Iyo nduru (kubva kuLatin vesica biliaris) inoshanda senzvimbo yekuchengetera bile, inoyerera yero mvura yakavanzwa nechiropa uye inobatanidzwa mukugaya.

Iyo gallbladder iri kurudyi kwedumbu. Icho chihombodo chakaita kunge peya chakawanikwa pazasi pechiropa. Yakasvibira muvara uye ine nhete madziro, inoyera paavhareji 7 kusvika 12 cm kureba. Iyo ine paavhareji 50 mL ye bile. Pamugumo wayo wezasi, iyo cystic duct inobatana neyakajairika hepatic duct kuti iite iyo yakajairika bile duct. Icho chiri kuburikidza neiyi duct iyo iyo bile inoyerera ichipinda mu duodenum, chikamu chekutanga chemukati mudumbu chinotevera dumbu.

Bile rine kunyanya mvura, bile munyu, bilirubin (pigment inokonzerwa nekudzikisirwa kwehemoglobin uye iyo inopa iyo bile yayo yakasvibira yero yeruvara), cholesterol uye phospholipids. Chete bile munyu uye phospholipid inobata mune yekugaya maitiro. Kunyangwe isina enzymes, bile inokwanisa, nekuda kwesalt yayo, kudzikisa saizi yemafuta maglobhules, uye nekudaro kufambisa chiito chemakemikari ekugaya.

Iko hunhu hwenduru kunoenderana nemamiriro e duodenum. Kana izvi zvisina chinhu, iyo bile inoyerera ichidzokera mucystic duct inochengetwa muguruva. Iyo yekupedzisira inozoisa iyo bile nekukweva zvishoma mvura yayo, nokudaro ichiita iro ramangwana chiito che bile bile. Kana chikafu chine mafuta chikapinda mu duodenum, iyo secretion ye cholecystokinin, mahormone anogadzirwa nemukati, inokonzeresa nduru kubvumirana, iyo inoburitsa iyo bile kupinda mune yakajairwa bile duct. Iyo yekupedzisira inosanganisirwa pamusuwo we duodenum nepancreatic duct (sezita rayo rinoratidza kuti rinouya kubva kurwatata), iyo inotakura enzyme yekugaya, kuita iyo hepato-pancreatic bulb. Kamwe mune ura hudiki, iyo bile uye pancreatic muto inotanga kuputsika kwemakemikari echikafu.

Biliary lithiasis : kuumbwa kwematombo mukati meguruva kana mukati meiyo bile ducts. Aya mabwe, akafanana nematombo madiki, anonyanya kuve akaumbwa nekristallstallized cholesterol. Chimiro, kukura uye nhamba zvinosiyana pamunhu nemunhu. Kunyangwe iwo achiwanzo kuve ane huturu, aya mabwe anogona kutadzisa iyo cystic uye yakajairika bile ducts, uye nekudaro kubuda kwese kune iyo duodenum. Mune ino kesi, iyo nyaya ine biliary colic iyo inogona kusvika kusvika kumaawa mana.

Matombo madiki ane simba rekudzora kuyerera kwenyongo inozomira kudzamara yagadzira iyo inonzi bile sludge, iyo inowanikwawo mune vamwe vanhu vane AIDS (3).

Chidzidzo chechina (4) chakaita kuti zvikwanise kuona mageneti ekubatwa kune lithiasis mumakonzo, zvichidaro zvichiratidza kuti zvinogona kuitika kubva kuchirwere ichi. Uye zvakare, mamwe madzinza, senge maIndia eNorth America, anoita kunge ari panjodzi ye lithiasis.

Pazera chero ripi zvaro, kufutisa zvakare kuri kuwedzera njodzi yekukudziridza nduru. Mune ongororo shanu (5) yevanhu 2012 vane makore zviuru gumi kusvika pamazana mapfumbamwe, zvakaonekwa kuti vana vane huremu hwakapetwa kakapetwa kaviri kutambura nemaronda, nepo njodzi yaive yakapetwa kasere kumatombo enduru. zvidzidzo zvine kufutisa kwakanyanya.

Muzhinji, vakadzi vanoratidzwa pachena kupfuura varume kune idzi nduru. Humwe hunhu hunogona kuwedzera njodzi yekuvandudza matombo.

Cholecystitis : kuzvimba kwenduru, iyo inogona kuperekedzwa nehutachiona. Inowanzoitika nekuda kwekuvapo kwematombo muguruva kana yakajairika bile duct.

