Pancreatitis pseudotumor: izimbangela, izimpawu kanye nezici ukwelashwa

Pancreatitis pseudotumor - uhlobo eside ezikhona pancreatitis ezingamahlalakhona phezu. Lesi sifo amadoda kakhulu ukudlula abantu besifazane. zokugula Igama livela lesiGreki elithi "amanyikwe" - kwamanyikwe, "itis" - ukuvuvukala "isimila" - isimila. Ngokwezwi nezwi ehunyushwa ngokuthi kungaba ngakho - ukuvuvukala kwamanyikwe ukuthi ulingisa inqubo neoplastic.

Pseudotumor pancreatitis: Ubangela, Izimpawu

izici ngodlame ekuthuthukiseni lesi sifo kuyinto zokugula uhlelo hepato-biliary (isib CL) kanye nokusetshenziswa nokunwetshiwe utshwala. Ingasaphathwa - imithi ukuthatha namanye zempilo. Ezimweni eziningi, pancreatitis pseudotumor is phetho a ezingamahlalakhona ukuvuvukala e kwamanyikwe nezicubu ingasaphathwa (cishe 10% nesenzakalo) ke kubonakele ngemva ukuvuvukala oyingozi.

Ukuthuthukiswa izimpawu ku isizinda cholelithiasis ngokuvamile ezilotshwe abesifazane. Nokho, akubona kuphela kungase kube isici ayeke ukunisa kakhulu lapha futhi ube kombungu kohlelo biliary, izifo imbobo Bile noma papilla ka Vater. Kulezi zimo, yisishiso eba ngenxa asakazwe esiqhubekayo Bile ku uvule imbobo pancreatic.

Enye yezindlela yentuthuko pseudotumor pancreatitis kungaba lymphogenous ukunqotshwa amanyikwe izicubu (ngokuvamile indlala ikhanda endaweni), nengivuvuke zibhebhetheka kusuka gallbladder ngokusebenzisa ISIZINDA lymph nempahla.

Emacaleni angaphezu ezingavamile, pseudotumor uhlobo pancreatitis okungamahlalakhona kungakwenza zenzeka ngokumelene ingemuva ukusetshenziswa eside estrogen, acetaminophen nezinye izidakamizwa noma uthwale noma yiluphi sitholwa njengefa. Futhi lapho omsakazo ngofuzo isifo siqhubeka ngenkuthalo, it kwandisa amathuba umdlavuza (umdlavuza), nensimbi ukuntula likhula ngokushesha.

ukubonakaliswa emitholampilo

I symptomatology le ndlela pancreatitis elihlobene ne kokucindezelwa yaleli pheshana biliary, ukwehluleka endocrine kanye nokuntuleka enzyme pancreatic abathintekayo ukugaya. Ngaphezu kwalokho, izimila kukhona izimpawu samanje futhi ubuhlungu obukhulu phakathi ukubonakaliswa emtholampilo. Pseudotumor esigabeni sokuqala amafomu kungenzeka asymptomatic.

Kodwa iziguli eziningi ukwethula elandelayo izimpawu zokugula:

• jaundice;
• ubuhlungu ibhande ukuthi kwenzeka ngemva ukungenisa noma okunamafutha acute ukudla, utshwala noma ukudla ngokweqile;

• ukudla undigested e kwesihlalo ;
• isicanucanu, kulandele ukuhlanza, ukuthi kuletha impumuzo;
• indle "Bold" (steatorrhea);
• uhudo nese ukuqunjelwa;
• ehle ukubekezelelana glucose;
• causeless kwesisindo;
• palpation - ikhanda gasket amanyikwe;
• ukwanda umdlavuza.

Izindlela zika ukubonakala izimpawu eziyinhloko

Esikhathini isifo echazwe nokwanda kwamanyikwe, okuyinto lihlotshaniswa okuvela izinhlumba (pseudotumor pancreatitis okungamahlalakhona, simila pancreatic), ukuthuthukiswa lipomatosis kanye izilonda sokuhlasela kwamasosha omzimba.

Ukuvuvukala ngokuvamile kuthinta ikhanda amanyikwe - indawo ophumayo we imbobo main pancreatic. Ngenxa yalokho, mithandazo ayisesemikhulu, futhi juice pancreatic stagnates emzimbeni. Ngenxa yalokho, uvule imbobo ugcwele, futhi ingcindezi kulo lukhula. Enzyme eziqukethwe juice, baqale ukugaya izicubu pancreatic, okuholela okuvela ezinzima ubuhlungu syndrome, okuyinto ngokuvamile ehambisana nobutha pseudotumor ifomu ezanele pancreatitis.

jaundice obstructive

Esikhathini indlela lokhu uphawu kudlala indima evelele umdlavuza ikhanda lakhulisiwe, ecindezela choledoch (Bile imbobo). Ngenxa Bile esibindini ayikwazi iyangena duodenum, ngenxa lapho ingcindezi ku inyuka wesiteshi Bile kancane kancane ingena ukusakaza igazi.

Izikhalazo main ne-jaundice obstructive kukhona indle ezishintshe umbala, ukulunywa ezinzima, umchamo onombala, futhi yellowing kwesikhumba futhi sclera.

