Ikhanda le-pancreas libonakaliswa ngesakhiwo esiyingqayizivele kanye nesimo esikhethekile. Ubonakala njengenye yezingxenye ezintathu zalo mzimba. Ukulandela wona kungumzimba, ohlukaniswe yikhanda ngesipuni - entanyeni. Insimbi igcina ngomsila oboshelwe kancane.
Ikhanda lakhiwe endaweni yezinga le-vertebrae yokuqala emibili ye-lumbar (kubantu abadala). Ezinganeni ezisanda kuzalwa, kutholakala ukuthi kukhudlwana, kunosayizi omncane. Ebudaleni, usayizi wekhanda uvamile kumamilimitha angama-35.
Inqubo ebambekile yamanyikwe isebenza njengengxenye yekhanda, etholakala ngemuva kwemithambo yegazi ene-mesenteric. Le ngxenye yesitho, okunzima kakhulu ukuhlola nokuhlanganisa ngokumelene nesizinda se-pancreatoduodenal resection.
Ngokuphulwa kokusebenza kwamanyikwe, ama-pancreatitis asobala noma angamahlalakhona. Lezi zifo ziholela ezinkingeni - i-necrosis yezicubu zezitho, ithumba, njll.
Ama-pancreas anatomy
Ubukhulu bama-pancreas buyahlukahluka ukusuka ngamasentimitha ayi-12 kuye kwayi-14, ubukhulu obulinganiselwa ku-2-3 cm, nobubanzi obungafika kumasentimitha ayi-9. Isisindo esijwayelekile singama-70-80 g. Ingxenye ye-endocrine imayelana ne-1-2% yesisindo esiphelele se-gland.
Isitho sangaphakathi sitholakala endaweni ese-peritoneum ngemuva kwesisu, esiseduze kwendandatho endaweni yokubizwa kwe-hypochondrium yangakwesobunxele. Ngemuva kukhona umthambo we-portal, i-diaphragm, imithambo yegazi enama-mesenteric engena esiswini esincane itholakala ngezansi.
Ngasemaphethelweni angenhla e-pancreas kukhona ama-lymphoid node nemithambo yegazi yomgogodla. Eduze kwekhanda kukhona i-duodenum.
Izingxenye zesitho:
- Ikhanda lifana nesicwecwana esincane, esenziwe endaweni yeleveli yokuqala noma yesithathu ye-lumbar vertebra. Ihlangana nokuhlangana namathumbu amancane, ngemuva kwethambo le-portal, ngaphambili kune-colon transverse.
- Umzimba walesi sitho ubonakala ngesimo sonxantathu. Ngamanye amagama, uma uyibona ngeso lengqondo esikrinini se-ultrasound, ibukeka njengonxantathu onezinhlaka ezi-3. Ngaphambili kune-bump bort, engemuva kwesifunda kanye nesifunda se-mesenteric.
- Umsila we-pancreas unesimo esithambile, esisezingeni le-11-12 le-vertebra ye-thoracic. Kukhuphukela ebolini, ngemuva kwendlala ye-adrenal, kwesokudla.
Isitho sonke simbozwe ngezicubu ezihlangene, eziqukethe ama-lobules. Engxenyeni evulekile kukhona iziqithi zeLangerhans. Umsebenzi wabo ukukhiqizwa kwama-hormone - i-insulin neglucagon, elawula ukugcwala koshukela egazini.
Ama-ducts aqobayo akha i-pancreatic duct, eqala maphakathi nomsila, igeleza iye endaweni ye-duodenum.
Isifo se-pancreatic
Ukwakheka kwe-Hypoechoic ku-pancreas yisimo sokuxilonga kwezifo ezithile - ama-cysts, uhlobo lwe-hemorrhagic of pancreatitis, cystadenoma - lesi sifo sithambekele ekuwohlokeni okubi, ama-metastases ezinsolweni zesimo esibuhlungu sezinye izitho zomzimba.
Uma umsila we-pancreas uphuphuma, lokhu kungakhombisa ukukhula kwe-pancreatitis eqeda noma engalapheki. Ngokuya ngekhodi yokubuyekezwa ye-ICD 10, lesi sifo sinikezwa izinombolo K86.0 no K86.1, ngokulandelana.
Izimbangela ze-pancreatitis eyingozi zibangelwa ukwanda kokuqhamuka kwama-enzymes yi-gland kanye nokuvinjezelwa kwe-ampoule ye-duodenal papilla. Kukhiqizwa ujusi we-pancreatic, kepha kunokuphazamiseka ekuphumeni kwawo ku-duodenum.
Ukuhlolwa kwe-Ultrasound kukhombisa ukukhuphuka kwe-parenchyma yesitho sangaphakathi, okufaka ingcindezi kwi-capsule. Njengoba isitho sihlinzekelwe kahle ngegazi, ukuvuvukala kukhula ngokushesha.
