1. Uphawu lwe-hepatojugular reflux
Xa ukusilela kwentliziyo yasekunene kubangela ukuxinana kwesibindi nokudumba, isibindi sinokucinezelwa ngezandla ukuze imithambo ye-jugular ivuleke ngakumbi. Ezona zinto zixhaphakileyo kukungasebenzi kakuhle kwe-ventricular yasekunene kunye nokuxinana kwe-hepatitis.
2. Uphawu lukaCullen
Ikwaziwa ngokuba luphawu lukaCoulomb, i-purple-blue ecchymosis eluswini olujikeleze i-umbilicus okanye udonga olusezantsi lwesisu luphawu lokopha okukhulu ngaphakathi kwesisu, okuxhaphake kakhulu kwi-retroperitoneal hemorrhagic, i-acute hemorrhagic necrotizing pancreatitis, i-ruptured abdominal aortic aneurysm, njl.njl.
3. Uphawu lweGrey-Turner
Xa isigulana sifumana i-pancreatitis ebukhali, ijusi ye-pancreatic igcwala ingena kwisithuba sezicubu ezingaphantsi kwesinqe kunye necala, inyibilike amafutha angaphantsi kwesinqe, kwaye ii-capillaries ziyaqhekeka kwaye zophe, nto leyo ebangela i-ecchymosis eluhlaza okwesibhakabhaka-mfusa kulusu kwezi ndawo, ebizwa ngokuba yi-Grey-Turner's sign.
4. Uphawu lweCourvoisier
Xa umhlaza wentloko yepancreas ucinezela i-common bile duct, okanye umhlaza wecandelo eliphakathi nelisezantsi le-bile duct ubangela ukuvaleka, kuvela i-jaundice ecacileyo. Isinyi senyongo esivuvukileyo esinamaqhuqhuva, esingathambiyo, sinomphezulu ogudileyo kwaye sinokushukunyiswa sinokuvakala, esibizwa ngokuba yiCourvoisier's sign, esaziwa ngokuba kukuvaleka okuqhubekayo kwe-common bile duct.
5. Uphawu lokucaphuka kwe-peritoneal
Ukubakho kokuthamba ngaxeshanye, ukuthamba okubuyayo kunye noxinzelelo lwemisipha yesisu esiswini kubizwa ngokuba luphawu lokucaphuka kwesisu, okwaziwa ngokuba yi-peritonitis triad. Luphawu oluqhelekileyo lwe-peritonitis, ingakumbi indawo yesilonda sokuqala. Indlela yokuthamba kwemisipha yesisu ixhomekeke kwisizathu kunye nemeko yesigulana. Imeko iyonke iyahluka, kwaye ukwanda kokudumba kwesisu luphawu olubalulekileyo lwemeko embi.
6. Uphawu lukaMurphy
Uphawu lweMurphy olubonisa ukuba une-acute cholecystitis luphawu olubalulekileyo ekuxilongweni kwezonyango. Xa kutsalwa indawo yenyongo phantsi komda ochanekileyo, inyongo evuvukileyo yachukunyiswa kwaye isigulane sacelwa ukuba siphefumle nzulu. Inyongo evuvukileyo nevuvukileyo yehla. Isigulane saziva iintlungu zisiba qatha saza sabamba umphefumlo waso ngequbuliso.
7. Uphawu lukaMcburney
Ukuthamba kunye nokuthamba okubuyayo kwindawo kaMcBurney kwisisu sasekunene (indawo edibana kuyo i-umbilicus kunye ne-1/3 ephakathi neyangaphandle yomqolo wasekunene ongaphezulu) zixhaphakile kwi-acute appendicitis.
8. U-Charcot's triad
I-acute obstructive suppurative cholangitis idla ngokubonisa iintlungu zesisu, ukugodola, umkhuhlane ophezulu, kunye ne-jaundice, eyaziwa ngokuba yi-Chaco's triad.
1) Intlungu yesisu: Ivela phantsi kwenkqubo ye-xiphoid nakwi-quartrant ephezulu yasekunene, idla ngokuba yi-colic, kunye nokuhlaselwa yi-paroxysmal okanye intlungu engapheliyo kunye nokwanda kwe-paroxysms, enokusasazeka egxalabeni lasekunene nasemqolo, ihamba nesicaphucaphu kunye nokuhlanza. Idla ngokubangelwa kukutya ukutya okunamafutha.
