Mhumbu: Kuongorora Kufananidza Kuenda | | El Paso, TX.

 

• Kuongororwa kwezvirwere zvemuviri kunogona kuiswa mu:
• Kuipa kweiyo utumbo turakiti (esophagus, mudumbu, diki & hombe ura, uye mupiro
• Kusagadzikana kwenhengo dzekugaya dzinowanikwa (Hepatobiliary & pancreatic kusagadzikana)
• Kusagadzikana kweiyo genitourinary & nhengo dzekubereka
• Kukanganiswa kwemuviri mudumbu nemidziyo mikuru
• Iyi mharidzo ine chinangwa chekupa ruzivo rwakanyanya rwevanhu vose kufungidzira imaging kuswedera pedyo uye kukodzera kukiriniki yekuchengetedza varwere vane zvirwere zvakanyanya zvemuviri
• Kufungidzira nzira dzakashandiswa panguva yekutsvakurudza kwezvipomha zvemuviri:
• AP mudumbu (Kub) uye CXR yakarurama
• Abdominal CT scanning (nemuromo uye IV kusiyana uye w / o kusiyana)
• Dzidzo yepamusoro nechezasi yeGI Barium
• Ultrasonography
• MRI (inoshandiswa seLiver MRI)
• MRI kuiswa uye enteroclysis
• MRI rectum
• Endoscopic Retrograde Cholangiopancreatography (ERCP) - kunyanya hepatobiliary uye pancreatic ductal pathology
• Nhoroondo ye nyukireya

Sei Kurayira Madzimai X-ray?

 

• Ivai nemuongorori wekutanga wegesi remuviri mumamiriro ekupedzisira. Semuenzaniso, kudzidza kwakashata mumurwere anononoka kunogona kukanganisa kudiwa kweTCT kana zvimwe zvinoparadzirwa
• Kuongororwa kwemashupu, marita, uye radiopaque kunze kwenyika
• Post-procedural evaluation intraperitoneal / retroperitoneal gas gasi
• Kuongorora kuwanda kwemagetsi emagu uye kusarudzwa kwe-postoperative (adynamic) ileus
• Kuongorora kutarisa kwepakati pemuviri
• Colonic transit zvidzidzo
• Kuchengeta renal calculi

 

 

Zvinofanira Kuziva pa AP Madzimai: Supine vs. Yakarurama vs. vs. Decubitus

• Mhepo Yerusununguko (pneumoperitoneum)
• Nhengo yekudzivirira: Kuvhara zvishongo: SBO vs LBO (3-6-9 mutemo) SB-kumusoro chikamu-3-cm, LB-kumusoro chikamu-6-cm, Caecum-upper-limit-9-cm. Cherechedza kurasikirwa kwehaustra, kunyora kuchera (kuvapo) kwevhirivule conivente (plica semilunaris) muSBO
• SBO: cherekedza makomo akasiyanasiyana emhepo-mvura pamatanho akatwasuka firimu nhanho manera - kutaridzika, kwakajairika kweSBO
• Cherechedza paucity ye rectal / colonic gas (yakabviswa) muSBO

 

 

• Abdominal CT scanning -hupenyu hunosarudzwa panguva yekutsvaga mheremhere yakaoma uye isingaperi yepamu kunyanya kune vanhu vakuru. Semuenzaniso, kumarara kwemuviri kunogona kuongororwa zvakajeka uye kugoverwa kupa ruzivo rwekliniki rwekugadzirira kuchengetedza
• Dumbu, renal uye pelvic ultrasound inogona kuitwa kubatsira kuongororwa kweappendicitis (esp. muvana), acute & chronic vascular pathology, hepatobiliary zvisizvo, obstetric uye gynecological pathology
• Kushandiswa kweionizing radiation (x-rays & CT) inofanirwa kudzikiswa muvana uye mamwe mapoka anotambura.

