Noma yisiphi isitho singabhekana nokuthuthukiswa kwe-neoplasm, ama-pancreas ngeke abe ngaphandle komthetho. Kwesinye isikhathi i-pseudocyst ivela ekhanda, emzimbeni noma emsileni, i-pathology ayinikezi zimpawu ezithile futhi ngenxa yalokho ayikwazi ukutholakala isikhathi eside.
Odokotela bathi lesi sifo cishe ngaso sonke isikhathi senzeka ngokumelene nesizinda se-pancreatitis esibi nesingamahlalakhona, amathuba okuthi ukwanda kwezifo kubantu abasinde lapho kulimala i-gland, izindonga zayo. Ngaphandle, i-neoplasm ifana ne-hematoma, phakathi inenqwaba yama-enzyme.
Lapho kuqhamuka i-cyanc pancreatic cyst ngenxa yokulimala, kuboniswa ukuhlinzwa, ukususwa kwe-cyst. Ngokusho kokubuyekezwa, ngemuva kokuhlinzwa kukhona umkhuba omuhle, ukuthuthuka okukhulu enhlalakahleni.
Ukuphathwa okuvamile kwe-ACE inhibitors kungavusa i-pseudocyst, ngeshwa, ukwelashwa okunjalo kuyisinyathelo esidingekayo enkambweni engapheli yesifo se-pancreatitis. Ngakho-ke, ngaphambi kokusebenzisa izidakamizwa zaleli qembu, kubalulekile ukuthi kutholakale ukukhula kwe-cyst yamanga.
Ngokuvamile, ukwakheka kuvela ngemuva kokuhlupheka i-atherosulinosis yamanyikwe. Inkinga ehlukile i-iatrogenic cysts yamanga, iba umphumela wokwelashwa okuhlinzwa. Lokhu akusho ukuthi i-neoplasm ingumphumela wephutha lezokwelapha, iba uhlobo lokuphendula komzimba kwinto eyehlisayo.
Izigaba zesifo nezimpawu
Kuyisiko ukwahlukanisa izinhlobo eziningana ze-pseudocysts, zitholakala ekhanda, emzimbeni we-pancreas, kwezinye izikhathi kutholakala emsileni wesitho. Ngaphezu kwalokho, ama-neoplasms ahlukaniswe yi-etiology: postoperative, pancreatic, post-traumatic.
Ukwelashwa kuncike endaweni ye-cyst yamanga nokunganakwa kwenqubo ye-pathological. Isigaba sokuqala sithatha inyanga nenyanga, phakathi nalesi sikhathi kukhiwa i-lesion cavity. Isigaba esilandelayo sithatha izinyanga ezintathu, umgodla uzokhululeka. Isigaba sesithathu sithatha izinyanga ezingaba yisithupha, manje sekuqala ukuvela isigubhu esiminyene.
Ekuqaleni kwesifo, ukwelashwa kuphulukisa kahle, amandla ashukumisayo ayakhayo, ezinye iziguli zizizwa zinezinkinga, imvamisa zihlotshaniswa nohlobo oluthile lwesifo esilinganayo.
Izazi ze-gastroenterologists zisengahlukanisa i-cyst ngokuya ngesinye isigaba, ngokuya ngezinhlobo zesifo:
- i-acute (ihlala ngaphansi kwezinyanga ezintathu);
- i-subacute (ingabi ngaphezu kwezinyanga eziyisithupha);
- okungapheli (iminyaka engaphezu kwezinyanga eziyisithupha).
Ukwelashwa okulula kunazo zonke yi-pseudocyst yama-pancreas ngendlela ebucayi yenqubo yokuvuvukala, i-cyst engapheli ingaqedwa kuphela ngendlela yokuhlinzwa. Udinga ukwazi ukuthi i-cyst ingenzeki ngekhophi elilodwa, isiguli sakha ukukhula okuningana ngasikhathi sinye.
I-pseudocyst yekhanda le-pancreatic ekuqaleni ayiniki izimpawu, isiguli asikwazi ngisho nokucabanga ngokuba khona kwalesi sifo. Odokotela batusa ukulalela impilo yabo, banake izimpawu ze-atypical. Okokuqala, lokhu kubuhlungu emgodini wesisu, ekuqaleni kuba nzima, njengoba isimo siba sibi kakhulu, ubuhlungu buba buthuntu noma bufike ngokuphelele, kusala imizwa emincane engathandeki nje.
Uma i-neoplasm iqubuka, kuba nezimpawu ezithile nezenhliziyo ekhulayo. Ngasohlangothini lohlelo lwezinhliziyo lungaba:
- isimo sokushaqeka;
- i-tachycardia;
- hypotension.
Izimpawu ezithile yisisu esishubile, izimpawu ze-peritonitis, nobuhlungu obukhulu. Lapho ukutheleleka kwenzeka, izinga lokushisa lomzimba liyakhuphuka, liya ngokuguquguquka phakathi kwama-37.9 kanye nama-39 degrees, isiguli siyathuthumela, kukhula i-neutrophilic leukocytosis.
Ezinye iziguli zithola isicanucanu nokuhlanza, kodwa ngenxa yezifo ezinjengalezi akuzona izimpawu. Lezi zimpawu zingakhombisa ukuqala kwezinkinga. Iziguli ezasinda ebuhlungu be-cyst yamanga ziqaphela izinhlungu ngaphansi kwembambo yangakwesokudla uma ikhanda livuvukala, noma kwi-hypochondrium yesobunxele lapho inkinga ithinta umsila noma umzimba wepancreas.
Ukungaphatheki kahle kufana ne-wave-wave, kaningi kubuhlungu futhi kubuhlungu be-paroxysmal.
