Welina mai, e ka hoa hoʻohana pūnaewele, i ka blog olakino pale. Mai ka manaʻo o ka ʻōnaehana hoʻoheheʻe, hoʻomaka pololei mākou me ke kumuhana: ʻo ka Courvoisier's gallbladder weliweli, i ʻike ʻia hoʻi ʻo Courvoisier-Terrier syndrome, he maʻi lapaʻau ia i hōʻike ʻia e ka hoʻonui ʻana o ka gallbladder, ka jaundice o ke kumu mechanical, a me nā ʻōpala i hoʻololi ʻia ke kala.
Ua wehewehe mua ʻia e Courvoisier lāua ʻo Terrier ma mua o 120 mau makahiki i hala aku nei a ua hoʻokumu ʻia e ka keakea o ka ampulla o Vater ma muli o kahi neoplasm a i ʻole kahi pōhaku i loko o ka ʻauwai bile i ʻike ʻia ʻo ke ʻauwai bile maʻamau ma kona ʻāpana hope loa.
Ma kēia ʻatikala e ʻimi mākou i nā kumu, nā hōʻailona, ka hōʻailona a me nā koho lapaʻau o ka maʻi Courvoisier, a me nā ʻano like ʻole o ka hōʻailona Courvoisier a me kāna hōʻailona nui, ka hoʻonui ʻia o ka gallbladder i ʻike ʻia ma o ka ʻili.
No laila, ʻo ka pilikia "i kākau ʻia e nā kānaka, no nā kānaka" A e luʻu hohonu kākou i loko o ke ao nei o ʻO ka ʻōpū o Courvoisier a e aʻo kākou e ʻike a e ʻimi i ke kōkua e mālama pono ai i kēia maʻi.
ʻO ka ʻōpū hoʻohoka o Courvoisier
He maʻi laha ʻole ka ʻōpū o Courvoisier akā he hopena koʻikoʻi ia e hiki ke loaʻa nā hopena koʻikoʻi i ke olakino. ʻIke pinepine ʻia ia i nā poʻe o ma waena o 45 a 55 mau makahiki a hana ʻia me kahi alapine haʻahaʻa, akā, ʻaʻole pono e hoʻowahāwahā ʻia kona alo ma muli o ka hoʻonui ʻia ʻana o ka gallbladder i hoʻokumu ʻia e ka ālai ʻana o ka biliary.
Hiki ke ʻokoʻa nā kumu o ke kūlana mai kēlā me kēia mea maʻi a kēia mea maʻi, ʻo ka mea maʻamau ka ālai ʻia ʻana o ke ala bile nui a i ʻole ke ala bile maʻamau ma muli o nā pōhaku gallstones, pancreatitis, a i ʻole ke kanesa pancreatic.
ʻO nā hōʻailona maʻamau e komo pū me ka ʻeha o ka ʻōpū, ka nausea a me ka luaʻi ʻana a i ʻole ka hoʻonui ʻia o ka palupalu ma ka ʻōpū ʻākau o luna, ke kuni, ka jaundice, a me ka ʻili maneʻo. Inā ʻaʻole mālama ʻia, hiki i ke kūlana ke alakaʻi i nā pilikia e like me ka maʻi ʻino, hiki ke hopena i ka septic shock a i ʻole ka make.
He mea nui e ʻike i nā hōʻailona kūpono a e ʻimi koke i ke kōkua lapaʻau ma nā haukapila a i ʻole nā keʻena lapaʻau i loko o ka ʻōnaehana mālama ola. lehulehu a pilikino pahaMa muli o ka wahi honua o ke kanaka, inā loaʻa kekahi o kēia mau hōʻailona, he mea nui ka ʻike mua ʻana a me ka mālama ʻana no ka hoʻokele pono ʻana i ka maʻi; akā naʻe, paʻakikī ka ʻike ʻana ma muli o ka hui pū ʻana o nā hōʻailona me nā maʻi ʻē aʻe.
He aha ka maʻi Courvoisier?
