I-sphincter yakho ye-Oddi (SO) yinto ongasoze wanikeza umcabango - ngaphandle uma isebenza phezulu. I-SO yakho iyi-valve ye-muscular elawula izimfihlo ezivela ku-gallbladder yakho kanye ne-pancreas emathunjini akho amancane. Uma le valve ingasebenzi ngendlela efanele, i-sphincter ye-Oddi yokukhubazeka (i-SOD) iyatholakala.
I-SOD yisimo esingavamile sempilo.
Ku-SOD, i-sphincter muscle spasms, okwenza ukuthi ihlale ivaliwe. Lokhu kungabangela ukusekelwa kwe-bile ne-pancreatic enzymes emidayeni yabo. Lesi sipele singabangela ukuvuvukala kwesibindi kanye / noma ama-pancreas.
I-SOD ihlukaniswe yaba yizinhlobo ezincane:
- Thayipha i-SOD: Ubukhona bobuhlungu, i-bile buct ekhulisiwe, nesibindi esiphezulu kanye / noma ama-enzyme e-pancreatic.
- Thayipha i-SOD II: Ubukhona bobuhlungu, nge-conduit ekhulisiwe noma amazinga e-enzyme ephakeme, kodwa hhayi kokubili.
- Uhlobo lwe-III lwe-SOD: Ubukhona bobuhlungu, kodwa akukho okungajwayelekile okubonwayo nge-ultrasound noma umsebenzi wegazi.
Uhlobo lwe-III lwe-SOD lungathunyelwa njenge-SOD esebenzayo. Lokhu kungaphinde kuphulwe ibe yi-SOD esebenzayo ye-bidiary kanye ne-SOD pancreatic SOD.
Izingozi ZeSOD
Amacala amaningi e-SOD akhiqizwa ngemuva kokususwa kwe-gallbladder noma isisu esiswini sokuhlinzwa ukulahlekelwa kwesisindo . Kulezo zimo ezenzeka emva kokususwa kwe-gallbladder, i-SOD ivame kakhulu kubantu besifazane kunamadoda, kodwa kubalulekile ukuqaphela ukuthi i-SOD ithinta kuphela amaphesenti amancane abantu.
Izimpawu ze-SOD
Isibonakaliso esiyinhloko se-SOD ubuhlungu obukhulu phakathi nendawo kuya phezulu kwesokudla kwesisu. Ubuhlungu bungasakazeka ehlombe noma ngaphesheya kwesifuba. Ama-episodes wezinhlungu angaba mfushane noma agcine amahora amaningana. Amazinga wezinhlungu angase ahluke kusukela kusiqephu kuya esiqhathanweni, futhi ububanzi bube bubucayi kuze kube lula.
Izimpawu ezihlobene zihlanganisa ukulahlekelwa ukudla, isisindo sokugcoba nesisindo. Ukushisa, ukuhlanza kanye ne-jaundice nakho kungenzeka. (Khumbula, izimpawu ezinzima ezifana nalezi zidinga ukwelapha ngokushesha.)
Ukuxilongwa kwe-SOD
Kunezivivinyo ezihlukahlukene ze-SOD. Umgomo wokuhlolwa kokuhlola ukuthola ukuhlolwa okuqondile mayelana nokuthi yini engase ibangele isifo sobuhlungu besisu. Nazi ezinye izinketho zokuxilonga:
Umsebenzi wegazi: Lokhu kuvame ukuhlolwa kokuqala okwenziwe. Udokotela wakho uzobheka izinyimba ezinamandla zesibindi noma ze-pancreas.
Ukucabanga: Udokotela wakho angase afune ukuzama ukuthola isithombe mayelana nalokho okwenzeka ngaphakathi kwakho, ikakhulukazi i-bile duct, isibindi kanye ne-pancreas. Lokhu kungenziwa nge-X ray, ultrasound, CT scan noma i-MRI.
I-MRCP: I- resonance magnetic resonance ye-cholangio-pancreatography isebenzisa idayi namagundane ukuze uthole isithombe se-bile ne-pancreatic ducts.
I-ERCP: I- endoscopic retrograde ye-cholangio-pancreatography isebenzisa i-endoscope, idayi ne-X-ray ukuhlola i-bile ne-pancreatic ducts. I-ERCP ayinamandla futhi ngakho-ke kunconywa kuphela iziguli zohlobo lwe-I noma II. I-manometry ye-SO ingenziwa ngesikhathi se-ERCP ukukala ukucindezelwa kwemisipha ye-sphincter futhi kubhekwa ukuthi inikeza ukuxilongwa okuqondile kwe-SOD.
Ukwelashwa kwe-SOD
Ukwelashwa kwe-SOD kuncike ebukhulu bezimpawu. Ngamacala amancane, udokotela wakho angase anikeze ukuphumula kwemisipha, i-antispasmodics kanye / noma ezinye izinhlobo zokunciphisa ubuhlungu.
Esimweni esinzima, i-SO iyakunqunywa ngesikhathi se-ERCP, inqubo eyaziwa ngokuthi i-sphincterotomy. Lokhu kwenziwa ukuze kususwe noma yikuphi amatshe angase agijime emidayeni noma ukuthuthukisa ikhono lamathanga okukhipha. Le nqubo yenziwa kuphela uma i-SO manometry ibonisa ukuba khona kwengcindezi ephezulu ngaphakathi kwe-SO futhi kucatshangwa ukuthi kulethe ukuphumula okuphawulekayo kweziguli ezingaba ngu-50%. Noma kunjalo, kunezingozi ezinkulu kule nqubo.
Okubi kakhulu kunengozi yokuthuthukiswa kwe-pancreatitis. Enye ingozi engenzeka ukuthi inqubo ingabangela ukulimala futhi ngaleyo ndlela kubuyiselwe izimpawu.
Imithombo:
Behar, J., et.al. "I-Gallbladder esebenzayo ne-Sphincter ye-Oddi Disorders" I- Gastroenterology 2006 130: 1498-1509.
"Sphincter of Oddi Ukukhubazeka" University of Maryland Health Centre Kufinyelelekile kuJulayi 22, 2105.
"I-Sphincter Odys Dysfunction" IYunivesithi yaseRochester Health Encyclopedia Ithole ngoJulayi 22, 2015.