I-Wirsung duct isebenza njenge-duct main (main) ye-pancreas, imigqa emincane efakwe kuyo. Ukwanda kwayo noma i-stenosis (ukuwohloka okuphikelelayo) akusona isifo esizimele, kepha kuwuphawu lwamanye ama-pathologies, ukuvame ukuvuvukala kokhokho noma okungamahlalakhona.
Uma kukhona ukuncipha kwama-ducts e-pancreatic, ukwelashwa kwalesi sifo kwenzeka ngokuhambisana nokwelashwa kwe-psychology eyisisekelo. Ukubuyiselwa emuva kudinga ukususa imithombo eyinhloko yesibonakaliso. Ezimweni eziningi, inkinga idinga ukungenelela kokuhlinzwa.
I-duct enkulu ingena kwi-duct ye-bile, bese ifakwa kwi-duodenum. Umsebenzi ukuletha ijusi le-pancreatic emgodini wokugaya ukudla. Isimo sifana namanyikwe. Isiteshi sisuka emsileni wesitho, sinqamula wonke umzimba siye ekhanda. Ubude buhlukahluka ngamasentimitha ayi-15-20 nobubanzi obuyi-4 mm.
Ukugeleza kwe-secretion ye-pancreatic kulawulwa kusetshenziswa umsipha okhethekile obushelelezi. Ukulimazeka kwesitho sangaphakathi kuholela ekunciphiseni ekukhiqizeni ujusi noma emiphumeleni yaso enolaka ezicutshini zabo. Ngenxa yalokhu, kutholakala ukuvuvukala kwe-duct, okuholela ekuphazamiseni izinqubo zokugaya ukudla.
I-duct ephambili yamanyikwe
Umugqa lapho ukuhanjiswa okuthunyelwa khona e-duodenum 12 kubhekwa njengokuhamba phambili kumanyikwe. Isiteshi, okugeleza kuso amanzana amaningi amancane, sakha uhlelo lonke lwezimbumbulu. Emaphethelweni kukhona i-sphincter elawula ukugeleza kwamanzi.
Ijamo libunjiwe, liphinda ukugoba kwamanyikwe. Kodwa-ke, ezinye izinguquko emzimbeni zingaholela ekubunjweni ngamadolo noma nge-S. Umuntu ngamunye unenombolo ehlukile yamabhokisi asizayo.
Uma umsele waseWirsung ubonakala ngesakhiwo esikhulu, khona-ke umuntu unezinto ezincane ezingama-30 zokukhipha. Uma ukhuluma ngesakhiwo esingalingani noma esingaxegi, khona-ke ngaphezulu kwama-50.
Esimweni sesakhiwo esikhulu, iziteshi ezisizayo ze-lobular zenziwa endaweni eyi-2 cm ukusuka komunye nomunye. Lapho isiguli sinenguqulo evulekile yohlelo, izikhala zifinyezwa kakhulu.
I-duct eyinhloko ye-pancreas ihlangana ne-duct evamile ye-bile bese igelezela ngaphakathi kwi-duodenum. Kodwa emisebenzini yezokwelapha kukhona izimo lapho isakhiwo se-anatomical sishintshwa ngandlela thile. Isibonelo, i-Wirsung duct igelezela ohlelweni lwethambo lesisu, elihlukaniswe i-bile duct ejwayelekile. Ukwenza kwasendaweni okunjalo kujwayelekile kubantu abayi-15-20%, akubhekwa njenge-pathology.
Kunokwehlukahluka ekwakhiweni kwezitho zangaphakathi, okuthi, ngaphansi kwethonya lezinto ezithile, amagatsha amakhulu okuhambisa abe ngamagatsha ama-2, asebenze ngokuhlukile, ngenxa yalokho kwakheka iziteshi ezimbili ezinkulu.
Isakhiwo esinjalo sizalwa ngokwemvelo, kuyaqabukela, kuholela ekunciphiseni okukhulu noma ekuvalweni ngokuphelele kwama-ducts.
Isakhiwo se-duct esingenamusa
Izinguquko kumanyikwe, ukuvulwa kweziteshi ezingeziwe, ukunwetshwa komgodi ophambili we-pancreatic, ukunciphisa kwawo, njll izinqubo ezingejwayelekile - konke lokhu kuholela ekuphazamisweni kwesistimu yokugaya ukudla.
