Chii BDS? Secondary BDS chirwere

Zvirwere zvomudumbu ezvinhu nhengo - a zvakajairika chirwere kuti kuitika vakawanda vaigara panyika yacho. Zvisinei, haasi munhu wose anoziva kuti zvirwere zvakawanda zvinokonzerwa gastrointestinal chirwere inoti zvikuru duodenal papilla. Kubva zvinhu yacho muverengi anodzidza kuti BDS ndiko, chii marudzi zvirwere aizivikanwa mushonga mamiriro ichi sezvo rokuongorora pathological ezvinhu uye kurapa izvo iyi rinoitwa.

Pfungwa BDS

Large duodenal papilla (BNS) inomiririra anatomical maumbirwo hemispherical chimiro, iyo unongoda pamusoro mucosa achiburuka chikamu duodenum. In mabhuku ezvokurapa BDS anogona kuwanikwa pasi mazita akasiyana - zvikuru duodenal papilla, uye papilla pamusoro Vater. Asi, chii BDS? Izvi kukura kubva 2 mm kusvika 2 cm mamiriro ayo anoita basa rinokosha zvikuru basa - rinobatanidza vanhuwo bile mutsinga dzinofamba nemukaka, huru pancreatic mutsinga dzinofamba nemukaka uye duodenum. BDS anoita aibuda bile uye pancreatic muto kupinda bowel duku uye chinonditadzisa intestinal zviri mukati ducts.

Marongerwo Obd anogona kuitika Kumwe kuchinja kunotanga pasi pokudzora dzakasiyana zvinhu -. Diverse pathogenic microflora, kumanikidza nokufamba uye kuchinja asidhi-chawo pakati nepakati, kurega kunotanga ari mhango, etc. Mukuwedzera, muviri mamiriro anogona kukanganiswa yokutama bile mutsinga dzinofamba nemukaka matombo kana zvimwe zvivako hwakasimba.

zvokurwara BDS

Zvirwere mikuru duodenal papilla ndiyo siyana chaizvo. With pokumuka nzira ano Diagnostics mhedziso pamusoro dzichipfekeka nepfungwa iri chivako ichi vari zvakawanda zvakajairika kupfuura kare akafunga. Zvisinei, nokuda rwaikurumidza kuuya uye panzvimbo yakaoma chirwere okurapa chinowanzoonekwa akatarisana akawandisa murombo zvabuda pakurapa varwere cholelithiasis kana pfungwa nomuviri zvemwana asati kuti abuda pakanyorwa kutyorwa muna BDS mamiriro.

BDS zvakafanana zvokurwara vaiona tumorous growths - hyperplastic polyps kusvika 87% pakati benign neoplasms. Polyps kazhinji regai panoda mu akaipa tishu. Adenoma - bole isingawanzowanikwi kenza chirwere Obd kusvika 25% malignancies zvose. BDS stenosis chirwere muna 4-40% wevarwere. Sezvo kutonga, BDS zvokurwara chokuita gallstone chirwere (GSD), iro rinowanikwa mune ose chegumi vanogaramo.

Kupatsanura pakati Diseases BDS

Zvirwere mikuru duodenal papilla iri Classified muzvikwata zvikuru zviviri:

• chikuru,
• yechipiri.

Zvirwere chikuru vanosanganisira avo zvirwere kuti kuitika vari vemunyika mukati sechivako Obd - papillitis (anogumbura chirwere); spastic Obd stenosis, izvo zvinogona papera kuchinjwa kuva papilloskleroz; Obd zera kuchinja; vachiberekwa anomalies; benign uye nyanyisa mapundu - lipoma, melanoma, fibroma, adenoma, polyps, papillomas.

Secondary zvirwere BDS - stenosis kunokonzerwa matombo omunduru. Zviratidzo zviri chirwere zvine chokuita zvakananga chikonzero nei akanga akashevedza. Saka, kana munhu pathological kwacho ndiko mhedzisiro zvirwere biliary ino, chirwere hwakafanana zviri GSD - zvokurwara, dzinoratidzwa nokuumbwa matombo ari gallbladder kana bile ducts, achiperekedzwa nokunzwa Kutambudzika yokumusoro quadrant, flatulence, chirungurira, sechisina musoro chair.

