1. Uphawu lwe-Hepatojugular reflux
Lapho ukwehluleka kwenhliziyo kwesokudla kubangela ukuminyana kwesibindi nokuvuvukala, isibindi singacindezelwa ngezandla ukuze senze imithambo ye-jugular ihlakazeke kakhulu. Izimbangela ezivame kakhulu ukungasebenzi kahle kwe-ventricular kanye ne-hepatitis yokuminyana.
2.Isibonakaliso sikaCullen
Okwaziwa nangokuthi uphawu lwe-Coulomb, i-ecchymosis onsomi-blue esikhumbeni esizungeze inkaba noma udonga lwesisu esingaphansi kuwuphawu lokopha okukhulu kwangaphakathi kwesisu, okuvame kakhulu ekopheni kwe-retroperitoneal, i-acute hemorrhagic necrotizing pancreatitis, ukuphuka kwe-aorta aneurysm yesisu, njll.
3.Uphawu lweGrey-Turner
Lapho isiguli siba ne-acute pancreatitis, ujusi we-pancreatic uphuphuma ungene esikhaleni sezicubu ezingaphansi okhalweni nasemaceleni, ancibilikise amafutha angaphansi kwesikhumba, futhi ama-capillaries aqhume futhi ophe, okuholela esikhumbeni se-bluish-purple ecchymosis, esibizwa nge-Grey-Turner's sign.
4.Uphawu lwe-Courvoisier
Lapho umdlavuza wekhanda le-pancreas ucindezela i-bile duct evamile, noma umdlavuza wezingxenye ezimaphakathi neziphansi ze-bile duct kubangela ukuvinjelwa, i-jaundice esobala iyenzeka. I-gallbladder evuvukele ene-cystic, engeyona ithenda, inendawo ebushelelezi futhi enganyakaziswa izwakala, ebizwa nge-Courvoisier's sign, eyaziwa nangokuthi ukuvinjwa okuqhubekayo komgudu we-bile ovamile. intela.
5.Isibonakaliso sokucasuka kwe-Peritoneal
Ukuba khona ngesikhathi esisodwa kwesisa, ukuphindeka kwesisa kanye nokuqina kwemisipha yesisu esiswini kubizwa nge-peritoneal irritation sign, eyaziwa nangokuthi i-peritonitis triad. Kuwuphawu olujwayelekile lwe-peritonitis, ikakhulukazi indawo yesilonda esiyinhloko. Inkambo yokucindezeleka kwemisipha yesisu incike kumbangela kanye nesimo sesiguli. Isimo esijwayelekile siyahlukahluka, futhi ukwanda kwesisu kwesisu kuwuphawu olubalulekile lwesimo esibi kakhulu.
6.Isibonakaliso sikaMurphy
Isibonakaliso esihle se-Murphy singenye yezimpawu ezibalulekile ekuxilongweni komtholampilo kwe-cholecystitis eyingozi. Lapho ubamba inyongo ngaphansi komugqa wemali ongakwesokudla, ithintwa i-gallbladder futhi isiguli sacelwa ukuba sihogele sijule. I-gallbladder evuvukele futhi evuvukele yehla. Isiguli sezwa ubuhlungu buyaqina futhi kungazelelwe sabamba umoya.
7.Isibonakaliso sikaMcburney
Ubumnene nobumnene obubuyela emuva endaweni kaMcBurney kwesokudla esingezansi kwesisu (ukuhlangana kwenkaba kanye nengxenye ephakathi nengaphandle engu-1/3 yomgogodla wesokudla wangaphambili ophakeme we-iliac) kuvamile ku-appendicitis ebukhali.
8.Unxantathu kaCharcot
I-acute obstructive suppurative cholangitis ngokuvamile iveza ubuhlungu besisu, ukugodola, umkhuhlane ophezulu, kanye ne-jaundice, eyaziwa nangokuthi i-Chaco's triad.
I-1) Ubuhlungu besisu: Kuvela ngaphansi kwenqubo ye-xiphoid kanye ne-quadrant engaphezulu kwesokudla, ngokuvamile i-colic, ngokuhlaselwa kwe-paroxysmal noma ubuhlungu obuqhubekayo ngokukhushulwa kwe-paroxysms, engakhipha ehlombe elingakwesokudla nangemuva, ehambisana nesicanucanu nokuhlanza. Kuvame ukuvuswa ngemva kokudla ukudla okunamafutha.
