Duwatsu masu tsakuwa

Duwatsun tsakuwa wasu matsaloli ne masu wahala a ciki wadanda suke samarda cikin gallbladder. Waɗannan na iya zama kaɗan kamar ƙwayar yashi ko girma kamar kwallon golf.

Dalilin gallstones ya bambanta. Akwai manyan nau'ikan duwatsu biyu:

• Duwatsu da aka yi da ƙwayar cholesterol - Wannan shine nau'in da aka fi sani. Gastal gallstones ba su da dangantaka da matakin ƙwayar cholesterol a cikin jini. A mafi yawan lokuta, ba za a iya ganinsu akan sikan CT ba.
• Duwatsu da aka yi da bilirubin - Waɗannan ana kiransu duwatsun launuka. Suna faruwa ne lokacinda aka lalata jajayen kwayoyin jini kuma yawan bilirubin yana cikin bile.

Duwatsun gall sun fi yawa a:

• Jima'i mace
• 'Yan Asalin Amurkawa da mutanen asalinsa na Hispanic
• Mutanen da suka wuce shekaru 40
• Mutanen da suke da kiba
• Mutane tare da tarihin dangin gall

Abubuwan da ke gaba suna ba ku damar haɓaka duwatsun gall:

• Kashin kashin jini ko dasasshen gabobin jiki
• Ciwon suga
• Rashin gallbladder ya zubar da bile da kyau (wannan yana iya faruwa yayin ciki)
• Ciwan hanta da cututtukan biliary (duwatsu masu launi)
• Yanayin lafiya da ke haifar da jan jini da yawa don halakarwa
• Rage nauyi mai sauri daga cin abinci mai karancin kalori, ko kuma bayan tiyatar asarar nauyi
• Samun abinci mai gina jiki ta wata jijiya na dogon lokaci (ciyarwar ciki)
• Shan kwayoyin hana daukar ciki

Mutane da yawa da ke da duwatsun gall ba su da wata alama. Wadannan galibi ana samun su yayin x-ray na yau da kullun, tiyatar ciki, ko wasu hanyoyin likita.

Koyaya, idan babban dutse ya toshe bututu ko bututun da ke malale mafitsara, ƙila ku sami ciwo mai tauri a tsakiyar zuwa saman babba na dama. Wannan an san shi da biliary colic. Ciwon yakan tafi idan dutsen ya shiga cikin ɓangaren farko na ƙaramar hanji.

Kwayar cutar da ka iya faruwa sun hada da:

• Jin zafi a cikin babba dama ko tsakiyar babba na aƙalla aƙalla mintuna 30. Ciwo na iya zama na kullum ko naƙura. Yana iya jin kaifi ko mara dadi.
• Zazzaɓi.
• Raunin fata da fararen idanu (jaundice).

Sauran cututtuka na iya haɗawa da:

• Kujerun kala-kala
• Tashin zuciya da amai

Gwaje-gwajen da aka yi amfani dasu don gano gallstall ko kumburin gallbladder sun hada da:

• Duban dan tayi, ciki
• CT scan, ciki
• Endoscopic retrograde cholangiopancreatography (ERCP)
• Gallbladder radionuclide scan
• Endoscopic duban dan tayi
• Magnetic rawa cholangiopancreatography (MRCP)
• Ercwararren ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwa (PTCA)

Mai ba ku kiwon lafiya na iya yin oda da gwaje-gwajen jini masu zuwa:

• Bilirubin
• Gwajin aikin hanta
• Kammala lissafin jini
• Enzyme na Pancreatic

Tiyata

Yawancin lokaci, ba a buƙatar tiyata sai dai in bayyanar cututtuka ta fara. Koyaya, mutanen da ke shirin yin tiyatar asarar nauyi na iya buƙatar cire duwatsun gall kafin aiwatar da aikin. Gabaɗaya, mutanen da ke da alamun cutar za su buƙaci tiyata nan da nan ko kuma jim kaɗan bayan an samo dutsen.

