Duban dan tayi ne mahimmin gwajin gwaji
Kalmar nan "cututtuka gallbladder" ta ƙunshi yanayin kiwon lafiya wanda ke shafar gallbladder, kamar gallstones, m ko ciwon cholecystitis na kullum (gallbladder ƙonawa sakamakon gallstones), da kuma gallbladder ciwon daji.
Yayin da alamun nazari, nazarin jiki, da kuma aikin jini suna taka muhimmiyar rawa wajen ganewar cututtukan cutar gallbladder, samun samfurin lantarki na ciki (da kuma yiwuwar wasu gwaje-gwajen gwagwarmaya) shi ne mafi muhimmanci a cikin tsarin bincike.
Tarihin likita
Idan likitan likitanku sun kamu da cututtuka, zai bincika game da alamun bayyanarku ko kuma ku ko duk danginku sun taɓa samun matsalolin da ke fama da su.
Misalan tambayoyi masu dacewa sun haɗa da:
- Kuna fuskantar ciwo na ciki, kuma idan haka ina? Ciwo a cikin hagu na dama ko na sama na ciki yana nuna damuwa ga matsala gallbladder.
- Shin jin zafi na ciki da cin abinci? Tare da gallstones, mummunar zafi mai zafi zai iya faruwa daya ko fiye da sa'o'i bayan cin abinci masu kyau kuma yana da akalla minti talatin.
- Shin kun taba samun ciwo mai zafi a ciki? Hanyoyi na ciwo mai raɗaɗi yana ci gaba da muni fiye da lokaci kuma zai iya haifar da rikitarwa kamar kamuwa da kamuwa da bile ko ƙumburi na pancreas .
- Kuna fuskantar wani bayyanar cututtuka banda ciwo, kamar fure, tashin zuciya, vomiting, ko asarar nauyi? Wadannan cututtuka masu alaƙa zasu iya taimakawa likita su nuna cewa cutar cutar da sauran matsalolin da ke faruwa.
Nazarin jiki
Nan gaba, likitan ku zai gwada lafiyar jiki, yana mai da hankali akan alamunku masu muhimmanci. Mutanen da ke da ƙwayar cholecystitis na iya zama zazzaɓi da kuma babban zuciya.
Kasancewar jaundice , alamar ta yellowing da fata na idanu da / ko fata, yana damuwa ne ga wani gallstone complication da ake kira choledocholithiasis wanda wani gallstone ya fita daga gallbladder kuma ya rufe babban bile duct (inda bile gudana a cikin hanji).
A lokacin jarrabawar ciki, likitanku za su lura ko ko dai wani bincike da ake kira "tsaro" yana da. Mutumin da ke da ƙananan cholecystitis zai iya "kiyaye" ko sanya hannayensu a gefen dama na ƙananan ciki inda aka samo gallbladder yayin gwajin jiki.
A ƙarshe, a lokacin jarrabawar jiki, likitanku za su yi fasalin da ake kira "Murphy's sign". Da wannan gwajin an tambayi mutum ya dauki numfashi mai zurfin ciki, ya bar yaron ya sauka don haka likita zai iya danna kan shi. Idan mutum ya sami babban ciwo a lokacin wannan gwaji (wanda ake kira "Murphy sign"), ya nuna cewa yana iya samun ciwo.
Labs
Mutanen da ke fama da cututtuka suna fama da ƙwayar jini . Kwayoyin jininka masu fararen ƙwayoyin jikinku ne na yaduwar cuta da kuma lokacin da sigina ya nuna wasu ƙuna ko kamuwa da cuta cikin jiki. Bugu da ƙari da yawan ƙwayar jini mai yawan jini, mai yiwuwa mutum ya iya ƙarfafa gwajin aikin aikin hanta .
Duk da yake akwai ƙaramin karuwa a cikin hanta enzymes, tsayi a cikin matakin bilirubin (kuma wani ɓangare na aikin hanta aikin jini) ya nuna yiwuwar yiwuwar cutar cututtuka (alal misali, idan an lalata gallstone a cikin kogin bile da / ko akwai kamuwa da cuta na bile).
