Isisu: Indlela yokuTyekisa yokuTyekisa | El Paso, TX.

• Ukuxilongwa kwezifo zesisu kungafakwa phakathi:
• Ukungavumelekanga kwe esisisu Iphecana (isisu, isisu, amathumbu amancinci & amakhulu, kunye nesihlomelo)
• Ukungaqhelekanga kwamalungu okwenziwa kokugaya ukutya (i-Hepatobiliary kunye ne-pancreatic disorders)
• Ukungaqheleki kwilungu lokuzala kunye namalungu okuzala
• Ukungaqhelekanga kwodonga lwesisu kunye neempahla ezinkulu
• Le nkcazo-ntetho ijolise ekunikeni olona lwazi lusisiseko jikelele ukucinga ngomfanekiso indlela kunye nolawulo olufanelekileyo lwekliniki yezigulane ezinezifo eziqhelekileyo zesisu
• Iindlela zokucinga ezisetyenziswe ngexesha lophando lwezikhalazo zesisu:
• AP isisu (KUB) kunye neCXR eqondileyo
• Ukuskena kwe-CT emathunjini (kunye nokwahlukana komlomo kunye ne-IV kunye nenye)
• Ucwaningo oluphezulu kunye nolwasezantsi lwe-Barium
• Ultrasonography
• I-MRI (esetyenziswa kakhulu njenge-Liver MRI)
• Ubuchwephesha beMRI kunye ne-enteroclysis
• MRI rectum
• I-Endoscopic Retrograde i-Cholangiopancreatographyography (ERCP) - kakhulu i-hepatobiliary ne-pancreatic pathology
• Imifanekiso yeNyukliya

Kutheni uLawula i-X-ray yesisu?

• Bandakanya uvandlakanyo lokuqala lwerhasi yamathumbu kwimeko engxamisekileyo. Ngokomzekelo, uphando olubi kwisigulane esincinci sinokuthi sithintele isidingo se-CT okanye ezinye iinkqubo eziphazamisayo.
• Uvavanyo lweetyhubhu zeradiopaque, imigca, kunye nemizimba yangaphandle yeradiopaque
• Ukuvavanywa kwenkqubo emva kwe-procedraperitoneal / retroperitoneal gas ezamahala
• Ukubeka esweni isantya segesi kunye nesisombululo se-elius postoperative (i-adynamic)
• Ukubekwa esweni kwendima yokuhlukelelana phakathi kweembilini
• Izifundo zokuhamba ngeColonic
• Ukubeka esweni i-calalli ye-renal

Yintoni ekufuneka uyiqaphele kwi-AP Iisisu: Phakamisa ngokuphambene noVukani kunye neCububitus

• Umoya wamahhala (i-pneumoperitoneum)
• Isithintelo samathumbu: I-loops edibeneyo: i-SBO vs LBO (umgaqo we-3-6-9) i-SB-upper umda-3-cm, i-LB-upper limit-6-cm, i-Caecum-upper limit-9-cm. Qaphela ilahleko ye-haustra, ukunyuswa kwenqaku (ubukho) be-valvule conivente (plica semilunaris) kwi-SBO
• I-SBO: Qaphela ubude obahlukeneyo amanqanaba olwelo lomoya kwileli yefilim ethe tye � imbonakalo, eqhelekileyo ye-SBO
• Phawula ukuphulukana kwegesi yamacoloni (i-evacuated) kwi-SBO

• Iskena se-CT esiswini -ukuziphatha okwenziwe ngexesha lokuphanda izikhalazo ezisisigxina ezingapheliyo kubantu abadala. Ngokomzekelo, ukubola kwesisu kungaxilongwa ngempumelelo kwaye kwenziwe ukunikezela ngolwazi lweklinikhi yokucwangcisa ukunakekelwa
• Isisu, i-renal ne-pelvic ultrasound inokwenziwa ukunceda ukufumanisa isifo se-appendicitis (esp. ebantwaneni), isifo esiqatha nesinganyangekiyo semithambo, ukungahambi kakuhle kwe-hepatobiliary, isifo sokubelekisa kunye nesifo somhlaza
• Ukusetyenziswa kwemitha ye-ionizing (i-x-reyi kunye ne-CT) kufuneka kuncitshiswe ebantwaneni nakwamanye amaqela abuthathaka.

