Caloosha: Habka Sawirka ogaanshaha | El Paso, TX.

 

• Ogaanshaha cudurrada caloosha waxaa loo kala saari karaa:
• Aan caadi ahayn ee xanuunka caloosha mareenka hunguriga (esophagus, caloosha, mindhicirka yar & weyn, iyo lifaaqa)
• Aan caadi ahayn ee xubnaha dheefshiidka dheeriga ah (xanuunka cagaarshowga & xameetida)
• Waxyaalaha aan caadiga ahayn ee genitourinary & xubnaha taranka
• Aan caadi ahayn ee gidaarka caloosha iyo maraakiibta waaweyn
• Bandhigan waxa uu ujeedadiisu tahay in ay bixiso fahamka guud ee aasaasiga ah sawirka ogaanshaha habka iyo maareynta bukaan-socodka ku habboon ee bukaannada qaba cudurrada ugu badan ee caloosha
• Hababka sawirka ee la isticmaalo inta lagu jiro baaritaanka cabashooyinka caloosha:
• AP caloosha (KUB) iyo CXR toosan
• Sawirka CT-ga caloosha (oo leh isbarbardhiga afka iyo IV iyo w/o ka soo horjeeda)
• Sare iyo Hoose GI Barium
• Ultrasonography
• MRI (inta badan loo isticmaalo sida Beerka MRI)
• MRI enterography iyo enteroclysis
• MRI malawadka
• Endoscopic Retrograde Cholangiopancreatography (ERCP) - inta badan hepatobiliary iyo ductal pathology.
• Sawirka Nukliyeerka

Maxaa U Dalbanaya Raajo Caloosha?

 

• Ku dar qiimaynta hordhaca ah ee gaasta mindhicirka meel degdeg ah. Tusaale ahaan, daraasad taban oo lagu sameeyay bukaanka ixtimaalka hooseeya ayaa laga yaabaa inay meesha ka saarto baahida CT ama hababka kale ee qallafsan.
• Qiimaynta tuubooyinka shucaaca, xadhkaha, iyo shucaaca qalaad
• Qiimaynta ka dib nidaamka gaaska bilaashka ah ee intraperitoneal/retroperitoneal
• La socodka xadiga gaaska mindhicirka iyo xallinta qalliinka (adynamic) ileus
• La socoshada marinka isbarbardhigga ee mindhicirka
• Daraasadaha socdaalka xiidanka
• La-socodka calculi kelyaha

 

 

Maxaa lagu Ogyahay AP Caloosha: Supine vs. Toosan vs. Decubitus

• Hawada Xorta ah (pneumoperitoneum)
• Xididdada mindhicirka: Siddooyinku kala dillaacay: SBO vs LBO (3-6-9 xeer) SB-upper xadka-3-cm, LB-upper xadka-6-cm, Caecum-upper xadka-9-cm. Xusuusnow luminta haustra, fidinta qoraalka (joogitaanka) valvule conivente (plica semilunaris) gudaha SBO
• SBO: ogow dhererka kala duwan ee heerarka dareeraha hawada ee jaranjarada filimka toosan, muuqaalka SBO
• Ogow yaraanta gaaska dabada/malawadka (la daadgureeyay) gudaha SBO

 

 

• Sawirka CT-ga caloosha -qaabka doorashada inta lagu jiro baaritaanka cabashooyinka caloosha ee ba'an iyo kuwa daba-dheeraada gaar ahaan dadka waaweyn. Tusaale ahaan, malignantiga caloosha ayaa si guul leh loo baari karaa waxaana loo diyaarin karaa iyadoo la bixinayo macluumaadka caafimaad ee qorsheynta daryeelka
• Ultrasound ee caloosha, kelyaha iyo miskaha Waxa la samayn karaa si ay u caawiso ogaanshaha cudurka appendicitis (tus. carruurta), ba'an & cudurada xididdada dhiigga ee dabadheeraad ah, cilladaha hepatobiliary, cudurada dhalmada iyo dumarka
• Isticmaalka shucaaca ionizing (raajada iyo CT) waa in la yareeyo carruurta iyo kooxaha kale ee nugul.

