{"id":970,"date":"2021-09-18T23:03:06","date_gmt":"2021-09-18T16:03:06","guid":{"rendered":"http:\/\/phauthuatnhi.vn\/vi\/?p=970"},"modified":"2021-09-18T23:03:44","modified_gmt":"2021-09-18T16:03:44","slug":"di-dang-tuy-va-ong-tuy","status":"publish","type":"post","link":"http:\/\/phauthuatnhi.vn\/vi\/cacloaibenh\/di-dang-tuy-va-ong-tuy\/","title":{"rendered":"D\u1ecb d\u1ea1ng t\u1ee5y v\u00e0 \u1ed1ng t\u1ee5y"},"content":{"rendered":"\n<p class=\"has-medium-font-size\"><strong>\u0110\u1ea1i c\u01b0\u01a1ng<\/strong><\/p>\n\n\n\n<ul><li>D\u1ecb d\u1ea1ng t\u1ee5y v\u00e0 \u1ed1ng t\u1ee5y bao g\u1ed3m nhi\u1ec1u d\u1ea1ng b\u1ea5t th\u01b0\u1eddng li\u00ean quan \u0111\u1ebfn t\u1ee5y v\u00e0 \u1ed1ng t\u1ee5y x\u1ea3y ra do bi\u1ebfn c\u1ed1 trong qu\u00e1 tr\u00ecnh ph\u00e1t tri\u1ec3n c\u1ee7a t\u1ee5y th\u1eddi k\u1ef3 ph\u00f4i thai.<\/li><li>\u0110\u00e2y l\u00e0 m\u1ed9t t\u00ecnh tr\u1ea1ng kh\u00f4ng th\u01b0\u1eddng g\u1eb7p. C\u00f3 th\u1ec3 g\u00e2y ra tri\u1ec7u ch\u1ee9ng ho\u1eb7c kh\u00f4ng. Tuy nhi\u00ean, nh\u1eefng tr\u01b0\u1eddng h\u1ee3p c\u00f3 tri\u1ec7u ch\u1ee9ng c\u1ea7n \u0111\u01b0\u1ee3c kh\u00e1m v\u00e0 ph\u00e1t hi\u1ec7n s\u1edbm \u0111\u1ec3 c\u00f3 nh\u1eefng can thi\u1ec7p \u0111i\u1ec1u tr\u1ecb th\u00edch h\u1ee3p nh\u1eb1m tr\u00e1nh c\u00e1c bi\u1ebfn ch\u1ee9ng kh\u00f4ng may c\u00f3 th\u1ec3 x\u1ea3y ra.<\/li><li>C\u00e1c lo\u1ea1i d\u1ecb d\u1ea1ng t\u1ee5y v\u00e0 \u1ed1ng t\u1ee5y<ul><li>C\u00e1c bi\u1ebfn th\u1ec3 kh\u00e1c nhau v\u1ec1 \u0111\u01b0\u1eddng \u0111i c\u1ee7a \u1ed1ng t\u1ee5y ch\u00ednh: c\u00f3 4 d\u1ea1ng.<\/li><li>C\u00e1c bi\u1ebfn th\u1ec3 kh\u00e1c khau v\u1ec1 h\u00ecnh d\u1ea1ng \u1ed1ng t\u1ee5y: chia th\u00e0nh nhi\u1ec1u d\u1ea1ng, trong \u0111\u00f3 t\u1ee5y ph\u00e2n \u0111\u00f4i l\u00e0 d\u1ea1ng hay g\u1eb7p nh\u1ea5t.<\/li><li>T\u1ee5y nh\u1eabn<\/li><li>B\u1ea5t th\u01b0\u1eddng k\u00eanh chung m\u1eadt t\u1ee5y.<\/li><li>M\u1ed9t s\u1ed1 d\u1ecb d\u1ea1ng hi\u1ebfm g\u1eb7p: \u1ed1ng t\u1ee5y \u0111\u00f4i, m\u00f4 t\u1ee5y l\u1ea1c ch\u1ed7, t\u1ee5y bao b\u1ecdc t\u0129nh m\u1ea1ch c\u1eeda, b\u1ea5t s\u1ea3n t\u1ee5y l\u01b0ng.<\/li><\/ul><\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>Ph\u00f4i thai h\u1ecdc<\/strong><\/p>\n\n\n\n<ul><li>T\u1ee5y h\u00ecnh th\u00e0nh t\u1eeb n\u1ee5 t\u1ee5y l\u01b0ng (dorsal pancreatic bud) v\u00e0 n\u1ee5 t\u1ee5y b\u1ee5ng (ventral pancreatic bud) c\u00f3 ngu\u1ed3n g\u1ed1c n\u1ed9i b\u1ecb t\u00e1 tr\u00e0ng, b\u1eaft \u0111\u1ea7u xu\u1ea5t hi\u1ec7n v\u00e0 ph\u00e1t tri\u1ec3n t\u1eeb tu\u1ea7n th\u1ee9 5 c\u1ee7a thai k\u1ef3. N\u1ee5 t\u1ee5y l\u01b0ng \u1edf trong m\u1ea1c treo ru\u1ed9t l\u01b0ng c\u00f2n n\u1ee5 t\u1ee5y b\u1ee5ng \u1edf c\u1ea1nh \u1ed1ng m\u1eadt (h\u00ecnh 1A).