Qhov Tseem Ceeb Qhov txawv - Pancreatitis vs Gallbladder Attack
Pancreas thiab gallbladder yog ob lub cev nyob ib sab ntawm ib sab hauv lub plab kab noj hniav. Vim tias qhov sib thooj hauv lawv txoj haujlwm, feem ntau ntawm cov chaw kho mob tshwm sim vim cov kab mob ntawm cov kab mob sib luag zoo ib yam. Pancreatitis, uas yog qhov mob ntawm cov ntaub so ntswg pancreatic, thiab gallbladder tawm tsam, uas yog vim qhov mob ntawm lub gallbladder, yog ob qho piv txwv zoo rau qhov zoo sib xws. Ob leeg ntawm cov mob no yog tus cwj pwm los ntawm qhov mob plab mob hnyav tshwm sim los ntawm thaj tsam epigastric ntawm lub plab. Txawm li cas los xij, qhov sib txawv tseem ceeb ntawm tus mob pancreatitis thiab gallbladder nres yog tias, hauv pancreatitis, pancreas tau mob thaum lub gallbladder tawm tsam nws yog lub gallbladder uas raug hloov pauv.
Tus kab mob pancreatitis yog dab tsi?
Kev mob ntawm cov ntaub so ntswg hauv pancreas txhais tau tias yog pancreatitis. Nyob ntawm lub sijhawm ntawm cov tsos mob, tus mob no tau muab faib ua ob pawg xws li mob pancreatitis mob thiab mob ntev. Kev sib txawv ntawm ob qho xwm txheej ntawm ib leeg yuav nyuaj vim tias txhua yam ua rau mob pancreatitis thaum tsis kho kom raug tuaj yeem ua rau muaj tus kab mob ntev.
mob pancreatitis
Tus mob pancreatitis yog ib qho mob ntawm tus mob pancreas vim kev raug mob hnyav.
Caus
- Gallstones
- Alcohol
- Kab mob xws li mumps thiab Coxsackie B
- Cov qog nqaij hlav pancreatic
- Cov teebmeem ntawm cov tshuaj sib txawv xws li azathioprine
- Hyperlipidemias
- Ntau yam iatrogenic ua rau
- Idiopathic ua rau
Pathogenesis
mob hnyav rau cov ntaub so ntswg
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Mob hnyav nce hauv qib calcium hauv lub cev
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ua kom ntxov ntxov ntawm trypsinogen rau hauv trypsin thiab kev puas tsuaj ntawm qhov degradation ntawm trypsin los ntawm chymotrypsin
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YCellular necrosis
Daim duab 01: Pancreas
Tshuaj Kho Mob
- Thaum pib, muaj mob plab sab sauv los ntawm epigastrium uas yog nrog xeev siab thiab ntuav. Thaum tus mob tsis tswj tau nws kis mus rau lwm qhov chaw ntawm lub peritoneum. Qhov no ua rau qhov mob hnyav dua thiab yog tias retroperitoneum koom nrog kuj tuaj yeem ua rau mob nraub qaum.
- Keeb kwm ntawm qhov zoo sib xws ntawm qhov mob hauv plab sab sauv
- Keeb kwm ntawm gallstones
- Hauv tus kab mob hnyav, tus neeg mob tuaj yeem muaj tachycardia, hypotension, thiab oliguria.
- Thaum kuaj lub plab, tuaj yeem muaj kev sib tw nrog kev saib xyuas.
- Periumbilical (Cullen's kos npe) thiab flank bruising (Grey Turner's kos npe)
Diagnosis
Qhov kev soj ntsuam tsis txaus ntseeg ntawm tus mob pancreatitis tau lees paub los ntawm kev tshawb nrhiav hauv qab no.
kuaj ntshav
Nyob rau hauv tus mob pancreatitis, qib serum amylase tau nce tsawg kawg peb zaug ntau dua li qib ib txwm nyob hauv 24 teev txij li qhov pib mob. Tab sis tsis pub dhau 3-5 hnub los ntawm kev tawm tsam, qib amylase poob rov qab mus rau qib qub. Yog li ntawd, nyob rau hauv ib qho kev nthuav qhia lig kev sim, cov ntshav amylase qib tsis pom zoo.
Serum lipase qib kuj nce txawv txav
Cov kev ntsuam xyuas hauv paus suav nrog FBC thiab cov ntshav electrolytes kuj tau ua.