Izindlela Zokuxilonga
Udokotela uqala ahlole izikhalazo zesiguli, ahlole izinga lempilo yakhe, enze ukuhlolwa okubonakalayo. Ngenxa palpation yesisu ne-peritoneum, udokotela unquma ukuba khona kwe-asymmetry, amabhola amancane. Uma isiguli sikhononda ngobuhlungu, ukuxilongwa kuqala ngokulethwa komchamo negazi.
I-X-ray enomehluko ithathwa njengendlela yesimanje yokucwaninga, uma kukhona i-cyst, iyabonakala ezithombeni, ngenxa yokwanda okusebenzayo, ukuguquguquka kwezinye izitho zangaphakathi kuyabonakala.
Kunconywa futhi ukwenza i-scanning ye-ultrasound, kukhombisa ukuthi leyo ngxenye yesimila itholakala kuphi, kwenza sikwazi ukuphika noma ukuqinisekisa ubunzima.
Ukusungula inqubo yokuvuvukala, ukucindezelwa kwezitho zangaphakathi nokwanda kwemithambo kuvumela inqubo ye-EDGS.
Enye indlela efundisayo eyenziwe nge-compact tomography, izokhombisa ukuvuvukala ngokunembe ngangokunokwenzeka. Lapho uthola i-cyst yamanga, kubalulekile ukwenza ukuhlolwa kwe-cytological.
Ukwelashwa nokwelashwa
Ukwelashwa kwama-pseudocysts ama-pancreas kungaba ngezokwelapha noma ukuhlinzwa, ukusetshenziswa kwezidakamizwa kunobulungiswa kuphela uma i-pseudocyst ivele hhayi kudala. Futhi, ukwelashwa kwezidakamizwa kuzosiza ekungabikho kobuhlungu emgodini wesisu, ubukhulu be-neoplasm abungaphezu kwamasentimitha ayi-6.
Kungenzeka ukuthi i-neoplasm ixazulule ngokwayo, ngakho-ke abanye odokotela bakhetha ukungazinqumeli izidakamizwa ngesikhathi sokuxilongwa kokuqala. Kulokhu, kuzodingeka ukubheka izinyanga eziningana, lapho umtholampilo uhlala, bese uqhubeka nokwelashwa ngemithi. Ngaphezu kwalokho, i-catheter ingafakwa, bese ama-disinfectants ethulwa ngayo. Uhlelo lokwelapha i-pancreatitis kanye ne-pseudo-aneurysm yamanyikwe lungaba ngokufanayo
Uma indlela yokwelashwa elondolozayo ingasizi, futhi i-pancreatic cyst ikhule yaba ngosayizi omkhulu, udokotela wenza isinqumo ngokuhlinzwa. Kunezindlela eziningana zokwelapha lokhu, enye yezindlela eziphumelela kakhulu kuzoba i-drainage. I-Linear endoscopic sonography nayo ingasetjenziswa, drainage yenziwe ngokusebenzisa:
- isisu;
- i-rectum.
Indlela inesizathu uma isimila sivele eduze kwesisu.
Indlela yokwelashwa ephelelwe isikhathi iyidonsa langaphakathi, umuthi wesimanje awusebenzisi, iziguli zibekezelela ukwelashwa okunjalo kabi, i-diagnostosis ayikuhle njalo.
Lapho konke okunye kwehluleka, ama-pseudocysts abhekiselwa ukususa ngokuphelele, ngesikhathi sokungenelela enza ukubonakala okukhulu emgodini wesisu. Le ndlela iyadabukisa, iyingozi, iyasebenza lapho kuvela inkinga emsileni noma ekhanda lamanyikwe.
Ngemuva kwenqubo, isiguli sikhonjiswa ukudla okuqinile.
Izinkinga ezingaba khona kanye nokuqagela
Uma kungekho ukwelashwa okufika ngesikhathi kwama-pancreas, i-neoplasm ibangela ukulimala okukhulu emzimbeni, kuba nezinkinga. Imvamisa, isiguli sibhekene nokuqhuma, ukuqina noma ukopha, ukudakwa nokuqukethwe. Ama-hemorrhages, ukulimala kwezitho ezitholakala eduzane, i-fistulas, inqubo yokutheleleka noma ukuguqulwa kwe-cyst yamanga ku-oncology akukagxiliwe. Uma inqwaba yezinkinga ingagwenywa, khona-ke akunakwenzeka ukuqiniseka ngokulimala.
I-pseudocyst ayikwazi ukubizwa ngokuthi isifo esibulalayo, kepha kukhona ubungozi. Amacala okufa nge-neoplasm afinyelela ku-14%, lokhu kwenzeka uma isiguli singayi kudokotela futhi singazidli izidakamizwa. Noma kunjalo, amathuba okufa awabandakanywa ngesikhathi sokuhlinzwa, esimweni lapho iphesenti lemiphumela edabukisayo lifinyelela 11. Ubungozi bukhula kakhulu lapho kuvela i-pseudocyst supplement, ukutheleleka.
Kumele kukhunjulwe ukuthi ukubuyela emuva kwe-pathology kungenzeka, kungenzeka kuncane, kepha nokho kunjalo. Ngokwezibalo, amathuba okuvuselelwa kabusha kwe-cyst yamanga ngamaphesenti angama-30. Kukholelwa ukuthi i-neoplasm ephindaphindayo iyingozi izikhathi eziningi kuneyokuqala. Ukubuyela emuva, isimila kungenzeka ukuthi singene kwinqubo ye-oncological, kanye nokuthuthukiswa kwezinkinga eziyingozi, kanti nokufa kwabantu kuleli cala kuphindeke kaningana.
Ukuthi ama-pancreatic cysts aphathwa kanjani achazwa kuvidiyo kule ndatshana.