ʻO ka maʻi o ʻO Courvoisier-Terrier He maʻi laha ʻole ia e hoʻopilikia ana i ka ʻōpū puʻuwai Ua ʻike ʻia ʻo ia e kahi ʻōkana i hoʻolōʻihi ʻia a hiki ke paʻi ʻia. Ua hoʻopaʻa mua ʻia ma mua o hoʻokahi kenekulia i hala aku nei e nā kauka Farani ʻelua ʻo Courvoisier lāua ʻo Terrier.
Hoʻokumu ʻia kēia syndrome e kahi ke ālai ʻia ʻana o ka ampulla o VaterHoʻokumu ʻia kēia ālai ʻia e ka ulu ʻana o ka neoplastic a i ʻole kahi pōhaku gall. Hoʻoulu ia i ka hōʻiliʻili ʻana o ka bile i loko o ke kahawai bile. ʻōpū puʻuwai, e hoʻonui ai a hiki ke ʻike ʻia ma ka ʻaoʻao ʻākau o luna o ka paia ʻōpū ma kou wahi.
ʻOiai ʻōpū puʻuwai ua hoʻonui ʻia a hiki ke ʻike ʻia Hoʻohanau ʻoi aku ka maopopo o ka syndrome o ʻO Courvoisier-TerrierHiki ke ʻike ʻia nā hōʻailona ʻē aʻe, e like me ka ʻeha ma ka ʻōpū ʻākau o luna, nā ʻōpala i hoʻololi ʻia ke kala, a me ka jaundice mechanical.
Hiki ke huikau kēia mau hōʻailona me nā hōʻailona o nā maʻi o ka ʻōpū ʻōpū puʻuwaie like me ka cholecystitis, kahi mumū o ka gallbladder, e pono ai kahi hōʻoia pololei a me ka manawa kūpono.
No ka ʻike ʻana i ka maʻi o ka syndrome Courvoisier-ʻO Terrier, he loiloi o ka mōʻaukala lapaʻau, kahi hoʻokolokolo kino piha me ka hoʻoikaika ʻana i ka ʻōpū, a me nā hoʻokolohua kiʻi e like me ka ultrasound, computed tomography (CT) scan, a me ka magnetic resonance imaging (MRI) he mea pono. E hoʻoholo kēia mau hoʻokolohua i ka ke kumu o ke ālai ʻana a me ka nui o ka pōʻino i loko o ka ʻōpū puʻuwai a me nā ʻōkana ʻē aʻe.
ʻO ka mālama ʻana no kēia kūlana e pili ana i ka wehe ʻoki ʻana i ka ʻōpū puʻuwai, me ka wehe ʻana i nā pōhaku mai ke kahawai bile nui a i ʻole ke kahawai bile maʻamau a me ka chemoradiation no nā pilikia neoplastic.
Nā kumu o ka maʻi Courvoisier
ʻO ka maʻi o Courvoisier He maʻi lapaʻau laha ʻole ia i hoʻokumu ʻia e ka pale ʻia ʻana o ka ampulla o Vater e kahi neoplasm a i ʻole kahi pōhaku gall obstructive i loko o ka ampulla o Vater.
ʻO kēia maʻi, i ʻike mua ʻia e Courvoisier a me Terrier, ua hōʻike ʻia e ka hoʻonui ʻia ʻana o ʻōpū puʻuwaiʻO ka jaundice mechanical a me nā ʻōpala i hoʻololi ʻia ke kala. Ke ālai ʻia nā ala bile, kahe ka bilirubin i loko o ke kahe koko, e hana ana i ka jaundice (melemele o ka ʻili a me nā keʻokeʻo o nā maka a ukali ʻia e ka maneʻo).
ʻO kahi hōʻailona waena o ka syndrome Courvoisier He ʻōpū puʻuwai he puʻupuʻu i hoʻonui ʻia e hiki ke ʻike ʻia ma o ka ʻili, a ʻo nā hōʻailona ʻē aʻe e komo pū me ka jaundice. Nā ʻano like ʻole o ka hōʻailona o Courvoisier Hiki paha ke kumu o ka carcinoma o ka ampulla a i ʻole ke ālai ʻia ʻana o ke kahawai hepatic maʻamau, akā ʻo ka maʻamau, ʻo ia ke ʻano o nā pōhaku gall.
