Isifo Se-Gallbladder

-Delile

• Yiziphi izinhlobo zesifo se-gallbladder?
• Amatshe amatshe amade
• Cholecystitis
• I-Choledocholithiasis
• Isifo se-gallbladder se-Acalculous
• I-biliary dyskinesia
• I-sclerosing cholangitis
• Umdlavuza we-gallbladder
• Ama-polyps we-gallbladder
• Isigaxa senyongo
• Ithumba lenyongo
• Sitholakala kanjani isifo se-gallbladder?
• Umlando wezokwelapha oningiliziwe
• Ukuhlolwa ngokomzimba
• I-X-ray yesifuba nesisu
• I-Ultrasound
• Ukuskena kwe-HIDA
• Okunye ukuhlolwa
• Selashwa kanjani isifo se-gallbladder?
• Izinguquko zendlela yokuphila
• Ukwelashwa
• Ukuhlinzwa
• Izinkinga ezikhona zesikhathi eside zesifo se-gallbladder
• Ngabe isifo se-gallbladder singavinjelwa?

Sibutsetelo sesifo se-gallbladder

Igama elithi isifo se-gallbladder lisetshenziselwa izinhlobo eziningana zezimo ezingathinta i-gallbladder yakho.

I-gallbladder iyisikhwama esincane esimise okwamapheya esingaphansi kwesibindi sakho. Umsebenzi wakho omkhulu we-gallbladder ukugcina inyongo ekhiqizwa isibindi sakho bese uyidlulisa ngomgudu othululela emathunjini amancane. IBile ikusiza ukuthi ugaye amafutha emathunjini akho amancane.

Ukuvuvukala kubangela iningi lezifo ze-gallbladder ngenxa yokucasuka kwezindonga ze-gallbladder, ezaziwa ngokuthi yi-cholecystitis. Lokhu kuvuvukala kuvame ukwenzeka ngenxa yamatshe enyongo avimba amapayipi aholela emathunjini amancane futhi abangele ukuba kwakhiwe i-bile. Kungagcina kuholele ku-necrosis (ukubhujiswa kwezicubu) noma ukulimala.

Yiziphi izinhlobo zesifo se-gallbladder?

Kunezinhlobo eziningi zesifo se-gallbladder.

Amatshe amatshe amade

Ama-gallstones akhula lapho izinto eziku-bile (njenge-cholesterol, usawoti we-bile, ne-calcium) noma izinto ezivela egazini (njenge-bilirubin) zakha izinhlayiya ezinzima ezivimba imigwaqo eya e-gallbladder ne-bile ducts.

Ama-gallstones nawo ajwayele ukwakheka lapho i-gallbladder ingaphumi ngokuphelele noma kaningi ngokwanele. Zingaba zincane njengohlamvu lwesihlabathi noma zikhulu njengebhola legalufu.

Izici eziningi zinomthelela engozini yakho yamatshe enyongo. Lokhu kufaka phakathi:

• ukukhuluphala ngokweqile noma ukukhuluphala
• ukuba nesifo sikashukela
• ukuba neminyaka engama-60 noma ngaphezulu
• uthatha imithi equkethe i-estrogen
• ukuba nomlando womndeni wama-gallstones
• ukuba ngowesifazane
• ukuba nesifo sikaCrohn nezinye izimo ezithinta ukuthi kufakwa kanjani izakhamzimba
• ukuba ne-cirrhosis noma ezinye izifo zesibindi

Cholecystitis

I-Cholecystitis uhlobo oluvame kakhulu lwesifo se-gallbladder. Izibonakalisa njengokuvuvukala okukhulu noma okungapheli kwe-gallbladder.

I-cholecystitis enamandla

I-cholecystitis enamandla ivame ukubangelwa ama-gallstones. Kepha futhi kungabangelwa izicubu noma ezinye izifo ezahlukahlukene.

Ingaletha nobuhlungu ohlangothini olungaphezulu kwesokudla noma engxenyeni ephezulu yesisu. Ubuhlungu buvame ukwenzeka ngemuva nje kokudla nobubanzi obuvela emihlungwini ebukhali kuze kube yizinhlungu ezibandayo ezingaphuma ziye ehlombe lakho langakwesokudla. I-cholecystitis enamandla nayo ingadala:

• imfiva
• isicanucanu
• ukuhlanza
• i-jaundice

I-cholecystitis engapheli

Ngemuva kokuhlaselwa kaningana kwe-cholecystitis ebukhali, i-gallbladder ingancipha futhi ilahlekelwe amandla ayo okugcina nokukhulula i-bile. Ubuhlungu besisu, isicanucanu nokuhlanza kungenzeka. Ukuhlinzwa kuvame ukwelashwa okudingekayo kwe-cholecystitis engapheli.