 

 

Sawirka Baadhista Cudurrada Waaweyn ee Hab-dhiska dheef-shiid kiimikaadka

• 1) Xanuunada hunguriga ku dhaca
• 2) Kansarka caloosha
• 3) Gluten Sensitive Enteropathy
• 4) Cudurka caloosha oo bararsan
• 5) adenocarcinoma ductal ganaca
• 6) kansarka mindhicirka
• 7) Cudurka loo yaqaan 'appendicitis' oo daran
• 8) Mindhicirrada yaryar oo xidhma
• 9) Volvulus

Xanuunada hunguriga

• Achalasia (achalasia aasaasiga ah): fashilka hunguriga habaysan ee peristalsis d/t nasinta daciifka ah ee hunguriga hoose ee hunguriga (LOS) oo leh fidinta hunguriga iyo joogsiga cuntada. Xannibaadda hunguriga fog (badanaa ay sababto buro) ayaa loo yaqaan "achalasia labaad" ama "pseudoachalasia." Peristalsis ee qaybta muruqa siman ee hunguriga waxaa laga yaabaa inay lumiso sababtoo ah cillad aan caadi ahayn ee Auerbach plexus (mas'uul ka ah nasashada muruqa siman) . Vagus neurons sidoo kale waa la saameeyaa
• Asaasiga ah: 30 -70s, M: F siman
• Cudurka Chagas (Trypanosoma Cruzi infection) oo leh burburinta neerfaha Myenteric plexus neurons ee nidaamka GI (megacolon & hunguriga)
• Hase yeeshee, wadnuhu waa xubinta ay saamaysay M/C
• Caafimaad ahaan: Dysphagia ee adkaha iyo dareeraha labadaba, marka la barbardhigo dysphagia adkaha kaliya xaaladaha kansarka hunguriga. Xabad xanuun iyo dib u gurasho. M/C Kansarka unugyada squamous hunguriga dhexe ee ku dhawaad ​​5% sababtoo ah cuncun joogto ah oo xuubka xabkaha ah oo joogsiga cuntada iyo dheecaanka. Oof wareenka hamiga ayaa laga yaabaa inuu kobco. Candida esophagitis
• Sawirka: �Shimbir-beak� oo ku taal liqidda barium GI sare, hunguriga oo furfuran, luminta peristalsis. Baaritaanka endoscopic waa muhiim.
• Rx: adag. Calcium channel blockers (short-term) .Balaadhinta sambabada, oo wax ku ool u ah 85% bukaanada qaba 3 -5% khatarta dhiigbaxa / daloolka. Cirbadeynta sunta botulinum waxay socotaa kaliya qiyaastii. 12 bilood daaweyn kasta. Waxa laga yaabaa inay nabarto xuubka hoose ee xuubka hoose ee u horseedaya khatarta sii kordheysa ee daloolinta inta lagu jiro myotomy xiga. Myotomy qalliin (Heller myotomy)
• 10-30% bukaanada ayaa ku dhaca reflux gastroesophageal (GERD)

 

 

• Presbyesophagus: loo isticmaalo in lagu qeexo muujinta shaqada mootada ee hooseysa ee hunguriga gabowga> 80-yo Sababo la xiriira kala-goynta arc reflex oo hoos u dhac ku yimid dareenka kala-baxa iyo isbeddelka peristalsis.
• Bukaan-socodka ayaa laga yaabaa inay ka cawdaan dysphagia ama xanuunka laabta, laakiin intooda badan waa asymptomatic
• Diffous/Distal spasm hunguriga (DES) waa cillad dhaqdhaqaaqa hunguriga oo laga yaabo inay u muuqato sida burjileec ama hunguriga tusbaxa ee liqidda barium.
• 2% xanuunka laabta ee aan wadnaha ahayn
• Manometry waa baaritaanka ogaanshaha heerka dahabka ah.