Aia kekahi mau kumu o ka syndrome CourvoisierʻO ke kumu maʻamau ka pale ʻana o nā ʻauwai bile e nā pōhaku gall. Hoʻokumu ʻia kēia mau waihona liʻiliʻi e like me ka ʻiliʻili i loko o ka ʻōpū puʻuwaia hiki ke hoʻoulu i ka maʻi, ka ʻeha, a me ke ālai ʻia ʻana o nā ʻauwai bile.
Nā kumu ʻē aʻe o ka syndrome Courvoisier Hiki i kēia ke lilo i mau puʻupuʻu i loko o ka pancreas, ka ʻōpū puʻuwai a i ʻole nā auwai bile, kahi e hiki ke keakea i ke kahe o ka bile i loko o ka ʻōpū liʻiliʻi no ka ʻeli ʻana o nā momona i ka meaʻai.
I kekahi mau kūlana, ʻo ka cholangitis, kahi mumū a me ka maʻi o nā ʻauwai bile, ke kumu o ka maʻi. No laila, he mea nui e ʻike i ke kumu o ka syndrome. Courvoisier e hoʻolako i ka tratamiento kūpono a pale aku i nā pilikia.
Nā hōʻailona o ka maʻi Courvoisier
ʻO ka maʻi o Courvoisier, kahi maʻi lapaʻau kakaikahi, hōʻike nui ʻia e ka hoʻonui ʻia ʻana o ʻōpū puʻuwai, hiki ke ʻike ʻia e ka palpation o waho.
ʻO ka maʻamau, ʻaʻohe ʻeha o kēia pehu a ʻaʻole hoʻi e mumū, ʻaʻole e like me nā maʻi biliary ʻē aʻe. Pehea e hana ai ka ʻōpū ʻōpū acalculous me ka paia lahilahi?Eia kekahi, ʻike pinepine ʻia ka jaundice, kahi e hoʻoulu ai i ka melemele o ka ʻili a me nā maka ma muli o ka hōʻiliʻili ʻana o ka bilirubin.
A laila, hiki ke loli ke ʻano o ka ʻōpala, e lilo ana i kala keʻokeʻo a hina paha ma muli o ka lawa ʻole o ka bile e hiki ai i ka ʻōpū. Hiki i kēia nele o ka bile ke alakaʻi i nā mea ʻē aʻe nā hōʻailonaʻeha He mea maʻamau nā hōʻailona o ka ʻōpū, e like me ka pehu ʻana, ka ʻōpū, a me ka dyspepsia. ʻO ka luaʻi, ka luaʻi ʻana, a me ka ʻeha o ka ʻōpū kekahi mau hōʻailona pinepine e hele pū me ka maʻi. ʻōpū puʻuwai.
I kekahi manawa, ʻike ʻia kahi ʻano like ʻole o ka hōʻailona Courvoisier ma muli o nā puʻupuʻu ʻino e ālai ana i nā ala bile. Hiki ke hele pū ʻia kēia ʻano me nā hōʻailona ʻē aʻe, e like me ka pohō kaumaha, ka nalowale o ka makemake, a me ka luhi.
Hiki ke ʻike ʻia ka hoʻonui ʻia ʻana o ke akepaʻa a me nā lymph nodes ma muli o ka laha ʻana o nā hunaola kanesa ma loko o ka ʻōnaehana biliary a me ka digestive, ʻo ia ke komo ʻana me kāna mau hōʻike digestive.
He mea nui e hoʻomaopopo i ka Hōʻailona y nā hōʻailonaʻeha o ka maʻi o Courvoisier ʻOkoʻa lākou mai kēlā kanaka a i kēia kanaka. Hiki i kekahi ke ʻike i nā hōʻailona āpau, aʻo kekahi e ʻike wale i kekahi mau hōʻailona. No laila, inā ʻoe e ʻike i kekahi o kēia mau mea nā hōʻailonaʻehaHe mea nui e ʻimi koke ʻoe i ke kōkua lapaʻau. He hōʻailona a me kahi tratamiento He mea nui nā hana wikiwiki no ka hoʻokō ʻana i nā hopena maikaʻi a me ka pale ʻana i nā pilikia.