I-Choledocholithiasis

Ama-gallstones angafakwa entanyeni ye-gallbladder noma emigodini ye-bile. Lapho i-gallbladder ixhunywe ngale ndlela, i-bile ayikwazi ukuphuma. Lokhu kungaholela ekutheni i-gallbladder ivuthe noma iphazamiseke.

Amapayipi e-bile axhunyiwe azoqhubeka nokuvimbela i-bile ekuhambeni kusuka esibindini iye emathunjini. I-Choledocholithiasis ingadala:

• ubuhlungu obukhulu phakathi kwesisu sakho esingenhla
• imfiva
• Ukugodola
• isicanucanu
• ukuhlanza
• i-jaundice
• izitulo ezinombala okhanyayo noma zobumba

Isifo se-gallbladder se-Acalculous

Isifo se-gallbladder se-Acalculous ukuvuvukala kwe-gallbladder okwenzeka ngaphandle kokuba khona kwama-gallstones. Ukuba nokugula okungalapheki okuphawulekayo noma isimo sezempilo esibi kukhonjisiwe ukuqala isiqephu.

Izimpawu ziyefana ne-cholecystitis ebukhali ngamatshe enyongo. Ezinye zezinto eziyingozi kulesi simo zifaka:

• ukuhlukumezeka okukhulu ngokomzimba
• ukuhlinzwa kwenhliziyo
• ukuhlinzwa esiswini
• ukusha okukhulu
• izimo ezizimele njenge-lupus
• ukutheleleka kwegazi
• ukuthola umsoco ngemithambo (IV)
• izifo ezibalulekile zebhaktheriya noma ezibangelwa amagciwane

I-biliary dyskinesia

I-biliary dyskinesia yenzeka lapho i-gallbladder inomsebenzi ophansi kunokujwayelekile. Lesi simo singahle sihlobene nokuvuvukala kwe-gallbladder okuqhubekayo.

Izimpawu zingabandakanya izinhlungu ezingaphezulu kwesisu ngemuva kokudla, isicanucanu, ukuqunjelwa, kanye nokugaya ukudla. Ukudla ukudla okunamafutha kungadala izimpawu. Imvamisa awekho amatshe enyongo ku-gallbladder ene-biliary dyskinesia.

Udokotela wakho angadinga ukusebenzisa isivivinyo esibizwa nge-HIDA scan ukusiza ukuxilonga lesi simo. Lokhu kuhlolwa kukala umsebenzi we-gallbladder. Uma i-gallbladder ingakhipha kuphela amaphesenti angama-35 kuye kwangama-40 okuqukethwe kwayo noma ngaphansi, khona-ke i-biliary dyskinesia ivame ukutholakala.

I-sclerosing cholangitis

Ukuvuvukala okuqhubekayo nokulimala ohlelweni lwe-bile duct kungaholela ekuqhekekeni. Lesi simo sibizwa ngokuthi yi-sclerosing cholangitis. Kodwa-ke, akwaziwa ukuthi yini ngempela ebangela lesi sifo.

Cishe isigamu sabantu abanalesi simo abanazo izimpawu. Uma izimpawu zenzeka, zingabandakanya:

• imfiva
• i-jaundice
• ukulunywa
• ukungakhululeki okuphezulu kwesisu.

Cishe abantu abanalesi simo nabo bane-ulcerative colitis. Ukuba nalesi simo kwenyusa nengozi yomdlavuza wesibindi. Njengamanje, ikhambi kuphela elaziwayo ukufakelwa isibindi.

Imithi ecindezela amasosha omzimba kanye naleyo esiza ukwehlisa i-bile eqine ingasiza ukuphatha izimpawu.

Umdlavuza we-gallbladder

Umdlavuza we-gallbladder yisifo esingajwayelekile. Kunezinhlobo ezahlukene zomdlavuza we-gallbladder. Kungaba nzima ukuselapha ngoba akuvamisile ukuthi kutholakale kuze kube sekwephuzile ekuqhubekeni kwesifo. Ama-gallstones ayinto ejwayelekile engcupheni yomdlavuza we-gallbladder.

