Retroperitoneal sarari. Gabobin da kogon ciki da kuma retroperitoneal sarari

Retroperitoneum - yankin, located a kan parietal peritoneum na baya ciki bango har sai da gaba saman na vertebral jikin da su m kungiyoyin murdede tsarin. A ciki ganuwar an rufe tare da fascial zanen gado. A siffar da sarari dogara kan yadda da raya adipose nama, kazalika a kan wuri da kuma girman da kayan ciki, wanda aka located in shi.

Ganuwar da retroperitoneal sarari

A gaban bango ne a peritoneum na kogon ciki na raya bango tare da visceral zanen gado pancreas, ciwon rabo daga hanji.

A saman bango kara daga haƙarƙari da lumbar ɓangare na diaphragm da dama jijiyoyin zuciya jijiya hanta da kuma phrenicolienal jijiya bar.

The raya da kuma gefen bangon wakilta kashin baya shafi da kewaye tsokoki, da fascia mai rufi intraperitoneal.

A kasa bango ne a notional iyaka ta hanyar iyaka line raba da kafafuwa da kuma retroperitoneal sarari.

sifofin

Range gawarwaki ne quite bambancin. Wannan ya hada da urinary tsarin, da kuma narkewa kamar, zuciya da jijiyoyin jini, endocrine. Retroperitoneal gabobin:

• koda.
• ureters.
• pancreas.
• da adrenal gland.
• ciki ɓangare na lakã.
• ciwon (hawa da sauka na da sassa).
• ɓangare na duodenum.
• tasoshi, jijiyoyi.

Fascial farantin, wanda suke a cikin retroperitoneal sarari, raba cikin da dama sassa. M baki da kodan suna located predpochechnaya da pozadipochechnaya fascia kafa daga retroperitoneal fascia. Predpochechnaya tsakiya da alaka da fascial zanen gado na da baya vena cava da kuma na ciki lakã. Pozadipochechnaya fascia "saka" a cikin intraperitoneal a wurin rufe da diaphragmatic kafafu da kuma psoas tsokoki.

Koda nama ya wuce ta wani ɓangare na ureter, kuma located tsakanin predpochechnoy pozadipochechnoy fascia. Tsakanin raya saman na baki rabo daga hanji da kuma retroperitoneal fascia ne perienteric nama (fascia retrocolic).

kogon ciki

A sarari, wanda aka located kasa da diaphragm da kuma cika ciki gabobin. Budewa - babba garun, da kuma dage thoracic kogon ciki baya. A gaban bango an wakilta murdede ciki na'ura. A baya - cikin kashin baya (lumbar na shi). A kasa na sarari da ke shiga cikin pelvic kogo.

Peritoneal rami da aka yi liyi tare da peritoneum - harsashi na wani hali serous, wanda motsa zuwa kayan ciki. A lokacin da girma jikuna an motsi daga bangon da ja peritoneum, girma a cikin shi. Akwai da dama zažužžukan ga wuri:

1. Intraperitoneal - jiki daga dukkan bangarorin da aka rufe peritoneum (da kananan hanji).
2. Mezoperitonealnoe - peritoneum rufe a kan uku tarnaƙi (hanta).
3. Extraperitoneal matsayin - peritoneum rufe jiki daga gefe daya ne kawai (kodan).

bincike da hanyoyin

Retroperitoneal sarari ba za a iya binciki, kazalika da gani tantance yanayin, duk da haka, jarrabawa na na ciki bango, rike palpation kuma feat. Irfan ne na farko da na asibiti hanyoyin amfani a lokacin da shawara tare da wani gwani. Kula da launi na fata, da gaban cavities ko protrusions, ayyana infiltrates, marurai na ciki bango.

A haƙuri da aka aza a kan kujera, ya sa a karkashin kugu matashi. A sakamakon da na ciki gabobin da kuma retroperitoneal sarari zuwa gaba da cewa damar domin palpation. Soreness bayyana a latsa ko tapping na ciki bango, na iya zama nuni da kumburi tafiyar matakai, marurai (a cikin t. H. Cystic).