ʻIke ʻia ka maʻi Courvoisier
He mea nui ka loiloi pono ʻana i ka mōʻaukala olakino o ka mea maʻi, ka hoʻokolokolo kino, a me nā hoʻokolohua hoʻokolohua no kālailai el ʻO ka maʻi CourvoisierHiki i ka mōʻaukala lapaʻau ke hōʻike i kahi mōʻaukala mua o nā gallstones a i ʻole ka mumū biliary. Eia kekahi, palpation o kahi ʻōpū puʻuwai ʻawaʻawa hoʻonui ʻia He hōʻailona ia o ka maʻi.
ka hoʻokolohua hōʻoia Hiki paha iā lākou ke hōʻike i nā pae kiʻekiʻe o nā enzymes ate a me bilirubin, he hōʻailona ia o ka jaundice obstructive. Hiki i nā ʻano hana kiʻi e like me ka ultrasound, computed tomography, a i ʻole magnetic resonance imaging ke hōʻoia i ka hōʻailona a kuhikuhi i ke kumu kumu.
I kekahi manawa, he biopsy No ka hoʻoholo ʻana i ke kumu o ke ālai ʻana, inā he ʻano maikaʻi ʻole a ʻano ʻino paha, hana ʻia kahi biopsy. Pili kēia i ka unuhi ʻana i kahi hāpana ʻiʻo mai ke kahawai bile a i ʻole ka pancreas me ka hoʻohana ʻana i kahi nila i alakaʻi ʻia e ke kiʻi.
Hiki nō hoʻi ke hoʻohana ʻia ka hoʻāʻo ʻana o ka cholangiopancreatography retrograde endoscopic (ERCP) e nānā i nā ʻauwai bile a loaʻa nā laʻana o nā ʻiʻo. ʻO kēia ʻano hana e pili ana i ka hoʻokomo ʻana i kahi endoscope ma o ka waha i loko o ka ʻōpū a me ka duodenum, a laila e hiki ai i nā ʻauwai bile.
He mea nui e hoʻomaopopo i ka maʻi e wehewehe ana i ke ʻano o ka syndrome. Courvoisier o nā maʻi ʻē aʻe e hoʻoulu ai i nā hōʻailona like, e like me ka hepatitis, pancreatitis, a i ʻole cholecystitis acute. He mea nui ka loiloi piha ʻana i ka mōʻaukala olakino o ka mea maʻi a me nā hōʻailona no ka ʻike pololei.
ʻO ka hōʻailona a me ka tratamiento nā hana kūpono no ka syndrome Courvoisier mea nui no pale i nā pilikia e like me Sepsis, maʻi, a i ʻole ka hāʻule ʻana o ke akepaʻa. No laila, inā ʻike ʻia kekahi mau hōʻailona e hōʻike ana i ke alo o ka maʻi, pono e ʻimi koke i ke kōkua lapaʻau.
Ka mālama ʻana i ka maʻi Courvoisier
No ka mālama ʻana i ka syndrome o Courvoisier He mea pono e hoʻouka i ke kumu o ka pilikia. ka hoʻāʻo ʻana o ka cholangiopancreatography retrograde endoscopic ʻO ERCP kahi koho kūpono no ka wehe ʻana i kahi pōhaku bile duct, ʻoiai e pono paha ke ʻoki ʻana e wehe i kahi puʻupuʻu e kumu ai ke ālai ʻana.
Eia kekahi, hiki ke hoʻohana ʻia ka chemotherapy a i ʻole ka radiation therapy e hoʻēmi i ka puʻupuʻu ma mua o ke ʻoki ʻana a i ʻole e hoʻopau i nā hunaola kanesa i koe ma hope o ke ʻoki ʻana.