Ukonakala kwezakhi zofuzo kungadala ukugqabhuka komsele omkhulu, ngenxa yalokho kwakhiwa amagatsha amaningi amagatsha. Lapho imisele yemisele, ikhuluma nge-stenosis - ukufakwa okuqinile kwemisele yemisele.
Ngenxa yokuxineka noma ukuvaleka kwama-tubules amancane, kuvela izinkinga zokugaya ukudla. Ukushintshwa kokuqina nokuguquguquka kwamanzi kuholela ekuthuthukisweni kwe-cystic fibrosis, okuholela ekuphazamiseni ukuguqulwa okungagcini endimeni kuphela, kepha nakwezinye izinhlelo zomzimba.
Ubungako obujwayelekile, ikakhulukazi, ububanzi be-duct main yi-2 mm. Uma ukwanda noma ukwehla kwaso kubonwa, khona-ke umsebenzi wamanyikwe uyaphazamiseka ngokuzenzakalela. Lapho i-Wirsung duct ye-pancreas inwetshiwe, kuholela ekwakhekeni kwamatshe, i-tumor neoplasms.
Lapho i-pancreatic duct yangaphakathi ivinjiwe, kuvela indlela engamahlalakhona yesibeletho. Ukuhlaselwa ngamandla, kuphindaphindeka ngemvamisa ethandekayo, kuvame ukudinga ukungenelela kokuhlinzwa ngenhlanganisela ephelele yesitho sangaphakathi.
Izimbangela nezimpawu zokunwebeka komgodi oyinhloko
Ukunwetshwa kwe-Wirsung duct yamanyikwe ngabantu abadala ngamaphesenti angama-80 kuyahambisana ne-etiology yezinye izilonda zesitho sangaphakathi. Cishe i-30% yezithombe zomtholampilo, akunakwenzeka ukuthola izizathu zokwanda, ngenxa yalokho i-pathogenesis ihlala iyimfihlakalo.
Izici ezicasulayo zokwanda okulinganiselwe noma okweqile kufaka phakathi: ukuhlinzwa emgudwini we-biliary noma isisu, i-pathology ye-duodenum 12, i-trauma ku-peritoneum.
Izimbangela zenqubo yokuvuvukala evilaphayo kumanyikwe kungenxa yokusebenzisa kabi utshwala, imiphumela yemithi ethile (izidakamizwa ze-antibacterial ne-hormonal). Kanye nokungalingani kwe-hormonal, izifo ezithathelwanayo.
Lapho i-pancreatic duct ibilisiwe, kwesinye isikhathi i-pathogenesis isuselwa kusengaphambili lokuthola ifa. Kulokhu, kuvela ukuthi i-pancreatitis “genetic” pancreatitis, okuholela ekushintsheni kwezitho eziseduze nezicubu ezithambile.
Ukubonakaliswa okuyinhloko komtholampilo kufaka ukuphulwa komgudu wokugaya ukudla. I-pancreatitis iyakwazi ukucunula kokubili ukuncipha kanye nokwanda komgodi ophambili. Ezenzweni zokwelapha, lesi sifo sibizwa ngokuthi "uchungechunge lwamachibi."
Ukuphambuka komsele we-pancreatic kube kungalingani, ku-lumen kukhona ama-inclusions aqinile - amatshe. Ukuboniswa kwemitholampilo:
- Isifo esibuhlungu kakhulu se-hypochondrium. Imithi ayisizi ukudambisa izinhlungu.
- Ukugaya, kubonakaliswa yisifo sohudo isikhathi eside ngesikhala sokudla okungaphanjwanga.
- Isicanucanu, ukugabha okungenakugwenywa.
- Yehlisa iphango, njll.
Izimpawu ezithile, ezibonisa ukwanda okuqhubekayo komgudu ophambili we-pancreas, azikho.
Ukuxilonga
Izindlela zokuxilonga zanamuhla zisiza ekuboneni ukuguqulwa okuncane kwe-duct, kunikeze ukuhlolwa kwesimo se-pancreas. I-Endoscopic retrograde pancreatocholangiography ibonakala njengenqubo yokufundisa kunazo zonke yokuhlola ububanzi besiteshi.
Le ndlela ethize yokuxilonga inika uchwepheshe wezokwelapha umbono hhayi kuphela nge-canal, kodwa futhi ngesimo sokusebenza kwama-ducts we-pancreatic kanye ne-bile ducts. Ngesikhathi sokukhwabanisa ngezokwelapha, udokotela ugcwalisa imisele ngosizo lwabasebenza ngokuhlukile, bese kusetshenziswa umshini we-X-ray.