Idan likitancin likitan ku na likitan dajin da aka yi akan gwaje-gwaje na hoto (alal misali, duban dan tayi, CT scan, ko MRI), zai iya yin umurni da gwajin jini, kamar CEA ko CA 19-9. Wadannan alamomi, duk da haka, ana iya hawan su a gaban sauran cututtuka, don haka ba su nuna kai tsaye ga ciwon daji na gallbladder ba. Sau da yawa fiye da haka ba, ana amfani da alamun ƙwayoyin tumatir don biyar da amsawar mutum zuwa maganin ciwon daji (idan an ɗauke shi a farkon).
Hoto
Yayin da tarihin likita, bincike na jiki, da kuma labs na iya taimakawa wajen gano asalin cututtukan cutar, wanda ake bukata don tabbatar da ganewar asali. A wasu kalmomin, dole ne a duba fuskar gallbladder, kuma ana yin wannan sau da yawa tare da duban dan tayi.
Duban dan tayi
Wani samfurin dan tayi yana jarrabawar gwajin hoto da ba ta da zafi wanda yayi amfani da raƙuman sauti don samar da hoto na gallbladder. Bugu da ƙari, gallstones, gallbladder bango thickening ko busa da kuma gallbladder polyps ko masses iya gani.
A yayin da ake yin amfani da duban dan tayi, mai fasaha na iya yin "Alamar Murphy". A lokacin wannan motsi, ana ɗaukar maɓallin lasisin dan tayi a kan gallbladder yayin da mai hakuri ya ɗauki numfashi mai zurfi. Idan tabbatacce, mutumin zai fuskanci jin zafi lokacin da aka danna gallbladder.
HIDA Scan
Idan ƙididdigar cutar rashin lafiyar cutar ba tabbas ba ne bayan bayanan duban dan tayi, za a iya duba HIDA. Wannan gwaji yana ba da izini don ganin yadda ake tafiyar da bile a cikin tsarin tsarin bile. A yayin dubawa na HIDA, an gano magungunan rediyo ta hanyar kwayar mutum. Wannan abu yana ɗauke da kwayoyin hanta kuma an cire shi cikin bile.
Idan ba za a iya ganin wannan jarrabawar gwajin ba "tabbatacciyar" saboda yana nufin cewa akwai wasu matsalolin (sau da yawa daga gallstone, amma mai yiwuwa daga kwayar cutar) a cikin kwakwalwa, wanda shine kwayar da ke dauke da bile daga gallbladder zuwa dabarun bile.
CT Scan
CT scan daga cikin ciki zai iya bayyana alamun annobar cutar gallbladder, kamar gallbladder kumburi bango ko tsatsar mai. Zai iya zama da amfani sosai don bincikar ƙwarewar rare, rikice-rikice na rayuwa mai tsanani da ƙananan cholecystitis, kamar lalacewar gallbladder (lokacin da rami ya tasowa a cikin gallbladder) ko kuma cholecystitis mai rikitarwa (wanda akwai kamuwa da cutar daga jikin kwayoyin cutar).
Magnetic Resonance Cholangiopancreatography (MRCP)
Wannan gwajin hoto ba tare da batawa ba zai bai wa likita damar nazarin bile ducts ciki da wajen hanta. Ana iya amfani da shi don ganewar asali dutse a cikin ƙwayar bile na kowa (yanayin da ake kira choledocholithiasis).
Endoscopic Retrograde Cholangiopancreatography (ERCP)
Kwayar ERCP duka na gwaji ne da kuma gwaji mai mahimmanci. A lokacin ERCP , wani likitan gastroenterologist (likita wanda ke kwarewa a cikin tsarin cututtukan kwayoyin halitta) zai sanya kyamara mai sauƙi, mai sauƙi wanda ake kira endoscope a cikin bakin mutum, ƙasa da esophagus, baya da ciki, da kuma cikin ƙananan hanji.
Wani mutum yana raguwa a lokacin wannan hanya don haka babu rashin jin daɗi. Sa'an nan kuma, ta hanyar ƙarshen katako, ƙananan ƙaramin motsi ya shigo cikin ƙauye na bile. An yi wa ƙwayar haɗin gilashi cikin ƙananan ƙwayar don yalwata tsarin tsarin bile, wanda za'a iya gani ta hanyar hasken rana.