Ukuqhelanisa ukuGqala kwezifo eziMkhulu zeSistim seNtlungu

• I-1) Izifo ezixhasayo
• 2) I-gastric carcinoma
• 3) I-Gluten Inensitive Feelings
• 4) Izifo ezithintekayo zezifo
• 5) I-adenocarcinoma ye-Pancreatic adenocarcinoma
• 6) I-carolooma ehambayo
• 7) I-Acute Appendicitis
• I-8) Isithintelo samancinci
• 9) Volvulus

Iingxaki ze-Esophageal

• I-Achalasia (i-achalasia yokuqala): Ukungaphumeleli kwe-esophageal peristalsis d/t ukuphumla okungahambi kakuhle kwe-esophageal sphincter (LOS) kunye nokwandiswa okuphawulweyo kommizo kunye nokutya. Ukuvaleka kommizo we-distal (kaninzi ngenxa yethumba) kuye kwabizwa ngokuba “yi-achalasia yesibini” okanye “pseudoachalasia. . I-vagus neurons nayo inokuchaphazeleka
• Iiprayimari: 30 -70, M: F elinganayo
• Isifo sikaChagas (iTrypanosoma Cruzi usulelo) ngokutshatyalaliswa kwe-Myenteric plexus neurons yenkqubo ye-GI (megacolon & esophagus)
• Nangona kunjalo, intliziyo yinxalenye echaphazelekayo ye-M / C
• Klinikhi: I-Dysphagia zombini isisulu kunye notywala, xa kuthelekiswa ne-dysphagia yeziqulatho kuphela kwiimeko ze-esophageal carcinoma. Intlungu yesifuba nokuhlaziywa. I-M / C ephakathi kwe-squamous cell carcinoma malunga ne-5% ngenxa yokugwenxa okungapheliyo kwe-mucosa nge-stasis yokutya kunye nemfihlo. Ukuphefumlelwa kwepneumonia kunokukhula. Candida esophagitis
• Ukwenza umfanekiso: �Umlomo wentaka� kumphezulu we-GI barium ukugwinya, ummizo owolukileyo, ukulahlekelwa yiperistalsis. Uvavanyo lwe-endoscopic lubalulekile.
• Rx: kunzima. I-calcium blockers blockers (ixesha elifutshane) .I-Pneumatic dilatation, esebenzayo kwi-85% yezigulane ezine-3 -5% ingozi yokuphuma kwegazi / ukuchithwa. Inaliti yetyhefu ye-botulinum ihlala malunga kuphela. Iinyanga ezili-12 ngonyango ngalunye. Ingakrazula i-submucosa ekhokelela kumngcipheko owonyukileyo wokugqobhoza ngexesha le-myotomy elandelayo. I-myotomy yotyando (Heller myotomy)
• I-10 -30% yezigulane zihlaziya i-reflux ye-gastroesophageal (GERD)

• Presbyesophagus: esetyenziselwa ukuchaza ukubonakaliswa kwemisebenzi yemoto ephazamisayo kwi-esophagus yokuguga> 80-yo Ngenxa yokuphazamiseka kwe-arc ye-reflex kunye nokunciphisa ukuvakalelwa kwi-distension kunye nokuguqulwa kwe-peristalsis.
• Izigulane zinokukhalaza nge-dysphagia okanye intlungu yesifuba, kodwa uninzi alubonakali
• Ukusabalalisa / ukusabalalisa i-spasm esophageal (DES) yintlungu ye-motility ye-oopopus engabonakala ngathi i-coorkscrew okanye i-rosary bead esophagus kwi-barium ingumgwinya.
• I-2% yeentlungu ezingezizo zomzimba zesifuba
• I-Manometry yimivavanyo yokuhlola i-standard-gold.

