I-gallbladder (kusuka ku-Latin vesica biliaris) isebenza njengendawo yokugcina i-bile, uketshezi oluphuzi olubonakalayo olukhishwa isibindi futhi olubandakanyeka enqubweni yokugaya.

I-gallbladder itholakala ngakwesokudla kwesisu. Yisikhwama esincane esimise okwamapheya esitholakala ngaphansi kwesibindi. Okuluhlaza okotshani ngombala kanye nodonga oluncane, isilinganiso silinganiselwa ku-7 kuya ku-12 cm ubude. Iqukethe ngokwesilinganiso i-50 mL ye-bile. Emaphethelweni awo aphansi, umgudu we-cystic ujoyina umgudu ovamile we-hepatic ukuze wakhe umgudu we-bile ovamile. Kungalo mgudu lapho i-bile igelezela khona ku-duodenum, ingxenye yokuqala yamathumbu amancane alandela isisu.

I-Bile iqukethe ikakhulukazi amanzi, usawoti we-bile, i-bilirubin (i-pigment ebangelwa ukuwohloka kwe-hemoglobin futhi enikeza i-bile umbala wayo ophuzi ophuzi), i-cholesterol nama-phospholipids. Ama-bile salts nama-phospholipids kuphela abamba iqhaza enqubweni yokugaya. Yize ingenawo ama-enzyme, i-bile iyakwazi, ngenxa yosawoti wayo, ukunciphisa usayizi wama-globules amafutha, ngakho-ke ukwenza lula ukusebenza kwama-enzyme wokugaya ukudla.

Ukuziphatha kwe-gallbladder kuncike esimweni se-duodenum. Uma lokhu kungenalutho, i-bile igeleza ibuyele emgudwini we-cystic ukuze igcinwe ku-gallbladder. Lesi sakamuva sibe sesigxilisa i-bile ngokumunca amanzi awo kancane, ngaleyo ndlela senze isenzo sesikhathi esizayo se-bile salts siphumelele. Lapho ukudla okunamafutha kungena ku-duodenum, ukukhishwa kwe-cholecystokinin, ihomoni ekhiqizwa amathumbu, kubangela ukuba inyongo ifinyele, bese ikhiphela i-bile emgudwini ovamile we-bile. Lesi sakamuva sihlanganiswe emnyango we-duodenum ngepayipi le-pancreatic (njengoba igama lalo lisikisela ukuthi livela kumanyikwe), eliphethe ama-enzyme wokugaya ukudla, ukwenza isibani se-hepato-pancreatic. Lapho isingenile emathunjini amancane, i-bile nejusi ye-pancreatic iqala ukuwohloka kwamakhemikhali kokudla.

I-lithiasis ye-biliary : ukwakheka kwamatshe ngaphakathi kwe-gallbladder noma ngaphakathi kwamapayipi enyongo. Lawa matshe, afana namatshe amancane amancane, akhiwa kakhulu yi-cholesterol ekhanyisiwe. Umumo wabo, ubukhulu kanye nenombolo kuyahlukahluka kumuntu nomuntu. Yize ngokuvamile enobungozi, lawa matshe angavimbela ama-cystic kanye nama-bile ducts ajwayelekile, ngakho-ke ukuphuma kwe-bile kuya ku-duodenum. Kulokhu, isihloko sine-biliary colic engahlala amahora angu-4.

Amatshe enyongo amancane anomthelela wokubambezela ukugeleza kwenyongo okuzobe kumile kuze kwakheke lokho okubizwa ngokuthi yi-bile sludge, etholakala nakwabanye abantu abane-AIDS (3).

Ucwaningo lwe-4 (2001) lwenza ukuthi kube nokwenzeka ukuhlonza izakhi zofuzo zokuthambekela kwe-lithiasis kumagundane, ngaleyo ndlela iphakamisa umsuka wofuzo ongaba khona kule pathology. Ngaphezu kwalokho, amaqembu athile ezizwe, njengamaNdiya aseNyakatho Melika, abonakala esengozini enkulu ye-lithiasis.

Kunoma ikuphi ubudala, ukukhuluphala ngokweqile nakho kuyingcuphe eyengeziwe yokwakhiwa kwamatshe enyongo. Ocwaningweni oluyi-5 (2012) lwabantu abangu-510 abaneminyaka engu-000 kuya kwengu-9, kwatholakala ukuthi izingane ezikhuluphele zinamathuba aphindwe kabili okuphathwa yi-gallstones, kuyilapho ingozi iphindwe kasishiyagalombili ye-gallstones. abantu abanokukhuluphala ngokweqile.

Ngokuvamile, abesifazane bavezwa kakhulu kunamadoda kulezi zinyongo. Ukuziphatha okuthile kungakhuphula ubungozi bokwenza amatshe.

