Igama elithi "isifo se-gallbladder" lichaza noma iyiphi inkinga yempilo ethinta i-gallbladder.
Nakuba imbangela evamile kakhulu yesifo se-gallbladder yi-gallstones (ebizwa ngokuthi i-cholelithiasis), kunezimbangela eziningi, okufaka ukuvuvukala kwe-gallbladder (okuthiwa i-cholecystitis), i-dyskinesia ye-biliary, isifo se-gallbladder esebenza kahle, i-primary sclerosing cholangitis, nomdlavuza we-gallbladder.
Izimbangela ezivamile
Ama-gallstones yi-manifest ejwayelekile kakhulu yesifo se-gallbladder nesimo ngenxa ye- cholesterol kakhulu noma i-bilirubin (i-pigment eyenziwa esibindi lapho amangqamuzana egazi abomvu ephukile).
Ama-gallstones ama-crystals afaka ngaphakathi kwe-gallbladder, okuyilungu elimelele eliphakathi kwe-kwesisu elisenhla kwesisu sakho ngaphansi kwesibindi sakho. Inhloso eyinhloko ye-gallbladder yakho ukugcina i-fluid, ebizwa ngokuthi i-bile, eyenziwe yisibindi. Kudingeka ibhilidi yokugaya nokumunca amafutha namavithamini athile ekudleni okudlayo.
Nge- cholesterol gallstones , i-bile yakho "igcwele amandla" nge-cholesterol futhi ayikwazi ukuyihlakaza njengayo ngokuvamile iyenzayo, ngakho-ke imatshe ifomu. Iningi labantu abanama-gallstones e-United States anamatshe e-cholesterol.
I-pigment gallstones ingahle ifake uma kune-bilirubin kakhulu. Izimo zezokwelapha ezifana ne-cirrhosis (i-bilirubin eningi kakhulu eyenziwa yisibindi) nesifo se-sickle cell (lapho amangqamuzana egazi abomvu aphukile khona) angabangela amatshe e-pigment.
Okokugcina, ama-gallstones angase enze uma i-gallbladder ingenalutho kahle i-bile (lokhu kubizwa nge-bile stasis).
Ezinye zezinto ezibeka ingozi ekuthuthukiseni ama-gallstones zihlanganisa:
- Ubulili besifazane
- Kudala kunama-40
- Ukukhulelwa
- Ukukhuluphala
- Ukudla okuphezulu kwe-cholesterol, ama-carbohydrate ahlanzekile (isibonelo, isinkwa esimhlophe), namafutha agcwele (isibonelo ushizi, ibhotela, nenyama ebomvu)
- Indlela yokuphila yama-sedentary
- Ukulahlekelwa kwesisindo ngokushesha
- Izifo ezithintekayo (isibonelo, isifo sikashukela, isifo se-metabolic, i-cirrhosis, isifo se-Crohn, i-cystic fibrosis, isifo se-sickle cell, noma ukulimala komgogodla)
- Imithi equkethe i-estrogen, njengezokwelapha zomlomo noma i-hormone therapy esikhundleni
- Eminye imithi efana ne-Sandostatin (octreotide), i-Rocephin (ceftriaxone), ne-thiazide diuretics njenge-Microzide (i-hydrochlorothiazide)
Izimbangela ezimbi
Ezinye izimbangela eziningi zihlobene nesifo se-gallbladder.
Cholecystitis
Ukuvuvukala kwe-gallbladder (ebizwa ngokuthi i-cholecystitis) kungase kuthuthuke ngenxa ye-gallstones (okuthiwa i-acute cholecystitis) noma engavamile, ngaphandle kwama-gallstones (okuthiwa i-cholecystitis acalculous).
I-cholecystitis enamandla ivela lapho i-gallstone efakwa ngaphakathi kwe-cystic duct, eholele ekuguleni kwesibindi. Ngaphandle kobuhlungu obuvamile (coliary colic) yokuba ne-gallstone, umuntu angase abe ne-fever, i-nausea, ukuhlanza, i-malaise, kanye / noma ukulahlekelwa kwesidlo. Inani eliphakeme elimhlophe lamaseli egazi livame ukukhona.