• Zenker diverticulum (ZD) isikhwama se-aka pharyngeal
• Ukugqithiswa kwinqanaba le-hypopharynx, nje lixhomekeke kwi-sphincter ephezulu ye-esophageal, eyaziwa njenge-Killian dehiscence okanye iKillian triangle
• Izigulane ziyi-60-80 yo kwaye ziza kunye ne-dysphagia, i-regurgation, i-halitosis, i-globus sensation
• Unokubangela inkxalabo ngeempembelelo kunye nokungaqhelekanga kwempompo
• Izigulane zinokuqokelela amayeza
• I-ZD- i-pseudodiverticulum okanye i-diverticulum yokukhupha ngenxa yokuhlanjululwa kwe-submucosa ngokusebenzisa i-Killian dehiscence, eyenza isikhwama apho ukutya kunye nezinye izinto ezingenakunokuziqokelela.

• Isifo seMallory-Weiss ibhekisa kwiinyembezi ze-mucosal kunye ne-submucosal ye-plexus ye-esophageal ye-venous ehambelana nobudlova / ukuhlanza kunye nokuqikelelwa kwesiqulatho sesisu ngokuchasene nomzantsi wommizo. Abanxila basengozini enkulu. Iimeko ezikhoyo kunye ne-hematemesis engenabuhlungu. Unyango ludla ngokuxhasa.
• I-Dx: umfanekiso udlala indima encinci, kodwa ukuchasana kwe-esophagram kunokubonisa iinyembezi ze-mucosal ezizaliswe ngumahluko (umfanekiso osezantsi osekunene). I-CT scanning inokunceda ukungabandakanyi ezinye izizathu zokopha kwe-GI ephezulu

• I-Boerhaave syndrome: ukuphulukana nokuqhaqhazela kwesibini ukuhlanza ngamandla
• Ukunikezelwa: M> F, ukuhlanza, intlungu yesifuba, i-mediastinitis, i-septic mediastinum, i-pneumomediastinum, i-pneumothorax i-pleural effusion
• Kwixesha elidlulileyo, kwakunokubulawa
• Iinkqubo zibandakanya ukugxothwa ngenkani kwesiqulatho sesisu ngakumbi ngokutya okukhulu okungagatywanga xa ummizo ukhontraktha ngamandla ngokuchasene neglottis evaliweyo nge-90% eyenzeka ngakudonga lwasekhohlo lwasemva.

• IHiatus hernias (HH): Ukuxutywa kwezinto eziswini lomzimba ngokusebenzisa i-hiatus ye-esophageal ye-diaphragm kwisigxina se-thoracic.
• Izigulana ezininzi ezine-HH azibonakalisi zimpawu, kwaye kukufunyaniswa kwengozi. Nangona kunjalo, iimpawu zinokubandakanya intlungu ye-epigastric / esifubeni, ukugcwala emva kokutya, isicaphucaphu kunye nokuhlanza.
• Ngamanye amaxesha i-HH ithathwa njengefana nesifo se-gastro-oesophageal reflux (GORD), kodwa kukho unxulumano olubi phakathi kwezi meko zimbini!
• 2-iintlobo: sliding hiatus hernia 90% & rolling (paraoesophageal) hernia 10%. Le yokugqibela inokukrwitsha okukhokelela kwi-ischemia kunye neengxaki.

• Leoomyomyoma yaseEsophageal yiM/C enobungozi bommizo we-neoplasm. Idla ngokuba nkulu kodwa ayiphazamisi. Iithumba zeGastrointestinal stromal (GIST) zezona ziqhelekileyo kummizo. Kufuneka yahlulwe kwi-Esophageal carcinomas.
• Ukucinga: u-esophagram ohlukileyo, ingxube ye-GI ye-Barium, i-CT. I-Gastroesophagoscopy yindlela ekhethekileyo yeDx.

