe kazhinji sezvawaimboita nekuti nduru dzinowanzodzoka.

Ungangoda kuve pane chinwiwa chemvura kana kutora mamwe matanho kuti upe nduru yako zororo mushure mekunge warapwa. Wako anokupa anokupa rairo kana iwe uchibva muchipatara.

Mukana wezviratidzo kana kunetseka kubva pakuvhiyiwa kwematombo kushoma. Vanenge vese vanhu vane chirwere chenduru vasina zviratidzo zvavo zvinodzoka.

Kuvharirwa nematombo kunogona kukonzera kuzvimba kana hutachiona mu:

• Gallbladder (cholecystitis)
• Tube inotakura bile kubva pachiropa kuenda kune nduru uye ura (cholangitis)
• Pancreas (chirwatata)

Fonera mupiki wako kana iwe uine:

• Marwadzo muchikamu chepamusoro chedumbu rako
• Yero yeganda kana machena eziso

Muvanhu vazhinji, nduru hadzigoni kudzivirirwa. Mune vanhu vakafutisa, kudzivirira kukurumidza kurasikirwa uremu kunogona kubatsira kudzivirira matombo.

Cholelithiasis; Gallbladder kurwisa; Biliary colic; Gallstone kurwisa; Biliary calculus: gallstones chenodeoxycholic acids (CDCA); Ursodeoxycholic acid (UDCA, ursodiol); Endoscopic kudzokorora cholangiopancreatography (ERCP) - nduru

• Gallbladder kubviswa - laparoscopic - kubuda
• Gallbladder kubviswa - kuvhura - kubuda
• Matombo emabwe - kubuda

• Kugaya chirongwa
• Itsvo cyst ine nduru - CT scan
• Gallstones, cholangiogram
• Cholecystolithiasis
• Cholelithiasis
• Gallbladder
• Kubviswa kweGallbladder - Series

Fogel EL, Sherman S. Zvirwere zveguruva uye bile ducts. Mune: Goldman L, Schafer AI, eds. Goldman-Cecil Mushonga. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016: chits. 155.

Jackson PG, Evans SRT. Biliary maitiro. Mu: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Chinyorwa Chekuvhiya. 20th ed. Philadelphia, PA: Elsevier; 2017: chitsiko 54.

Wang D QH, Afdhal NH. Gallstone chirwere. Muna: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger uye Fordtran's Gastrointestinal uye Chirwere Chirwere: Pathophysiology / Diagnosis / Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016: chits 65.