Umdlavuza we-gallbladder ungasakazeka usuke odongeni lwangaphakathi lwenyongo uye ezingqimbeni ezingaphandle bese uya kwesibindi, ama-lymph node, nezinye izitho. Izimpawu zomdlavuza we-gallbladder zingafana nalezo ze-cholecystitis ebukhali, kepha kungahle kungabikho zimpawu nhlobo.

Ama-polyps we-gallbladder

Ama-polyps e-gallbladder yizilonda noma ukukhula okwenzeka ngaphakathi kwe-gallbladder. Imvamisa banobungozi futhi abanazimpawu. Kodwa-ke, kuvame ukunconywa ukuthi kususwe i-gallbladder yama-polyps amakhulu kunesentimitha elilodwa. Banethuba elikhulu lokuba nomdlavuza.

Isigaxa senyongo

I-gangrene ingenzeka lapho i-gallbladder ikhula ukugeleza kwegazi okunganele. Lesi ngesinye sezinkinga ezinkulu kakhulu ze-cholecystitis ebukhali. Izici ezandisa ubungozi bale nkinga zifaka:

• ukuba ngowesilisa futhi uneminyaka engaphezu kwengama-45 ubudala
• ukuba nesifo sikashukela

Izimpawu ze-gallbladder gangrene zingafaka:

• ubuhlungu obuthuntu esifundeni senyongo
• imfiva
• isicanucanu noma ukuhlanza
• ukudideka
• umfutho wegazi ophansi

Ithumba lenyongo

Ithumba le-gallbladder livela lapho i-gallbladder ivutha ubomvu. Ubuthi ukuqoqwa kwamangqamuzana amhlophe egazi, izicubu ezifile, namagciwane. Izimpawu zingafaka izinhlungu ezisezingeni eliphezulu esiswini kanye nomkhuhlane nokugodola.

Lesi simo singenzeka ngesikhathi se-cholecystitis ebukhali lapho itshe lenyongo livimba i-gallbladder ngokuphelele, ivumela i-gallbladder ukuthi igcwale ubomvu. Kuvame kakhulu kubantu abanesifo sikashukela nesenhliziyo.

Sitholakala kanjani isifo se-gallbladder?

Ukuthola isifo se-gallbladder, udokotela wakho uzokubuza ngomlando wakho wezokwelapha futhi enze ukuhlolwa kwesisu. Lokhu kuzobandakanya ukuhlola ubuhlungu esiswini. Kungasetshenziswa ukuhlolwa noma inqubo eyodwa noma eziningi ezilandelayo:

Umlando wezokwelapha oningiliziwe

Uhlu lwezimpawu obhekene nazo kanye nanoma imuphi umlando wakho noma womndeni wesifo se-gallbladder kubalulekile. Ukuhlolwa kwezempilo okujwayelekile kungenziwa futhi ukuthola ukuthi ngabe zikhona yini izimpawu zesifo sesibindi sesikhathi eside.

Ukuhlolwa ngokomzimba

Udokotela wakho angenza umzamo okhethekile ngesikhathi sokuhlolwa kwesisu ukuze afune lokho okubizwa ngokuthi "uphawu lukaMurphy."

Ngalesi sikhathi sokuhambisa, udokotela wakho uzobeka isandla sakho esiswini sakho endaweni ye-gallbladder. Bese bezokucela ukuthi uthathe umoya ngenkathi uhlola futhi uzizwa indawo. Uma uzwa ubuhlungu obukhulu, kuphakamisa ukuthi ungaba nesifo se-gallbladder.

I-X-ray yesifuba nesisu

I-cholecystitis enezimpawu kwesinye isikhathi izokhombisa amatshe kuma-X-ray esiswini uma amatshe equkethe i-calcium. I-X-ray yesifuba ingakhombisa ubuningi noma inyumoniya.

Kodwa-ke, ama-X-ray akusona isivivinyo esihle kakhulu sokukhomba isifo se-gallbladder. Zivame ukusetshenziselwa ukukhipha ezinye izimbangela ezingaba khona zobuhlungu ezingahlobene namatshe enyongo, i-gallbladder, noma isibindi.

