Ereyga "cudurka cirroolada" wuxuu sharxayaa wixii dhibaato caafimaad ah ee saameeya qashinka.
In kasta oo cudurada ugu badan ee cudurka cambaarta loo yaqaan 'gallbladder' uu yahay qanjo barar (oo loo yaqaanno cholelithiasis), waxaa jira dhowr waxyaalood oo kale, oo ay ku jiraan infekshin galbeedeed (oo loo yaqaanno cholecystitis), biliary dyskinesia, cudurada qufuca, qufaca ilkaha, iyo kansarka gallbladder.
Sababaha Caadi ahaaneed
Galleyda ayaa ah calaamadaha ugu caansan ee cudurrada gallbladder iyo foomka ka yimaada kolestaroolka ama bilirubin badan (xujo lagu sameeyo beerka marka unugyada dhiigga casaan la jebiyo).
Gallstones waa crystals taas oo ka sameysan gudaha gudaha xargaha, taas oo ah unug casri ah oo ku yaal dhinaca sare ee calooshaada hoostiisa hoostiisa. Ujeedada ugu muhiimsan ee saliingahaaga ayaa ah in la keydiyo dheecaan, loo yaqaanno bile, kaas oo ay sameeyaan beerka. Bile waxay lagama maarmaan u tahay dheefshiidka iyo nuugista dufanka iyo fiitamiinada qaarkood cuntada aad cunayso.
Iyada oo qanjidhada kolestaroolka , kolka aad "shooga" leh kolestaroolka oo aan awoodin in la kala gooyo sida caadiga ah, sidaa daraadeed dhagxaan. Inta badan dadka qaba maaddooyinka gallstone ee Maraykanka waxay leeyihiin dhagxaanta kolestaroolka.
Gawracatada xashiishka ayaa laga yaabaa inay sameyso haddii uu jiro bilirubin badan. Xaaladaha caafimaad sida cirrhosis (bilirubin aad u badan ayaa laga sameeyaa beerka) iyo cudurrada sickle cell (meesha unugyada dhiigga cas la jebiyo) waxay keeni karaan dhagxaanta.
Ugu dambeyntii, gallonka ayaa laga yaabaa inay sameyso haddii cirbadda aan xoqin si habboon (tan waxaa lagu magacaabaa bile stasis).
Qaar ka mid ah arrimahan halista ah ee lagu horumarinayo xayawaanka waxaa ka mid ah:
- Dheddig lab ah
- Da'da ka weyn 40 sano
- Uurka
- Cayilka
- Cuntooyinka sare ee kolesteroolka, carbohydrates la safeeyey (tusaale ahaan, rootiga cad), iyo dufanka buuxa (tusaale ahaan jiis, subag, iyo hilibka cas)
- Hab-nololeedka ku-meel-gaadhka ah
- Miisaanka oo degdega
- Cudurrada asaasiga ah (tusaale ahaan, sonkorow, calaamadaha dheef-shiid kiimikaadka, cirrhosis, cudurka Crohn, cystic fibrosis, cudurrada sickle cell, ama dhaawaca laf-dhabarka)
- Daawooyinka ay ku jiraan estrogen, sida p-pillerka ama daaweynta hoormoonka beddelidda hormoonka
- Daawooyinka kale sida Sandostatin (octreotide), Rocephin (Ceftriaxone), iyo tiazide diuretics sida Microzide (hydrochlorothiazide)
Sababaha Sababay
Qaar ka mid ah sababaha kale waxay la xiriiraan cudurka cagaarshowga.
Cholecystitis
Caabuqa xaydha (oo loo yaqaanno cholecystitis) ayaa laga yaabaa inuu ku kordho natiijada gallstones (oo loo yaqaanno cholessstitis daran) ama ka yaraa, oo aan lahayn gallasones (oo loo yaqaano cholessstitis acalculous).
Cuddurrada Xanuunku wuxuu dhacaa marka qashinka lagu daro gudaha cystic cyst, taasoo horseedaysa barar xardhan. Marka laga reebo xanuunka caadiga ah (colic biciriga) ee haysta dhagax dhagax, qofku wuxuu yeelan karaa xummad, lallabbo, matag, xajin, iyo / ama lumis cunto xumo. Tirada unugyada dhiiga cad oo sare u kac ah ayaa sidoo kale jira.