Pane pfungwa kubatanidzwa stenosis - kutyorwa BNS mabasa kuti vavapo tikafunga ane urikanwi pamusoro duodenum. Muchiitiko chino, pane kushayikwa BNS.

pfungwa nomuviri zvemwana asati

Kana pathological pezvakaitwa marongerwo anokonzerwa kuzvimba Obd pancreatic chirwere kuratidzwa akafanana zviratidzo pfungwa nomuviri zvemwana asati.

Pfungwa nomuviri zvemwana asati - chinhu kushoma munyika rwatata. Zvinokosha kucherechedza kuti mufananidzo chirwere angava akasiyana - zvokurwara anokwanisa kutanga nokukurumidza, vachitora rikwanise chimiro, kana regai anozviratidza kwenguva refu, iyo kwese kuti chirwere chimiro chekubuda.

The chikuru chiratidzo rikwanise pfungwa nomuviri zvemwana asati ane simba chaizvo nokuveza kurwadziwa rokumusoro nomudumbu - kurudyi kana kuruboshwe repamusoro quadrant. Pain anogona kutakura herpes uye haana kurega kunyange pashure kutora antispasmodics kana analgesics. Ndiro BDS uye migumisiro zvichizoita kutyora mabasa ayo.

Kuwedzera marwadzo pfungwa nomuviri zvemwana asati kuitika gag dzepanguva, tsandanyama simba, dzungu. The chikuru zviratidzo pfungwa nomuviri zvemwana asati nokuda Ultrasound vari kuchinja chimiro uye roughness pakati micheto rwatata. In nechirwere pamusoro cysts dzinogona kuonekwa mumuviri. Ndinofanira kutaura kuti chirwere chakaoma. Uye panguva kukurumidza kupindira kunogona kutungamirira kurufu.

Spastic stenosis BDS

Stenosis Obd - benign zvokurwara chendima, izvo zviri kukonzerwa mhingaidzo pamusoro pancreatic mutsinga dzinofamba nemukaka uye nenduru nokuda anogumbura kuchinja uye cicatricial constrictions papillae. Sei zvinoitika? Ndima ibwe iri muchikuvadza papilla uye kushingaira hweHIV vari pazvirugu kunotungamirira pave fibrous zvinyama uye stenotic kumatunhu Obd ampoules.

Sezvo chikazozikamwa, sechivako BDS zvakananga kunokanganisa munhu zera. Vanhu vakwegura vari cholelithiasis kutambura-sclerotic atrophic chimiro echirwere papillita. The contingent, izvo haana zera makore makumi matanhatu vakawanikwa, pasi hyperplastic kuchinja BDS (adenomatous, adenomiomatoznye).

Recent makore, nokuti kuti, iri nechirwere kwezvirwere BDS endoscopes anoshandiswa, zvinokwanisika kuti zvakajeka kusiyanisa constrictive uye catarrhal (nestenoziruyuschy) papillitis. The chimiro chokutanga zvokurwara chokuita cholelithiasis. Kana muviri asingadi kuumba mabwe, kukura hosha iri chirwere chirwere kuti anopararira kusvika node ano.

Forms stenosis BDS

Zvichienderana morphological vatambi vari vatatu siyana stenosis:

• anogumbura-sclerotic stenosis - a zvokurwara kuti kunoratidzwa kunosiyana inosiyana fibrosis;
• fibrocystic stenosis - kukanganisika umo paumbwe fibrosis pamwe cysts vakaumba diki - zvakweretwa mumasero zvinoshamisa kunowedzera kudzvinya mhasuro fibers;
• adenomiomatozny Stenosis - zvokurwara, panguva iyo adenomatous hyperplasia isiri yekenza omumuviri, uyewo internet hypertrophy pamusoro kumeso tsandanyama uye fibrous overgrowth pamusoro fibers, kutyorwa zvikuru rinowanzoberekera vanhu vakwegura.

Mukuwedzera, vanga stenosis BDS Classified:

• chinonyanya,
• yechipiri.