Cholecystitis : ukuvuvukala kwe-gallbladder, okungase kuhambisane nokutheleleka. Ngokuvamile kwenzeka ngenxa yokuba khona kwamatshe ku-gallbladder noma i-bile duct evamile.

I-porcelain vesicle : ngemuva kwe-cholecystitis, i-calcium inganamathela ezindongeni ze-gallbladder, eziqina. Isihloko sibe nalokho okubizwa ngokuthi i-porcelain vesicle.

I-cholestatic jaundice : Lapho imigudu yenyongo ivalekile, i-bile igeleza ibuyele egazini. Njengoba i-bilirubin ingasakhiphi esitulweni, iba ingenambala, kuyilapho isikhumba siphenduka sibe phuzi kancane. Ngasikhathi sinye, izinga le-urinary bilirubin liyakhuphuka, okuholela emchameni omnyama. Lezi yizimpawu ze-cholestatic jaundice.

I-Choledochal cysts : ukuvuvukala okungavamile kwemigudu yenyongo. Isifo esikhona kusukela ekuzalweni, sandisa amathuba okuba nomdlavuza wenyongo.

Ukuhlangana okungajwayelekile kwe-pancreatic-biliary : ukuzalwa okungaqondakali kokuhlangana phakathi kwenyongo evamile kanye namapayipi e-pancreatic. Kulokhu, ama-enzyme akhiqizwa ama-pancreas awakwazi ukufinyelela ku-duodenum. Ngemuva kwalokho zingadala ukucasuka kwe-gallbladder.

Umdlavuza we-gallbladder : Njenge-cholecystitis, ukubonakala kwe-carcinoma ye-gallbladder kuthanda amatshe enyongo. I-pathology engavamile eFrance, ihlasela ikakhulukazi abesifazane abangaphezu kweminyaka engama-70. Imvamisa itholwa sekwephuzile lapho isakazeka ezithweni ezingomakhelwane, ngezinye izikhathi ihambisana nobuhlungu besisu, ukuhlanza nokuphelelwa ukudla. Kufanele kucatshangelwe izici zobuzwe ukuze kuhlolwe ukwenzeka kwayo. Ukuchayeka ku-Thorotrast (9) (indlela ehlukile eyayisetshenziswa ngaphambilini emfanekisweni wezokwelapha) nakho kwandisa ingozi yokuba nomdlavuza wenyongo.

Lapho amatshe engabaliwe futhi engadluli ngosayizi othile, ukwelashwa ukuwaqothula, njenge-Actigall, kungenzeka. I-Ablation, engenawo umthelela wangempela nsuku zonke, isalokhu ijwayelekile ezimweni ze-gallstones.

Ukudla kungathonya ukwakheka kwe-gallstones. Ukudla okunekhalori ephezulu kuvame ukukhuthaza ukubukeka kwabo, kuyilapho ukudla okunothe ngemicu yemifino kunciphisa leli phesenti. Uma kwenzeka ukubonakala kokuqala kwamatshe, ukulungiswa kwendlela yokuphila (ukunciphisa ukusetshenziswa kwamafutha, ushukela, i-hydration enhle, umsebenzi ojwayelekile womzimba, njll.) kungakhulula ngokushesha noma yikuphi ubuhlungu.

Izifo ezithile zamathumbu, njengesifo sikaCrohn, zingaphindeka kabili noma ziphindaphinde kathathu ukwanda kwamatshe enyongo (10).

I-Ultrasound yesisu: isivivinyo esilula futhi esisheshayo ukukhomba amatshe enyongo. Ikwazi ukubona u-90% wezibalo. Kuhlotshaniswa nokuhlolwa kwezinto eziphilayo (ukuhlolwa kwegazi nokuhlaziywa kwe-bilirubin) ukuze kulinganiswe ubucayi besimo.

I-Echo-endoscopy: lokhu kuhlolwa kwemizuzu engamashumi amabili kukuvumela ukuthi ubheke ingaphakathi le-gallbladder futhi ufunde ne-pancreas ngokungeziwe.

Ukususwa kwe-gallbladder (noma i-cholecystectomy): Ukuhlinzwa okungenziwa ukwelapha amatshe enyongo we-gallbladder noma i-bile bile evamile lapho kuhambisana nobuhlungu obukhulu.

E-Antiquity, u-Galen wasungula inkolelo-mbono yamahlaya amane (11) lapho ibhalansi yamahlaya (igazi, i-bile ephuzi, i-bile emnyama, i-phlegm) ilawula impilo yengqondo neyomzimba yomuntu. Imabula ephuzi ihlotshaniswa nentukuthelo, kuyilapho i-bile emnyama ivusa ukudangala nokudabuka. Lesi sakamuva sasibhekene nezinkinga nobubi. Kusuka kulo mbono wesiGreki lapho inkulumo ethi “ukuba nenyongo” (12) ivela khona.