 

• Zenker diverticulum (ZD) kiishka pharyngeal
• Soo bixidda heerka hypopharynx, oo u dhow xuubka hunguriga sare, oo loo yaqaan qallafsanaanta Killian ama saddexagalka Killian
• Bukaanku waa 60-80 yo waxayna la joogaan dysphagia, regurgitation, halitosis, dareenka globus
• Waxaa laga yaabaa inay ku adkaato hamiga iyo cilladaha sambabada
• Bukaan-socodka waxaa laga yaabaa inay urursadaan daawooyinka
• ZD- waa pseudodiverticulum ama pulsion diverticulum oo ka timaadda herniation of submucosa iyada oo loo sii marayo dehiscence Killian, samaynta kiish halkaasoo cuntada iyo waxyaabaha kale ay ku urursan karaan.

 

• Mallory-Weiss syndrome Waxa loola jeedaa jeexjeexyada xuubka iyo xuubka hoose ee xuubka dhuunta hunguriga ee hunguriga fog ee la xidhiidha dib u soo kabashada/ matagga rabshadaha leh iyo odoroska waxyaabaha caloosha ku jira ee ka dhanka ah hunguriga hoose. Khatar gaar ah ayay ku jiraan khamriga. Kiisaska la socda hematemesis aan xanuun lahayn. Daawaynta caadi ahaan waa taageero.
• Dx: sawirku door yar ayuu ka ciyaaraa, laakiin isbarbardhigga hunguriga ayaa laga yaabaa inuu muujiyo jeexjeexyo xuubka xuubka ah oo ay ka buuxaan isbarbardhig (sawirka midig ee hoose). Baaritaanka CT-ga ayaa laga yaabaa inuu ku caawiyo in laga saaro sababaha kale ee dhiigbaxa GI sare

 

• Boerhaave syndrome: dilaaca hunguriga ka dib matag xoog leh
• Soo bandhigid: M>F, matag, laab xanuun, mediastinitis, septic mediastinum, pneumomediastinum, pneumothorax pleural effusion
• Waagii hore, waxay ahayd mid aan kala go' lahayn oo dhimasho ah
• Farsamooyinka waxaa ka mid ah in si xoog leh looga saaro maaddooyinka caloosha ku jira gaar ahaan cuntooyinka aan dheefshiidka lahayn marka hungurigu si xoog ah ula qabsado glottis xiran iyadoo 90% uu ka dhaco derbiga dambe ee bidix.

 

• Hiatus hernias (HH): herniation ee waxa ku jira caloosha iyada oo loo marayo hiatus hunguriga hunguriga ee diaphragm galay daloolka thoracic.
• Bukaanno badan oo qaba HH ​​waa asymptomatic, waana helitaan shil ah. Si kastaba ha ahaatee, calamadaha waxaa ka mid noqon kara xanuunka epigastric/xabadka, qanjidhada ka dib, lallabo iyo matag
• Mararka qaarkood HH waxaa loo arkaa inay la mid tahay cudurka gastro-oesophageal reflux disease (GORD), laakiin waxaa jira xidhiidh xumo u dhaxaysa labada xaaladood!
• 2-nooc: hiatus hernia silbanaya 90% & rolling (paraoesophageal) hernia 10%. Midda dambe ayaa laga yaabaa inay ceejiso taasoo keenta ischemia iyo dhibaatooyin.

 

• Cudurka Esophageal Leiomyoma waa M/C neoplasm hunguriga benign. Badanaa way weyn tahay laakiin weli ma xannibayso. Burooyinka xiniinyaha mindhicirku (GIST) ayaa ah kuwa ugu yar hunguriga. Waa in laga soocaa kansarka Esophageal.
• Sawirka: ka soo horjeeda hunguriga, liqidda barium GI sare, CT scan. Gastroesophagoscopy waa habka Dx ee doorashada.