- X-ray hauv siab yuav tsum tau coj mus rau qhov tsis suav nrog qhov ua rau gastroduodenal perforation
- Abdominal USS
- Txhim kho CT scan
- MRI
Cov teeb meem ntawm Tus Mob Pancreatitis
- Multi-organ dysfunction
- Systemic inflammatory response syndrome
- YPancreatic abscesses, pseudocysts thiab necrosis
- pleural effusion
- ARDS
- Pneumonia
- mob raum mob
- Paralytic ileus
- YPortal vein thrombosis
- Hypoglycemia lossis hyperglycemia
- DIC
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Kev tswj hwm
Muaj peev xwm poob dej ntau thaum lub sijhawm pib ntawm tus kab mob. Yog li ntawd, nws yog ib qho tseem ceeb uas yuav tsum muaj kev tswj xyuas cov hlab ntsha zoo, kab hauv nruab nrab thiab lub tso zis tso zis los saib xyuas cov ntim ntim thiab lub raum ua haujlwm.
Lwm cov txheej txheem thiab cov kauj ruam ua raws thaum tswj hwm tus mob pancreatitis yog,
- Nasogastric suction kom txo tau qhov kev pheej hmoo ntawm aspiration pneumonia
- Baseline arterial blood gas txhawm rau txheeb xyuas cov xwm txheej hypoxic
- Kev tswj cov tshuaj tiv thaiv kab mob
- Tshuaj kho mob qee zaum yuav tsum tau txo qhov mob
- Kev noj qhov ncauj ua rau muaj feem kis tau tus kab mob. Yog li ntawd, nyob rau hauv cov neeg mob uas tsis muaj gastroparesis, nasogastric tswj cov zaub mov yog ua hauj lwm whereas nyob rau hauv cov neeg uas muaj gastroparesis post-pyloric pub yog instituted.
Tus mob pancreatitis
Tus kab mob pancreatitis yog qhov mob txuas ntxiv ntawm cov ntaub so ntswg ua rau ua rau tsis muaj kev puas tsuaj.
Aetiology
- Alcohol
- Hereditary cause
- Trypsinogen thiab inhibitory protein defects
- YCystic fibrosis
- Idiopathic ua rau
- Tauma
Tshuaj Kho Mob
- mob epigastric uas tawm mus rau sab nraub qaum. Nws tuaj yeem yog qhov mob episodic lossis mob tsis tu ncua
- poob qis
- Anorexia
- Muaj tau malabsorption thiab qee zaum mob ntshav qab zib
Kev kho mob
Kev kho mob ntawm tus mob pancreatitis ntev nws txawv raws li hauv qab kab mob.
Yuav ua li cas yog Gallbladder Attack?
Cov kab mob sib kis ntawm lub gallbladder ua rau mob hnyav yog hu ua gallbladder attacks.
Caus
- Gallstones
- hlav hauv lub gallbladder lossis biliary tract
- Ascending cholangitis
- Tauma
- kab mob hauv tsob ntoo biliary
Pancreatitis
Tshuaj Kho Mob
- mob plab epigastric uas tawm mus rau sab xis ntawm lub xub pwg lossis sab nraub qaum ntawm lub scapula
- Ntaus thiab ntuav
- Qee zaus ua npaws
- plab plab
- Steatorrhea
Daim duab 02: Gallbladder
Kev tshawb nrhiav
- kuaj ntshav ua haujlwm
- suav ntshav
- USS
- CT scan kuj ua tau qee zaum
- MRI
Kev tswj hwm
Raws li tus mob pancreatitis ntev, kev kho mob ntawm lub gallbladder tawm tsam kuj txawv raws li qhov tshwm sim ntawm tus kab mob.
Kev hloov pauv kev ua neej xws li tshem tawm kev rog tuaj yeem pab txo qis kev pheej hmoo ntawm cov kab mob gallbladder.
Kev tswj qhov mob thiab txo tus neeg mob qhov tsis xis nyob yog thawj feem ntawm kev tswj hwm. Muaj zog tshuaj loog zoo li morphine tej zaum yuav xav tau nyob rau hauv cov mob hnyav tshaj plaws. Txij li thaum o ntawm lub gallbladder yog lub hauv paus pathological ntawm tus kab mob, cov tshuaj tiv thaiv kab mob yog muab los tswj cov o. Yog hais tias qhov kev cuam tshuam ntawm lub biliary tsob ntoo yog vim ib tug qog, phais resection ntawm nws yuav tsum tau nqa tawm.
Kev nyuaj siab
- peritonitis vim perforation thiab tso kua paug
- plab hnyuv obstruction
- Malignant transformation
Dab tsi zoo sib xws ntawm Pancreatitis thiab gallbladder Attack?
- Kab mob ntawm cov ntaub so ntswg yog lub hauv paus ntawm ob yam kab mob
- mob plab plab yog qhov chaw kho mob tseem ceeb ntawm ob yam kab mob.