Porcelain vesicle : mushure me cholecystitis, calcium inogona kunamatira kumadziro eguruva, iro rinoomarara. Musoro uyu unobva waita inonzi porcelain vesicle.

Cholestatic jaundice : Kana iyo ducts yeguruva yakavharwa, bile inoyerera ichidzokera muropa. Sezvo bilirubin isingachabudiswe muchituru, inova isina ruvara, nepo ganda rinoshanduka kuita yero zvishoma. Panguva imwecheteyo, iyo weti bilirubin nhanho inowedzera, izvo zvinoguma nerima weti. Izvi ndizvo zviratidzo zvecholestatic jaundice.

Choledochal cysts : kuzvimba kwakasarudzika kwenzara dze bile. Zvirwere zviripo kubva pakuzvarwa, zvinowedzera mukana wekubatwa negomarara redunduru.

Isina kujairika pancreatic-biliary junction : congenital anomaly yemubatanidzwa pakati peyakajairika bile uye pancreatic ducts. Muchiitiko ichi, ma enzymes anogadzirwa nerwatata haakwanise kusvika kune duodenum. Ivo vanogona ipapo kukonzeresa kutsamwa kwedunduru.

Gomarara redundiro : Sezvakaita cholecystitis, kuoneka kwecarcinoma yeguruva kunofarirwa nenduru. Chirwere chisingawanzoitika muFrance, chinonyanya kubata vakadzi vane makore anodarika makumi manomwe. Inowanzoonekwa ichinonoka painopararira kunhengo dzakavakidzana, dzimwe nguva inofambidzana nemarwadzo emudumbu, kurutsa uye kurasikirwa nechido. Ethnic zvinhu zvinofanirwa kutariswa kuti zviongorore kuitika kwayo. Kuratidzira kuThorotrast (70) (musiyano wepakati wakamboshandiswa mukufungidzira kwekurapa) kunowedzerawo njodzi yekuva nekenza yegunduru.

Kana matombo asina kuverengwa uye asingapfuure imwe saizi, kurapwa kuanyungudutsa, senge Actigall, zvinogoneka. Ablation, iyo isina chaicho chinokanganisa zuva nezuva, inoramba iri tsika mune zviitiko zvematombo.

Kudya kunogona kukanganisa kuumbwa kwematuru. Kudya kwakanyanya kwekoriori kunowedzera kusimudzira chitarisiko chavo, nepo chikafu chakapfuma mumashizha emiriwo chichideredza ichi chikamu. Muchiitiko chekutanga kuoneka kwematombo, gadziriso yemararamiro (kudzikisira mukushandisa kwemafuta, shuga, yakanaka hydration, chiitiko chemuviri wenguva dzose, nezvimwewo) inogona kukurumidza kubvisa chero kurwadziwa.

Zvimwe zvirwere zvemudumbu, zvakaita seCrohn's disease, zvinogona kuwanda kana kutowedzera katatu kuwanda kwematuru (10).

Ultrasound yemudumbu: iri nyore uye nekukurumidza bvunzo kuti uone matombo. Inogona kuona 90% yekuverenga. Iyo inosanganisirwa neye bvunzo bvunzo (kuongororwa kweropa uye kuongororwa kwebilirubin) kuitira kuti ufungidzire kukomba kwemamiriro acho ezvinhu.

Echo-endoscopy: iyi ongororo yemaminetsi makumi maviri inokutendera kuti utarise mukati meguruva uye kudzidza pancreas nekuwedzera.

Gallbladder kubviswa (kana cholecystectomy): Kuvhiya kunogona kuitwa kurapa nduru dzeguruva kana nzira yakajairika yenyuchi kana ichibatanidzwa nekurwadziwa kwakanyanya.

MuAntiquity, Galen akavandudza dzidziso yeanosetsa mana (11) zvinoenderana nekuyera kwemanyemwe (ropa, yero bile, dema bile, phlegm) rinotonga hutano hwepfungwa nemuviri wemunhu. Iyo machena machena inosanganiswa nehasha, nepo iyo nhema nhema inomutsa kushushikana uye kusuwa. Iyo yekupedzisira yaive, mupfungwa, yakanangana nekushushikana uye zvakaipa. Kubva pachirevo chechiGiriki ichi ndipo panobva izwi rinoti "kuva nenyuchi" (12).