2) Ukubanda nomkhuhlane: Emva kokuvaleka kombhobho wenyongo, uxinzelelo olungaphakathi kombhobho wenyongo luyanda, nto leyo edla ngokukhokelela kusulelo lwesibini. Iibhaktheriya kunye neetyhefu zinokubuyela egazini ngemibhobho yenyongo ye-capillary kunye ne-hepatic sinusoids, nto leyo ebangela ithumba lesibindi senyongo, i-sepsis, i-septic shock, i-DIC, njl.njl., ngokubanzi izibonakalisa njengomkhuhlane okhulayo, kunye nobushushu bomzimba obufikelela kuma-39 ukuya kuma-40°C.
3) I-Jaundice: Emva kokuba amatye evale umbhobho wenyongo, izigulana zinokuba nomchamo otyheli omnyama kunye nokudaywa okutyheli kolusu kunye ne-sclera, kwaye ezinye izigulana zinokuba nokurhawuzelelwa lusu.
9. Imiqondiso emihlanu kaReynolds (Renault)
Ukuvalelwa ejele ngamatye akupheli, ukudumba kuya kusiba mandundu ngakumbi, kwaye isigulane sifumana ukuphazamiseka kwengqondo kunye nomothuko ngokusekelwe kwi-Charcot's triad, ebizwa ngokuba yi-Raynaud's pentalogy.
10. Uphawu lukaKehr
Igazi elikwisisu livuselela i-diaphragm yasekhohlo, nto leyo ebangela iintlungu zegxalaba lasekhohlo, nto leyo exhaphakileyo ekuqhekekeni kwe-splenic.
11. Uphawu lwe-Obturator (uvavanyo lwe-obturator internus muscle)
Isigulana sasikwimeko yokulala phantsi, isinqe nethanga lasekunene zigobile zaza zajikeleziswa ngaphakathi, nto leyo ebangela intlungu yesisu esisezantsi ngasekunene, ebonakala kwi-appendicitis (i-appendix ikufutshane nomsipha we-obturator internus).
12. Uphawu lukaRovsing (uvavanyo lokunyuka kwamaxabiso ekholoni)
Isigulana silele phantsi, isandla saso sasekunene sicinezela isisu esisezantsi ngasekhohlo kwaye isandla saso sasekhohlo sicinezela ikholoni ekufutshane, nto leyo ebangela intlungu esiswini esisezantsi ngasekunene, nto leyo ebonakala kwi-appendicitis.
13. Uphawu lokucaphuka kwe-barium ye-X-ray
I-Barium ibonisa iimpawu zokurhawuzelelwa kwicandelo lamathumbu anesifo, ngokukhupha ngokukhawuleza kunye nokuzaliswa kakubi, ngelixa ukuzaliswa kulungile kwicandelo eliphezulu nelisezantsi lamathumbu. Oku kubizwa ngokuba yi-X-ray barium irritation sign, exhaphakileyo kwizigulana ezine-ulcerative intestine tuberculosis.
14. Uphawu oluphindwe kabini lwe-halo/uphawu olujolise kulo
Kwinqanaba elisebenzayo lesifo sikaCrohn, i-CT enterography ephuculweyo (CTE) ibonisa ukuba udonga lwamathumbu lujiyile kakhulu, i-mucosa yamathumbu iphuculwe kakhulu, inxalenye yodonga lwamathumbu ihlulwe ngokwahlukeneyo, kwaye iringi yangaphakathi ye-mucosal kunye neringi yangaphandle ye-serosa ziphuculwe kakhulu, zibonisa uphawu lwe-halo ephindwe kabini okanye uphawu olujoliswe kulo.
15. Uphawu lwekama yomthi
Kwinqanaba elisebenzayo lesifo sikaCrohn, i-CT enterography (CTE) ibonisa ukwanda kwemithambo yegazi ye-mesenteric, ngokwahlukileyo inyusa uxinano lwamafutha e-mesenteric kunye nokufiphala, kunye nokwanda kwe-lymph node ye-mesenteric, okubonisa "uphawu lwe-comb yomthi".
16. I-azotemia ye-Enterogenic
Emva kokopha kakhulu kwindlela ephezulu yesisu, iimveliso zokugaya iiproteni zegazi ziyafunxwa emathunjini, kwaye uxinzelelo lwe-urea nitrogen egazini lunokwanda okwethutyana, olubizwa ngokuba yi-enterogenic azotemia.
