Abdominal etuto: akpatara na-akpata

Thin serosa - peritoneum - nke na otu ụdị ma ọ bụ ọzọ na-emi odude na elu akụkụ nke akụkụ, nwere kpọmkwem na-echebe Njirimara. Ka ihe atụ, na ikpe nke na mbufụt, ọ nwere ike delimit-emetụta ebe, akpụ abdominal etuto. Na ọgwụ òtù a na-akpọ "soldering", ya bụ, na e guzobere adhesions n'etiti n'akụkụ akụkụ ka enweta a mechiri emechi ohere.

definition

Abdominal etuto - a purulent mbufụt nke ihe ngwa ma ọ bụ a akụkụ-ya nile, na ihe ọzọ agbaze anụ ahụ na Capsule guzobere oghere gburugburu ya. Ọ pụrụ kpụrụ kpamkpam ọ bụla "n'ala" nke abdominal uji eze na esonyere mgbaàmà nke igbu egbu, ahụ ọkụ na sepsis.

Ke adianade do, ọrịa ga-enwe ihe mgbu, kwuru, sị agbachitere abdominal mọzụlụ, na o kwere omume ọgbụgbọ na vomiting. Mgbe ụfọdụ, na oké ikpe, adhesions ime ka nsia mgbochi.

Epidemiology

Abdominal etuto, ọ bụghị ihe ijuanya, na-emepụta na-esonụ usoro ịwa ahụ na a na-tụgharịrị ka a sikwuoro nke ụdị ọgwụgwọ. Na echiche nke ibu na ọnụ ọgụgụ nke arụmọrụ rụrụ kwa afọ, ọnụ ọgụgụ nke ndị dị otú ahụ nsogbu na-enwekwu nta nke nta. A isi ọrụ a bụ ọnụ nke ọgụ na nile iji ọgwụ nje na microorganisms akpụ nkwụsi ike na-egbochi mgbochi nke postoperative nsogbu.

Dị ka ubiere nke mgbakwunye, otu percent nke ịwa ahụ ọrịa na-emepe emepe postoperative etuto. Nke a na ọnụ ọgụgụ dị elu ma ọ bụrụ na aka bụ ngwa ngwa na oge na preoperative nkwadebe bụ.

ihe ize ndụ ihe

Isi ihe ize ndụ na-akpata, n'ihi na nke o nwere ike ịbụ ihe etuto nke abdominal oghere - bụ, n'ezie, cavernous n'ịwa ahụ. Ọ na-akacha emee mgbe omume maka pancreatic ọrịa, ńsí eriri afo, bowel loop kpachie.

Ọdịdị nke mbufụt ruru n'ebe nsia ọdịnaya na peritoneum, na ya ofufe na ọrụ ime ụlọ. Ọ nwere ike mere site masịrị abdominal trauma. Na ebe nke mkpakọ emepụta aseptic mbufụt, nke bụ mesịrị sonyere abụọ osisi.

Ihe karịrị ọkara nke etuto bụ ma parietal (parietal) ibe nke peritoneum, ma ọ bụ n'etiti ya parietal na visceral Ibé akwụkwọ.

ihe

Abdominal ahụ etuto (ICD10 - K65) nwere ike ịbụ n'ihi trauma nke afo, ka ihe atụ, ogologo compressions ma ọ bụ ujo, na-efe efe nke nsia tube (iersiteoz, salmonellosis, ịba ahụ ọkụ), mmepe nke mkpali Filiks ke akụkụ ma ọ bụ mucosa, nakwa dị ka mgbe perforation onya nke afo ma ọ bụ eriri afọ.

E nwere atọ isi ihe mere:

1. Ọnụnọ nke abụọ peritonitis ruru agbawa nke ihe odide ntụkwasị, insolvency nsia anastomoses mgbe abdominal arụmọrụ, necrosis nke pancreatic isi, abdominal trauma.
2. Purulent mbufụt nke pelvic akụkụ, ndị dị otú ahụ dị ka salpingitis, parameters piosalpinks, tubo-ovarian etuto na ndị ọzọ.
3. Nnukwu mbufụt nke pancreas na ńsí eriri afo, ọnyá afọ.