2) Ukugodola kanye nemfiva: Ngemva kokuvinjelwa kwemigudu yenyongo, ingcindezi engaphakathi komgudu wenyongo iyanda, ngokuvamile okuholela ekuthelelekeni kwesibili. Amagciwane kanye nobuthi kungageleza kubuyele egazini ngokusebenzisa imigudu ye-capillary bile kanye nama-sinusoid esibindi, okuholela esibindini se-biliary, i-sepsis, ukushaqeka kwe-septic, i-DIC, njll., ngokuvamile kubonakala njengemfiva ehlanzayo, nezinga lokushisa lomzimba lifinyelela ku-39 kuya ku-40 ° C.
3) I-Jaundice: Ngemva kokuba amatshe evale umgudu wenyongo, iziguli zingase zibe nomchamo ophuzi omnyama kanye namabala aphuzi esikhumbeni kanye ne-sclera, futhi ezinye iziguli zingase zibe nokulunywa kwesikhumba.
9.Reynolds (Renault) izimpawu ezinhlanu
Ukuboshwa kwamatshe akuqediwe, ukuvuvukala kuya kuba kubi nakakhulu, futhi isiguli siba nokuphazamiseka kwengqondo nokushaqeka okusekelwe ku-triad kaCharcot, ebizwa ngokuthi i-pentalogy kaRaynaud.
10.Isibonakaliso sikaKehr
Igazi emgodini wesisu livuselela i-diaphragm yesokunxele, okubangela ubuhlungu behlombe kwesokunxele, okuvamile ekuqhekekeni kwe-splenic.
11. Uphawu lwe-Obturator (ukuhlolwa kwe-obturator internus muscle)
Isiguli sasisesikhundleni se-supine, i-hip nethanga elingakwesokudla liguquguquke bese lizungeza ngaphakathi, libangele ubuhlungu obuphansi besisu obungakwesokudla, obubonakala ku-appendicitis (i-appendix iseduze ne-obturator internus muscle).
12. Uphawu lukaRovsing (ukuhlolwa kokwehla kwamandla emali kwekholoni)
Isiguli sisesimweni sokulala, isandla saso sokudla sicindezela isisu esingaphansi kwesokunxele bese isandla sobunxele sicindezela i-colon proximal, okubangela ubuhlungu esiswini esingezansi kwesokudla, esibonakala ku-appendicitis.
13.I-X-ray uphawu lokucasuka kwe-barium
I-Barium ibonisa izimpawu zokucasuka engxenyeni yamathumbu egulayo, ngokukhipha ngokushesha nokugcwalisa okungalungile, kuyilapho ukugcwaliswa kuhle ezingxenyeni zamathumbu angaphezulu naphansi. Lokhu kubizwa nge-X-ray barium irritation sign, evamile ezigulini ezine-ulcerative tuberculosis. .
14. Uphawu lwe-halo oluphindwe kabili/uphawu oluqondiwe
Esigabeni esisebenzayo se-Crohn's disease, i-CT enterography (CTE) ethuthukisiwe ibonisa ukuthi udonga lwamathumbu luqina kakhulu, i-mucosa yamathumbu ithuthukiswa kakhulu, ingxenye yodonga lwamathumbu ihlukaniswe, futhi indandatho yangaphakathi ye-mucosal nendandatho yangaphandle ye-serosa ithuthukiswa kakhulu, ibonisa i-halo ephindwe kabili. uphawu noma uphawu oluqondiwe.
15. Uphawu lwekama lezinkuni
Esigabeni esisebenzayo sesifo sika-Crohn, i-CT enterography (CTE) ikhombisa ukwanda kwemithambo yegazi ye-mesenteric, okuhambisanayo nokukhuphuka kwamafutha e-mesenteric nokufiphala, kanye nokwandiswa kwe-lymph node ye-mesenteric, okubonisa “uphawu lwekama lokhuni”.
16. I-Enterogenic azotemia
Ngemuva kokuphuma kwegazi okukhulu endaweni engenhla yamathumbu, imikhiqizo yokugaya amaprotheni egazi idonswa emathunjini, futhi ukuhlushwa kwe-urea nitrogen egazini kungase kukhule okwesikhashana, okubizwa ngokuthi i-enterogenic azotemia.