 

 

Kuongororwa Kufananidzirwa Kwemajeri Makuru Evanhukadzi

• 1) Matambudziko eEophageal
• 2) Gastric carcinoma
• 3) Gluten Sensitive Enteropathy
• 4) Chirwere Chirwere Chirwere
• 5) Pancreatic ductal adenocarcinoma
• 6) Colorectal carcinoma
• 7) Zvakakwana Appendicitis
• 8) Chidziro chechidiki
• 9) Volvulus

Esophageal disorders

• Achalasia (primary achalasia): kutadza kweakarongeka esophageal peristalsis d / t kukanganisika kwekuzorora kwepasi esophageal sphincter (LOS) ine yakamisikidzwa kuwedzerwa kwesophagus uye chikafu stasis. Kuvhiringidzwa kweiyo distal esophagus (kazhinji nekuda kwethumba) kwave kunzi "yechipiri achalasia" kana "pseudoachalasia." . Vagus neurons inogona zvakare kukanganiswa
• Primary: 30 -70s, M: F yakaenzana
• Chagas chirwere (Trypanosoma Cruzi hutachiona) nekuparadzwa kweMyenteric plexus neurons yeGI system (megacolon & esophagus)
• Zvisinei, mwoyo ndeye M / C nhengo yakakanganiswa
• Clinically: Dysphagia kune zvese zvakanyanyisa uye zvinodhaka, mukuenzanisa nedysphagia yezvinyorwa chete mumatambudziko e esophageal carcinoma. Kuora kwepfupa uye kudzokerazve. M / C mid esophageal squamous cell carcinoma munenge 5% pamusana pekutsamwa kusingaperi kwemucosa ne stasis yezvokudya uye zvinyorwa. Kupisa pneumonia kunogona kukura. Candida esophagitis
• Kufungidzira: Bird -beak pamusoro wepamusoro GI barium kumedza, yakasimudzwa esophagus, kurasikirwa kweperistalsis. Kuongorora kwekupedzisira kunokosha.
• Rx: zvakaoma. Calcium channel blockers (pfupi -term) Kuwedzera kwepneumatic, inoshanda mu85% yevarwere vane 3 -5% dambudziko rekubuda ropa / kupera. Botulinum jekisi yexikisi inongogumira chete. Mwedzi 12 pakurapa. Inogona kuvhara iyo submucosa inotungamirira kuwandu hwekukanganisa kwehupenyu panguva inotevera myotomy. Kuvhima myotomy (Heller myotomy)
• 10 -30% yevarwere vanoita gastroesophageal reflux (GERD)

 

 

• Presbyesophagus: yaishandiswa kurondedzera kuratidzwa kwekudzikira kwemota basa mune yekukwegura esophagus> 80-yo Nekuda kwekukanganisa kweiyo Reflex arc ine yakadzikira senzwi kune distension uye shanduko mune peristalsis.
• Varwere vangave vachinyunyuta dysphagia kana kurwadziwa kwepfuva, asi vazhinji vanoratidzika
• Diffuse / distal esophageal spasm (DES) iyo inonzi motility disorder yeeophagus iyo inogona kuonekwa semucheka wekona kana rosary bead yeopu pa swallowum swallow.
• 2% yemarwadzo asina cheputi chepfupa
• Manometry ndiyo yegoridhe-yakaenzana kuongororwa test.

 

• Zenker diverticulum (ZD) aka pharyngeal pouch
• Kubuda kwepamusoro kwehutano hwe hypopharynx, kunongowedzera kune wepamusoro esophageal sphincter, inozivikanwa seKillian dehiscence kana Killian triangle
• Varwere vane 60-80 yo uye vanopa ne dysphagia, regurgitation, halitosis, globus sensation
• Itai kunetseka nechishuvo nemapurmaria zvisiri izvo
• Varwere vanogona kuunganidza mishonga
• ZD- inonzi pseudodiverticulum kana kukwezva diverticulum inokonzerwa nekucheneswa kwe submucosa kuburikidza neKillian dehiscence, kugadzira ganda apo zvokudya nezvimwe zvirimo zvingawedzera.