I-cholecystitis ye-Acalculous yenza izibonakaliso nezimpawu ezifanayo njenge-cholecystitis ephawulekayo, noma kunjalo, ayikho i-gallstone okwamanje. Esikhundleni salokho, ochwepheshe bakholelwa ukuthi lesi simo sivela ku-gallbladder stasis ne-ischemia (ukugeleza kwegazi okubi).
Lolu hlobo lwesifo se-gallbladder ngokuvamile luvela ezigulini ezigula kakhulu.
Ezinye izinto ezandisa amathuba omuntu wokuthuthukisa izifo ze-acalculous gallbladder zihlanganisa:
- Izifo ezinzima (ngokwesibonelo, i-acute myelogenous leukemia, i-AIDs, isifo senhliziyo esiyingozi, isifo senhliziyo yesifo sikashukela, isifo sezinso sokuphela kwesifo, nesifo se-vasculitis)
- Ukushisa
- Ukubeletha
- Ukuqeda amasosha omzimba
- Ukutheleleka okukhulu noma ukuhlukunyezwa
- Imithi ethile (isibonelo, opiates)
- Ukumpontshelwa okuningi
- I-ventilation yemishini
- Ukuthola ukudla okunomsoco nge-vein yakho (ebizwa ngokuthi ukudla okuphelele kokudla komzimba)
I-Biliary Dyskinesia
I-dyskinesia ye-biliary ichaza isifo se-bridary system restruction esihlobene nokungajwayelekile komsebenzi we-sphincter ka-Oddi-isakhiwo somzimba esizungezile indawo lapho i-buct ejwayelekile ehambisana khona ne-pancreatic duct njengoba ingena emathunjini amancane.
Njengoba i-sphincter ye-Oddi ingasebenzi ngendlela efanele kuleso sifo, ukuvimbela amabhiliyali kungenzeka. Lezi ziqephu ezihambelanayo zesithiyo se-biliary zibangelwa ubuhlungu be-gallstone-njengobuhlungu obunzima, obuhlala njalo engxenyeni engenhla noma ephezulu engxenyeni yesisu.
Nakuba i-ultrasound yesisu ingaveza ukuthi i-bile ehamba phambili, i-test ebizwa ngokuthi i-sphincter ye-mandi ye-Oddi ingasetshenziselwa ukuhlolisisa ngokucacile i-dyskinesia ye-biliary. Uma i-sphincter ye-Oddi ingcindezi iphakanyisiwe (ukuhlolwa kulungile), umuntu angase asuswe i-sphincter (ebizwa ngokuthi i-endoscopic sphincterotomy).
Akucaci ukuthi yini ebangela i-dyskinesia ye-biliary. Kubonakala kaningi kubantu abaye basuswe; nakuba iningi labantu abaye lalabo abasebenzisa izidakamizwa zisuswe bengaboni i-biysary dyskinesia. Olunye ochwepheshe baye basikisela ukuthi lesi sifo siphumelela ngokusuka kwe-spasm noma ukulahleka kwesisindo kumfutho we-sphincter.
I-Functional Gallbladder Disorder
Ukungasebenzi kahle kwe-gallbladder disorder kubhekisela kubantu abazwa ubuhlungu be-biliary (ukungakhululeki ngakwesokudla noma isikhungo esisodwa kwesisu) ngokungabikho kwe-gallstones noma i-sphincter ye-Oddi ukungasebenzi.
Abantu abane-disorder gallbladder disorder babe nokuhlolwa kwegazi okuvamile, ngaphandle kobufakazi bokuvuvukala noma izinkinga zesibindi. Zine-ultrasound evamile ye-gallbladder engenabufakazi bokuthi i-gallstones.
Ngemva kokulawula ezinye izimo ezingase zilingise ubuhlungu bezinyoni (isibonelo, ischemic isifo senhliziyo noma isifo se-peptic ulcer), umuntu angase ahlolwe okuthiwa yi-cholescintigraphy ebizwa ngokuthi yi-cholecystokinin (CCK) ukuqinisekisa ukuxilongwa kwe-functional gallbladder disorder.