17.Mallory-Weiss syndrome
Ukubonakaliswa okuyinhloko komtholampilo kwalesi sifo ukwanda okungazelelwe kokucindezela kwangaphakathi kwesisu ngenxa yokucanuzela kwenhliziyo okukhulu, ukuhlanza nezinye izizathu, okubangela ukudabuka kwe-longitudinal ye-mucosa kanye ne-submucosa ye-distal cardiac cardia kanye ne-esophagus, ngaleyo ndlela kubangele ukopha kwe-gastrointestinal ephezulu. Izimpawu eziyinhloko yi-acute hematemesis engazelelwe, eyandulelwa ukuphinda ukuphinda noma ukuhlanza, kubizwa nangokuthi i-esophageal ne-cardia mucosal tear syndrome.
18. I-Zollinger-Ellison syndrome (i-gastrinoma, i-Zollinger-66Ellison syndrome)
Iwuhlobo lwesimila se-gastroenteropancreatic neuroendocrine esibonakala ngezilonda eziningi, izindawo ezingavamile, ukungenwa kalula yizinkinga zezilonda, nokusabela kabi emithini elwa nesilonda evamile. Uhudo, ukukhishwa kwe-asidi ephezulu yesisu, kanye namazinga aphezulu e-gastrin egazini kungenzeka. ngaphezulu.
I-Gastrinomas ivamise ukuba mancane, futhi cishe amaphesenti angama-80 atholakala ngaphakathi kukanxantathu “we-gastrinoma” (okungukuthi, ukuhlangana kwenyongo nomgudu ovamile wenyongo, ingxenye yesibili neyesithathu ye-duodenum, nentamo nomzimba wamanyikwe). Ngaphakathi kukanxantathu owenziwe ukuhlangana), ngaphezu kuka-50% we-gastrinomas ayingozi, futhi ezinye iziguli ziye zametastasized lapho zitholwa.
19. I-Dumping syndrome
Ngemva kwe-subtotal gastrectomy, ngenxa yokulahlekelwa umsebenzi wokulawula we-pylorus, okuqukethwe kwesisu kuyathululwa ngokushesha, okuholela ochungechungeni lwezimpawu zomtholampilo ezibizwa ngokuthi i-dumping syndrome, evame kakhulu ku-PII anastomosis. Ngokwesikhathi lapho izimpawu zivela ngemva kokudla, ihlukaniswe yaba izinhlobo ezimbili: ekuqaleni nasekupheleni.
●I-Early dumping syndrome: Izimpawu ze-hypovolemia yesikhashana njengokushaya kwenhliziyo, ukujuluka okubandayo, ukukhathala, nebala eliphaphathekile zivela ngemva kwesigamu sehora ngemva kokudla. Kuhambisana nesicanucanu nokuhlanza, amajaqamba esiswini, nesifo sohudo.
●Late dumping syndrome: kwenzeka emahoreni angu-2 kuya kwangu-4 ngemva kokudla. Izimpawu eziyinhloko yisiyezi, ibala eliphaphathekile, umjuluko obandayo, ukukhathala, nokushaya kwenhliziyo okusheshayo. Indlela yokusebenza ukuthi ngemuva kokudla kungena emathunjini, ivuselela ukukhiqizwa kwe-insulin enkulu, okubuye kuholele ku-hypoglycemia esebenzayo. Kubizwa nangokuthi i-hypoglycemia syndrome.
20. I-Absorptive dystrophy syndrome
Kuyisifo somtholampilo lapho imisoco ishoda khona ngenxa yokungasebenzi kahle kwamathumbu amancane ekugayeni nasekumunceni imisoco, okwenza ukuthi imisoco ingakwazi ukumuncwa ngendlela evamile futhi ikhishwe endle. Ngokomtholampilo, kuvame ukuvela njengesifo sohudo, esincanyana, esindayo, esinamafutha nezinye izimpawu zokumunca amafutha, ngakho kubuye kuthiwe yi-steatorrhea.
21.PJ syndrome (i-pigmented polyposis syndrome, i-PJS)
Kuyisifo esingavamile se-autosomal dominant tumor syndrome esibonakala ngesikhumba kanye ne-mucosal pigmentation, ama-polyps amaningi e-hamatomatous emgudwini wamathumbu, kanye nokuba sengozini kwesimila.
I-PJS yenzeka kusukela ebuntwaneni. Njengoba iziguli zikhula, ama-polyps akhula kancane kancane futhi anda, okubangela izinkinga ezihlukahlukene, njengokungenwa yisisu, ukuvaleka kwamathumbu, ukopha emathunjini, umdlavuza, ukungondleki, nokukhubazeka kokukhula kwezingane.
22. I-Abdominal compartment syndrome
Ukucindezela kwangaphakathi kwesisu komuntu ovamile kuseduze nokucindezela komkhathi, 5 kuya ku-7 mmHg.
