Virsungov pancreatic mutsinga dzinofamba nemukaka. Kuparidzira Wirsung mutsinga dzinofamba nemukaka

Basa rwatata kazhinji yakakura. muviri ichi kunze (exocrine) uye dzimwe (kwemakemikari anobudiswa) secretion rinobatanidzwa muna zvomudumbu kwacho nomurau muviri wacho lipid, carbohydrate uye mapuroteni muviri. Zvinetso mumuviri basa kunoratidza pamusoro mamiriro Wirsung mutsinga dzinofamba nemukaka. Chenjera kuzvimba kweprostate anoratidza kuwedzera wayo, uye iri chisingaperi pfungwa nomuviri zvemwana asati aona kuwedzera ayo, yaiteverwa pamwe nzvimbo stenosis (aienda). In zvirwere shwanu excretory mutsinga dzinofamba nemukaka kuchinja kuitika dzakaonekwa kushandisa ano chirwere nzira.

Virsungov mutsinga dzinofamba nemukaka

Huru pancreatic mutsinga dzinofamba nemukaka kunosvika pamwe yose kureba kwakaita rwatata, richisvika rwemberi pamusoro wayo. Virsungov mutsinga dzinofamba nemukaka Anoumba Fusion zviduku ductal lobular muviri une avhareji kureba masendimita 20. Gwara uyu kazhinji terminates ari duodenum, panguva nzvimbo paumbwe nomuviri wakadaro, sezvinoita sphincter. Dzinovaka ukama ductless shwanu kuti ari duodenum dzichipfekeka zvakakwana, ndiwo mugumisiro kubudiswa anogadzirwa pachishandiswa pancreatic muto kugutsikana dumbu kwemari.

Kukura uye Maumbirwe mutsinga dzinofamba nemukaka Wirsung vanhu vakawanda havasi zvakafanana uye kuvimba munhu nemamiriro muviri. Akawanda zviri pamwe chete nevakawanda bile mutsinga dzinofamba nemukaka (vanhuwo bile mutsinga dzinofamba nemukaka) uye anopinda duodenum. Nhamba wamativi waro nevakawanda mutsinga dzinofamba nemukaka angava akasiyana. Govera 4 kwavo mhando:

• Joint zvose inflow mutsinga dzinofamba nemukaka kupinda ura, apo ivo vanoumba yepakutanga chinu. Sphincter pamusoro oddi iyi, kufukidza zvose kuerera, zvachose rinogumisa navo panguva yayo rutapudzo. Izvi mhando kunoitika muna 55% nyaya.
• Remubatanidzwa zvose ducts pedyo duodenum pasina inotungamirwa zvayo ampoules. Izvi mhando kunoratidzwa 33.6%.
• Kuparadzana vasawira duodenum rimwe nerimwe ducts. Ichi isingawanzowanikwi mhando reshiyo kunoitika muna 4%.
• Kubatanidzwa nomumwe mutsinga dzinofamba nemukaka ari rebei kubva papilla pamusoro Vater. Vose vari yakazaruka kuti duodenum uye kubata masvingo avo. Anenge 8.5% dzokushungurudzwa anoratidza kuti kwemapazi yoga.

Izvi anatomical zvinhu zvinokosha zvakakwana kana mukana wokuti pathological okunatsiridza Wirsung mutsinga dzinofamba nemukaka. Ukama nevakariri bile mutsinga dzinofamba nemukaka kune huru mutsinga dzinofamba nemukaka uye musoro omumuviri, ukama hwavo pamwe duodenum chinoita chinokosha kukosha mukunzwisisa uye kukura vanoverengeka pathologies uye zviratidzo pancreatic kenza.

Ultrasound mufananidzo

Modifications pakati rwatata (vasingadzoreki nhengo parenchyma) inogona kukonzerwa siyana zvinhu. Vane zvinoonekwa pasi Ultrasound ongororo, izvo anotibvumira kufungidzira kukura uye nemamiriro parenchyma, ona contours pakati pathological ezvinhu, uyewo mamiriro kweprostate ducts. The zvinhu zvirwere chaizvo, diagnosable panguva yokurohwa, uye anoratidza fungidzira zvakasiyana kuti unogona kusanganisira virsungov pancreatic mutsinga dzinofamba nemukaka.

Sezvineiwo, zvinokosha kuziva kuti vanhu vakawanda utano tinganetseka zviratidzo diffuse kuchinja chokuita mamiriro nezvakatipoteredza uye kushandisa mishonga ine preservatives siyana uye stabilizers.

Zviratidzo abnormalities kubudikidza Ultrasound

Most vanozivikanwa zvirwere zvakadai pfungwa nomuviri zvemwana asati, chenjera uye chisingaperi nezvimiro pankreolitiaz, cysts nezvimwe pathologies.

Diffuse parenchyma kuwedzera shwanu kazhinji kunokonzera rikwanise pfungwa nomuviri zvemwana asati. Kuongorora muviri contours avhiringidzwa, inogona kuchengetwa kwaro mamiriro bofu makwapa kuti chingava pamusana ropa kana necrosis shwanu. Kutsunga kuwedzera Wirsung kuyerera ducts nezvimwe mumasero.

Mugore chirwere chakafanana saizi pfungwa nomuviri zvemwana asati muviri murege vanosangana nokuchinja. contours Its musava damerau uye gogonera. Echo shwanu rinenge ipfupi. In pamberi fibrosis vakachengeta chisimbiso parenchyma virsungov mutsinga dzinofamba nemukaka iri kujekesa uye akaremara, uye masvingo aro chisimbiso. Kazhinji dzakaonekwa kutyora ductal patency. Similar anogumbura kuchinja migumisiro paumbwe cysts, uye calcification.