Lokhu kuhlolwa kunquma ingxenyana ye-ejection ye-gallbladder (kungakanani umculi oshiya i-gallbladder). Uma ingxenyana ye-ejection iphansi, njengamaphesenti angaba ngu-40, ukuhlolwa kusekela ukuxilongwa kwe-functional gallbladder disorder. Ukwelashwa kwalesi sifo kuhlanganisa ukususwa kwe-gallbladder (ebizwa ngokuthi i-cholecystectomy).
Ngenkathi singacacile, kungenzeka ukuthi abantu abanenkinga yokungena emathunjini yomzimba (ngokwesibonelo, ukungcola okungavamile) kungase kube engozini yokuthuthukisa ukusebenza kwe-gallbladder disorder.
I-Primary Sclerosing Cholangitis
I-Primary sclerosis cholangitis (i-PSC) isifo esihlala isikhathi eside esiholela ekugqibeleni kwe-bile. Ngenxa yokuvuvukala okungapheli, ama-bucts e-bile aphelelwa amandla, okwenza ukuthi i-blockages, ngakho i-bile ayikwazi ukukhipha. Ngenxa yalokho, i-bile yakha esibindi, ilimaze amangqamuzana wesibindi futhi ibangele i-cirrhosis. Uma kungelashwa ngokufakelwa kwesibindi, i-PSC ingabangela umdlavuza wesibindi kanye / noma i-gallbladder.
Into ebaluleke kakhulu engozini yokuthuthukisa i-PSC ine-ulcerative colitis. Empeleni, iningi labantu abane PSC bane-ulcerative colitis. Ehlangothini lwe-flip, kuphela amaphesenti amancane abantu abane-ulcerative colitis ekugcineni ahlakulele i-PSC.
I-Gallbladder Cancer
Umdlavuza we-Gallbladder awuvamile futhi kwenzeka lapho amangqamuzana e-gallbladder ekhula ngokushesha futhi engalawuleki.
Kokubili i-gallstones ne-primary sclerosis cholangitis yandisa ithuba lomuntu lokuthuthukisa umdlavuza we-gallbladder, nakuba ama-gallstones ajwayelekile kakhulu. Eqinisweni, ngokusho kwe-American Cancer Society, okungenani abantu abathathu kwabayisine abanomdlavuza we-gallbladder banama-gallstones uma betholakala.
Ezinye izici ezingozini zokuthuthukisa isifo se-gallbladder zihlanganisa:
- Ubulili besifazane
- Ubudala obudala
- Ukukhuluphala
- Uhlanga (Mexican American noma American American)
- Ukwelashwa okungapheli ngama-bacteria, i-Salmonella Typhi
- Ama-cyst ngaphakathi kwe-biling buct evamile
- I-Gallbladder polyps
- Ukungahambi kahle kwe-bile ducts
> Imithombo:
> Afdhal N. (2017). Cholecystitis acalculous. Ukubonakaliswa kwemitholampilo, ukuxilongwa, nokuphathwa. Ashley SW, Lindor KD (ed). UpToDate, Waltham, MA: UpToDate Inc.
> I-American Cancer Society. (2016). Yiziphi Izingozi Ze-Gallbladder Cancer?
> Catalano MF, Thosani NC. (2016). Ukubonakaliswa kwemitholampilo nokuxilongwa kwe-sphincter ye-Oddi ukungasebenzi. I-Howell DA (ed). UpToDate, Waltham, MA: UpToDate Inc.
> Jessri M, Rashidkhan B. Amaphethini wezinkukhu kanye nobungozi bokugula kwesifo se-gallbladder. J Health Popul Nutriti. 2015 Mar; 33 (1): 39-49.
> Stinton ML, uShaffer EA. I-Epidemiology ye-Gallbladder Disease: I-Cholelithiasis ne-Cancer. Gut Liver . 2010 Ngo-Apr; 6 (2): 172-87.