Har ila yau, amfani da X-ray Nazarin :

• X-haskoki na ciki da kuma hanjinsu.
• urography - karatu aiki na urinary tsarin da aka bullo da wani bambanci wakili.
• pancreatography - kima na pancreas da gabatarwar bambanci matsakaici.
• pneumoperitoneum - gabatar da gas a cikin kogon ciki tare da kara X-haskoki.
• aortography - nunawa patency ciki lakã.
• angiography aortic rassan.
• venacavography - Ƙimar na vena cava.
• lymphography.

Daga instrumental hanyoyin yin amfani da duban dan tayi, CT da MRI na retroperitoneal sarari. su suna da za'ayi a wani asibiti ko outpatient asibitin.

Duban jarrabawa

Universal yadu used Hanyar cewa an sosai daukarsa saboda kasancewa, sauƙi na dauke da tsaro. Retroperitoneal sarari nasa ne daya daga cikin gwajin zones.

Cikin manyan dalilan da Amurka:

• Pathology na pancreas - pancreatitis, ciwon sukari, pancreatic necrosis.
• duodenal miki cutar - peptic miki, duodenitis.
• cututtuka na urinary tsarin - hydronephrosis, koda insufficiency, glomerulonephritis, pyelonephritis.
• Pathology na adrenal gland - m gazawar;
• jijiyoyin bugun gini cuta - atherosclerosis, da kuma sauran jini cuta.

Za'ayi amfani na musamman inji ciwon haska. A haska ne amfani da agara na ciki bango, motsi tare da shi. Lokacin da matsayi ne a canji a cikin tsawon na ultrasonic kalaman, inda Hoton ne kõma a kan duba da nazari sashin jiki.

lissafta tomography

CT retroperitoneal sarari da ake amfani domin sanin ko gane mahaukaci pathologies daga cikin tsarin da kayan ciki. Domin dace dauke da amfani da mafi m sakamakon da gudanarwa a bambanci wakili. A hanya ne aka nuna na ciki rauni ko lumbar yankin na zargin ƙari, tare da rauni da lymphatic tsarin a cikin wannan sashi, urolithiasis, polycystic koda cuta, ko shafewa na gaban kumburi cututtuka.

CT na ciki da kuma retroperitoneal sarari na bukatar shirye-shiryen ga hanya. A kawai 'yan kwanaki daga cikin abinci zame abinci da fararwa flatulence. A gaban maƙarƙashiya wajabta laxatives shirye-shirye enema halitta.

A haƙuri aka sanya a kan surface, wanda an zubar da cikin rami na'urar daukar hotan takardu. The na'urar yana da wani musamman zobe juyawa a kusa da magana ta jiki. Likita ma'aikatan ne daga ofishin da kuma kallon da scene ta cikin gilashin bango. Sadarwa yana goyan bayan da a biyu-hanyar sadarwa. A cewar wani binciken da gwani ance da ake so Hanyar magani.

Magnetic rawa Dabarar

A cikin hali na ba-m duban dan tayi da CT ko, idan ya cancanta a tattara mafi m data likita ta zayyana MRI retroperitoneum. Menene wannan hanyar dogara a kan zaba fannin nazari. MRI iya gane gaban wadannan yanayi:

• mahaukaci karuwa a jikin.
• retroperitoneal ƙari.
• gaban hemorrhage da cysts.
• jihar a karkashin dagagge matsa lamba a cikin portal jannayẽnsa.
• Pathology na lymphatic tsarin.
• urolithiasis.
• Sistem sakulasan cuta.
• gaban metastases.

Lalacewar retroperitoneal

Mafi sau da yawa akwai wani hematoma, wanda ya tashi a sakamakon inji rauni. Nan da nan bayan rauni, zai iya isa wani babban size, yin shi da wuya a bambance a ganewar asali. A gwani iya gauraya da hematoma su lalata da m jiki. The rauni ne tare da hemorrhagic tura saboda m jini hasãra.

Haske bayyananen rage-rage sauri fiye da a cikin hali na lalacewar kayan ciki. Ƙayyade da jihar damar laparoscopy. Pneumoperitoneum nuna hijirar na retroperitoneal gabobin da kuma blurring su shaci. Har ila yau, amfani da duban dan tayi da kuma lissafta tomography.

cuta

M Pathology ne da ci gaban da kumburi tsari. A wadannan jihohi suke da daraja, dangane da kumburi da wuri na abin da ya faru:

• kumburi retroperitoneal kitse.
• parakolit - pathological aiwatar faruwa a baya da sauko ko hawa ciwon a cikin nama located in retroperitoneum.
• paranephritis - kumburi da perinephric kitse.

