chiwindi abscess

Kodi abscess pachiwindi ndi chiyani

Chiwindi abscess ndi chotupa chodzazidwa ndi mafinya. Kutupa kwa chiwindi kumatha kuchitika mwa aliyense. Payokha, sikuyika moyo pachiwopsezo, chifukwa mafinya amatsekedwa ndikulekanitsidwa ndi minofu yonse. Koma zitha kukhala zowopsa ngati kapisoziyo ikatsegulidwa ndipo zomwe zili mkatimo zimatuluka. Zitha kuchitika mwadzidzidzi, chifukwa chake muyenera kufunsa dokotala nthawi zonse.

Ngati chiphuphu pachiwindi chikapezeka msanga, nthawi zambiri chimachiritsika. Popanda chithandizo, imatha kuphulika ndikufalitsa matendawa, zomwe zimayambitsa sepsis, matenda owopsa a magazi a bakiteriya.

Zimayambitsa chiwindi abscess akuluakulu

Pali zifukwa ziwiri zazikulu zomwe zingakhumudwitse abscess pachiwindi.

Zopatsirana:

• matenda a bakiteriya mu biliary thirakiti;
• matenda a bakiteriya a pamimba pamimba kugwirizana ndi appendicitis, diverticulitis, kapena matumbo perforation;
• matenda a m'magazi;
• Entamoeba histolytica matenda (chamoyo chomwe chimayambitsanso kamwazi ya amoebic - imatha kufalikira kudzera m'madzi kapena kukhudzana ndi munthu ndi munthu).

Zowopsa:

• endoscopy ya bile ducts ndi ducts;
• nkhonya, ngozi;
• kugwa kwa moyo.

Palinso zinthu zomwe zimachulukitsa chiwopsezo chokhala ndi abscess pachiwindi:

• Matenda a Crohn;
• shuga;
• ukalamba;
• mowa;
• kuwonongeka kwa chitetezo cha mthupi chifukwa cha zinthu monga HIV kapena Edzi, komanso ma immunodeficiencies ena, kugwiritsa ntchito corticosteroid, kuika ziwalo, kapena chithandizo cha khansa;
• kusadya bwino;
• kupita kumadera omwe matenda a amoebic amapezeka kwambiri.

Zizindikiro za abscess pachiwindi akuluakulu

Zizindikiro zazikulu za chiphuphu cha chiwindi ndi zodandaula nazo zimasiyana, koma nthawi zambiri zimaphatikizapo kuphatikiza kwa zizindikiro:

• kupweteka m'mimba (makamaka kumtunda kumtunda kwa mimba kapena pansi pa nthiti);
• matope amtundu wadongo kapena imvi, zonyansa;
• mkodzo wamdima;
• chikasu pakhungu ndi maso oyera (jaundice);
• kutsegula m'mimba;
• kutentha thupi kapena kuzizira;
• kupweteka pamodzi;
• nseru ndi kusanza kapena popanda;
• kusowa chilakolako;
• kuwonda kosadziwika;
• malaise kapena ulesi;
• thukuta.

Nthawi zina, chiphuphu m'chiwindi chikhoza kukhala choopsa kwambiri. Imbani XNUMX nthawi yomweyo ngati wodwala ali ndi izi:

• kusintha kwadzidzidzi m’makhalidwe, monga ngati kusokonezeka maganizo, kunjenjemera, kulefuka, kuona zilubwelubwe, ndi kumutu;
• kutentha kwakukulu (pamwamba pa 38 ° C);
• kutopa kapena kutopa;
• kuthamanga kwa mtima (tachycardia);
• mavuto opuma monga kupuma movutikira, vuto kapena kulephera kupuma, kupuma movutikira kapena kutsamwitsidwa;
• ululu wamphamvu;
• kusanza.

Chithandizo cha chiwindi abscess akuluakulu

Matendawa amatsimikiziridwa ngati pali cystic kapena madera olimba m'chiwindi, kumene purulent madzimadzi okhala ndi zikhalidwe zabwino amamasulidwa pamene zomwe zili mkati zimatengedwa. Ndikofunika kupeza mayeserowa mwamsanga ndikuyamba kulandira chithandizo chifukwa cha chiopsezo chachikulu cha zovuta.

Diagnostics

Pambuyo pofufuza ndi kusonkhanitsa anamnesis za momwe wodwalayo anadwala, mayesero angapo ayenera kuchitidwa. Choyamba, ichi ndi mayeso ambiri a magazi - ma enzymes a seramu omwe akuwonetsa ntchito ya chiwindi (alkaline phosphatase, ALT, AST), zikhalidwe zamagazi, nthawi ya prothrombin ndi nthawi yoyambira ya thromboplastin, kuyesa kwa seramu kwa ma antibodies ku Entamoeba histolytica,

Kuphatikiza apo, kusanthula kwa chopondapo kwa Entamoeba histolytica antigen kudzatengedwa ndikuyesa antigen kapena polymerase chain reaction (PCR) ya aspirated abscess fluid.

Amapanganso chiwindi cha ultrasound ndi computed tomography.

Mankhwala amakono

Kutupa kwa chiwindi kumathandizidwa ndi mankhwala onse komanso opaleshoni.

Maantibayotiki. Mankhwala osiyanasiyana amagwiritsidwa ntchito pochiza chiphuphu cha chiwindi. Kusankha kwawo kumadalira chikhalidwe cha matenda. Mankhwala akuluakulu:

• aminoglycosides monga amikacin (Amikin) kapena gentamicin (Garamycin);
• clindamycin (Cleocin);
• kuphatikiza kwa piperacillin-tazobactam (Zosin);
• Metronidazole (Flagyl).

Ngati ndi chiphuphu cha amoebic, matendawa akachira, wodwalayo amapatsidwa mankhwala ena kuti aphe amoeba m'matumbo kuti chiphuphucho chisabwerenso.

njira za opaleshoni. Iwo ndi osiyana, ndipo kusankha kumadalira mlingo wa kuwonongeka kwa chiwindi ndi kuopsa kwa mkhalidwe wa wodwalayo:

• kukhumba - pamenepa, mafinya amatulutsidwa ndi singano kudzera pamimba, zimachitika kangapo (kwa abscesses zosakwana 5 cm);
• ngalande - pamafunika kuyika catheter kuti ikhetse mafinya (pa chiphuphu choposa 5 cm).

Njira zonsezi ndi laparoscopic, zomwe zimachitika kudzera m'madulidwe ang'onoang'ono. Koma nthawi zina opaleshoni yotsegula imafunika peritonitis, zilonda zokhala ndi mipanda yokhuthala, zilonda zong'ambika, zotupa zazikulu zingapo, komanso njira zotulutsira madzi zomwe zidalephera kale.

Kupewa chiwindi abscess akuluakulu kunyumba

Sizingatheke nthawi zonse kupewa abscess pachiwindi. Komabe, nthawi zambiri, mutha kuchepetsa chiwopsezo chokhala ndi matenda popewa kudya kapena madzi omwe ali ndi kachilomboka, ndikuchepetsa kuyenda kumadera omwe matenda a amoebic ali ofala.

Mafunso ndi mayankho otchuka

Adayankha mafunso athu okhudza chiphuphu cha chiwindi gastroenterologist, hepatologist, katswiri wa zakudya Natalya Zavarzina.