 

• Mallory-Weiss syndrome inoreva mucosal uye submucosal misodzi yepalus oesophageal venous plexus inosangana nechisimba kugadzirisa / kurutsa uye kurongeka kwezvokudya zvechingwa zvinopikisana nechepasi. Zvinodhaka zvine ngozi chaiyo. Mhosva dziripo nemarwadzo asingatauri hematemesis. Mishonga inowanzosigira.
• Dx: Kufananidza kunobatsira zvishoma, asi kusiyana kweesophagram kunogona kuratidza mamwe mucosal misodzi yakazadzwa nemusiyano (pasi wekodzero chaiyo). CT kuongorora kunogona kubatsira kubvisa zvimwe zvikonzero zvekumusoro kweGI kubuda ropa

 

• Boerhaave syndrome: sophageal rupture yechipiri kune kurutsa kusimba
• Mharidzo: M> F, kurutsa, kurwadziwa kwepfupa, mediastinitis, septic mediastinum, pneumomediastinum, pneumothorax pleural effusion
• Munguva yakapfuura, yaigara ichiuraya
• Nzira dzinosanganisira kubviswa zvakasimba kwezvokudya zvine gastric zvikuru kunyanya nezvokudya zvakakura zvisingaverengeki apo sophagus inobvumirana zvakasimba kurwisana glottis yakavharwa ne 90% inowanikwa pamwe nechekumashure kwemashure enderolateral

 

• Hiatus hernias (HH): kunyoreswa kwemuviri zviri mukati kuburikidza ne-esophageal hiatus yechipfupa mumumvuri we thoracic.
• Varwere vakawanda vane HH havakwanisi kuverenga, uye ndeyekutsvaga kunowanzoitika. Zvisinei, zviratidzo zvinogona kusanganisira epigastric / chest pain, postpandial fullness, kushungurudza uye kurutsa
• Dzimwe nguva HH inonzi inofanana ne gastro-oesophageal reflux chirwere (GORD), asi pane kuwirirana kwakashata pakati pemamiriro maviri aya!
• 2-mhando: inotsvedza hiatus hernia 90% & rolling (paraoesophageal) hernia 10%. Iyo yekupedzisira inogona kudzipa inotungamira kune ischemia uye matambudziko.

 

• Esophageal Leiomyoma ndiye M / C benign esophageal neoplasm. Inowanzove yakakura asi isiri isina kudzivirira. Maviri emakumbo emakumbo (GIST) ndiwo anonyanya kuonekwa mumutumbi. Inofanira kusiyaniswa kubva kuEsophageal carcinomas.
• Kufananidza: Kusiyana esophagram, GI yepamusoro yeBARUM swallow, CT kuongorora. Gastroesophagoscopy ndiyo Dx nzira yekusarudza.

• Esophageal carcinoma: iyo inowedzera nekuwedzera dysphagia, pakutanga kuoma uye kuenderera mberi kune zvinodhaka nekudzivirira mune mamwe matambudziko akakwirira
• <1% yekenza dzese uye 4-10% yeese maGI malignancies. Iko kunozivikanwa kwevanhurume kupererwa neiyo squamous cell subtype nekuda kwekusvuta uye doro. Barrett esophagus uye adenocarcinoma
• M: F 4: 1. Vanhu vemavara ndivo vanonyanya kunetseka kupfuura vanhu vema White 2: 1. Kutaura kusina kunaka!
• Chirwere cheBangium chinogona kuva nehanya pakuziva masimba evanhu. Gastroesophagoscopy (endoscopy) inopupurira kuongororwa ne biopsy yemaviri
• Pasi pose maronda anonyanya kufanana ndeye 2ndary gastric fundal carcinoma inopinda sopal
• Serofu inoshandiswa inowanzoonekwa pakati pepakati, Adenocarcinoma munzvimbo inonzi distal