Ingcindezi yangaphakathi kwesisu ≥12 mmHg i-intra-abdominal hypertension, kanye ne-intra-abdominal pressure ≥20 mmHg ehambisana nokwehluleka kwesitho esihlobene nomfutho wegazi ophakathi kwesisu i-abdominal compartment syndrome (ACS).
Ukubonakaliswa kwemitholampilo: Isiguli sinokucinana kwesifuba, ukuphefumula kanzima, ukuphefumula kanzima, nokushaya kwenhliziyo okusheshayo. Ukuvuvukala kwesisu kanye nokucindezeleka okuphezulu kungase kuhambisane nobuhlungu besisu, imisindo yamathumbu ibe buthakathaka noma inyamalale, njll. I-Hypercapnia (PaCO?> 50 mmHg) kanye ne-oliguria (ukukhishwa komchamo ngehora <0.5 mL / kg) kungenzeka esigabeni sokuqala se-ACS. I-Anuria, i-azotemia, ukwehluleka ukuphefumula kanye nesifo senhliziyo esiphansi senhliziyo kwenzeka esigabeni sakamuva.
23. I-Superior mesenteric artery syndrome
Eyaziwa nangokuthi i-benign duodenal stasis kanye ne-duodenal stasis, uchungechunge lwezimpawu ezibangelwa ukuma okungavamile komthambo we-mesenteric ophakeme ocindezela ingxenye evundlile ye-duodenum, okuholela ekuvinjweni okuyingxenye noma okuphelele kwe-duodenum.
Kuvame kakhulu kwabesifazane abadala be-asthenic. Ukuqunjelwa, isicanucanu, nokuhlanza kuvamile. Isici esivelele salesi sifo ukuthi izimpawu zihlobene nokuma komzimba. Uma isikhundla se-supine sisetshenziswa, izimpawu zokucindezelwa ziba zimbi, kanti lapho isimo esivamile, isikhundla sedolo-esifubeni, noma isikhundla sohlangothi lwesobunxele, izimpawu zingakhululeka. .
24. I-Blind loop syndrome
I-syndrome yohudo, i-anemia, i-malabsorption nokulahlekelwa isisindo okubangelwa ukugqwala kokuqukethwe kwamathumbu amancane kanye nokukhula kwebhaktheriya ku-lumen yamathumbu. Ibonakala kakhulu ekwakhekeni kwezihibe eziyizimpumputhe noma izikhwama eziyizimpumputhe (okungukuthi izihibe zamathumbu) ngemva kwe-gastrectomy kanye ne-anastomosis yamathumbu. Futhi kubangelwa i-stasis.
25. Isifo samathumbu amafushane
Kusho ukuthi ngemva kokukhishwa okukhulu kwamathumbu amancane noma ukukhishwa ngaphandle ngenxa yezizathu ezihlukahlukene, indawo esebenzayo yokumunca yamathumbu iyancipha kakhulu, futhi amathumbu asele asebenzayo awakwazi ukulondoloza umsoco wesiguli noma izidingo zokukhula kwengane, kanye nezimpawu ezifana nesifo sohudo, ukuphazamiseka kwe-acid-base/water/electrolyte, kanye nama-syndromes abuswa ukuphazamiseka kwe-absorption ne-metabolism ehlukahlukene.
26. I-Hepatorenal syndrome
Ukubonakaliswa okuyinhloko komtholampilo yi-oliguria, i-anuria ne-azotemia.
Izinso zesiguli zazingenazo izilonda ezinkulu. Ngenxa ye-portal hypertension enzima kanye ne-splanchnic hyperdynamic circulation, ukugeleza kwegazi okuhlelekile kwehliswe kakhulu, futhi izinto ezihlukahlukene ze-vasodilator ezifana ne-prostaglandin, i-nitric oxide, i-glucagon, i-atrial natriuretic peptide, i-endotoxin, ne-Calcium peptide ehlobene nofuzo ayikwazi ukwenziwa i-dilate i-vascular bed; inani elikhulu le-peritoneal fluid lingabangela ukwanda okukhulu komfutho we-intra-abdominal, okunganciphisa ukugeleza kwegazi kwezinso, ikakhulukazi i-renal cortex hypoperfusion, okuholela ekuhlulekeni kwezinso.
I-80% yeziguli ezinesifo esikhula ngokushesha ziyafa phakathi namasonto ama-2. Uhlobo oluqhubeka kancane luvame kakhulu emtholampilo, luvame ukuveza ukukhishwa kwesisu okuphikisayo kanye nenkambo ehamba kancane yokwehluleka kwezinso.