• Kansarka hunguriga ee hunguriga: lagu soo bandhigo kororka dysphagia, marka hore ilaa adkaha iyo u gudubka dareeraha leh xannibaadda xaalado aad u horumarsan
• <1% dhammaan kansarrada iyo 4-10% dhammaan cudurrada GI. Waxaa jira isu-soo-bax la aqoonsan yahay oo leh nooca unugga-squamous-ka ee ay sababto sigaarka iyo khamriga. Barrett hunguriga iyo adenocarcinoma
• M: F 4:1. Shakhsiyaadka madow ayaa aad uga nugul shaqsiyaadka cad 2:1. Saadaasha liidata!
• Liqidda barium waxay noqon kartaa mid xasaasi u ah aqoonsiga cufka hunguriga. Gastroesophagoscopy (endoscopy) ayaa xaqiijinaysa ogaanshaha iyada oo la adeegsanayo biopsy unugyada
• Guud ahaan xumaanta ugu badan waa kansarka fundal gastric 2ndary oo soo duulay hunguriga fog
• Unugga squamous waxaa sida caadiga ah laga helaa hunguriga dhexe, Adenocarcinoma ee gobolka fog

• Kansarka caloosha: malignant aasaasiga ah ee epithelium gastric. Naadirka ka hor da'da 40. Da'da dhexe ee cudurka ogaanshaha gudaha Mareykanka waa 70 sano ragga iyo 74 sano haweenka. Japan, South Korea, Chile, iyo wadamada bariga Yurub waxay leeyihiin mid ka mid ah heerarka ugu sarreeya ee kansarka caloosha ee adduunka. Heerarka kansarka caloosha ayaa hoos u dhacaya adduunka oo dhan. Kansarka gastric waa sababaha 5aad ee dhimashada kansarka la xiriira. Ururka qaba caabuqa Helicobacter pylori 60-80%, laakiin kaliya 2% dadka qaba H. Pyloris ayaa ku dhaca kansarka caloosha. 8-10% waxay leeyihiin qayb qoys oo la dhaxlo.
• Lymphoma gastric wuxuu sidoo kale ku xiran yahay caabuqa H. Pyloris. Burada unugga Stromal ee xiidmaha mindhicirka ama GIST waa neoplasm kale oo saameeya caloosha
• Caafimaad ahaan: Ma jiraan wax calaamado ah marka ay tahay mid kore oo suurtagal ah in la daweyn karo. Ilaa 50% bukaanada ayaa laga yaabaa inay qabaan cabashooyin GI oo aan gaar ahayn. Bukaannada ayaa laga yaabaa inay la kulmaan anorexia iyo miisaan lumis (95%) iyo sidoo kale calool xanuun aan caddayn. Lalabbo, matag, iyo dheregsanaanta hore ee d/t xannibaadda ayaa laga yaabaa inay ku dhacdo burooyin waaweyn ama nabarro gudaha ah oo wax u dhimaya kala-baxa caloosha.
• Saadaasha: Inta badan kansarka caloosha ayaa la ogaadaa goor dambe waxaana laga yaabaa inay muujiso duulaan maxalli ah oo leh adenopathy gobolka, beerka, iyo faafidda mesenteric. Heerka badbaadada 5-sano oo ah 20% ama ka yar. Japan iyo S. Kuuriya, barnaamijyada baadhista hore waxay kordhiyeen badbaadada ilaa 60%
• sawirka: Barium GI sare ee daraasadda, CT scanning. Baaritaanka endoscopic waa habka doorashada ee cudurka. Sawirada, kansarka caloosha waxa uu u muuqan karaa sida exophytic (polypoid) cuf ama nooca fungative, boog ama faleebo/nooca fidsan (Linitis Plastica). Baaritaanka CT-ga ayaa muhiim u ah in la qiimeeyo soo galitaanka maxalliga ah (nodes, mesentery, beerka, iwm.)