• Gastric carcinoma: primary malignancy ye gastric epithelium. Kazhinji vasati vava nemakore 40. Nguva yepakati pekuongororwa muUnited States ndeye 70 makore kwevarume uye 74 kwemakore nekuda kwevakadzi. Japan, South Korea, Chile, uye Eastern Europe dzine imwe yepamusoro yepamusoro yekenza yepamu munyika. Kenza yemukondombera inoderera pasi rose. Chirwere chepabonde chirwere che 5th chinokonzera kufa nekenza. Kushamwaridzana neHelicobacter pylori chirwere 60- 80%, asi chete 2% vanhu vane H. Pyloris vanoita kenza yemudumbu. 8-10% ine nhengo yemhuri yakagara nhaka.
• Gastric Lymphoma inobatanidzawo neHylorlor infection. Gestrointestinal Stromal Cell Tumorori kana GIST ndeimwe chirwere chinokonzera mudumbu
• Clinically: Hapana zviratidzo kana zvisingatauri uye zvinogona kuporesa. Kusvikira ku 50% yevarwere vangave vasina zvikwangwani zveGI zvisiri izvo. Varwere vanogona kupa neoreoreia uye kuora kurasikirwa (95%) pamwe nekurwadziwa kwepamuviri kusina kujeka. Nausea, kurutsira, uye kusanganisa satiety d / t kudzivirira kunogona kuitika nemavhumu anokonzera kana zvipembenene zvinopisa zvinokonzera kusuruvara kwemudumbu.
• Prognosis: Kazhinji kemukari inoratidzirwa inoratidzwa munguva pfupi uye inogona kuratidza kupindira kwekune imwe nzvimbo nechekudzivirira zvirwere, chiropa, uye mesenteric kupararira. A 5-gore rinoponesa muzana we20% kana pasi. MuJapan uye S. Korea, mapurogiramu ekuongorora mavambo akawedzera kupona kusvika ku60%
• kuri: Barium kumusoro GI kudzidza, CT scanning. Endoscopic kuongororwa ndiyo nzira yekusarudzwa. Pamusoro pekufungidzira, Mukenza weGastric ungaratidzika semafungiro emhando yepamusoro (polypoid) mashoma kana kuti Fungative type, Ulcerative kana Infiltrative / disperse type (Linitis Plastica). CT kuongorora kunokosha kuti uongorore kupinda kwenharaunda (node, mesentery, chiropa, nezvimwewo)

• Chirwere cheCeliac non-tropical sprue Aka Gluten-sensitive enteropathy: A T-cell mediated autoimmune chronic gluten-induced mucosal kukuvara kwakaguma nekurasikirwa kwevilli mumutambo muduku wechipfuva uye muviri malabsorption (kureva, sprue). Inofungidzirwa mune dzimwe mamiriro ehurumende kushaya simba anemia yechikonzero chisina kugadziriswa. Inowanikwa muCaucasians (1 mu200) asi inowanikwa muAsia uye vanhu vatsvuku. Tsamba mbiri: girasi duku muduku. Kazhinji mu 3rd uye 4th makumi emakore ehupenyu.
• Clinically: Hurwa nemimba ndeyem / c chiratidzo, malabsorption yemuviri / mavitamini: IDA nemagaiac-positive, diarrhea, kudzivirira, steatorrhea, kuora muviri, osteoporosis / osteomalacia, dermatitis herpetiformis. Kuwedzera kushamwaridzana neT-cell lymphoma, Kuwedzera kushamwaridzana ne esophageal squamous cell carcinoma, SBO
• Dx: Kumusoro kweGI kunopedzisira kune dzimwe nhengo dzakasiyana-siyana dzinonzi biodenal biopsies inofungidzirwa se chirwere chekuongorora nokuda kwechirwere ichi. Histology inoratidza T-cell kupinda uye lymphoplasmacytosis, Villi atrophy, Crypts hyperplasia, Submucosa, uye Serosa hazviperi. Rx: kubviswa kwezvinhu zvinokonzera gluten
• Kufananidza: Hazvidiwi kuDx asi paBurum swallow swallowororcopy: mucosal atrophy uye kuparadzwa kwemucosal folds (advanced cases chete). SB kuwedzerwa ndiyo yakanyanya kuwanikwa yekuwana. Nodularity ye duodenum (bubbly duodenum). Kuchinja kwe jejunal uye ileal mucosal folds:
• JeJejunum inoita kunge ileum, iyo ileum inoita kunge jejunum, uye duodenum inoita kunge gehena.