Caga-qabadku wuxuu keenaa calaamado iyo calaamado isku mid ah oo loo yaqaanno cholessstitis daran, si kastaba ha ahaatee, ma jiraan wax gallstone ah. Taa baddalkeeda, khabiiradu waxay rumaysanyihiin natiijada xaaladdan ka imanaysa galbiyaha taranka iyo ischemia (dhiig yaraanta socodka).
Cudurka noocan ahi wuxuu ku dhacaa bukaanka daran.
Qodobada qaar ee kordhiya fursadda ay u leeyihiin inay ku dhacaan cudurka cirbadaha xameeya qaaxada waxaa ka mid ah:
- Jirooyinka khatarta ah (tusaale ahaan, calaamadaha 'leelemia myelogenous leukemia', 'AIDs', 'cudurada wadnaha', 'heart failure'), cudurada kalyaha oo dhammaaday, iyo vasculitis)
- Gubasho
- Dhalashada
- Nidaamka difaaca ee la xakameynayo
- Infekshan weyn ama shoog
- Dawooyinka qaarkood (tusaale ahaan, opiates)
- Ku-shubid badan
- Qalabka hawo mareenka
- Qaadashada nafaqada illaa xiidankaaga (oo loo yaqaan guud ahaan nafaqada maskaxda)
Biliary Dyskinesia
Cudurka Biliaryenku wuxuu sharxayaa cillad ka mid ah nidaamka cirridka bileyska ah kaas oo la xariira isbedelka foosha ee habdhismeedka Oddi oo ah hareeraha muruqyada ee ku wareegsan aagga meelaha qulqulka caadiga ah ee xaamiladu ay ku raacaan tuubada pankreatic markay galaan mindhicirka yar.
Tan iyo markii uu odd-qaafka Oddi aanu si haboon u shaqaynayn cudurkan, xannibaadda biliiga ah ayaa dhici karta. Xaaladahan kala-goysyada ah ee isdaba-marinta waxay keenaan xargo-hurdi-sida xanuun, xanuun joogto ah oo ku yaal qaybta sare ama qaybta dhexe ee caloosha.
Inkasta oo ultrasound-ka caloosha laga yaabo inuu muujiyo xuubka xajmiga caadiga ah ee ballaaran, baaritaan lagu magacaabo mashiinka Oddi ee loo yaqaan "Oddi" ayaa loo isticmaali karaa si qoto-gala si loo ogaado cudurka biliary-dyskinesia. Haddii foojignaanta cadaadiska Oddi ay sare u kacdo (tijaabadu waa mid wanaagsan), qof ayaa laga qaadi karaa qashin-qubka (oo loo yaqaan 'spaschopter endoscopic').
Ma cadda sababta waxa keena xanuunka 'biliary dyskinesia'. Waxaa badanaa lagu arkaa dadka kuwaas oo hartay xannibaadayaashooda; inkasta oo dadka badankood ee qaada caatoorkii la iska saaray ayan la kulmeynin bilaaryo dyskinesia. Khabiiro kale ayaa soo jeediyay in dhibaatadani ay ka timaaddo isdaba-joogga ama dareen-celinta musqusha muruqa.
Cudurka Kaadi-Bararka leh
Xanuunka dheefshiidka ee xaddidan wuxuu loola jeedaa dadka qaba xanuunka biliary (raaxo darro dhinaca qaybta sare ama qaybta caloosha) marka maqnaanshaha qadhaadh ama sifaha qallafsan ee Oddi.
Dadka qaba xanuunka qufuca shaqeynaya waxay leeyihiin baaritaano dhiig oo caadi ah, iyada oo aan lahayn caddaynta caabuq ama dhibaatooyinka beerka. Waxay sidoo kale leeyihiin ultrasound caadiga ah ee gallbladder leh oo aan lahayn caddaynta gallstones.
Ka dib markii lagu xukumay shuruudo kale oo laga yaabo in ay ku dhejiyaan xanuunka madaxa (tusaale ahaan, cudurada is-galka ee is-galku ama cudurka ulcer), qof ayaa laga qaadi karaa baaritaan lagu magacaabo "cholecystokinin" (CCK) -shaxanka loo yaqaan 'cholecystaphaphy' si loo xaqiijiyo ogaanshaha ciladda gallbladder.