• Cudurka Celiac aka sprue non-tropical aka Gluten-sensitive enteropathy: Unugyada T-guud ee dhexdhexaadinta difaaca jirka ee daba-dheeraaday ee uu sababay dhaawaca xuubabka taasoo keentay luminta villi ee mindhicirka yar ee u dhow iyo malabsorption-ka caloosha (ie, sprue). Waxaa lagu tixgaliyaa xaaladaha qaarkood ee dhiig yaraanta birta ee sabab aan la go'aamin. Waxay ku badan yihiin dadka Caucasians (1 200kiiba) laakiin naadir ku ah Aasiya iyo shakhsiyaadka madowga ah. Laba meelood: koox yar oo carruurnimada hore ah. Caadi ahaan 3aad iyo 4aad ee nolosha.
• Caafimaad ahaan: Calool xanuunka waa calaamadda m / c, cilladda nafaqooyinka / fitamiinada: IDA iyo saxarada guaiac-positive, shuban, calool-istaag, steatorrhea, miisaan lumis, osteoporosis / osteomalacia, dermatitis herpetiformis. Kordhinta xidhiidhka la leh T-cell lymfoma, korodhka xidhiidhka leh kansarka unugyada hunguriga, SBO
• Dx: endoscopy-ga sare ee GI oo leh biopsies badan oo duodenal ah ayaa loo arkaa a heerka ogaanshaha cudurada baruurta. Histology waxay daaha ka qaadaysaa dhex galka T-unugga iyo lymphoplasmacytosis, Villi atrophy, Crypts hyperplasia, Submucosa, iyo Serosa waa la badbaadiyay. Rx: baabi'inta alaabooyinka ku jira gluten-ka
• Sawirka: Looma baahna Dx laakiin Barium liqa fluoroscopy: atrophy xuubka iyo baabi'inta laalaabka xuubka (xaalad sare oo keliya). Kala-baxa SB waa helitaanka ugu caansan. Nodularity of duodenum (bubbly duodenum). Dib u noqoshada jejunal iyo laalaabka xuubka ileal:
• �Jejunumku waa u ekaa ileum, ileumku wuxuu u eg yahay jejunum, duodenumkuna wuxuu u eg yahay cadaab.

Cudurrada mindhicirka bararsan: Cudurka Crohn (CD) & Colitis Ulcerative (UC)

• CD: Caabuqa difaaca jirka ee joogtada ah oo saameeya qayb kasta oo ka mid ah mareenka GI ee afka ilaa dabada laakiin bilawga inta badan waxay ku lug leedahay ileumka terminal. Soo bandhigida M/C: calool xanuun/maroojin iyo shuban. Jidka: samaynta granulomata oo ka duwan UC waa transmural, oo suurtogal ah in ay keento adag. Meelaha uu caabuqu saameeyay caadi ahaan waa barar
• Dhibaatooyinku aad bay u badan yihiin: nafaqo-xumada/fitamiinnada oo xumaada (anemia, osteoporosis, dib u dhac korriinka carruurta, u nuglaanshiyaha GI malignant, calool-istaaga, samaynta fistula, caloosha dheeraadka ah: uveitis, arthritis, AS, erythema nodosum iyo kuwa kale. 10-20% waxaa laga yaabaa inuu u baahdo qaliin caloosha ah 10-sano ka dib CD sida caadiga ah adkeynta, fistilization, BO.
• Dx: bukaan-socod, CBC, CMP, CRP, ESR, serological tests: DDx of IBD: anti-Saccharomyces cerevisiae antibodies (ASCA), perinuclear antineutrophil cytoplasmic antibody (p-ANCA) histologically ama serum. Tijaabada Calprotectin ee saxarada waxay caawisaa DDx IBS waxayna qiimeeyaan jawaabta daawaynta, dhaqdhaqaaqa/soo noqoshada cudurka.
• Dx doorashada: endoscopic, ileoscopy, iyo biopsies badan ayaa muujin kara isbeddellada endoscopic iyo histological. Fiidiyowga kaabsulka endoscopy (VCE), Imaging ayaa laga yaabaa inay caawiso Dx ee dhibaatooyinka. Rx: dawooyinka difaaca jirka, dawo kaabista, cunto, probiotics, hawlwadeen. Ma jirto dawo laakiin ujeedadu waa in la dhaliyo cafiska, la xakameeyo calaamadaha lagana hortago/daaweeyo dhibaatooyinka
• Sawirka Dx: KUB ilaa DDx SBO, Barium enema (hal iyo laba jeer is barbar dhig), mindhicir yar ayaa raacaya. Natiijooyinka: nabarrada ka booda, nabarrada aphthous/qoto dheer, mareenka fistula/mareenka sanka, Calaamadda xadhkaha, dufanka gurguurta ee la riixay ee LB, muuqaalka dhagaxa dhagaxa ka sameysan ee d/t fissures/ boogaha riixaya xuubka, CT scan oo leh afka iyo isbarbardhigga IV.