Indlela ukuthola pseudotumor pancreatitis noma isiguli

Kuchazwe uphethwe izindlela ukuthi bafakwe akhawunti zonke izikhalazo kanye ukubonakaliswa emitholampilo ye isifo futhi ekhipha ezinye izifo, hhayi kuphela kwamanyikwe (isib, umdlavuza), kodwa futhi izitho eduze, nge nezimpawu ezifanayo. Ngenxa yale njongo kuphoqelekile:

• kokubonisana gastroenterologist.
• umlando wezokwelapha kanye nezikhalazo (pancreatitis ngaphambi, cholelithiasis, ukuphuza imithi, izikhalazo ubuhlungu ngakwesokudla quadrant engenhla kanye nesifunda epigastric, nabanye).
• Ukuhlola nesineke ukuziphatha palpation (uphawu kungenzeka nokuba nesisa endleleni endaweni kwamanyikwe).
• Ukuhlolwa kwegazi. Ukuze uthole ifomu elinikeziwe pancreatitis ukukhuphuka isici amazinga trypsin, Amylase futhi lipase, kahle-glucose ukubekezelelana.
• Ukunqunywa isimila nakomaka futhi polypeptide pancreatic (ukuqeda umdlavuza). Ngokwandisa inani antigen carcinoembryonic, CA-125, CA 19-9, polypeptide pancreatic, isimila uphethwe kuqinisekisiwe, futhi lapho izinto ngenhla echazwe ekunciphiseni ngokuthini khona ukuvuvukala, okufakazela uphethwe "pancreatitis pseudotumor".
• US amanyikwe (khona hypertrophy, futhi ushintsho isakhiwo Amapayipi indlala izicubu, ukungabi / khona calcifications).
• CT noma i-MRI (ukubekela eceleni neoplasms abulalayo).
• ERCP. izinguquko imaging amasu e uvule imbobo pancreatic.
• tseliakografiya okukhethwayo (isimo ukuzimisela izitsha pancreatic).

Ukwelapha

Pseudotumor pancreatitis, okuyinto ukwelashwa esikhathini acute esiqhutshwa gastoenterologii, libhekene inamagquma Yiqiniso (ie alternation remissions futhi exacerbations).

Ukwelashwa yalesi sifo kuhilela ukuqokwa Ukudla uyazonga (ithebula №5). Kuvunyelwe ukudla njalo (kahlanu eziyisithupha ngosuku), kodwa izingxenye ezincane. Izindlela zokupheka: abilayo baking, kuyaqabukela - eqeda. okunamafutha okunqatshelwe, ukudla okuthosiwe, amaqanda ethosiwe, itiye eqinile, ikhofi, ngokuqinile okunomkhawulo inani inyama (ikakhulukazi ingulube) kanye nobisi.

I yagxila yokuyelapha ukwelashwa etiotropic, okusho nokuqedwa izici ayeke ukunisa (utshwala, izidakamizwa) kanye nezizathu eziye zabangela lesi simo. Ngokwesibonelo, uma amatshe atholakala enyongweni - cholecystectomy, nokunye.

imithi kufanele okuhloswe ngazo Oqondisa intra- futhi exocrine ndlala esingamahlalakhona. Ukuze wenze lokhu, linqume izidakamizwa, ama-enzyme, "Pancreatin" ngokuhlanganyela "Solizimom" noma "lipase". Ukuze wehlise steatorrhea antacids esetshenziswa ne-calcium supplements.

Ukuze kuncishiswe dyskinesia anticholinergics iqondiswa. Ukuze ngempumuzo ezinzima ubuhlungu syndrome antispasmodics esetshenziswa noma "Atropine". Njengoba indlela ephumelelayo for sphincter spasmolytic ka Oddi zisebenzisa "Mebeverin" noma "Gimekromon". Ukwelapha eside exacerbation zihlanganisa ama-antimicrobial. Uma yokwelapha izidakamizwa akusenzi nokuvuvukala wendlala yabesilisa, futhi hypersecretion ke ukhethe komzimba lendawo (wendawo) noma lesifunda emisebeni ukuchayeka.

Ngaphandle lokhu kwelashwa, ngokuvamile okwanele Pseudotumor pancreatitis ukuqhuba ukuhlinzwa endoscopic (isib papillosphincterotomy) yakhelwe decompress uhlelo ductal. nokugxambukela siyasebenza ikakhulukazi uma strictures prepalillyarnogo ikhadi, papillostenoze, ukwanda ikhanda amanyikwe, ephelezelwa jaundice obstructive futhi kokucindezelwa ezivamile Bile imbobo.

zokuvimbela

Izinyathelo e sitholakele "pancreatitis pseudotumor" ukunciphisa, ngokuyinhloko, kuya Ukuyekwa kwezindlela ukusetshenziswa izinhlobo zophuzo oludakayo. Kubalulekile futhi ngoba ukwelashwa okufanele futhi ifike ngesikhathi izifo ezingaba eyoqala lokhu egunjini lokuhlolwa kwezifo. It kusiza ukuvimbela isifo futhi icocekile, kulawulwa reception Uchwepheshe izidakamizwa yingozi.

ukuba nombono ongafani ngeke

Izinhlelo ngo-okwenziwe pancreatitis echazwe ifomu kuqhathaniswa evumayo. Lesisifo ezingavamile ne exacerbations futhi itotoba, futhi endocrine esingamahlalakhona akuvamile kubandakanya ukuthuthukiswa umonakalo kwezinso futhi angiopathy. Ukuqhubeka kwalesi sifo kungenziwa wayeka ekukhetfweni ukwelashwa okufika ngesikhathi kanye nokuqaliswa izincomo udokotela ukuba khona ngezikhathi ukuthethelelwa. Hlala uphilile!