Na mgbakwunye na n'elu, mgbe ụfọdụ, ihe na-akpata nke etuto nwere ike mbufụt nke perinephric anụ ahụ, osteomyelitis, lumbar spain, tuberculous spondylitis. Ọtụtụ mgbe na mbufụt seeded staphylococci, streptococci, clostridia na isherihy, ntụgharị na osisi, nke na-ejikarị ike eme na eriri afọ.

pathogenesis

Etuto postoperative abdominal egosi n'ihi oké mmeghachi omume nke usoro ahụ ji alụso ubọk ke esịtidem gburugburu ebe obibi ma ọ bụ mmeputakwa nke microorganisms. The gị n'ụlọnga nwere ike banye n'ime n'ime peritoneal oghere na n'ọbara ma ọ bụ Lymph, nakwa dị ka seep site nsia mgbidi. Ke adianade do, e nwere mgbe a n'ihe ize ndụ nke ibute ọrịa na dọkịta na-awa na-edebe aka ya, ngwaọrụ ma ọ bụ ihe n'oge ọrụ. Ihe ọzọ protrude ozu na-ekwurịta okwu mpụga gburugburu ebe obibi, dị ka fallopian akpa ma ọ bụ eriri afọ.

Anyị nwere ike ewepu ọdịdị mkpali infiltrates mgbe penetrating abdominal ọnyá, ọnyá na perforations divergence isi agịga Ma do mgbe ịwa ahụ.

Peritoneum mkpatụ ka ọdịdị nke na-akpali akpali na-akpata (mbufụt) stereotypically, ya bụ, ya site fibrin na ya elu nke ga ịrapagidesi ọnụ akụkụ ụfọdụ nke mucosa ma si otú delimits n'ekwú n'aka ike anụ ahụ. Ọ bụrụ na nke a nchedo na-ebibi dị ka a n'ihi nke abu, ndị mkpali detritus aga n'ime-eri ego nke afo na shelving ohere. Na mmepe nke ndị dị otú a dịruru ná njọ aha sepsis.

mgbaàmà

Gịnị na-eme ka a nwoke mgbe ọ kpụrụ abdominal etuto? Mgbaàmà ndị yiri ọ bụla mkpali ọrịa:

1. High, a na mberede mmalite nke fever esonyere akpata oyi na profuse ajirija.
2. Ịbịaru mgbu ke afo, nke na-adịkwu na aka ma ọ bụ nsogbu.
3. Ugboro urination, dị ka peritoneum na-agbatị na ya wutere eriri afo mgbidi baroreceptors.
4. Ifịm ụfọdụ n'ụdị afọ ntachi.
5. Ọgbụgbọ na vomiting mgbe elu nke fever.

Ke adianade do, ọrịa nwere ike palpitations. Ọ na-adị ihe abụọ mere: a oké ahụ ọkụ na igbu egbu. Na dị ka a pathognomonic mgbaàmà bụ muscle erughị ala pịa. Nke a bụ a na-echebe mpiaji, nke na-egbochi ihe ọzọ imerụ ndị nanị ire ọkụ ebe.

Ọ bụrụ na ndị etuto na-emi odude na n'okpuru diaphragm, na mgbakwunye na nke ọsọ mgbaàmà ndị na-arụtụ aka na nke a mma. The mbụ dị iche bụ na mgbu metụtara nanị akụkụ ụfọdụ na hypochondrium, mụbara n'oge n'ike mmụọ nsọ na ọchị na scapular mpaghara. Nke abụọ dị iche - a mgbanwe gait. Man amalite involuntarily na-elekọta ndị ọrịa na eberede n'ebe ya, iji belata muscle erughị ala.

nsogbu

Abdominal ahụ etuto (ICD-10 - K65) nwere ike ịnọgide na undiagnosed ma ọ bụrụ na-emepe emepe na ndabere nke ndị ọzọ dị oké njọ ọnọdụ, ma ọ bụ onye ọrịa na-adịghị na-achọ enyemaka. Ma anyị kwesịrị icheta na dị ka a n'ihi nke eleghara omume nwere ike ịzụlite na-egbu mmadụ, ndị dị ka sepsis na-agbasa peritonitis.

