Chizindikiro chofala kwambiri cha matenda a gallbladder ndi kupweteka kumtunda kumanja kwa mimba, kumene ndulu imapezeka. Malinga ndi mtundu wa matenda a ndulu omwe alipo komanso ngati mavuto aliwonse akuchitika, munthu akhoza kutengeka ndi malungo, kunyowa, kusanza, ndi / kapena jaundice.
Zovuta za matenda a gallbladder zimachokera ku kukhalapo kwa gallstones ndipo zimaphatikizapo kachilombo ka kanema kawiri (kotchedwa ascending cholangitis), kutupa kwa kapangidwe (kotchedwa pancreatitis), chifuwa cha gallbladder (chotchedwa gangrenous cholecystitis), kapena chifuwa Kutsekedwa ndi ndulu (yotchedwa gallstone ileus).
Zizindikiro Zowonjezereka
Kupweteka kumtunda kwa mbali ya mimba ndi chizindikiro chofala kwambiri cha gallbladder matenda ndipo kawirikawiri zotsatira za gallstones.
Mimba Yamimba
Ngakhale kuti magalasi ambiri amakhala mu ndulu ndipo samayambitsa zizindikiro, ena amatha kukhala mumtsinje wa cystic (chubu yomwe ili pamphepete mwa ndulu) kapena m'kati mwa mankhwala (tube yomwe imanyamula bile kuchokera ku gallbladder mpaka matumbo). Kulepheretsa kumeneku kumayambitsa kupweteka m'mimba, komwe kumatchedwa koliary colic.
Biliary colic kawirikawiri imatchulidwa ngati ululu waukulu, wosasinthasintha umene umakhalapo nthawi zonse (osati kwenikweni colicky, ngakhale dzina lake). Ngakhale kuti ululu umakhala pamwamba kumtunda kwa mimba, nthawi zina amapezeka chapakatikatikati mwa mimba (yotchedwa epigastrium) ndipo, mocheperapo, pansi pa mfupa. Nthawi zina ululu umayenda (kumayambira) mpaka kumapazi a kumanja. Colic ya biliary imapezeka m'mipingo ndipo nthawi zambiri, koma nthawi zonse, imayamba chifukwa chodyera mafuta.
Kuwonjezera pa kuponyedwa kwa ndulu, kupweteka kwa m'mimba kumtunda kumachitika m'magulu ena a ndulu, monga:
- Cholecystitis: Matendawa amatanthauza ndulu yotupa. Ngakhale kuti kawirikawiri imawoneka ngati vuto la gallstones (lotchedwa cholecystitis), imatha kupezeka mwa anthu opanda ndondomeko yamchere (yotchedwa acalculous cholecystitis). Mosiyana ndi ululu wa ndulu, kupweteka kwa biliary monga cholecystitis kumatenga nthawi yoposa maora asanu ndipo nthawi zambiri zimagwirizanitsidwa ndi malungo komanso kuchuluka kwa maselo oyera.
- Biliary dyskinesia : Matendawa amachititsa kupweteka kwa m'mimba m'mimba ndipo zimachitika pamene sphincter ya Oddi (minofu yomwe ili pambali imene bile imathamangira m'matumbo ang'onoang'ono) sagwira ntchito bwino, ndipo imayambitsa kubisa.
Matenda ogwirira ntchito : Mu matenda awa, munthu alibe umboni wa zithunzithunzi kapena sphincter ya mavuto a Oddi koma akupitiriza kumva zochitika za ululu m'mimba.
Khansara yapamwamba ya khungu: Munthu yemwe ali ndi khansa ya ndulu nthawi zambiri alibe zizindikiro. Ngakhale kuti khansayo imakula, kupweteka kumtunda kwa kumimba kumachitika pamodzi ndi zilonda zam'mimba, chifuwa, kunyowa, kutopa, ndi kulemera.
Jaundice
Jaundice, yomwe imatchulidwa ndi chikasu cha azungu a maso ndi khungu, imatha kudwala matenda a gallbladder omwe amalepheretsa kuti mchere ukhale wolimba.
Mphuno ndi Kutupa
Nsowa ndi kusanza zingachitike ndi ndondomeko yamwala koma nthawi zambiri zimawoneka mu cholecystitis (kutupa kwa ndulu) kapena kupopera (kutupa kwa ziphuphu).
Fever
Kutentha sikuyenera kuchitika ndi ndondomeko yamwala koma ikhoza kuchitika ndi ndulu yotupa kapena matenda / kutupa kwa tsamba la biliary.
Zizindikiro Zambiri
Kuwonjezera pa ululu wam'mimba wam'mimba, anthu adziwonetsa zizindikiro zina za matenda a gallbladder.
Komabe, chifukwa cha chikhalidwe chawo, akatswiri amafunsa ngati zizindikirozo ndi mbali ya matenda omwe amakhalapo; Mwa kuyankhula kwina, munthu akhoza kukhala ndi matenda a gallstones ndi matenda ena, monga matenda a reflux a gastroesophageal (GERD) kapena matenda a zilonda zam'mimba .