• Sawir laga soo qaaday bukaanka Crohn kaas oo mindhicir yar laga soo gooyay xannibaado.
• (A) Sawirka CT wuxuu muujinayaa barar aan gaar ahayn halka
• (B) MRE ee isla aagga ayaa muujinaya adkeyn fibrostenotic ah

• UC: si gaar ah waxay ku lug leedahay oo kaliya xiidanka laakiin ileitis dhabar-wash ayaa laga yaabaa inuu kobco. Bilawga caadi ahaan waa 15-40s waxayna aad ugu badan tahay ragga, laakiin bilawga da'da 50 ka dib waa caadi. In badan oo ka mid ah Waqooyiga Ameerika iyo Yurub (hygiene hypothesis). Etiology: Isku-dhafka deegaanka, hidda-socodka iyo isbeddellada microbiome-ga ee mindhicirka ayaa ku lug leh. Sigaar cabista iyo appendectomy hore waxay u muuqdaan inay muujinayaan xiriir xun oo ay la leeyihiin UC, si ka duwan CD-ga loo tixgeliyey qaar ka mid ah arrimaha khatarta ah.
• Astaamaha Caafimaadka: Dhiigbaxa malawadka (caadi ah), shuban, dheecaan malawadka, tenesmus (mararka qaarkood), xanuunka caloosha hoose iyo fuuqbax daran oo ka yimaada dheecaanka malawadka (xaalad daran, gaar ahaan dadka waayeelka ah), colitis fulminant iyo megacolon sun ah ayaa noqon kara uurjiif laakiin waa dhibaatooyin naadir ah. . Pathology: Ma jiro granulomata. Boogaha waxay saameeyaan xuubka xuubka iyo xuubka hoose. Pseudopolyps waxay u taagan tahay sida xabkaha la badbaadiyey ee sarreeya.
• Nidaamka bilawga ah wuxuu had iyo jeer saameeyaa malawadka wuxuuna ahaanayaa cudur maxalli ah (proctitis) gudaha (25%). 30% fiditaanka cudur ee u dhow ayaa dhici karta. UC waxaa laga yaabaa inay u soo bandhigto dhinaca bidix (55%) iyo pancolitis (10%). Kiisaska badankoodu waa kuwa fudud ilaa dhexdhexaad
• Dx: colonoscopy oo leh ileoscopy oo leh cadaymo badan ayaa xaqiijinaya Dx. Shaybaarada: CBC, CRP, ESR, Calprotectin Fecal, Dhibaatooyinka: dhiig-yarida, megacolon sunta ah, kansarka mindhicirka, cudurada mindhicirka ka baxsan: arthritis, uveitis, AS, Pyoderma gangrenosum, sclerosing cholangitis aasaasiga ah. Rx: 5-aminosalicylic acid afka ama daawaynta malawadka, corticosteroids, daawooyinka immunomodulatory, colectomy waa daawo.
• Sawirka: looma baahna Dx laakiin barium enema waxay muujin kartaa boogaha, suulka daabacaadda, xaaladaha horumarsan waayida hastra iyo cidhiidhiga xiidanka soo saara xiidanka-lead-ka. kiisaska. CT ayaa laga yaabaa inay ka caawiso Dx ee dhibaatooyinka. Sawirka filimka caadiga ah wuxuu muujinayaa xiidanka-tuubada-lead-ka iyo sacroiliitis sida Enteropathic arthritis (AS)