La ka hoʻopau ʻana i ke cholecyst, a i ʻole ka wehe ʻana o ka nā ʻiʻo biliaryʻO kēia kekahi lāʻau lapaʻau kūpono. Hiki ke hana ʻia kēia kaʻina hana me ka hoʻohana ʻana i ʻoki kino hāmama kuʻuna a i ʻole ke ʻoki laparoscopicʻOi aku ka liʻiliʻi o nā ʻoki e pono ai no kēia kaʻina hana a ʻoi aku ka wikiwiki o ka manawa hoʻōla. Inā he moʻolelo ko ka mea maʻi no nā pōhaku gallstone a i ʻole kahi gallbladder i hoʻonui ʻia e hoʻoulu ai i ka ʻeha, hiki ke ʻōlelo ʻia he cholecystectomy.
Ke mālama ʻia ka syndrome CourvoisierPono paha ka mea maʻi e hoʻololi i ko lākou nohona e pale aku ai i ka hoʻi hou ʻana. Hiki i kēia ke komo pū me ka mālama ʻana i kahi kaumaha olakino, ka pale ʻana i nā meaʻai palai a me nā mea momona, a me ka noho wai pono ʻana. He mea nui hoʻi e hele i nā manawa hoʻopaʻa maʻamau me kahi loea mālama ola e ʻike i nā hoʻi hou ʻana a i ʻole nā pilikia.
Hiki i nā lāʻau lapaʻau hoʻohui ke kōkua i nā maʻi me ka syndrome CourvoisierHiki i ka Acupuncture a i ʻole ka noʻonoʻo ʻana ke kōkua i ka hoʻokele ʻana i nā hōʻailona a hoʻolaha i ka maikaʻi holoʻokoʻa; akā naʻe, pono e hoʻohana ʻia kēia mau koho me nā lāʻau ʻē aʻe. tratamiento kauka maʻamau. He mea nui e kamaʻilio nā mea maʻi me kā lākou loea mālama ola e pili ana i kekahi lāʻau lapaʻau hoʻopihapiha ma mua o ka hoʻomaka ʻana.
ka hopena
I ka hopena me nā kumu koʻikoʻi loa, He maʻi kakaikahi akā koʻikoʻi ka maʻi Courvoisier ka mea e hoʻonui ai i ka ʻōpū ʻōpū puʻuwaiʻO ka jaundice mechanical a me nā ʻōpala i hoʻololi ʻia ke kala. Hoʻokumu ʻia ia e ka pale ʻana o ka ampulla o Vater e kahi neoplasm a i ʻole kahi pōhaku bile duct.
Ua wehewehe ʻia e Courvoisier A ʻoiai ua ʻike ʻia ʻo Terrier i 120 mau makahiki i hala aku nei, pili mau kēia kūlana i kēia lā. ʻO ka hōʻailona nui he ka hoʻonui ʻia ʻana o ka gallbladder hiki ke ʻike ʻia ma o ka ʻili, a hiki nō hoʻi ke hana i ka jaundice.
ʻOiai ʻaʻohe lāʻau lapaʻau paʻa no ka syndrome Courvoisier, ka ʻike mua a me kahi tratamiento Hiki i ka lāʻau kūpono ke alakaʻi i nā hopena maikaʻi aʻe. No laila, he mea nui e ʻimi i ke kōkua lapaʻau inā loaʻa iā ʻoe kekahi o kēia mau mea: nā hōʻailonaʻeha pili i kēia maʻi.
ʻO kēia ka manawa kūpono loa e kaʻana like i ka ʻike olakino pale ma nā pāpili kaiapili, e ʻae ana iā ia e hōʻea i nā poʻe hou aʻe ma ka honua holoʻokoʻa a kōkua i ka hōʻemi ʻana i ka nui o nā pilikia i hōʻike ʻia ma nā helu helu anu. Mahalo no kou waiho ʻana i kāu manaʻo no ka poʻe hoʻolohe kūpaʻa o ka blog. A hui hou kākou ma ka pou ʻike aʻe!
Kauka Jorge Delgado, Kauka Lapaʻau. ʻO ka ʻōpū hoʻopūhoihoi o Courvoisier.