I-Ultrasound

I-ultrasound isebenzisa amaza omsindo ukukhiqiza izithombe ngaphakathi komzimba wakho. Lokhu kuhlolwa kungenye yezindlela eziyinhloko udokotela wakho azisebenzisayo ukwenza ukuxilongwa kwesifo se-gallbladder. I-ultrasound ingahlola i-gallbladder ukuba khona kwama-gallstones, izindonga eziqinile, ama-polyps, noma uquqaba. Ingakhomba futhi noma yiziphi izingqinamba ngaphakathi kwesibindi sakho.

Ukuskena kwe-HIDA

Ukuskena kwe-HIDA kubheka uhlelo lwamapayipi ngaphakathi kwenyongo nesibindi. Kuvame ukusetshenziswa lapho umuntu enezimpawu ze-gallbladder kodwa i-ultrasound ayikhombisanga isizathu sezimpawu. Ukuskena kwe-HIDA kungasetshenziselwa ukuhlolwa okuphelele kohlelo lwe-bile duct.

Lokhu kuhlolwa kungalinganisa ukusebenza kwe-gallbladder kusetshenziswa into engenabungozi enemisebe ye-radioactive. Le nto ifakwa emthanjeni bese iyabukwa njengoba idlula enyameni. Kungabuye kufakwe elinye ikhemikhali elenza ukuthi i-gallbladder ikhiphe i-bile.

Ukuskena kwe-HIDA kukhombisa ukuthi i-gallbladder ihambisa kanjani i-bile ngohlelo lwe-bile duct. Futhi ingalinganisa izinga lenyongo eliphuma ngaphandle kwe-gallbladder. Lokhu kwaziwa njengengxenyenamba yokukhipha. Ingxenyenamba ejwayelekile yokukhipha i-gallbladder ibhekwa phakathi kwamaphesenti angama-35 kuye kwangama-65.

Okunye ukuhlolwa

Okunye ukuhlolwa kwe-imaging, njengokuhlolwa kwe-CT ne-MRI, nakho kungasetshenziswa. Ukuhlolwa kwegazi kuyenziwa futhi ukubheka ukwanda kokubalwa kwamaseli amhlophe nokusebenza kwesibindi okungajwayelekile.

I-Endoscopic retrograde cholangiopancreatography (ERCP) isivivinyo esihlasela kakhulu kepha esiwusizo. Ikhamera eguquguqukayo ifakwa emlonyeni futhi yehle idlule isisu emathunjini amancane. Idayi yokuqhathanisa ijojowe ukukhombisa uhlelo lwe-bile duct nge-X-ray ekhethekile.

I-ERCP isivivinyo esiwusizo ikakhulukazi uma kusolwa ukuvinjelwa ngenxa yamatshe enyongo. Noma iyiphi i-gallstone ebangela ukuvinjelwa ingahle isuswe phakathi nale nqubo.

Selashwa kanjani isifo se-gallbladder?

Izinguquko zendlela yokuphila

Njengoba izimo ezithile zezempilo zandisa ubungozi bokwakheka kwenyongo, izinguquko endleleni yokuphila zingasiza ukuphatha isifo se-gallbladder kubantu abangenazo izimpawu. Ukukhuluphala ngokweqile nokuba nesifo sikashukela kwandisa amathuba okuba nenyongo. Ukwehlisa isisindo nokulawula kahle isifo sikashukela kungasiza ukunciphisa ingozi yakho.

Kodwa-ke, ukulahleka kwesisindo okusheshayo nakho kungadala ukwakheka kwetshe lenyongo. Khuluma nodokotela wakho ngezindlela eziphephile zokwehlisa isisindo.

Umsebenzi owandayo nawo ubonakala wehla ukwakheka kwamatshe enyongo kanye nokwehlisa ama-triglycerides aphezulu, uhlobo lwamafutha egazini. Kuvame ukunconywa ukuyeka ukubhema nokunciphisa ukuphuza utshwala futhi.

Ukwelashwa

Isiqephu sokuqala sokuvuvukala kwe-gallbladder kuvame ukuphathwa ngemithi yezinhlungu. Ngenxa yokuthi ubuhlungu buvame ukuba bukhulu, kudingeka imishanguzo kadokotela. Udokotela wakho angakunikeza imithi nge-codeine noma i-hydrocodone. Ama-anti-inflammatories we-IV angabekwa, noma imishanguzo yobuhlungu enamandla njenge-morphine.