Alamun fara da harafin nuni maye: zazzabi, hyperthermia, gajiya, sha, kara yawan leukocytes da erythrocyte sedimentation kudi. Palpation detects gaban m yankunan, bulging na ciki bango, tsoka tashin hankali.

Daya bayyanuwar surkin jini kumburi ne ƙurji samuwar, wanda aka akai-akai la'akari asibitin bayyanar lankwashewa contracture hali a cikin hip hadin gwiwa da rauni.

Suppurative matakai cewa unsa da na ciki gabobin da kuma retroperitoneal sarari, nauyi a gare ta da rikitarwa:

• peritonitis.
• ƙurji a mediastinum.
• osteomyelitis kafafuwa da karankarman ƙirji.
• ƙurji.
• hanji fitsari.
• zane na ruɓaɓɓen jini a cikin gluteal yankin, a cinya.

marurai

Neoplasms iya tashi daga bambancin kyallen takarda:

• adipose nama - lipoma, lipoblastoma.
• murdede tsarin - myoma, miosarkoma.
• lymphatics - lymphangioma, lymphosarcoma.
• jini sosudy- hemangioma, hemangiosarcoma.
• jijiyoyi - neuroblastoma retroperitoneal sarari;
• fascia.

Marurai na iya zama m ko benign, kazalika da guda ko mahara. The asibiti manifestations zama na fili lokacin da ƙari fara kau da m gabobin saboda ta girma, warwarẽwarsu ga aiki. Marasa lafiya koka da rashin jin daɗi da kuma zafi a ciki, baya, kugu. Wani lokaci da ƙari ne m da damar a lokacin na yau da kullum dubawa.

Manyan ƙari retroperitoneal sa nauyi, venous ko jijiya jini stasis saboda matsawa daga tasoshin. Bayyana kumburi na kafafu, kafafuwa tsawo jijiyoyinmu daga cikin ciki bango.

Yãfẽwa marurai kadan canji jihar na haƙuri, amma a yanayin saukan musamman manyan girma na ilimi.

sympathicoblastoma

Ilimi yana da wani babban mataki na malignancy. Ana rinjayar da m ɓangare na juyayi tsarin da tasowa, yafi a yara. Farkon bayyanar saboda Neuroblastoma tasowa daga sel amfrayo, cewa shi ne, da ƙari ne na amfrayo asalin.

A halayyar sarrafawa zama daya daga cikin adrenal gland, da kashin baya shafi. Kamar kowane ƙari, neuroblastoma retroperitoneal sarari yana da dama, saukarwa da cewa ba ka damar sanin dace magani da kuma hangen nesa da cutar yi.

• Stage na halin da hujjõji sarrafawa marurai ba tare da Lymph kumburi hannu.
• Stage II, Buga A - da wuri ba shi da sarari iyaka, neoplasm partially cire. Lymph nodes ba su da hannu a cikin tsari.
• Stage II, Type B - samuwar wani unilateral sarrafawa. Metastases aka tsare a cikin jiki sashi inda ƙari da aka located.
• Stage III ne halin da yaduwa na neuroblastoma a karo na biyu da rabi daga cikin jiki, metastasis zuwa gida Lymph nodes.
• IV ƙari mataki ne tare da m metastases - hanta, huhu, hanjinsu.

A asibitin dogara a kan sarrafawa na neuroblastoma. Idan shi ne a cikin ciki, shi ne mai sauki gane da palpation kanta, haddasa narkewa kamar cuta, akwai lameness da kuma zafi a cikin kasusuwa na gaban metastases. Iya ci gaba inna da kuma paresis.

ƙarshe

Retroperitoneal sarari ne a baya na kogon ciki. Kowace daga cikin jikinsu, wanda aka located a nan, shi ne wani ɓangare daga cikin dukan kwayoyin. Malfunctions na akalla daya daga cikin tsarin take kaiwa zuwa fundamentally kowa pathological canje-canje.