Imtixaankani wuxuu xisaabiyaa qayb ka mid ah jajabka ee jeegjiraha (inta cunsuriyuhu ka baxo gallbladder). Haddii jajabku yaraado, sida in ka yar 40 boqolkiiba, baaristu waxay taageertaa cilad-xumada xanuunka xardhan. Daaweynta xanuunkaan waxay keeneysaa in laga saaro qashinka (oo loo yaqaan 'cholecystectomy').
Iyadoo aan weli la caddayn, waxaa suurtogal ah in dadka qaba xanuunka caloosha ee maskaxda ku jira (tusaale ahaan, faaruqin aan caadi ahayn) ay halis ugu jiraan inay yeeshaan jiritaanka qufuca shaqada.
Calaamadaha ugu horreeya ee "Cholangitis"
Cholangitis Primary Sclerosis (PSC) waa cudur muddo dheer ah oo keena xitaa xummad xummad leh. Sababtoo ah infakshanka dabaysha, duufka xitaa wuxuu noqdaa mid jilicsan, taasoo keenta xannibaad, sidaas darteed xitaa ma daadin karo. Sidaas darteed, xitaa waxay kudheeraataa beerka, dhaawaca unugyada beerka oo keena cirrhosis. Haddii aan lagu daaweyn beerka beerka, PSC waxay keeni kartaa beerka iyo / ama kansarka qanjidhada.
Khatarta ugu weyn ee horumarinta PSC waxay leedahay ulcerative colitis. Xaqiiqdii, dadka ugu badan ee qaba PSC waxay leeyihiin ulcerative colitis. Dhinaca garabka, kaliya boqolkiiba dadka yar ee qaba colitis boogta ayaa ugu dambeyntii horumarinaysa PSC.
Kansarka Gallbladder
Kansarka Gallbladder waa dhif iyo dhacdaa marka unugyada xaydha ee si dhaqso ah u kordha oo aan la xakameyn.
Cudurka qanjidhada iyo xajmiga muruqyada ee hooseeya ayaa kordha qofka fursadihiisa inuu ku dhaco kansarka qudaarta, xitaa inkastoo qaxweecadu ay aad u badan tahay. Dhab ahaantii, sida laga soo xigtay ururka Cancer Society, ugu yaraan seddex ka mid ah afar qof oo qaba kansarka qanjidhada dhuxusha ayaa leh qashinka marka la ogaado.
Qodobada kale ee halista ah ee lagu hayo cudurka cirroolada waxaa ka mid ah:
- Dheddig lab ah
- Da 'weyn
- Cayilka
- Asal ahaan (Dadka Ameerikaanka ah ama Hindida Maraykanka ah)
- Infekshinka joogtada ah ee bakteeriya, Salmonella Typhi
- Gubashooyinka gudaha xuubka caadiga ah
- Burooyinka xayawaanka ah
- Xaalado aan caadi ahayn oo ka soo baxa xaydha
> Ilo:
> Afdhal N. (2017). Caga-jebecyada Acalculous cholecystitis. Jaantuska caafimaadka, ogaanshaha, iyo maamulka. Ashley SW, Lindor KD (ed). UpToDate, Waltham, MA: UpToDate Inc.
> Bulshada Mareykanka ee Kansarka. (2016). Waa Maxay Xaaladaha Khatarta Kansarka Kansarka?
> Catalano MF, Thosani NC. (2016). Jaantuska daaweynta iyo ogaanshaha sifaha qallafsan ee Oddi. Howell DA (ed). UpToDate, Waltham, MA: UpToDate Inc.
> Jessri M, Rashidkhan B. Qaababka cuntada iyo khatarta cudurka cagaarsho-baxa: Daraasad-kormeerid kayska-ku-salaysan ee cusbitaalada haweenka qaangaarka ah. J Caafimaadka Popul Nut. 2015 Maarso 33 (1): 39-49.
> Stinton ML, Shaffer EA. Epidemiology ee Cudurka Gallbladder: Cholelithiasis iyo Cancer. Gut Beerka . 2010 Apr; 6 (2): 172-87.