• I-Esophageal carcinoma: zinikezwa ngokunyuka kwama-dysphagia, okokuqala ukuya ezinqabileyo kunye nokuqhubela phambili kutywala kunye nokuphazamiseka kwiimeko eziphambili
• <1% yazo zonke i-cancer kunye ne-4-10% yazo zonke izifo ezinobungozi ze-GI. Kukho ukwaziwa kwangaphambili kwamadoda kunye neesquousous cell subtype ngenxa yokutshaya notywala. I-Barrett esophagus kunye ne-adenocarcinoma
• M: F 4: 1. Abantu abamnyama banomdla ngaphezu koBantu abamhlophe 2: 1. Ukugqithisa kakubi!
• Ingxube ye-barium ingaba neengxaki ekuboniseni ubunzima be-esophageal. I-Gastroesophagoscopy (endoscopy) iqinisekisa ukuxilongwa nge-biopsy yeesishu
• Ngokugqithiseleyo ukugula okuqhelekileyo yi-2ndary fundal carcinoma ehlasela i-distal esophagus
• Iseli le-squamous ifunyanwe kwi-middleopopus, i-Adenocarcinoma kwingingqi ye-distal

• Gastric carcinoma: isifo esisisiseko se-epithelium esiswini. Kudala ngaphambi kwexesha le40. Iminyaka yobudala ekuxilongweni e-United States yiminyaka eyi-70 yabesilisa kunye ne-74 iminyaka kubafazi. IJapan, iSouth Korea, iChile, kunye namazwe aseMpuma yeYurophu anesinye sezinga eliphezulu kakhulu lomdlavuza wesisu emhlabeni. Iqondo lomdlavuza wesisu linciphela kwihlabathi jikelele. Umhlaza wesisu ngumdla we-5th wokufa komhlaza. Umbutho kunye no-Helicobacter pylori usulelo lwe-60- 80%, kodwa i-2% yabemi kunye no-H. Pyloris bahlakulela umhlaza wesisu. I-8-10% inelifa lentsapho elizuze ilifa.
• I-Gastric Lymphoma idibaniswa noHerrys. Isisu seStromal Cell Tumor okanye i-GIST yinye isisu esichaphazela isisu
• Klinikhi: Akukho zibonakaliso xa zingekho kwaye ziyakwazi ukuphilisa. Ukufikelela kwi-50% yezigulane zinokuba nezikhalazo ze-GI ezingezizo. Izigulana zingabonisa nge-anorexia kunye nokulahleka kwesisindo (95%) kunye neentlungu ezingavaliyo esiswini. Ukuxubusha, ukuhlanza, kunye nokukhuselwa kwantoni-ntshukumo yokuqala kungenzeka ngezilwanyana ezinobunzima okanye izilonda ezingenangqondo ezingaphazamisekanga isisu.
• Ukuxela: Uninzi lweengcambu zesifo segciwane ezixilongwe emva kwexesha kwaye zingabonakalisa ukuhlasela kwendawo kunye ne-adenopathy yesithili, isibindi, kunye nokusabalaliswa kwe-mesenteric. Inani le-5 lokusinda kwe-20% okanye ngaphantsi. EJapan naseSouth Korea, iinkqubo zokuhlola ukuqala kwandisa ukwanda kwe-60%
• iMifanekiso: Isifundo se-Barium esiphezulu se-GI, ukuskena kwe-CT. Uvavanyo lwe-Endoscopic yindlela yokukhetha ukuxilongwa. Ekucingeni, umhlaza wesisu unokuvela njenge-exophytic (polypoid) ubunzima okanye uhlobo lweFungative, Ulcerative okanye Infiltrative / diffuse type (Linitis Plastica). Ukuskena kwe-CT kubalulekile ukuvavanya uhlaselo lwasekhaya (iindawo, i-mesentery, isibindi, njl.)