Imishanguzo engaphezulu kwekhawunta efana ne-ibuprofen (Advil) ne-naproxen (i-Aleve) kungenzeka ingasetshenziswa kaningi ngenxa yengozi eyengeziwe yokuthukuthela nokuhlanza. Uma uphelelwe amanzi emzimbeni, izidakamizwa ezilwa nokuvuvukala nazo zingadala izingqinamba ezinzima zezinso.

Iningi labantu linobunzima bokulawula ubuhlungu kanye nezimpawu ezihambisana nakho ekhaya. Khuluma nodokotela wakho ukuze nixoxe ngendlela engcono kakhulu yokwelashwa.

Ucwaningo oluqhubekayo lubheke ekusetshenzisweni kwemithi ezetimibe neqhaza layo ekwehliseni ukwakheka kwamatshe enyongo e-cholesterol. Lo muthi ushintsha ukuthi umzimba umunca kanjani i-cholesterol ephuma emathunjini.

Ukuhlinzwa

Ukuhlinzwa kuzonconywa ukususa i-gallbladder yakho uma uhlangabezane neziqephu eziningi zokuvuvukala. Ukuhlinzwa kwe-gallbladder kuyaqhubeka nokuba yindlela ephumelela kakhulu yokwelapha isifo se-gallbladder esisebenzayo.

Ukuhlinzwa kungenziwa ngokuvula isisu sakho nge-incision, noma nge-laparoscopically. Lokhu kuhilela ukwenza izimbobo ezimbalwa zokudonsa odongeni lwesisu nokufaka ikhamera. Ukuhlinzwa nge-laparoscopic kuvumela ukululama ngokushesha. Le ndlela incanyelwa abantu abangenazo izinkinga zesifo se-gallbladder esibalulekile.

Ngemuva kokuhlinzwa kwe-gallbladder nganoma iyiphi indlela, akuvamile ukuthi abantu bahlangabezane nohudo oluthile. Ngokusho komtholampilo iMayo, abantu abafinyelela kwabathathu kwabayishumi bangaba nesifo sohudo ngemuva kokuhlinzwa ngenyongo.

Kubantu abaningi, isifo sohudo sizohlala amasonto ambalwa kuphela. Kepha ezimweni ezimbalwa, ingahlala iminyaka. Uma isifo sohudo siqhubeka ngemuva kokuhlinzwa isikhathi esingaphezu kwamasonto amabili, khuluma nodokotela wakho. Ngokuya ngezinye izimpawu, ungadinga ukuhlolwa kokulandelwa.

Izinkinga ezikhona zesikhathi eside zesifo se-gallbladder

I-gallbladder ingakha iphaseji engajwayelekile, noma i-fistula, phakathi kwe-gallbladder namathumbu okusiza ukucubungula inyongo yesibindi. Lokhu kuvame ukuba yinkinga yokuvuvukala okungapheli okuhlobene namatshe enyongo.

Ezinye izinkinga zingabandakanya:

• ukuvimbela amathumbu
• ukuvuvukala kanye nesibazi
• i-perforation (imbobo ku-gallbladder)
• ukungcoliswa kwamagciwane esiswini, okwaziwa nge-peritonitis
• ushintsho olubi (amaseli wokushintsha enza isimila somdlavuza)

Ngabe isifo se-gallbladder singavinjelwa?

Izici ezithile zobungozi besifo se-gallbladder, ezifana nobulili nobudala, azikwazi ukuguqulwa. Noma kunjalo, ukudla kwakho kungadlala indima ekwakheni ama-gallstones. Ngokusho kweNational Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), ukudla okune-fiber eningi namafutha anempilo kungasiza ekuvimbeleni amatshe enyongo.

Izinhlamvu ezihlanjululwe (ezitholakala ezinhlamvini ezinoshukela nelayisi elimhlophe, isinkwa, ne-pasta) namaswidi anoshukela kuhlotshaniswa nengozi enkulu yesifo se-gallbladder. Izinhlamvu eziphelele njengelayisi elinsundu nesinkwa sikakolweni esiphelele namafutha avela ezinhlanzini nakumafutha omnqumo konke kunconyiwe.

Izinkinga zangaphambili ze-gallbladder ziyabonwa futhi zelashwe, izinkinga ezingenzeki kakhulu kungenzeka. Kubalulekile ukukhuluma nodokotela wakho uma uhlangabezana nanoma yiziphi izimpawu noma izimpawu zesifo se-gallbladder.