• kansarka mindhicirka (CRC) m/c Kansarka marinka GI-ga iyo 2-aad ee malignant-ka ugu badan ee dadka waaweyn. Dx: endoscopy iyo biopsy. CT waa hababka inta badan loo isticmaalo diyaarinta. Dib-u-soo-celinta qalliinka ayaa laga yaabaa inay dawo noqoto inkasta oo heerka badbaadada shanta sano uu yahay 40-50% iyadoo ku xiran habaynta. Qodobbada khatarta ah: fiber yar iyo dufan badan iyo cunto borotiinka xoolaha, buurnaanta (gaar ahaan ragga), colitis raaga. Adenoma xiniinyaha (polyps). Qoyska adenomatous polyposis syndromes (Gardener syndrome) iyo Lynch syndrome sida polyposis aan qoyska ahayn.
• Caafimaad ahaan: bilawga dhagarta leh ee caadooyinka mindhicirka oo bedelay, dhiig cusub ama melena, dhiig yaraanta birta oo ka timaada luminta dhiiga joogtada ah ee sixirka gaar ahaan burooyinka dhinaca midig. Calool-xidhka, xiidmaha, dhiig-baxa culus iyo cudurrada dheef-shiid kiimikaadka gaar ahaan Beerka ayaa laga yaabaa inay bilow u noqdaan. Jidka: 98% waa adenocarcinomas, waxay ka soo jeedaan adenomas colonic (polyps neoplastic) oo hore u jiray oo leh isbeddel xun. Heerka badbaadada shanta sano waa 40-50%, iyadoo marxaladda hawlgalka ay tahay qodobka keliya ee ugu muhiimsan ee saameeya saadaasha. Burooyinka M/C rectosigmoid (55%),
• NB Qaar ka mid ah adenocarcinomas esp. noocyada mucinous sida caadiga ah soo bandhigay habsaameen oo badiyaa sido saadaal liidata ay sabab u tahay soo bandhigid daahday iyo dheecaanka xabka iyo faafitaan gudaha/ fog
• Imaging: Barium enema waa dareenka burooyinka> 1 cm, hal ka duwanaansho: 77-94%, kala duwanaansho labajibaaran: 82-98%. Colonoscopy waa habka doorashada ee ka hortagga, ogaanshaha, iyo aqoonsiga kansarka mindhicirka. Iskaanka CT-ga isbarbardhigga ah ayaa loo isticmaalaa dejinta iyo qiimaynta saadaasha ee metts.
• Baadhitaanka: colonoscopy-ga: ragga 50 yo-10-sano haddii ay caadi tahay, 5-sano haddii polypectomy, FOB, qaraabo darajada 1aad ee CA bilaabay ilaa 40 yo

 

• Kansarka ganaca: ductal epithelial adenocarcinoma (90%), saadaal aad u liidata oo leh dhimasho sare. 3aad M/C kansarka caloosha. Colon waa #1, caloosha #2. Kansarka ganaca ayaa 22% ka ah dhammaan dhimashada dhimashada ay sabab u tahay xumaanta caloosha iyo mindhicirka, iyo 5% dhammaan dhimashada kansarka. 80% kiisaska 60+. Sigaar cabista sigaarku waa khatarta ugu xooggan deegaanka, cunno qani ku ah dufanka xoolaha iyo borotiinka. Cayilka. Taariikhda qoyska. M/C laga helay madaxa iyo habka aan la aqbalin.
• Dx: Iskaanka CT waa muhiim. Duullaanka Halbowlaha Mesenteric Sare (SMA) wuxuu muujinayaa cudur aan la daweyn karin. 90% adenocarcinomas pancreatic waa wax aan lagu sifeynin Dx. Bukaanjiifka badankoodu waxay ku dhintaan 1 sano gudahood Dx. Caafimaad ahaan: cagaarshow aan xanuun lahayn, abd. Xanuun, Xameetida Courvoisier: cagaarshow aan xanuun lahayn iyo xameeti oo weyn, Trousseau's syndrome: trombophlebitis migratory, cudurka macaanka ee cusub ee Mellitus, heer gobol iyo fogaan metastasis.
• CT Dx: cufnaanta ganaca oo leh falcelin desmoplastic xoog leh, kobcin liidata, iyo hoos u dhac yar marka loo eego qanjirka caadiga ah ee ku xiga, duulaanka SMA.