• Izifo ze-Celiac zika-non-tropical sprue aka I-Gluten-sensitive sensopathy: I-T-cell mediated autoimmune ye-autoimmune ye-gluten-induced mucosal umonakalo okhokelela ekulahlekeni kwe-villi kwi-proximal bowel encinci kunye ne-gastrointestinal malabsorption (okt, i-sprue). Kucingelwa kwezinye iimeko zokunqongophala kwe-iron anemia yesizathu esingaqinisekanga. Ixhaphakile eCaucasus (1 kwi-200) kodwa inqabile kubantu baseAsia nabamnyama. Iincopho ezimbini: iqela elincinane ebuntwaneni bokuqala. Ngokuqhelekileyo kwi-3rd kunye ne-4th yamashumi eminyaka yobomi.
• Klinikhi: Intlungu yesisu ngumonakalo we-m / c, i-malabsorption yezondlo / iivithamini: i-IDA kunye nezigulane ezigugu, isifo sohudo, ukugcoba, i-steatorrhea, ukulahleka kwesisindo, i-osteoporosis / osteomalacia, i-dermatitis herpetiformis. Ukwandisa ubudlelwane kunye ne-T-cell lymphoma, Ukunyuka kunye ne-esophageal squamous cell carcinoma, i-SBO
• I-Dx: I-endoscopy ephezulu ye-GI eneendidi ze-biopsies ezininzi zicingelwa umgangatho wokuhlola isifo esiqwengileyo. I-Histology ibonisa ukungena kwe-T-cell kunye ne-lymphoplasmacytosis, i-Villi atrophy, i-Crypts hyperplasia, i-Submucosa ne-Serosa. Rx: ukupheliswa kweemveliso ezine-gluten
• Ukucinga: Akukho mfuneko kwi-Dx kodwa kwi-Barium igin fluoroscopy: i-mucosal atrophy kunye nokutshabalalisa i-mucosal folds (iimeko eziphambili kuphela). Ukuhluthwa kwe-SB kukufumana ngokuqhelekileyo. I-nonodityity ye-duodenum (bubbly duodenum). Ukuguqulwa kwamagqabi ejejethi kunye nealeal mucosal:
• �Ijejunam ijongeka njengeleum, ileum ifana nejejunum, ize iduodenum ifane nesihogo.

Isifo samathumbu esivuthayo: Isifo seCrohn (CD) kunye neUlcerative Colitis (UC)

• CD: ukuguquka okungaqhelekiyo okubuyisela ngokutsha okuchaphazela nayiphi na inxalenye yephepha le-GI ukusuka emlonyeni ukuya kwi-anus kodwa ekugqibeleni ngokuqhelekileyo kubandakanya i-leum yokuphela. Inkcazo ye-M / C: iintlungu zesisu / ukuxubha kunye ne-diarrhea. Indlela: Ukwakhiwa kwe-granulomata engafaniyo ne-UC yintshukumo, eyinokuthi ikhokelela kwimigangatho. Iindawo ezichaphazelekayo ukuvuvukala ngokuqhelekileyo zichanekile
• Iingxaki zininzi: i-malabsorption yezondlo / iivithamini (i-anemia, i-osteoporosis, ukulibaziseka kokuphuhliswa kwabantwana, ukuthinteka kwi-GI, ukukhutshwa komzimba, ukuveliswa kwe-fistula, ukubonakaliswa kwesisu esiswini: i-uveitis, i-arthritis, i-AS, i-erythema nodosum kunye nabanye.10- 20% unokufuna ukuhlinzwa kwesisu emva kwe-10-iminyaka eyiCD ngokuqhelekileyo ukwenzela ukugqithisa, i-fistiluzation, i-BO.
• I-Dx: iiklinikhi, i-CBC, i-CMP, i-CRP, i-ESR, iimvavanyo zeserological: i-DDx ye-IBD: i-anti-saccharomyces cerevisiae antibodies (ASCA), i-anti-nuclear antibody (p-ANCA) okanye i-serum. Uvavanyo lwe-Fecal Calprotectin lunceda iDDx IBS kwaye livavanye impendulo kwonyango, umsebenzi wesifo / ukubuyela kwakhona.
• Dx yokukhetha: i-endoscopy, i-ileoscopy, kunye ne-biopsies ezininzi zingabonisa ukutshintsha kwe-endoscopic kunye neenguqu zakhe. I-capsule endoscopy yeVideo (VCE), ukucingwa kunokunceda ngeDx yeengxaki. I-Rx: iziyobisi ezingenayo i-immunomodulatory, unyango olongezelelweyo, ukutya, i-probiotics, ukusebenza. Akukho unyango kodwa injongo kukukhuthaza ukuxolelwa, ukulawula iimpawu nokukhusela / ukunyanga iingxaki
• Ukufanekisa i-Dx: KUB kuya kwi-SBO ye-DDx, i-enum ye-Barium (ngokungafani kunye nokuphindwe kabini), isilwanyana esilandelayo silandela. Iziphumo: ukuqhekeka izilonda, i-aphthous / isilonda esisisigxina, iifistula / amaphetshana wesinasi, uphawu lwesigxina, inqanaba ehambayo iphosa i-LB, ukubonakalisa i-cobblestone d / t izifungo / izilonda zinyusa i-mucosa, i-CT yokutshekisha nge-oral and IV.