Zina mwazizindikiro zosadziwika ndi izi:
- Kupweteka pachifuwa
- Burping
- Kumverera kukhala wodzaza mwamsanga kuposa momwe inu mukudyera
- Kubwezeretsa madzi
- Kutseka
- Kutentha kotentha kumbuyo kwa bere kapena m'mimba pamkati
- Nosea ndi / kapena kusanza popanda coliary colic
Pruritus
Pruritus (kuyabwa) ndi chizindikiro china, chomwe chimapezeka makamaka ndi matenda otchedwa primary sclerosis cholangitis , matenda aakulu, opuwala a gallbladder ndi chiwindi.
Ma pruritus nthawi zambiri amadetsa nkhawa ndipo amawoneka chifukwa cha bile acid accumulation. Anthu omwe ali ndi sclerosing cholangitis angakhalenso ndi ululu wamimba pamimba, jaundice, ndi kutopa.
Mavuto
Pali mavuto ambiri omwe angathe kuchitika chifukwa cha matenda a gallbladder.
Zovuta Cholangitis
Cholangitis yoopsa imayambitsidwa ndi kachilombo kabakiteriya kamene kali ndi kachilombo ka biliary. Kuwonjezera pa malungo ndi ululu wam'mimba wam'mimba, munthu akhoza kupweteka kwambiri, kuthamanga kwa magazi, ndi kusokonezeka.
Pancreatitis
Pancreatitis imatanthawuza kutupa kwa makoswe ndipo kawirikawiri imawoneka ngati vuto la gallstones. Izi ndi chifukwa kuti ndulu ndi zopamba zimaphatikizapo ndondomeko ya ndondomeko ya bile, kotero kuti miyala yokhometsa ingalepheretse kutuluka kwa michere ya pancreatic.
Zizindikiro za ndondomeko ya galasi zimaphatikizapo kufulumira kwapwetekedwe koopsa, kupwetekedwa kwa epigastric, komanso kunyoza ndi kusanza. Chithandizo chimaphatikizapo madzi, kupweteka, kuyang'anira, ndi kuchotsa kutseka. Kuchotsa ndulu kumagwiranso ntchito.
Gangrenous Cholecystitis
Ichi ndi chovuta kwambiri cha cholecystitis, makamaka kwa anthu achikulire, anthu omwe ali ndi shuga, kapena anthu omwe amachedwetsa chithandizo cha mankhwalawa. Chopweteka chotchedwa gangrenous chimatengedwa ngati chithandizo chachipatala, chomwe chimafuna kuchotsa opaleshoni ya ndulu (cholecystectomy) pomwepo.
Gallbladder Perforation
Ngati nthendayi imakhala yowopsya, phokoso (kapena dzenje pakhoma la ndulu) lingapangitse kukhala ndi vuto la pericholecystic abscess (chotsitsa cha pus mkati mwa ndulu). Izi zimakhala zoopsa komanso zoopsa, zomwe zimafuna cholecystectomy.
Cholecystoenteric Fistula / Ilefstone Yamwala
Ngati dzenje limapanga ndulu, fistula (ndime) mumatumbo ang'onoang'ono akhoza kuyamba. Ngati galasi likadutsa mu fistula, chitetezo cha matumbo chikhoza kuchitika (wotchedwa gallstone ileus).
Kutentha Kwambiri Kwambiri
Kutengera kwa khoma la gallbladder ndi mabakiteriya omwe amapanga mpweya kungayambitse kutulutsa mitsempha yotchedwa emphysematous cholecystitis. Anthu omwe ali pachiopsezo kuti vutoli likhale ndi vuto lachilombo ndi okalamba komanso omwe ali ndi matenda a shuga.
Nthawi Yomwe Muwone Dokotala / Pitani kuchipatala
Ngati mukukumana ndi ululu uliwonse wamimba, nkofunika kuona dokotala wanu kuti apeze matenda oyenera. Ngati dokotala akukudziwani kuti ali ndi ndondomeko, amatha kukuwongolera kuti muyambe kufufuza opaleshoni, makamaka ngati mukukumana ndi zigawo zowonjezera za biliary.
Ngati muli ndi ululu wamimba kwambiri, wotsalira, ndi / kapena wokhudzana ndi malungo, kunyowa koopsa, kusanza, ndi / kapena jaundice, onetsetsani kuti mwapeza kuchipatala nthawi yomweyo kuchipatala.
> Zotsatira:
> American Cancer Society. (2016). Zizindikiro ndi Zizindikiro za Khansa Yamtundu.
> Zakko SF, Afdhal NH. (2016). Zovuta cholecystitis: Pathogenesis, zochitika zachipatala, ndi matenda. Chopra S, (ed). Kupititsa patsogolo, Waltham, MA: UpToDate Inc.
> Dayal N, Meseeha. (2017). StatPearls. Biliary Colic.
> Zakko SF. (2017). Matenda a miyala yamtengo wapatali kwa anthu akuluakulu. Chopra S, (ed). Kupititsa patsogolo, Waltham, MA: UpToDate Inc.
> Zaliekas J, Munson JL. Zovuta za mitsempha yam'mimba: Matenda a Mirizzi, ilestone ya gallstone, gallstone pancreatitis, mavuto a "miyala" yotayika. Kliniki Yopaleshoni North Am . 2008 Dec; 88 (6): 1345-68.