Letšoao le tloaelehileng haholo la gallbladder lefu ke bohloko bo ka holimo ho lehlakoreng le letona la mpa, moo gallbladder e leng teng. Ho itšetlehile ka mofuta oa lefu la gallbladder le teng le hore na mathata a mang a etsahala, motho a ka 'na a ba le feberu, ho nyekeloa ke pelo, ho hlatsa, le / kapa lefu la lefu.
Mathata a gallbladder lefu a bakoa haholo ke ho ba teng ha gallstones 'me a ka kenyelletsa tšoaetso ea sebete se tloaelehileng sa bile (se bitsoang ho nyoloha k'holangitis), ho ruruha ha li-pancreas (bitsoa pancreatitis), sekoti sa gallbladder (se bitsoa gangrenous cholecystitis), kapa sefuba thibelo e tsoang gallstone (e bitsoang gallstone ileus).
Matšoao a Kamehla
Bohloko bo karolong e ka holimo le letona ea mpa ke letšoao le tloaelehileng la gallbladder lefu le hangata liphello tsa gallstones.
Bohloko ba mpa
Le hoja boholo ba li-gallstones li lula ka har'a gallbladder 'me li sa bake matšoao, tse ling li kenngoa ka mokokotlo oa cystic (tube e molaleng oa gallbladder) kapa ka tloaelo e tloaelehileng ea bile (tube e nang le bile ho tloha gallbladder ho mala). Tšitiso ena e baka bohloko ba mpeng, bo bitsoang boliary colic.
Biliary colic ka tloaelo e hlalosoa e le bohloko bo matla, bo bobebe bo sa feleng (eseng colicky, ho sa tsotellehe lebitso la eona). Le hoja bohloko bo atisa ho fumanoa ka lehlakoreng le ka holimo le letona la mpa, ka linako tse ling li fumaneha karolong e ka holimo ea mpa (e bitsoa epigastrium) 'me, ka tsela e sa tloaelehang, e ka tlas'a lebese. Ka linako tse ling bohloko bo tsamaea (ho khanyetsa) ho ea lehetleng le letona. Colic ea biliary e hlaha likarolong tse ngata mme hangata, empa eseng kamehla, e bakoa ke ho ja lijo tse mafura.
Ntle le tlhaselo ea gallstone, mahlaba a ka mpeng a ka holimo a ka mahlakoreng a ka holimo a ka hlaha maloetseng a mang a li-gallbladder, tse kang:
- Cholecystitis: Boemo bona bo bolela ho ruruha ha gallgladder. Le hoja hangata e hlaha e le tlhaloso ea gallstones (e bitsoang acute cholecystitis), e ka 'na ea boela ea etsahala ho batho ba se nang li-gallstones (tse bitsoang acalculous cholecystitis). Ho fapana le tlhaselo ea gallstone, bohloko ba biliary-joaloka cholecystitis bo nka nako e telele ho feta lihora tse tšeletseng 'me hangata bo amana le feberu le palo e phahameng ea lisele tsa mali.
- Biliary dyskinesia : Boemo bona bo baka bohloko bo ka mpeng bo hodimo mme bo etsahala ha sphincter ea Oddi (sebopeho sa mongobo se ka lehlakoreng leo bile le ntšang ka lona ho kenang ka maleng a mangata) ha se sebetse hantle, se etsa hore bokhopo bo thibe.
Bothata bo sebetsang ba lefu la sebete : Bothateng bona, motho ha a na bopaki ba li-gallstones kapa sphincter ea mathata a Oddi empa o tsoela pele ho bona liketsahalo tsa bohloko bo ka mpeng.
Kankere ea kankere e tsoetseng pele: Motho ea tšoeroeng kankere ea kankere hangata ha a na matšoao. Leha kankere e ntse e hōla, bohloko bo ka lehlakoreng le ka holimo le letona la mpa bo ka etsahala hammoho le litsupa tse nang le matšoafo ka mpeng, jaundice, ho nyekeloa ke pelo, mokhathala le ho lahleheloa ke boima.
Jaundice
Jaundice, e boleloang ke yellowing ea makhooa a mahlo le letlalo, e ka 'na ea hlaha ka maloetse a gallbladder a sitisang buc ducts.
Sefuba le ho Senya
Nosea le ho hlatsa li ka 'na tsa e-ba le tlhaselo ea gallstone empa li atisa ho bonoa ka cholecystitis (ho ruruha ha gallbladder) kapa ho pholletsa le mafu (ho ruruha ha liphakaretsi).
Feberu
Feberu ha ea lokela ho etsahala ka tlhaselo ea gallstone empa e ka 'na ea e-ba le gallbladder inflammation kapa ka tšoaetso / ho ruruha ha pampiri ea biliary.
Matšoao a mangata
Ntle le mahlaba a mpa a ka holimo-lekaneng, batho ba tlalehile matšoao a mang a gallbladder lefu.
Leha ho le joalo, ka lebaka la tlhaho ea bona ea tlhaho, litsebi li botsa hore na matšoao ana ke karolo ea lefu le phelang; ka mantsoe a mang, motho a ka 'na a tšoaroa ke li-gallstones le boemo bo bong ba bongaka, joaloka lefu la reflux la gastroesophageal (GERD) kapa boloetse ba seso .