• Ukucingwa kwisigulane sikaCrohn esinesigqithiso esincinci sokukhupha.
• (A) I-CT scan ibonisa ukudumba okungaqhelekanga kanti
• (B) I-MRE yendawo enye ibonisa ukuqina kwe-fibrostenotic

• UC: Ngokwesiqhelo ibandakanya ikholoni kuphela kodwa i-backwash ileitis inokuphuhla. Ukuqala ngokuqhelekileyo kwi-15-40s kwaye kuxhaphake kakhulu kumadoda, kodwa ukuqala emva kweminyaka engama-50 kuqhelekileyo. Okuqhelekileyo kuMntla Melika naseYurophu (hygiene hypothesis). I-Etiology: Indibaniselwano yokusingqongileyo, imfuzo kunye notshintsho lwe-microbiome yamathumbu luyabandakanyeka. Ukutshaya kunye ne-appendectomy yokuqala idla ngokubonisa unxulumano olubi kunye ne-UC, ngokungafaniyo ne-CD iqwalasele ezinye zezinto ezinobungozi.
• Impawu zonyango: Ukopha kwi-rectal (okuqhelekileyo), urhudo, ukukhutshwa kwe-rectal mucous discharge, i-tenesmus (ngamathuba athile), iintlungu ezisezantsi zesisu kunye nokuphelelwa ngamandla kwamanzi okuphuma kwi-purulent rectal discharge (kwiimeko ezinzima, ngakumbi kubantu abadala), i-fulminant colitis kunye ne-megacolon enetyhefu inokuba yi-fetus kodwa ziingxaki ezinqabileyo. . I-Pathology: Akukho granulomata. Izilonda zichaphazela i-mucosa kunye ne-submucosa. I-pseudopolyps ibonakala njenge-mucosa ephakamileyo egciniweyo.
• Inkqubo yokuqala ihlala ichaphazela i-rectum kwaye ihlala isifo sendawo (proctitis) kwi-25%). I-30% Ukwandiswa kwesifo esikufutshane kunokwenzeka. I-UC inokubonisa njengecala lasekhohlo (55%) kunye ne-pancolitis (10%). Uninzi lwamatyala luphakathi ukuya phakathi
• I-Dx: i-colonoscopy ene-ileoscopy ene-biopsies ezininzi iqinisekisa i-Dx. IiLabs: CBC, CRP, ESR, Fecal calprotectin, Iingxaki: anemia, megacolon enetyhefu, umhlaza wekholoni, isifo samathambo, uveitis, AS, Pyoderma gangrenosum, Primary sclerosing cholangitis. Rx: I-5-aminosalicylic acid yonyango yomlomo okanye ye-rectal, i-corticosteroids, i-immunomodulatory drugs, i-colectomy yonyango.
• Ukucinga: akufuneki kwi-Dx kodwa i-barium enema inokubonakalisa izilonda, i-thumbprinting, kwiimeko eziphambili ukulahlekelwa kwe-haustra kunye nokunciphisa ikholoni evelisa ikholoni ye-lead-pipe. iimeko. I-CT inokunceda nge-Dx yeengxaki. Umfanekiso wefilim engenanto uveza �ikholoni yombhobho okhokelayo� kunye nesacroiliitis njengeEnteropathic arthritis (AS)