27. I-Hepatopulmonary syndrome
Ngesisekelo se-cirrhosis yesibindi, ngemva kokungabandakanyi izifo eziyinhloko ze-cardiopulmonary, i-dyspnea nezimpawu ze-hypoxia ezifana ne-cyanosis kanye ne-clubbing yeminwe (izinzwane) zivela, ezihlobene ne-intrapulmonary vasodilation kanye nokungasebenzi kahle kwe-oxygenation yegazi, futhi ukubikezelwa kubi.
28.Mirizzi syndrome
Intamo ye-Gallbladder noma i-cystic duct stone impaction, noma kuhlangene nokuvuvukala kwe-gallbladder, ingcindezi
Kwenzeka ngokuphoqelela noma ngokuthinta umgudu ovamile we-hepatic, okubangela ukwanda kwezicubu ezizungezile, ukuvuvukala noma i-stenosis yomgudu ovamile we-hepatic, futhi ubonakala emtholampilo njengochungechunge lwe-syndromes yomtholampilo ebonakala nge-obstructive jaundice, i-biliary colic noma i-cholangitis.
Isisekelo se-anatomical sokwakheka kwawo ukuthi ipayipi le-cystic kanye ne-hepatic duct evamile kude kakhulu ndawonye noma indawo yokuhlangana kwe-cystic duct kanye ne-hepatic duct evamile iphansi kakhulu.
29.Budd-Chiari syndrome
I-Budd-Chiari syndrome, eyaziwa nangokuthi i-Budd-Chiari syndrome, ibhekisela eqenjini le-portal hypertension noma i-portal kanye ne-inferior vena cava hypertension ebangelwa ukuvinjelwa komthambo we-hepatic noma i-vena cava engaphansi ngaphezu kokuvuleka kwayo. isifo.
30.Isifo sikaCaroli
I-Congenital cystic dilation ye-intrahepatic bile ducts. Indlela yokusebenza ayicacile. Kungase kufane ne-choledochal cyst. Isigameko se-cholangiocarcinoma sikhulu kunesomphakathi jikelele. Izimpawu zokuqala zomtholampilo yi-hepatomegaly kanye nobuhlungu besisu, ikakhulukazi njenge-biliary colic, eyinkimbinkimbi ngenxa yesifo se-bacterial bile duct. Imfiva kanye ne-jaundice ephakathi kwenzeka ngesikhathi sokuvuvukala, futhi izinga le-jaundice ngokuvamile lincane.
31. I-Puborectal syndrome
Kuwukuphazamiseka kokuthulula okubangelwa ukuvinjelwa kokuphuma kwe-pelvic floor ngenxa ye-spasm noma i-hypertrophy yemisipha ye-puborectalis.
32. I-Pelvic floor syndrome
Ibhekisela eqenjini lama-syndromes abangelwa ukungahambi kahle kwe-neuromuscular ezakhiweni zesitezi se-pelvic okuhlanganisa i-rectum, i-levator ani muscle, kanye ne-anal sphincter yangaphandle. Ukubonakaliswa komtholampilo okuyinhloko kuwubunzima bokukhipha isisu noma ukungaziphathi kahle, kanye nokucindezela phansi kwe-pelvic nobuhlungu. Lezi zinkinga ngezinye izikhathi zihlanganisa ubunzima bokukhipha indle, futhi ngezinye izikhathi ukungasebenzi kahle kwe-fecal. Ezimweni ezimbi kakhulu, zibuhlungu kakhulu.
Thina, i-Jiangxi Zhuoruihua Medical Instrument Co., Ltd., singumkhiqizi waseChina ogxile ezintweni ezisetshenziswayo ze-endoscopic, ezifanai-biopsy forceps, i-hemoclip, polyp ugibe,inaliti ye-sclerotherapy, fafaza i-catheter, amabhulashi e-cytology, guidewire,ubhasikidi wokubuyisa amatshe, i-catheter ye-nasal biliary drainagenjll ezisetshenziswa kakhulu kuI-EMR,ESD, I-ERCP. Imikhiqizo yethu iqinisekiswe yi-CE, futhi izitshalo zethu ziqinisekiswe yi-ISO. Izimpahla zethu zithunyelwe eYurophu, eNyakatho Melika, eMpumalanga Ephakathi nasengxenyeni ye-Asia, futhi zithola kabanzi ikhasimende lokuqashelwa nokudumisa!
Isikhathi sokuthumela: Sep-06-2024