17. Isifo sikaMallory-Weiss
Eyona nto ibonakalayo kwesi sifo kukunyuka ngequbuliso koxinzelelo lwangaphakathi esiswini ngenxa yesicaphucaphu esinzima, ukuhlanza nezinye izizathu, ezibangela ukukrazuka okude kwe-mucosa kunye ne-submucosa ye-distal cardiac cardia kunye ne-esophagus, ngaloo ndlela kubangele ukopha kwesisu okuphezulu. Iimpawu eziphambili yi-sudden Acute hematemesis, elandelwa kukurhawuzelela okuphindaphindiweyo okanye ukuhlanza, ikwabizwa ngokuba yi-esophageal and cardia mucosal tear syndrome.
18. Isifo sikaZollinger-Ellison (i-gastrinoma, isifo sikaZollinger-66Ellison)
Luhlobo lwe-gastroenteropancreatic neuroendocrine tumor ebonakaliswa zizilonda ezininzi, iindawo ezingaqhelekanga, ukuchaphazeleka lula kwizifo zesilonda, kunye nokusabela kakubi kumayeza aqhelekileyo okulwa nesilonda. Urhudo, ukukhutshwa kwe-asidi ephezulu esiswini, kunye namanqanaba aphezulu e-gastrin egazini anokubakho.
IiGastrinomas zihlala zincinci, kwaye malunga ne-80% zikwi-“gastrinoma” triangle (oko kukuthi, indawo edibana kuyo i-gallbladder kunye ne-common bile duct, inxalenye yesibini neyesithathu ye-duodenum, kunye nentamo nomzimba we-pancreas). Ngaphakathi kwi-triangle eyenziwe yi-junction), ngaphezulu kwe-50% yee-gastrinomas ziyingozi, kwaye ezinye izigulana ziye zasasazeka xa zifunyenwe.
19. Isifo sokulahla inkunkuma
Emva kotyando lwesisu olungaphantsi kwesisu, ngenxa yokulahlekelwa ngumsebenzi wokulawula we-pylorus, umxholo wesisu ukhutshwa ngokukhawuleza kakhulu, nto leyo ebangela uthotho lweempawu zeklinikhi ezibizwa ngokuba yi-dumping syndrome, exhaphake kakhulu kwi-PII anastomosis. Ngokwexesha apho iimpawu zibonakala emva kokutya, zahlulwe zibe ziintlobo ezimbini: kwangethuba nasemva kwexesha.
●Isifo sokudumba kwangethuba: Iimpawu ze-hypovolemia yexeshana ezifana nokubetheka kwentliziyo, ukubila okubandayo, ukudinwa, kunye nolusu olukhanyayo zibonakala emva kwesiqingatha seyure emva kokutya. Oku kuhamba nesicaphucaphu nokuhlanza, iintlungu zesisu, kunye norhudo.
●Isifo sokudumba emva kwexesha: senzeka emva kweeyure ezi-2 ukuya kwezi-4 emva kokutya. Iimpawu eziphambili sisiyezi, umbala okhanyayo, ukubila okubandayo, ukudinwa, kunye nokubetha kwentliziyo ngokukhawuleza. Indlela yokusebenza kukuba emva kokuba ukutya kungene emathunjini, kuvuselela ukukhutshwa kwe-insulin eninzi, nto leyo ekhokelela kwi-hypoglycemia esabelayo. Ikwabizwa ngokuba yi-hypoglycemia syndrome.
20. Isifo sokungakwazi ukufunxa i-absorptive dystrophy
Sisifo seklinikhi apho izondlo zinqongophele khona ngenxa yokungasebenzi kakuhle kwamathumbu amancinci ekugayeni nasekufunxeni izondlo, nto leyo ebangela ukuba izondlo zingakwazi ukufunxwa ngendlela eqhelekileyo kwaye zikhutshwe kwindle. Ngokwezonyango, kudla ngokubonakala njengesifo sorhudo, ukubhitya, ubunzima, ukutyeba kunye nezinye iimpawu zokufunxa amafutha, ngoko ke ikwabizwa ngokuba yi-steatorrhea.
21. Isifo se-PJ (isifo se-polyposis esinombala, i-PJS)
Yi-autosomal dominant tumor syndrome engaqhelekanga ebonakaliswa yi-pigmentation yesikhumba kunye ne-mucosal, ii-polyps ezininzi ze-hamartomatous kwindlela yesisu, kunye nokuchaphazeleka lula yi-tumor.