Qhov txawv ntawm Pancreatitis thiab Gallbladder Attack yog dab tsi?
Pancreatitis vs Gallbladder Attack |
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| Kev mob ntawm cov ntaub so ntswg hauv pancreas txhais tau tias yog pancreatitis. | Kev mob ntawm lub gallbladder ua rau mob hnyav yog hu ua gallbladder attack. |
| Organ | |
| Kab mob tshwm sim hauv pancreas. | Kab mob tshwm sim hauv lub gallbladder. |
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Ua rau mob pancreatitis: Gallstones Alcohol Kab mob xws li mumps thiab Coxsackie B Cov qog nqaij hlav pancreatic Cov teebmeem ntawm cov tshuaj sib txawv xws li azathioprine Hyperlipidemias Ntau yam iatrogenic ua rau Idiopathic ua rau Ua rau mob pancreatitis ntev: Alcohol Hereditary cause Trypsinogen thiab inhibitory protein defects YCystic fibrosis Idiopathic ua rau Tauma |
Ua rau lub gallbladder nres: Gallstones hlav hauv lub gallbladder lossis biliary tract Pancreatitis Ascending cholangitis Tauma kab mob hauv tsob ntoo biliary |
| Tshuaj kho mob | |
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Kev kho mob tshwj xeeb mob pancreatitis:
Kev kho mob tshwj xeeb mob pancreatitis:
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Kev kho mob lub gallbladder nres:
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| Diagnosis | |
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Kev kuaj mob pancreatitis yog los ntawm kev tshawb nrhiav hauv qab no. kuaj ntshavNyob rau hauv tus mob pancreatitis, qib serum amylase tau nce tsawg kawg peb zaug ntau dua li qib ib txwm nyob hauv 24 teev txij li qhov pib mob. Tab sis tsis pub dhau 3-5 hnub los ntawm kev tawm tsam, qib amylase poob rov qab mus rau qib qub. Yog li ntawd nyob rau hauv ib tug lig kev nthuav qhia kuaj cov ntshav amylase qib tsis pom zoo. Serum lipase qib kuj nce txawv txav Cov kev ntsuam xyuas hauv paus suav nrog FBC thiab cov ntshav electrolytes kuj tau ua.
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Kev Tshawb Fawb:
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| Kev tswj hwm | |
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Kev tswj tus mob pancreatitis suav nrog, · Nasogastric suction kom txo qis kev pheej hmoo ntawm kev mob ntsws ntsws · Baseline arterial blood gas txhawm rau txheeb xyuas cov xwm txheej hypoxic · Kev tswj cov tshuaj tiv thaiv kab mob prophylactic · Tej zaum yuav tsum tau tshuaj loog kom txo qhov mob · Kev noj qhov ncauj ua rau muaj feem kis tau tus kab mob. Yog li ntawd nyob rau hauv cov neeg mob uas tsis muaj gastroparesis, nasogastric tswj cov zaub mov yog ua hauj lwm whereas nyob rau hauv cov neeg uas muaj gastroparesis post-pyloric pub yog instituted. Kev kho mob ntawm tus mob pancreatitis ntev nws txawv raws li hauv qab kab mob. |
Kev tswj qhov mob thiab txo tus neeg mob qhov tsis xis nyob yog thawj feem ntawm kev tswj hwm. Cov tshuaj loog muaj zog zoo li morphine tej zaum yuav xav tau rau qhov mob hnyav tshaj plaws. Vim qhov mob ntawm lub gallbladder yog lub hauv paus ntawm tus kab mob, cov tshuaj tiv thaiv kab mob tau muab los tswj qhov mob. Yog tias qhov cuam tshuam ntawm tsob ntoo biliary yog vim muaj qog, kev phais yuav tsum tau ua. |
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Cov teeb meem ntawm tus mob pancreatitis yog,
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Cov teeb meem ntawm gallbladder tawm tsam yog,
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Summary - Pancreatitis vs Gallbladder Attack
Tus mob ntawm tus txiav yog hu ua pancreatitis thiab qhov mob ntawm lub gallbladder ua rau mob hnyav hu ua gallbladder attack. Qhov sib txawv ntawm qhov chaw ntawm qhov mob yog qhov sib txawv loj ntawm pancreatitis thiab gallbladder nres.
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Koj tuaj yeem rub tawm PDF version ntawm kab lus no thiab siv nws rau offline hom phiaj raws li cov ntawv sau tseg. Thov download PDF version ntawm no Qhov txawv Ntawm Pancreatitis thiab Gallbladder Attack