• I-Colorectal carcinoma (CRC) m / c umhlaza wephepha le-GI kunye ne-2nd eyona nto ixhaphakileyo kubantu abadala. I-Dx: i-endoscopy kunye ne-biopsy. I-CT yeyona ndlela isetyenziswa rhoqo kwiqonga. Uqhaqho loqhaqho lunonyango nangona izinga lokusinda leminyaka emihlanu lingama-40- 50% ngokuxhomekeke kwiqonga. Izinto ezinobungozi: i-fiber ephantsi kunye namafutha aphezulu kunye nokutya kweprotheni yezilwanyana, ukukhuluphala (ingakumbi kumadoda), isifo esingapheliyo se-ulcerative colitis. I-colon adenomas (iipolyps). I-Familial adenomatous polyposis syndromes (I-Gardener syndrome) kunye ne-Lynch syndrome njenge-polyposis engeyiyo yosapho.
• Klinikhi: Ukuqala okungaqondakaliyo kunye nemikhwa etshintshileyo yamathumbu, igazi elitsha okanye i-melena, i-anemia yokunqongophala kwe-iron ekulahlekeni kwegazi okungapheliyo ngokukodwa kwi-tumor yasekunene. Ukuvaleka kwamathumbu, intussusception, ukopha kakhulu kunye nesifo se-metastatic ngokukodwa kwiSibindi kunokuba yintetho yokuqala. Indlela: I-98% i-adenocarcinomas, ivela kwi-colonic adenomas esele ikhona (i-polyps ye-neoplastic) kunye nokuguqulwa okubi. Umyinge weminyaka emihlanu wokusinda yi-40-50%, kunye nenqanaba ekusebenzeni eyona nto ibalulekileyo echaphazela ukuxilongwa. I-M / C i-rectosigmoid tumors (55%),
• NB Ezinye i-adenocarcinomas esp. iintlobo ze-mucinous zivezwa ngokukhawuleza kwaye zihlala zixhatshazwa ngenxa yokungeniswa kwexesha kunye ne-mucin kunye nokusabalalisa kwendawo
• Ukucinga: I-Barium enema yi-sensitivities ye-polyps> 1 cm, umehluko omnye: 77-94%, ukuchasana kabini: 82-98%. I-Colonoscopy yindlela ekhethwa yokuthintela, ukufumanisa, kunye nokuchongwa kwe-colorectal carcinoma. I-CT scanning eyomeleziweyo isetyenziselwa ukubeka kunye novavanyo lwe-prognosis ye-mets.
• Ukuhlola: i-colonoscopy: amadoda 50 yo-10-iminyaka xa eqhelekileyo, iminyaka eyi-5 ukuba i-polypectomy, i-FOB, i-1st degree kunye ne-CA iqalise ukuhlola kwi-40 yo

• Cancer Pancreatic: i-adenocarcinoma ye-epithelial (90%), i-prognosis ephosakeleyo kakhulu kunye nokufa okuphezulu. I-3rd M / C yomhlaza wesisu. I-Colon ngu-#1, isisu #2. I-cancer ye-Pancreatic i-22% yabo bonke abantu abafa ngenxa yokunyangwa kwesisu, kunye ne-5% yabo bonke abantu ababulawa ngumhlaza. I-80% yamatyala kwi-60 +. Ukutshaya i-cigarette yinkalo eyingozi kakhulu yendalo engqongileyo, ukutya okucebileyo kumafutha kunye neeprotheni. Ukunyanya. Imbali yentsapho. I-M / C ifunyenwe entloko kwaye iyancipha inkqubo.
• Dx: I-CT scanning ibalulekile. Ukuhlaselwa kwe-Superior Mesenteric Artery (SMA) kubonisa isifo esingenakulinganiswa. I-90% ye-pancreatic adenocarcinomas ayinakwenzeka kwi-Dx. Uninzi lwezigulane zifa ngaphakathi kwe-1-year ye-Dx. Ngokonyango: i-jaundice engenabuhlungu, abd. Iintlungu, i-gallbladder ye-Courvoisier: i-jaundice engenabuhlungu kunye ne-gallbladder eyandisiweyo, i-Trousseau's syndrome: i-migratory thrombophlebitis, isifo seswekile esitsha, i-metastasis yengingqi kunye nekude.
• CT Dx: ubunzima be-pancreatic ene-demoplastic reaction eyomeleleyo, ukuphuculwa okulambathayo, kunye nokuncipha kancinci xa kuthelekiswa nedlala eliqhelekileyo elikufutshane, uhlaselo lwe-SMA.