Kwenziwa ukuhlolwa kwelabhoratri. Kuyadingeka ukwenza ukuhlola kwegazi okune-biochemical, ufunde iphrofayili ye-lipid, ukwakheka kwegazi okuyikhwalithi, ukunquma ukuqoqwa kwama-enzymes ohlelweni lokugaya ukudla, kanye nokuhlaziywa komchamo jikelele.
Ezinye izindlela zokuxilonga zibandakanya:
- I-Sonography (i-ultrasound) yezitho zesisu. Ikuvumela ukuba ubone ngeso lengqondo isiteshi esikhulu, ukukala ububanzi baso. Le ndlela iyasebenza kulezo zithombe lapho isiguli singakhuluphele. Isiteshi seWirsung sibukeka kalula emzimbeni we-pancreas kunomsila noma ekhanda, ngenxa yobuchopho bokufika kwasekhaya maqondana nodonga lwamagagasi e-ultrasonic.
- I-MRI isiza ukubona ngeso lengqondo ipheshana elisetshenzisiwe kanye nemicu yepancreas, ikuvumela ukuthi uhlole ngokuningiliziwe i-parenchyma ezungezile.
I-Endoscopic retrograde pancreatocholangiography kuyindlela engahlaseli, ngenxa yalokho kunqunyelwe ezimweni lapho i-MRI ne-ultrasound zingezindlela zokufundisa.
Izindlela zokwelapha
Lapho ukuxilongwa kuqinisekisa ukwanda kwe-duct main, udokotela, ikakhulukazi udokotela ohlinzayo, ukhetha amaqhinga okwelapha okuhlinzwa. Kungenxa yezimpawu zesithombe somtholampilo, iminyaka yesiguli, izinga lokunciphisa, nezinye izinto.
Udokotela ohlinzayo angabuyisela kabusha indawo ye-stenotic ngokusebenzisa i-arthroplasty ye-percutaneous. Njengenye indlela, kwakhiwa kabusha i-Wirsung duct kanye ne-bile ducts noma ukumiswa kabusha kwekhanda le-pancreatic ngokuhlinzwa kwepulasitiki okwalandela kwepheshana le-biliary kwenziwa. Inketho yokugcina iyivelakancane kakhulu.
Ukwelapha ukwanda kwe-duct kuyahambelana ne-algorithm ekwelapheni i-pathology eyinhloko - i-pancreatitis. Lapho umsebenzi wesitho sangaphakathi usenziwa ngokujwayelekile, inqubo yokuvuvukala iyavezwa, bese izindunduma zibuyele kokujwayelekile.
Indlela yokwelapha i-pancreatitis ebaluleke kakhulu:
- Ukwenqatshelwa kokudla. Ukuzila ukudla nge-pancreatitis kumele kuqashelwe kuso sonke isikhathi sokwanda.
- Ukusetshenziswa kwe-antispasmodics.
- Ukuphathwa kwe-intravenous kwe-colloidal ne-saline.
- Ukunquma umuthi ovimbela umsebenzi wama-enzyme wokugaya ukudla.
Kwesinye isikhathi ukuhlinzwa kuyadingeka. Isibonelo, ukusetshenziselwa ngokwengxenye kwengxenye yamanyikwe, noma ukususwa kwamatshe emacandeni.
I-pancreatitis ye-Sluggish, evusa ukunwetshwa okuqhubekayo komgodi oyinhloko, iphathwa ngosizo lokudla kwezempilo, amavithamini kanye nezakhiwo zamaminerali. Kunikezwa nemithi yobuhlungu.
I-futurenosis ngokumelene nesizinda sokulashwa kwezidakamizwa okufika ngesikhathi nokwanele kwama-pancreas kuyinto enhle. Izinyathelo zokuvimbela ukwanda kwe-duct zifaka inombolo yokudla yesi-5, ukwenqaba iziphuzo ezidakayo, ukwelashwa okufika ngesikhathi kwama-ducts we-bile kanye ne-pancreatic pathologies.
Ungazigwema kanjani izingqinamba nokuthi ungayelapha kanjani i-pancreatitis ebaluleke kakhulu echazwe kule vidiyo kule ndatshana.