Chirwere cheHosha Chirwere: Chirwere cheCrohn (CD) & Ulcerative Colitis (UC)

• CD: chisingarambizve kudzoka-kuregera kunokonzera kuputika kunobata chero chikamu chegwaro reGI kubva pamuromo kusvika kune anus asi pakutanga kutanga kunowanzobatanidza nechokuguma neum. M / C mharidzo: kurwadziwa kwepamuviri / kugumburwa nekurwara. Nzira: granulomata kuumbwa kwakasiyana neUC inoshandura-shanduka, izvo zvingangotungamirira kumagetsi. Nharaunda dzinokonzerwa nekuputika zvinowanzoita patchy
• Zvinetso zvakawanda: malabsorption yezvimiti / mavhithamini (anemia, osteoporosis, kukurumidza kunonoka kwevana, kunokonzerwa neGI kuuraya, kuvhara muviri, fistula maitiro, kuwedzera-mumimba zviratidzo: uveitis, arthritis, AS, erythema nodosum nevamwe.10- 20% inogona kuvhiyiwa mucheche mushure me10-makore eCD kazhinji kune zvigadziriswa, fistiluzation, BO.
• Dx: kliniki, CBC, CMP, CRP, ESR, maitiro ekudzivirira: DDx yeBD: anti-Saccharomyces cerevisiae antibodies (ASCA), pineinuclear antineutrophil cytoplasmic antibody (p-ANCA) zvisiri izvo kana mu serum. Fecal Calprotectin test inobatsira DDx IBS uye kuongorora mhinduro kumushonga, chirwere chekuita / kudzokazve.
• Dx yekusarudza: endoscopy, ileoscopy, uye mikana yakawanda inogona kuratidza endoscopic uye histological change. Vhidhiyo capsule endoscopy (VCE), kufungidzira kunogona kubatsira neDx yezvinetso. Rx: immunomodulatory drugs, mishonga inobatanidza, kudya, probiotics, operative. Hapana mushonga asi chinangwa ndechokukurudzira kuregererwa, kudzora zviratidzo uye kudzivirira / kubata zvinetso
• Kufananidza Dx: Kub kuDBO DDx, Barium enema (kusarura uye kuwirirana kwechipiri), zvishoma zvishoma zvinotevera. Zvitsva: kuregerera zvipembenene, aphthous / zvakakomba zvipembenene, fistula / mapepa e sinus, Chiratidzo chechidimbu, chinokambaira mafuta chinokonzera mashizha eLB, cobblestone kuonekwa d / t kupisa / ulcers kusunga mucosa, CT kupenya nemuromo uye IV kusiyana.

• Kufungidzira kubva kumurwere waCrohn uyo aive aine diki matumbo resection yekuvhiringidzwa.
• (A) CT scan inoratidza kusina kuvhiringidza kwakadaro asi
• (B) MRE yemunzvimbo imwechete inoratidza kugadzirwa kwefrostenotic

• UC: unhu hunosanganisira chete hutoni asi bhukwash ileitis inogona kukura. Kutaridzika kunowanzo pa 15-40s uye kunowanikwa kune varume, asi kutanga kwezera re 50 kwave kuchijairikawo. Zvinowanzoitika muNorth America neEurope (hygiene hypothesis). Etiology: Kubatanidzwa kwezvakatipoteredza, maitiro uye maitiro ehupenyu hunochinja zvinosanganiswa. Kusvuta uye kutanga appendectomy zvinoratidzira kuratidza kusashamwaridzana neUC, zvakasiyana neCD zvakarangarira zvimwe zvezvipingamupinyi.
• Clinical Features: Routal bleeding (inowanzo), chirwere, chirwere chinonzi rectal mucous discharge, tenesmus (pane dzimwe nguva), kurwadziwa kwepamuviri kwepamusoro uye kuora mvura kwakanyanya kubva ku purulent rectal discharge (muzviitiko zvakakomba, kunyanya kune vakwegura), fulminant colitis uye mexicacon inotyisa inogona kuva fetal asi haisi nyore . Pathology: Hapana granulomata. Kuora mwoyo kunobatsira mucosa uye submucosa. Pseudopolyps inouya sepamusoro yakachengetwa mucosa.
• Nzira yekutanga inobata nguva dzose rectum uye inoramba iri yeropa (proctitis) mu (25%). 30% Kuwedzera kwechirwere chirwere chinogona kuitika. UC inogona kuisa sechitseri-sided (55%) uye pancolitis (10%). Kuwanda kwematambudziko kune unyoro kuenzanisa
• Dx: colonoscopy neeoscopy ine maitiro akawanda anosimbisa Dx. MaRabs: CBC, CRP, ESR, Fecal calprotectin, Matambudziko: anemia, megacolon inotyisa, megacolon, kenza yemukoroni, yakawedzera-colonic zvirwere: arthritis, uveitis, AS, Pyoderma gangrenosum, Primary sclerosing cholangitis. Rx: 5-aminosalicylic acid muromo kana rectal topical therapy, corticosteroids, immunomodulatory drugs, colectomy inorapa.
• Kufananidza: hazvidiwe kune Dx asi barium enema inogona kuburitsa maronda, kupurinda zvigunwe, mumatambudziko epamberi kurasikirwa kwehaustra uye kuderera kwekoloni inoburitsa lead-pipe colon. kesi. CT inogona kubatsira neiyo Dx yezvinetso. Plain firimu mufananidzo unoratidza adlead-pipe colon uye sacroiliitis se Enteropathic arthritis (AS)