Daga wani ERCP, ana iya ganin fuskar da aka cire a biranen lokaci guda. Za a iya ganin nauyin bile ducts tare da ERCP, kuma za'a iya sanya wani sutura don ci gaba da bude duct. A ƙarshe, a lokacin ERCP, likita na iya ɗaukar samfurin nama (wanda ake kira biopsy) na kowane polyps ko masanan.
Binciken Bambanci
Yayinda yake da hankali don tsammanin cututtukan gallbladder idan mutum yana fama da ciwo a cikin ƙananan ƙananan ɓangaren ƙwayar su, dole ne a yi la'akari da sauran ilimin daji (mafi yawan matsalolin hanta). Wannan shi ne saboda hanta ɗinku kuma yana samuwa a saman gefen dama na ciki kuma an haɗa shi zuwa gallbladder ta hanyar jerin biliary ducts.
Misalan matsalolin hanta wanda zai haifar da ciwo a gefen dama na ciki ciki har da:
- Hepatitis (alal misali, hepatitis na bidiyo) : Bayan ciwo, wasu alamun bayyanar cutar hepatitis na iya haɗawa da jaundice, launin launi , da duhu.
- Fitz-Hugh-Curtis Syndrome (perihepatitis): Wannan cuta tana nufin ƙonewa daga cikin hanta da ke faruwa a cikin matan da ke fama da cututtukan ƙwayoyin ƙwayoyin cuta.
- Rashin ƙugiya: Mutane da ke fama da ciwon sukari, waɗanda suka shafe hawan hanta, ko waɗanda suke da hanta mai haɗari, gallbladder, ko kuma pancreatic cuta sun fi yawan haɗarin tasowa.
- Magungunan fili na Portal: Wannan cuta tana nufin jini a cikin tashar portal, wanda shine jini wanda yake ɗauke da jini ga hanta daga hanji.
- Cutar cutar Budd-Chiari: Wannan ciwo ne mai wuya wanda yakan faru yayin da ake hana rikici da ɓoye hanta.
Baya ga ciwo a gefen dama na ciki, mutumin da ke fama da cututtukan cuta zai iya sha wahala a cikin tsakiyar yankin na ciki (wanda ake kira ciwon zuciya).
Wasu mawuyacin haddasa mummunan ciwo sun hada da:
- Cutar cututtuka na Gastroesophageal (GERD): Bugu da ƙari ga ciwo mai tsanani, mutumin da ke tare da GERD zai iya lura da ƙwannafi da matsalolin da suke haɗuwa.
- Cututtukan cututtuka na cututtuka: Wannan yanayin yana bayyana ƙurar da ke ci gaba a kan rufin ciki ko ɓangare na ƙananan hanji. Jin zafi ciwon ciki shine mafi yawan alamu.
- Gastritis: Wannan yanayin yana nufin ƙonewa na ciki ciki kuma yana iya haifar da wasu dalilai daban-daban kamar barasa, anti-inflammatories, ko cutar.
- Pancreatitis: Mutane tare da pancreatitis sau da yawa shawo kan kwatsam, mai tsanani epigastric ko hagu-gefe ciwon da cewa radiates zuwa ga baya da kuma hade da tashin hankali da vomiting.
- Zuciyar Zuciya (cututtukan zuciya): Raunin ciwo zai iya zama alama ta farko na ciwon zuciya . Mai yiwuwa mutum yana da gajeren numfashi na ƙwayoyin cuta da na zuciya.
> Sources:
> Ibrahim S, Rivero HG, Erlikh IV, Griffith LF, Kondamudi VK. Gudanar da miki da kuma rashin kulawa da gallstones. > Likita Am Am Fam . 2014 Mayu 15, 89 (10): 795-802.
> Cibiyar Ciwon Ƙwayar Yammacin Amirka. (2016). Yaya Yayinda Gallbladder Ciwon Cutar ta gano?
> Sanders G, Kingsnorth AN. Binciken Clinical: Gallstones. > BMJ . 2007 Aug 11; 335 (7614): 295-99.
> Zakko SF, Afdhal NH. (2016). Ƙananan cholecystitis: Pathogenesis, siffofin asibiti, da kuma ganewar asali. Chopra S, (ed). UptoDate, Waltham, MA: UpToDate Inc.