• Ana amfani da wata dabara da ake kira laparoscopic cholecystectomy. Wannan aikin yana amfani da ƙananan raɗaɗɗen tiyata, wanda ke ba da damar saurin warkewa. Mai haƙuri zai iya zuwa gida sau da yawa daga asibiti cikin kwana 1 na tiyata.
• A baya, yawanci ana yin bude kwaleji (cire gallbladder). Koyaya, wannan ƙirar ba ta da yawa a yanzu.

Endoscopic retrograde cholangiopancreatography (ERCP) da kuma hanyar da ake kira sphincterotomy za a iya yi don nemo ko magance gallstones a cikin bile duct gama gari.

MAGUNGUNA

Za a iya ba da magunguna a cikin nau'in kwaya don narke duwatsun ƙwayar cholesterol. Koyaya, waɗannan kwayoyi na iya ɗaukar shekaru 2 ko fiye da haka don aiki, kuma duwatsun na iya dawowa bayan ƙarewar jiyya.

Ba da daɗewa ba, ana shigar da sinadarai cikin gallbladder ta cikin catheter. Sinadarin yana saurin narkar da duwatsun cholesterol. Wannan maganin yana da wahalar aiwatarwa, saboda haka ba a yin shi sau da yawa. Sinadaran da aka yi amfani da su na iya zama masu guba, kuma duwatsun gall na iya dawowa.

LITTAFIN

Har ila yau, an yi amfani da gigice lithotripsy (ESWL) na gallbladder ga mutanen da ba za su iya yin tiyata ba. Ba a amfani da wannan maganin kamar sau ɗaya saboda sau da yawa gallon yakan dawo.

Wataƙila kuna buƙatar kasancewa a cikin abincin ruwa ko ɗauki wasu matakai don ba wa mafitsara hutu bayan an yi muku magani. Mai ba ku sabis zai ba ku umarni lokacin da kuka bar asibiti.

Samun alamun bayyanar cututtuka ko rikitarwa daga aikin tiyatar gall yana da ƙasa. Kusan dukkan mutanen da suka yi aikin tiyatar gall ba su da alamun bayyanar su.

Katangewa daga duwatsun gall na iya haifar da kumburi ko kamuwa da cuta a cikin:

• Gallbladder (cholecystitis)
• Bututun da ke ɗauke da bile daga hanta zuwa mafitsara da hanji (cholangitis)
• Pancreas (pancreatitis)

Kira mai ba ku sabis idan kuna da:

• Jin zafi a ɓangaren sama na ciki
• Raunin fata ko fararen idanu

A cikin yawancin mutane, ba za a iya hana duwatsun gall ba. A cikin mutanen da ke da kiba, guje wa saurin hasara na iya taimaka wa hana gallstones.

Cholelithiasis; Harin mafitsara; Biliary colic; Harin tsakuwa; Biliary calculus: gallstones chenodeoxycholic acid (CDCA); Ursodeoxycholic acid (UDCA, ursodiol); Endoscopic retrograde cholangiopancreatography (ERCP) - duwatsu masu daraja

• Cirewar ciki ta mafitsara - laparoscopic - fitarwa
• Cirewar gwal - buɗe - fitarwa
• Duwatsun tsakuwa - fitarwa

• Tsarin narkewa
• Cwayar koda tare da duwatsu masu duwatsu - CT scan
• Gallstones, cholangiogram
• Cholecystolithiasis
• Cholelithiasis
• Ruwan kwalliya
• Cire Gallbladder - Jerin

Fogel EL, Sherman S. Cututtuka na gallbladder da bile ducts. A cikin: Goldman L, Schafer AI, eds. Magungunan Goldman-Cecil. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016: babi na 155.

Jackson PG, Evans SRT. Biliary tsarin. A cikin: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Littafin Sabiston na tiyata. 20th ed. Philadelphia, PA: Elsevier; 2017: babi na 54.

Wang D QH, Afdhal NH. Ciwon tsakuwa. A cikin: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger da cututtukan hanta da cutar Fordtran: Pathophysiology / Diagnosis / Management. 10 ed. Philadelphia, PA: Elsevier Saunders; 2016: babi na 65.