I-PJS yenzeka ukususela ebuntwaneni. Njengoko izigulane zikhula, ii-polyps zesisu ziyanda kancinci kancinci, nto leyo ebangela iingxaki ezahlukeneyo, ezinje ngokungena ngaphakathi emzimbeni, ukuvaleka kwamathumbu, ukopha kwamathumbu, umhlaza, ukungondleki kakuhle, kunye nokudodobala kokukhula kwabantwana.
22. Isifo sendawo yesisu
Uxinzelelo lwangaphakathi esiswini somntu oqhelekileyo lusondele kuxinzelelo lomoya, oluyi-5 ukuya kwi-7 mmHg.
Uxinzelelo lwangaphakathi kwesisu ≥12 mmHg luxinzelelo lwegazi olungaphakathi kwesisu, kwaye uxinzelelo lwangaphakathi kwesisu ≥20 mmHg oluhamba nokungasebenzi kakuhle kwamalungu omzimba okunxulumene noxinzelelo lwegazi olungaphakathi kwesisu yi-abdominal compartment syndrome (ACS).
Iimpawu zeklinikhi: Isigulana sixinene esifubeni, siphelelwa ngumphefumlo, sinengxaki yokuphefumla, kwaye intliziyo ibetha ngokukhawuleza. Ukuvuvukala kwesisu kunye noxinzelelo oluphezulu kunokuhamba neentlungu zesisu, isandi samathumbu sibuthathaka okanye sinyamalale, njl. I-Hypercapnia (PaCO?>50 mmHg) kunye ne-oliguria (ukuphuma komchamo ngeyure <0.5 mL/kg) zinokwenzeka kwinqanaba lokuqala le-ACS. I-Anuria, i-azotemia, ukungaphumeleli kokuphefumla kunye nesifo sentliziyo esiphantsi kwenzeka kwinqanaba lokugqibela.
23. I-Superior mesenteric artery syndrome
Ikwaziwa nangokuba yi-benign duodenal stasis kunye nokungahlali kakuhle kwe-duodenal, uthotho lweempawu ezibangelwa yindawo engaqhelekanga yomthambo we-mesenteric ongaphezulu ocinezela icandelo elithe tye le-duodenum, nto leyo ebangela ukuvaleka kwe-duodenum kancinci okanye ngokupheleleyo.
Ixhaphake kakhulu kubafazi abadala abane-asthenic. Ukuqunjelwa, isicaphucaphu, kunye nokuhlanza zixhaphakile. Uphawu oluphambili lwesi sifo kukuba iimpawu zinxulumene nesimo somzimba. Xa kusetyenziswa indawo yokulala phantsi, iimpawu zokucinezelwa ziyanda, ngelixa xa indawo yokuthambekela, indawo yedolo nesifuba, okanye indawo yecala lasekhohlo, iimpawu zinokuphela.
24. Isifo se-Blind loop
Isifo sorhudo, i-anemia, ukungafunxwa kakuhle komzimba kunye nokuncipha kobunzima okubangelwa kukungami kakuhle komxholo wamathumbu amancinci kunye nokukhula kakhulu kweebhaktheriya kwi-lumen yamathumbu. Ibonakala kakhulu ekwakhiweni kwee-blind loops okanye ii-blind bags (oko kukuthi ii-intestinal loops) emva kokususwa kwesisu kunye ne-gastrointestinal anastomosis. Kwaye kubangelwa kukungami kakuhle komzimba.
25. Isifo samathumbu amafutshane
Kuthetha ukuba emva kokususwa kwamathumbu amancinci okanye ukususwa ngenxa yezizathu ezahlukeneyo, indawo yokufunxa esebenzayo yamathumbu iyancipha kakhulu, kwaye amathumbu asebenzayo aseleyo awakwazi ukugcina isondlo sesigulana okanye iimfuno zokukhula komntwana, kunye neempawu ezifana norhudo, iingxaki ze-acid-base/water/electrolyte, kunye ne-syndromes ezilawulwa ziingxaki zokufunxa kunye ne-metabolism yezakhamzimba ezahlukeneyo.
26. Isifo sesibindi
Iimpawu eziphambili zeklinikhi yi-oliguria, i-anuria kunye ne-azotemia.