Subdiaphragmatic ahụ etuto nwere ike gbazee na aperture agbaji n'ime pleural uji eze, na-akpụ adhesions e. Ndị dị otú ahụ a dịruru ná njọ nwere ike ọbụna iduga akpa ume mmerụ. Ya mere, ọ bụrụ na mgbe a wasịrị ma ọ bụ ihe ọjọọ, na ị na-ahụ ọkụ ma ọ bụ ihe ọ bụla ihe mgbu, adịghị atụ anya na ihe niile ga-agabiga site n'onwe ya. Na nke a nke mmezi atule ike na-afụ ụfụ.

nchọpụta nsogbu

Postoperative abdominal etuto na a ọgwụ ịchọpụta pụtara mfe. The kasị ihe ọmụma ụzọ na-x-ray, ultrasound, CT na MRI nke obi na afo akụkụ. Ke adianade do, ọ bụ mee ka ndị inyom na-eme ka a mgbapu mmamiri uko elele ma e nwere a purulent streaks na sloping ebe.

Ọzọkwa, echefukwala banyere laabu nchoputa. Ke ofụri ofụri, analysis ọbara ga-hụrụ a nkọ na-abawanye na erythrocyte sedimentation ọnụego (ESR), wbc ga nwere a dị ịrịba ama na-agbanwe gaa n'aka ekpe, o kwere omume ọbụna na-eto eto iche na zuru ọnụ ọgụgụ nke mkpụrụ ndụ ga-amụba ruru neutrophils.

Standard na nchoputa nke etuto bụ abdominal ultrasound. E nwere doro anya ihe ịrịba ama na-egosi na ọnụnọ nke mkpali infiltrate:

• guzobere nwere doro anya ndepụta na oké Capsule;
• n'ime ya bụ a mmiri mmiri;
• ọdịnaya inhomogeneous Ọdịdị na ekewa n'ígwé;
• Ọ bụ n'elu mmiri mmiri gas.

Ọgwụgwọ abdominal ahụ etuto

Isi usoro ọgwụgwọ nke ahụ etuto, n'ezie, bụ ịwa ahụ. Ọ dị mkpa ka igbapu na etuto oghere na antiseptik asacha na ogwu mgbochi ngwọta. Conservative ọgwụgwọ adịghị enye ọ bụla nkwa na mbufụt-agbaze, na ọmụmụ n'ime otu etuto onwe gị kpọpụrụ.

N'ezie, mgbe ndị na-elekwasị anya na-wepụrụ, onye ọrịa a chọrọ idepụta antimicrobial ọgwụ ndị a iche iche sara mbara ude. Na-emekarị, dọkịta na-edepụta n'otu oge abụọ ọgwụ ọjọọ dị iche iche na usoro nke edinam na n'ụzọ dị irè-ebibi dị iche iche ndị nnọchiteanya nke microbial osisi.

Mgbe uru aka onye ọrịa nke na o kwere omume na-esi nke ọgwụgwọ, dị ka vomiting, enweghị agụụ, mbufụt nke papillary oyi akwa nke ire, isi ọwụwa, na Ugboro urination. Na dọkịta ga-echeta ha ma tinye ha na-adakarị picture nke ọrịa.

Prediction na mgbochi

Abdominal ahụ etuto (code ICD 10 - K65) - nnọọ a oké njọ sikwuoro, otú ọrịa na dọkịta kwesịrị ịga na mgbochi nke ọnọdụ a. Ọ dị mkpa nke ọma na n'ụzọ zuru ezu na-emeso mkpali oria ọ bụla nke abdominal uji eze, ijide n'aka na-eduzi pre- na post-ịkpa nkwadebe nke onye ọrịa, nakwa dị ka mma-igba ogwu na ngwá na dọkịta na-awa aka.

N'ihi na-enyo enyo na appendicitis ma ọ bụrụ na nke a na mberede ịrị elu okpomọkụ dịghị mkpa ka na-eche maka ihe ịrịba ama nke si n'elu, na ị kwesịrị ị na ozugbo ịkpọ onye dọkịta maka ndụmọdụ. Ọ pụrụ ịzọpụta ndụ gị na ahụ ike.

Enwe si abdominal etuto esịmde iri anọ percent. Ọ niile na-adabere na otú nile usoro, ebe ọ na-dị na otú ọ na-akpata ọrịa. Ma na-adọ ọgwụgwọ na ọgwụ ndị likelihood nke ihe ọjọọ pụta na-ebelata.