Nokuumbwa matombo ari parenchyma kana pankreolitiaz, mugumisiro anogumbura pezvakaitwa kweprostate, kana kutyorwa kuri water drainage pakati makemikari. Pakutanga vakachengeta kurega kunotanga ari ducts muviri, zvichiguma nokuwedzera Wirsung mutsinga dzinofamba nemukaka. Muchikamu chinotevera pavaipfuura pathological mamiriro kunoitika kunayisa pamusoro puroteni mune pancreatic muto uye shelving calcifications kuti Ultrasound chinoratidzwa sezvo michero diffuse parenchymal echogenicity. Advanced siyana chirwere zvinoisa pankreolitiazu.

On the shwanu mamiriro anogona kukanganisa vamwe pathological ezvinhu zvomukati (chirwere chemwoyo, chiropa, cirrhosis).

Zvarakasiya dzakaonekwa mu rwatata, zvingava nokuda zvirwere zvakasiyana, asi kazhinji causative zvinhu vanoita pankreolitiaz uye pfungwa nomuviri zvemwana asati.

pfungwa nomuviri zvemwana asati

Kubva chiremba Mukuona pfungwa nomuviri zvemwana asati (kuzvimba rwatata) anokwanisa iyerere iri rikwanise kana chirwere chimiro. The mhaka chirwere chingava kugumiswa muto zveminda kunotangira muviri ari duodenum nokuda blockage ari mutsinga dzinofamba nemukaka. In kuramba tichishanda kuzvimba kweprostate makemikari anotanga kugaya Sero yavo. Chinokonzera kuzvimba zvingakonzerwawo kuvadza prostate, nokuda kwayo kuzvimba.

Chenjera pfungwa nomuviri zvemwana asati kakawanda nokuda pamberi matombo omunduru, izvo nechigumbuso ducts kana udhakwa, zvichiguma dzakaonekwa occlusion Rinodzora diki ducts.

Pankreolitiaz

Pankreolitiazom akadana pathological ezvinhu dzinoratidzwa paumbwe matombo Wirsung kenza mutsinga dzinofamba nemukaka kana ayo ramifications. Zviratidzo chirwere vari cramping kurwadziwa epigastric nharaunda, zvichiratidza kuti lumbar nharaunda.

Kuvapo mabwe kutadzisa water drainage pamusoro pancreatic muto kunotungamirira mumatumbu matambudziko. With kwakadaro kurega kunotanga iri US yakaratidza kuti virsungov kuyerera awanda uye vakachengeta Tensile duku mutsinga dzinofamba nemukaka masvingo.

Zvisinei, tinofanira kuyeuka kuti Ultrasound mufananidzo haapi mashoko azere kuti chirwere. Zvakakodzera kuti vaite dzimwe inspections. Sezvo kazhinji kuziva miedzo diffuse okunatsiridza rwatata kana chiropa, somuenzaniso, virsungov mutsinga dzinofamba nemukaka haina mufanidziro. Ongorora nayo muudzame kubatsira vamwe chirwere nzira.

Kuoma kunzwisisa nechirwere

Kunzwisisa nechirwere pamusoro zvokurwara iri chokuita rwatata yaiva. Hazvina zvakadzika zvakakwana ari mumuviri womunhu. tsvakurudzo wake rinofanira kuitwa vanokwanisa vashandi chete uye anosanganisira mazhinji zvishandiso uye mumarabhoritari unyanzvi. Izvi nokungwarira kuitwa kudzidza kwevari pancreatic makemikari (pancreatic isoamylase, lipase, trypsin mu weti, ropa riri duodenal mukati). Kuti asimbise insufficiency pamusoro exocrine mumasero zvakafanira kutsanangura zviratidzo zviri fecal elastase ari mutsvina yadzo. An chinokosha bvunzo zvakajairika ropa, kunyatsoongorora shuga, abdominal sonography, Doppler.

For axial toaisa pamusoro mudumbu MRI yakatarwa.

Mune ezvinhu zvakarurama kunzwisisa wo akaita chirwere laparoscopy. Nekuti pancreatic mashandiro kazhinji kunyengera zvokurwara pamusoro pancreatic mutsinga dzinofamba nemukaka uye biliary turakiti, nokungwarira vakatakura ERCP.

MR cholangiography

Magnetic resonance cholangiopancreatography mu obstructive muchimiro pfungwa nomuviri zvemwana asati kunoita kudzidza zvakadzama mamiriro Wirsung mutsinga dzinofamba nemukaka. Ichi chimwe chezvinhu ano nzira dzisiri ionizing kuzviongorora gallbladder kwayo ducts uye pancreatic mutsinga dzinofamba nemukaka. Zvinopa mukana kuwana mashoko akarurama kupfuura pamusoro mamiriro mitumbi izvi, kusarudza kuvapo mukati kwavari polyps, matombo, strictures, kuona okunatsiridza nemidziyo uye node nodes.

mabatiro

Treatment dzakaonekwa mu rwatata diffuse kuchinja zvinogona kuitwa kuchinja uye woshanda nzira. Kusarudza zvakarurama kurapwa nzira zvinoenderana yezvakaita chirwere, kuvapo concomitant zvirwere uye mukuru ezvinhu omurwere.

Kazhinji nokuda mukupera chirwere uye vabatwe echogenic zviratidzo kusingarapiki, kwete kubva atanga.

Kudzorerwa kwomuzvarirwo muviri zvivako runobvira chete kana kuitwa nenguva nenzira yakakodzera kurapa uye zvaidiwa zvose kunenge yose nyanzvi.