• Appendicitis: imeko eqhelekileyo kwi-radiology jikelele kwaye yimbangela enkulu yokuhlinzwa kwesisu kwizilwanyana eziselula
• I-CT yindlela yokuziphatha ekhethekileyo yokubona ukulungiswa kwezixhobo
• I-Ultrasound kufuneka iqeshwe kwizigulane kunye nabantwana
• I-KUB Radiographs akufanele idlale indima ekuxilongweni kwe-appendicitis
• Kumfanekiso, i-appendicitis ityhila isihlomelo esidumbileyo esinodonga olujiyileyo, ulwandiso, kunye ne-periappendiceal fat stranding. Iziphumo ezifanayo zokuqina kodonga kunye nokwandiswa ziphawulwe e-US. Uphawu oluqhelekileyo �uphawu oluphawulwe kumgca omfutshane we-US.
• Ukuba i-appendix i-retro-caecal kunokuba i-US ingaphumeleli ukubonelela nge-Dx kunye ne-CT echanekileyo
• I-Rx: yokusebenza ukuphepha iingxaki

• Umngcipheko omncinci (SBO) -80% yazo zonke izithintelo zamathumbu emathunjini; i-20% eseleyo ngenxa yesithintelo esikhulu seembilini. Unesilinganiso sokufa se-5.5%
• M / C kubangele: nayiphi na i-Hx yokuhlinzwa kwangasemva kwesisu kunye nokunamathela
• Inkcazo ye-Classical is constipation, ukwandisa isisu esiswini kunye nesisulu kunye nokuhlanza
• Ii-radiographs ziphela kuphela ze-50% ezithintekayo kwi-SBO
• I-CT iya kubonisa imbangela ye-SBO kwi-80% yamatyala
• Kukho imigaqo echaseneyo yokunciphisa isilwanyana esincinci, kodwa i-3.5 cm iyingqikelelo engalindelekanga yembilini
• Kwi-Abd x-reyi: supine vs. upright. Izibilini ezinwetshiweyo, ivalvulae eyoluliweyo (i-mucosal folds), amanye amanqanaba olwelo lomoya � ileli yokunyathela.
• Rx: utyandwa �esisisu esibukhali.�

• Volvulus-m/c kwi-Sigmoid colon esp. kubantu abadala. Esona sizathu: ukuqhinwa okungapheliyo kunye nokujija okungafunekiyo kwe-sigmoid kwi-sigmoid mesocolon. Ikhokelela ekuthinteleni kwamathumbu amakhulu (LBO). Abanye oonobangela abaqhelekileyo: ithumba kwikholoni. Sigmoid vs. Caecum volvulus
• Ngokonyango: iimpawu ze-LBO kunye nokuqhina, ukuqunjelwa kwesisu, intlungu, isicaphucaphu, kunye nokuhlanza. Ukuqala kunokuba qatha okanye kungapheliyo
• NgokweRadiographically: ilahleko ye-haustra kwi-LB, LB distension (>6-cm), �uphawu lwembotyi yekofu� isilayidi esilandelayo, isiphelo esisezantsi sevolvulus ikhomba kwi-pelvis
• I-NB: Umgaqo wesithupha kwisilonda esincinci kufuneka ube ngu-3-6-9 apho i-3-cm SB, i-6-cm LB kunye ne-9-cm Coecum
• Rx: utyando �esisisu esibukhali.�

Ucaphulo

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