Izintso zesigulane zazingenazo izilonda ezinkulu. Ngenxa yoxinzelelo olukhulu lwegazi oluvela kwi-portal kunye nokujikeleza kwegazi okukhawulezayo, ukuhamba kwegazi okuhambayo kwancitshiswa kakhulu, kwaye izinto ezahlukeneyo ze-vasodilator ezifana ne-prostaglandins, i-nitric oxide, i-glucagon, i-atrial natriuretic peptide, i-endotoxin, kunye neepeptides ezinxulumene ne-calcium gene azinakwenziwa zisibindi, nto leyo ebangela ukuba i-systemic vascular bed ikhule; inani elikhulu lolwelo lwe-peritoneal lunokubangela ukunyuka okukhulu koxinzelelo lwangaphakathi kwesisu, okunokunciphisa ukuhamba kwegazi kwizintso, ingakumbi i-renal cortex hypoperfusion, okukhokelela ekungasebenzini kwezintso.
Ama-80% ezigulana ezinezifo ezikhula ngokukhawuleza ziyafa kwiiveki ezimalunga nezimbini. Uhlobo olukhula kancinci kancinci luqheleke kakhulu kwiklinikhi, luhlala lubonakala ngokuphuma kwegazi esiswini okungenakuphikiswa kunye nokungasebenzi kakuhle kwezintso.
27. Isifo seHepatopulmonary
Ngokusekelwe kwisifo sesibindi, emva kokukhupha izifo eziphambili zentliziyo nemiphunga, kuvela ukuphelelwa ngamandla kunye neempawu ze-hypoxia ezifana ne-cyanosis kunye ne-clubbing yeminwe (iinzwane), ezinxulumene nokungasebenzi kakuhle kwemithambo yegazi ngaphakathi kwemiphunga kunye nokungasebenzi kakuhle kwe-oxygenation yegazi kwimithambo yegazi, kwaye i-prognosis ayilunganga.
28. Isifo seMirizzi
Ukuchaphazeleka kwamatye entanyeni yenyongo okanye kwi-cystic duct, okanye kudityaniswe nokudumba kwenyongo, uxinzelelo
Kwenzeka ngokunyanzela okanye ngokuchaphazela umjelo wesibindi oqhelekileyo, okubangela ukwanda kwezicubu ezijikelezileyo, ukudumba okanye i-stenosis yomjelo wesibindi oqhelekileyo, kwaye ngokwezonyango kubonakala njengoluhlu lweempawu zeklinikhi ezibonakaliswa yi-jaundice ethintelayo, i-biliary colic okanye i-cholangitis.
Isiseko sokwakheka kwayo kukuba i-cystic duct kunye ne-common hepatic duct zinde kakhulu xa zidibene okanye indawo apho i-cystic duct kunye ne-common hepatic duct zidibana khona iphantsi kakhulu.
29. Isifo sikaBudd-Chiari
I-Budd-Chiari syndrome, ekwaziwa ngokuba yi-Budd-Chiari syndrome, ibhekisa kwiqela le-portal hypertension okanye i-portal kunye ne-inferior vena cava hypertension ebangelwa kukuvaleka komthambo wesibindi okanye i-inferior vena cava engaphezulu komgodi wayo.
30. Isifo sikaCaroli
Ukwanda kwe-cystic ye-congenital ye-intrahepatic bile ducts. Indlela yokusebenza ayicacanga. Isenokufana ne-choledochal cyst. Ukwanda kwe-cholangiocarcinoma kukhulu kunokwabantu ngokubanzi. Iimpawu zokuqala zeklinikhi ziintlungu ze-hepatomegaly kunye nesisu, ikakhulu njenge-biliary colic, eyinkimbinkimbi sisifo se-bacterial bile duct. Umkhuhlane kunye ne-jaundice engapheliyo zenzeka ngexesha lokudumba, kwaye inqanaba le-jaundice lihlala lincinci.
31. Isifo se-Puborectal
Sisifo sokurhuda esibangelwa kukuvaleka komngxuma womgangatho we-pelvic ngenxa yokuxinana okanye i-hypertrophy yemisipha ye-puborectalis.
32. Isifo somgangatho wePelvic
Ibhekisa kwiqela lee-syndromes ezibangelwa kukungasebenzi kakuhle kwemithambo-luvo kwizakhiwo zomgangatho we-pelvic kuquka i-rectum, i-levator ani muscle, kunye ne-external anal sphincter. Iimpawu eziphambili zeklinikhi kubunzima bokuchitha okanye ukungachithi, kunye noxinzelelo kunye nentlungu yomgangatho we-pelvic. Ezi ngxaki ngamanye amaxesha ziquka ubunzima bokukhupha indle, kwaye ngamanye amaxesha ukungachithi indle. Kwiimeko ezinzima, ziba buhlungu kakhulu.
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Ixesha leposi: Sep-06-2024