Primary stenosis haakonzeri zvachinja bile ducts. Zvokurwara kunokonzerwa chinopedza kuchinja zviri papilla, anoonekwa ari atrophy pamusoro tsandanyama rukoko. Dzimwe nguva chinonyanya stenosis chinhu vachiberekwa kuremara.

Secondary stenosis iri migumisiro huripo kuchinja sechivako nokuda kukuvara papillae vaitamira matombo kana kuvhiyiwa.

Zvichienderana kukura kupararira chirwere stenosis BNS mugove:

• pamusoro kure,
• zvakafanana.

Diagnostics

Kusvika panguva mushonga akashandisa dzinobudirira wandei zvirwere Diagnostics Obd. Ngatimbokurukurai zvimwe zvacho. Endoscopic ultrasonography - nzira yokutora umo achishandisa Manyiminya mudziyo - ari endoscope - kudzidza vakatakura Obd chivako. Photography papilla, yaakaita akafanana kudzidza, wataurwa pamusoro apa.

Transabdominal ultrasonography - achivhara kuongororwa nzira kushandisa Ultrasound runovabvumira kwazvo zvakarurama kuziva STRUCTURAL zvachinja gallbladder, chiropa, rwatata, uye ducts. Uyezve, nzira anosarudza kuti homogeneity pamusoro mhango uye nenduru dundira motility, kuvapo / kusavapo intracavitary inclusions.

Akatevera nzira diagnosing pathologies BDS - ultrasonic cholecystography - kumonyanisa vachishandisa iyo akaongorora motor-kubvisa kushanda nduru dundira kwemaawa maviri mushure mekugamuchira choleretic kwemangwanani.

Dynamic hepatobiliary scintigraphy - muitiro, iyo yakavakirwa - Assessment kuti absorptive-excretory kushanda chiropa. Fractional chromatic duodenal inoda kufunga kuona mataurire nduru dundira; colloidal Kugadzikana hepatic bile chakapatsanurwa wayo bacteriological sezvamunoita. Kana gastroduodenoscopy Anoongororawo mamiriro of BDS, uyewo pakuongorora yezvakaita ari bile anova iripo. Kuwedzera nzira idzi pane kombiyuta tomography uye mumarabhoritari Diagnostics.

BDS: kurapwa

Hwaro Mabatirwo stenosis of BDS vane basa kudzorera chakaipa chokubuda bile uye pancreatic muto kupinda duodenum. Maererano nechinangwa ichi pane zvinotaurwa, kuchengetwa izvo zvichakubatsira kuti vabudirire pakurapa:

• psychotherapy, mabatiro netsinga, dzikamisa hormone zvese, kurerutsa kunetseka, kuzorora, kudya kwakakodzera;
• Mabatirwo pathologies ari abdominal mhango,
• kubviswa dyspeptic zvinhu.

Kuti kubvisa neurotic nepfungwa vaishandisa sedatives infusions kana decoctions wemiriwo siyana. Uyezve, varwere akaratidza psychotherapy.

An chinokosha chezvinonhuwira inobudirira kurapwa zvokudya:

• fractional kudya;
• pakuzvinyima doro uye carbonated nokumwa, uyewo zvokudya aisvuta uye zvakakanyiwa namafuta;
• vakaomerwa kubvuma zai yolks, kubika, ruomba, simba kofi netii;
• kakawanda kudya makabheji, gorosi bran uye Buckwheat;
• kugamuchira antispasmodics, iyo bvisa marwadzo kurwiswa.

BDS stenosis kunowanzokonzerwa kubatwa zvomusejari nzira. Kusiyanisa nekorrigiruyuschie uye kugadzirisa mashandiro. Boka rokutanga rinosanganisira endoscopic PST, inoda kufunga BDS.

Munguva kuregererwa varwere kuwedzera kudya rakarumbidza Nokuraramisa kurapa - kunobatsirei vachifamba nezuva, mangwanani jimunasitikisi, kushambira.

Mukupfupikisa, zvinganzi muchidimbu kuti vazhinji zvirwere zvomudumbu kuitika tikafunga munhu atadze kushanda zvakanaka mamiriro imwe duku. kutyorwa kwakadaro kukonzera matambudziko akakomba mumuviri uye kazhinji amenable kuti kururamiswa chete kuvhiyiwa. Ndizvo zvinotaura BDS.