Iziguli zikhononda ngobuhlungu obukhulu. Badinga ukwelashwa ngokushesha. Ukungazinaki izimpawu kukhulisa amathuba ezinkinga - i-necrosis ne-peritonitis.
Uma kungekho ukwelashwa okwanele kwama-pancreas esigabeni esibuhlungu, khona-ke inqubo engapheli yokuvuvukala iyenzeka. Iza ngezindlela ezilandelayo:
- Uhlobo lokuqala. Isifo esizimele, ukuvuvukala kubangelwa utshwala, ukungondleki, isifo se-metabolic.
- Uhlobo lwesibili lukhula ngenxa yezifo zezinye izitho zokugaya - isifo se-gallstone, ukuvuvukala kwe-gallbladder (cholecystitis).
- Uhlobo lwangemva kokuhlukumezeka luwumphumela wokuhlolwa kwe-endoscopic noma ukulimala okuhlukahlukene.
Ifomu elingamahlalakhona lihambisana nokungasebenzi kahle kwe-gland, ngenxa yokuthi angeke ikhiqize ama-enzyme ngesilinganiso esifanele. I-Ultrasound yesitho ikhombisa ukuphazamiseka kokungafani esakhiweni, i-sclerosis of the ducts, kanye nokwakheka kwamatshe.
Imiphumela yenqubo yokuvuvukala evilaphayo yi-cysts kanye nama-tumors. Ama-tumor neoplasms angama-hormone asebenzayo futhi ane-hormone-passive.
Kunzima ukukuxilonga, kuvame ukutholakala nesifo sikashukela i-mellitus. Ama-tumors aphathwa ngokuhlinzwa kuphela.
Ukwelashwa kwekhanda nomsila
I-capancer pancreatitis iwuhlobo lwefomu lesifo esingalapheki. Igama lawo kungenxa yokwanda kwekhanda lesitho sangaphakathi sohlelo lokugaya ukudla. Izimpawu eziphambili zihlanganisa nobuhlungu obukhulu. Izinkinga zivame ukuvela ezigulini - i-jaundice eqhubekayo ethuthukayo.
Ukuxilongwa kwenziwa ngesisekelo semiphumela etholwe yi-CT, i-MRI ne-ultrasound. Babonisa ukwakheka okuhle kwesitho, ubukhulu bekhanda bungaphezu kwamasentimitha amane. Kwesinye isikhathi ama-cysts akha ngaphandle kwe-parenchyma.
Ukwelashwa kwekhanda lepancreatic kudinga ukuhlinzwa. Imithi ngeke isize ekwelapheni isiguli. Indlela yokwelapha ukuhlinza i-lapanotomy ephakathi, okusho ukungasebenzi kahle kwekhanda ngokusho kukaKocher. Okubi kokuhlinzwa kwe-pancreatic kufaka izinga eliphakeme lokuxineka, ubunzima bokusebenza kobuchwepheshe.
I-Iron ngokumelene nesizinda sezinqubo zokuvuvukala inyuka ngokungalingani. Imvamisa, ukuvuvukala komsila uqobo - iba denser futhi ibanzi, okuholela ekuvinjelweni komthambo we-splenic kanye nefomu le-portal ye-renal hypertension.
Ukunwetshwa komsila kunezizathu:
- Itshe elivala umgodi.
- Uhlobo lwe-cystic ye-adenoma.
- Ukunikezwa kwekhanda.
- Ama-Pseudocists.
- I-tumor ye-papilla encane yesisu.
- I-pancreatic cyst.
- Umdlavuza wepancreatic.
Imvamisa, ukwanda komsila kubangelwa i-tumor neoplasms. Esikhathini sokuqala, kunzima ukusola inqubo ye-pathological. Ngokuvamile, isimila siyatholakala lapho sifinyelela usayizi ohlaba umxhwele. Ukwelashwa okuwukuhlinzwa kuphela. Kepha inobunzima bayo, ngoba ukuze ungene emsileni wesitho, udinga ukuhamba ngokhakhayini noma izinso kwesokunxele.
Ngesikhathi sokuhlinzwa, umsila othintekayo uyakhishwa, imithambo yegazi iyema. Uma kulimala izitho eziseduze, khona-ke kukhishwa ngokuphelele noma ngokwengxenye. Izingxenye ezisusiwe ngesikhathi sokuhlinzwa zithunyelwa ukuze ziyohlolwa umlando. Ukwelashwa okuthe xaxa kuya ngemiphumela yako.
Mayelana nesakhiwo nemisebenzi yamanyikwe kuzosho uchwepheshe kuvidiyo ekulesi sihloko.