• Cudurka loo yaqaan 'appendicitis': Xaalad aad u badan oo ku jirta dhaqanka guud ee shucaaca waana sababta ugu weyn ee qalliinka caloosha ee bukaanka da'da yar
• CT waa habka ugu xasaasisan ee lagu ogaado xanuunka loo yaqaan 'appendicitis'
• Ultrasound waa in lagu shaqaaleeyaa bukaanada yaryar iyo carruurta
• KUB Radiographs waa in aanay wax door ah ka ciyaarin ogaanshaha xanuunka appendicitis
• Sawirka, xanuunka 'appendicitis' wuxuu muujinayaa lifaaqa bararsan oo leh darbi dhumucdiisuna, balaadhinta, iyo baruurta xuubka xuubka. Natiijooyinka la midka ah ee dhumucda derbiga iyo ballaarinta ayaa lagu xusay Maraykanka. Calaamadda bartilmaameedka ee caadiga ah waxay ku taal dhidibka gaaban ee booska baaritaanka Maraykanka.
• Haddii lifaaqa uu yahay retro-caecal marka loo eego US waxa laga yaabaa inay ku guul darreysato inay bixiso Dx sax ah iyo iskaanka CT ayaa loo baahan karaa
• Rx: qalliin si looga fogaado dhibaatooyinka

• Xannibaadaha mindhicirka (SBO) -80% dhammaan xannibaadda mindhicirka ee farsamada; 20% soo hartay waxay ka dhalataa xannibaadda weyn ee mindhicirka. Waxay leedahay heerka dhimashada 5.5%
• M/C sababa: Hx kasta oo qalliin hore oo caloosha ah iyo dhejisyo
• Soo bandhigida qadiimiga waa calool-istaagga, kordhinta kala-baxa caloosha oo leh lallabbo iyo matag
• Sawir-qaadista ayaa 50% keliya u nugul SBO
• CT waxay muujin doontaa sababta SBO 80% kiisaska
• Waxaa jira shuruudo doorsooma oo loogu talagalay xannibaadda mindhicirka yar ee ugu badan, laakiin 3.5 cm waa qiyaas muxaafid ah oo ah mindhicirka dillaacsan.
• On Abd x-ray: supine vs. toosan. Mindhicir dilaacay, fidsan valvulae conivente (laalaabka xuubka), beddelka heerarka dareeraha hawo � sallaanka.
• Rx: qalliin sida � caloosha ba'an

• Volvulus-m/c ee Sigmoid colon esp. waayeelka. Sababta ugu weyn: calool-istaagga dabadheeraad ah oo leh sigmoid-ka-soo-baxa oo ku leexanaya sigmoid mesocolon. Waxay u horseedaa calool istaag weyn (LBO). Sababaha kale ee caadiga ah: burada mindhicirka. Sigmoid vs. Caecum volvulus
• Kiliinik ahaan: calaamadaha LBO ee calool-istaagga, calool-xanuun, xanuun, lallabbo, iyo matag. Bilawga waxa uu noqon karaa mid degdeg ah ama ba'an
• Shucaac ahaan: luminta haustra ee LB, kala duwanaanta LB (> 6-cm), calaamadda digirta qaxwada
• FG: Xeerka suulka ee mindhicirka fidsan waa inuu ahaadaa 3-6-9 halka 3-cm SB, 6-cm LB & 9-cm Coecum
• Rx: qalliin sida � caloosha ba'an.�

tixraacyada

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