• Colorectal carcinoma (CRC) m / c kenza yepeji yeGI uye 2nd inowanzovhiringidza vanhu vakuru. Dx: endoscopy uye biopsy. CT ndiyo miitiro inowanzoshandiswa pakutsvaga. Kutsvakurudza resection kunogona kunge kuchirapa kunyange zvazvo makore mashanu ekupona kwemazana ari 40- 50% zvichienderana nekugadzira. Zvinokonzera njodzi: pasi fibhi uye mapuroteni ane mafuta akawanda uye emhuka, kuora muviri (zvikurukuru mumarume), kusingaperi kwechirwere chirwere. Colonic adenomas (polyps). Familial adenomatous polyposis syndromes (Gardener syndrome) uye Lynch syndrome sevasiri polyposis.
• Clinically: kunyengedza kutanga nemararamiro akashandurwa, ropa idzva kana melena, kuperevedza kwesimbi kusagadzikana kubva kuhutachiona hwekuwedzerwa kwemazuva mashoma mumakumbo akanaka. Kuvhara muviri, kubata, kubuda kunorema uye chirwere chemasastatic kunyanya kuChiropa chingangova kutanga kutaura. Nzira: 98% ndiyo adenocarcinomas, inomuka kubva kare-yakagara iripo colonic adenomas (neoplastic polyps) ine shanduko yakaipa. Iko makore mashanu ekupukunyuka muzana ndeye 40-50%, nechitambo chekushanda chimwe chinhu chinonyanya kukosha chinokonzera kufungidzira. M / C rectosigmoid tumors (55%),
• NB Zvimwe adenocarcinomas esp. Mucinous types dzinowanzotaurwa nenguva uye dzinowanzotadza kusagadzikana nekuda kwekuguma kwehurukuro uye mucin secretion uye kupararira kwekuno / kure
• Kufungidzira: Barium enema inonzwarisa polyps> 1 cm, imwechete musiyano: 77-94%, yakapetwa kaviri: 82-98%. Colonoscopy ndiyo nzira yesarudzo yekudzivirira, kuona, uye kuzivikanwa kwecolorectal carcinoma. Kusiyanisa-kunatsiridzwa CT kuongorora kunoshandiswa pakuratidzira uye kufungidzira kuongororwa kwemamets.
• Kuchengetedza: colonoscopy: varume 50 yo-10-makore kana yakajairika, 5-makore kana polypectomy, FOB, 1st degree neA CA inotarisa ku 40 yo

 