Tse ling tsa matšoao ana a tloaelehileng a kenyeletsa:
- Mahlaba a sefuba
- Burping
- Ho ikutloa eka o tlala kapele ho feta ka mor'a hore o je
- Ho nchafatsa metsi
- Ho thibela
- Ho utloahala mollo ka mor'a lebese kapa ka mpeng e ka holimo
- Nosea le / kapa ho hlatsa ntle le colic biliary
Pruritus
Pruritus (ho hlohlona) ke letšoao le leng le hlahang ka tloaelo le boemo bo bitsoang primary sclerosis cholangitis , boloetse bo sa foleng, ba ho ruruha ba gallbladder le sebete.
Hangata li-pruritus li fokolisa haholo 'me mohlomong li hlaha ka lebaka la bile acid accumulation. Batho ba nang le lihlooho tse ka sehloohong ba hlahisang li-cholangitis ba ka boela ba e-ba le mahlaba a ka mpeng a ka holimo-lekaneng, jaundice le mokhathala.
Mathata
Ho na le mathata a 'maloa a ka' nang a hlaha ka lebaka la lefu la gallbladder.
E bobebe Cholangitis
Li-acute cholangitis li bakoa ke tšoaetso ea baktheria ea pampiri ea biliary ho motho ea nang le tšitiso ea biliary. Ho phaella ho feberu le mahlaba a ka mpeng a ka holimo-lekaneng, motho a ka 'na a tšoaroa ke lefuba, khatello e tlaase ea mali le pherekano.
Pancreatitis
Pancreatitis e bolela ho ruruha ha li-pancreas 'me hangata ho hlaha e le tlhaloso ea li-gallstones. Lebaka ke hore gallbladder le likoekoana li arolelana lik'hemik'hale tsa metsi, kahoo gallstone e thibelang e ka thibela ho phalla ha li-enzyme tsa pancreatic.
Matšoao a lefu la ho fokola ha pelo a kenyeletsa hangata ka potlako ho bohloko bo matla, lefu la epigastric, hammoho le ho nyefoloha le ho hlatsa. Kalafo e akarelletsa metsi, ho laola bohloko, ho hlahloba le ho tlosa thibelo. Ho tlosoa ha gallbladder ho boetse ho etsoa ka tloaelo.
Gangrenous Cholecystitis
Ena ke bothata bo tloaelehileng ka ho fetisisa ba cholecystitis, haholo-holo ho batho ba hōlileng, batho ba nang le lefu la tsoekere, kapa batho ba liehang ho batla phekolo bakeng sa litlhaselo tsa bona. Chorecystitis ea Gangrenous e nkoa e le tšohanyetso ea bongaka, e hlokang ho tlosoa ho buuoa ha gallbladder (cholecystectomy) hang-hang.
Gallbladder Perforation
Haeba letlalo le e-ba le sehlōhō, ho phunyeha (kapa lesoba leboteng la gallbladder) ho ka ba le phello e hlahisang palesa ea pericholecystic (pokello ea pus ka hare ho gallbladder). Tlhaloso ena e tebile ebile e beha bophelo kotsing, e hlokang hore ho be le khethollo ea tlhaho e hlahelang.
Cholecystoenteric Fistula / Gallstone Ileus
Haeba lesoba (perforation) le etsoa ka gallbladder, fistula (potoloho) ka maleng a ka 'na a hlaha. Haeba lejoe le feta fistula, tšitiso ea sefuba e ka hlaha (e bitsoang gallstone ileus).
Emphysematous Cholecystitis
Ho tšoaetsoa ha lebota la gallbladder le libaktheria tse nang le khase ho ka etsa hore motho a tsoe kelellong ea cholecystitis. Batho ba bangata ba kotsing ea ho ba le bothata ba lefu lena ho kenyelletsa le ba botsofali le ba nang le lefu la tsoekere.
Nako ea ho bona ngaka / ea ea sepetlele
Haeba u e-na le mahlaba leha e le afe a mpa, ke habohlokoa hore u bone ngaka ea hau bakeng sa ho hlahlojoa hantle. Haeba ngaka ea hao e u tšoenya ka li-gallstones, mohlomong o tla u bitsa bakeng sa tlhahlobo ea ho buuoa, haholo-holo haeba u e-na le likarolo tse pheta-phetoang tsa coli ea biliary.
Haeba u e-na le bohloko bo ka mpeng, bo tsitsitseng, le / kapa bo amanang le feberu, ho nyefoloha ho matla, ho hlatsa, le / kapa lefu la khama, etsa bonnete ba hore u batla ngaka hang-hang sepetlele.
> Mehloli:
> Mokhatlo oa Kankere oa Amerika. (2016). Matšoao le Matšoao a Kankere ea Gallbladder.
> Zakko SF, Afdhal NH. (2016). Kakaretso ea cholecystitis: Pathogenesis, likarolo tsa kliniki, le ho hlahlojoa. Chopra S, (ed). UpToDate, Waltham, MA: UpToDate Inc.
> Letsatsi la N, Meseeha. (2017). StatPearls. Colic Biliary.
> Zakko SF. (2017). Ho thata ho ba le lefu la majoe ho batho ba baholo. Chopra S, (ed). UpToDate, Waltham, MA: UpToDate Inc.
> Zaliekas J, Munson JL. Mathata a li-gallstones: lefu la Mirizzi, gallstone ileus, gallstone pancreatitis, mathata a "gallstones" e lahlehileng. Mooki oa Bophelo North Am . 2008 Dec; 88 (6): 1345-68.