• Pancreatic Cancer: ductal epithelial adenocarcinoma (90%), kunyanya kufungidzira nekufa kwepamusoro. 3rd M / C kenza yemukamu. Colon iri #1, mudumbu #2. Mukenza wepancreatic anoverengera 22% yevose vanofa nekuda kwekudya kwepamuviri, uye 5% yevose vanofa nekenza. 80% yematambudziko mu60 +. Sodya fodya ndiyo yakasimba yezvakatipoteredza njodzi chinokonzera, kudya kunopfuma mumafuta emhuka uye mapuroteni. Kuwedzera muviri. Nhoroondo yemhuri. M / C inoonekwa mumusoro uye inogadzirisa nzira.
• Dx: CT kuongorora kunokosha. Kurwiswa kweSuperior Mesenteric Artery (SMA) inoratidza chirwere chisingadzoreke. 90% yepancreatic adenocarcinomas haigadzirisike paDx. Vazhinji varwere vanofa mukati megore rimwe reDx. Kiriniki: isingarwadzi jaundice, abd. Pain, Courvoisier's gallbladder: painless jaundice uye yakawedzera nduru, Trousseau s syndrome: inofamba thrombophlebitis, nyowani yekutanga chirwere cheshuga mellitus, matunhu uye ari kure metastasis.
• CT Dx: pancreatic masimba ane simba remasoplastic reaction, mashoma ekusimudzira, uye zvishoma nezvishoma kutetwa kwechienzanidzo nechepakati chemaitiro akafanana, SMA inopinda.

• Appendicitis: chinowanzoitika mumharaunda yakawanda yehurology uye inoita chikonzero chikuru chekuvhiyiwa mumimba kune vechidiki vaduku
• CT ndiyo inonyanya kunzwisisika kuti ione appendicitis
• Ultrasound inofanira kushandiswa kuvarwere vaduku nevana
• KUB Radiographs haafaniri kutamba nharo mukuongororwa kwe appendicitis
• Pakufungidzira, appendicitis inoburitsa yakatsva appendix ine madziro kuomesa, kuwedzera, uye periappendiceal mafuta stranding. Zvakafanana zvakawanikwa zvekusimba kwemadziro uye kuwedzera zvinoratidzwa paUS. Chaizvoizvo target sign inozivikanwa pane pfupi pfupi axis yekumisikidza nzvimbo.
• Kana iyo appendix iri retro-caecal kupfuura US inogona kukundikana kupa Dx uye CT kuongorora kwakakodzera kunogona kudiwa
• Rx: inoshanda kuti isabatwa nezvinetso

• Chidiki chekudzivirira (SBO) -80% yezvose mechanical matumbo ekudzivirira; iyo 20% yakasara inokonzerwa nekudzivirira kukuru kwemuviri. Iine chiyero chekufa kwe5.5%
• M / C dzinokonzera: chero hupi Hx yekuvhiyiwa kwepamuviri uye kubatisisa
• Chikoro chekutaura kuvhara, kuwedzera kumimba kwemashure nekunyunyuta uye kurutsa
• Radiographs chete 50% inonzwisisika yeSBO
• CT icharatidza chikonzero cheSBO mu80% yematambudziko
• Ikoko kune zvinowanzoenderana nehuwandu hudiki hwekudzivirira hutachiona, asi 3.5 cm ndeyekufungidzira kusingatarisirwi kwechikwata chinoputika
• PaAbd x-ray: supine vs. yakamira. Dilated bowel, yakatambanudzwa valvulae conivente (mucosal folds), imwe nzira yemhepo-yemvura mazinga step manera.
• Rx: inoshanda se acute dumbu.

• Volvulus-m / c muSigmoid colon esp. muvakwegura. Chikonzero chikuru: kusagadzikana kusingaperi nekugadzirisa sigmoid kushandura pa sigmoid mesocolon. Inotungamirira Kukudzivirira Kwemakumbo Makuru (LBO). Zvimwe zvinokonzera zvinokonzera: tumorumbu yekoloni. Sigmoid vs. Caecum volvulus
• Muchipatara: zviratidzo zveLBO nekudzivirira, kubvisa pamuviri, kurwadziwa, kushungurudza, uye kurutsa. Kutarisana kungave kwakaoma kana kusingaperi
• Radiographical: kurasikirwa kwehaustra muLB, LB distension (> 6-cm), coffee bean sign inotevera slide, iyo yekupedzisira magumo evolvulus anonongedzera muchiuno.
• NB: Mutemo wechigunwe chemuviri wakadzvanywa unofanira kunge uri 3-6-9 uko 3-cm SB, 6-cm LB & 9-cm Coecum
• Rx: inoshanda se acute dumbu.

References

• www.radiopaedia.org
• reference.medscape.com/