<\/li><li>V\u00e0o tu\u1ea7n th\u1ee9 7 c\u1ee7a thai k\u1ef3, khi t\u00e1 tr\u00e0ng xoay ph\u1ea3i v\u00e0 c\u00f3 h\u00ecnh ch\u1eef C th\u00ec n\u1ee5 t\u1ee5y b\u1ee5ng di chuy\u1ec3n v\u1ec1 ph\u00eda l\u01b0ng c\u00f9ng v\u1edbi s\u1ef1 d\u1eddi l\u1ed7 \u0111\u1ed5 \u1ed1ng m\u1eadt (h\u00ecnh 1B). Cu\u1ed1i c\u00f9ng, n\u1ee5 t\u1ee5y b\u1ee5ng n\u1eb1m ngay b\u00ean d\u01b0\u1edbi n\u1ee5 t\u1ee5y l\u01b0ng (h\u00ecnh 1C). Sau \u0111\u00f3, nhu m\u00f4 t\u1ee5y \u0111\u01b0\u1ee3c t\u1ea1o ra, c\u00e1c \u1ed1ng b\u00e0i xu\u1ea5t c\u1ee7a n\u1ee5 t\u1ee5y l\u01b0ng v\u00e0 n\u1ee5 t\u1ee5y b\u1ee5ng s\u00e1t nh\u1eadp h\u1ee3p nh\u1ea5t. N\u1ee5 t\u1ee5y b\u1ee5ng t\u1ea1o ph\u1ea7n m\u1ecfm m\u00f3c v\u00e0 ph\u1ea7n d\u01b0\u1edbi \u0111\u1ea7u t\u1ee5y. Ph\u1ea7n c\u00f2n l\u1ea1i c\u1ee7a t\u1ee5y c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb n\u1ee5 t\u1ee5y l\u01b0ng (h\u00ecnh 1D).<\/li><li>\u1ed0ng t\u1ee5y ch\u00ednh (\u1ed1ng Wirsung) \u0111\u01b0\u1ee3c t\u1ea1o ra b\u1edfi \u0111o\u1ea1n xa c\u1ee7a \u1ed1ng t\u1ee5y l\u01b0ng v\u00e0 to\u00e0n b\u1ed9 \u1ed1ng t\u1ee5y b\u1ee5ng. \u0110o\u1ea1n g\u1ea7n c\u1ee7a \u1ed1ng t\u1ee5y l\u01b0ng c\u00f3 th\u1ec3 ti\u00eau \u0111i ho\u1eb7c t\u1ed3n t\u1ea1i c\u00f3 d\u1ea1ng \u1ed1ng nh\u1ecf g\u1ecdi l\u00e0 \u1ed1ng t\u1ee5y ph\u1ee5 (\u1ed1ng Santorini). \u1ed0ng t\u1ee5y ch\u00ednh c\u00f9ng v\u1edbi \u1ed1ng m\u1eadt ch\u1ee7 \u0111\u1ed5 v\u00e0o t\u00e1 tr\u00e0ng t\u1ea1i v\u1ecb tr\u00ed nh\u00fa t\u00e1 l\u1edbn, c\u00f2n \u1ed1ng t\u1ee5y ph\u1ee5 \u0111\u1ed5 v\u00e0o t\u00e1 tr\u00e0ng t\u1ea1i v\u1ecb tr\u00ed nh\u00fa t\u00e1 b\u00e9.<\/li><\/ul>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img loading=\"lazy\" width=\"1024\" height=\"244\" src=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/didang1-1024x244.jpg\" alt=\"\" class=\"wp-image-975\" srcset=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/didang1-1024x244.jpg 1024w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/didang1-300x71.jpg 300w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/didang1-768x183.jpg 768w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/didang1.jpg 1083w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><figcaption><strong>H\u00ecnh 1: Qu\u00e1 tr\u00ecnh ph\u00e1t tri\u1ec3n t\u1ee5y th\u1eddi k\u1ef3 ph\u00f4i thai<\/strong><\/figcaption><\/figure><\/div>\n\n\n\n<p class=\"has-medium-font-size\"><strong>Ph\u00e2n lo\u1ea1i<\/strong><\/p>\n\n\n\n<p><strong>C\u00e1c bi\u1ebfn th\u1ec3 kh\u00e1c nhau v\u1ec1 \u0111\u01b0\u1eddng \u0111i<\/strong> c\u1ee7a \u1ed1ng t\u1ee5y ch\u00ednh (the course types of main pancreatic duct) c\u00f3 4 d\u1ea1ng bao g\u1ed3m: d\u1ea1ng d\u1ed1c xu\u1ed1ng (50%) (h\u00ecnh 2A), d\u1ea1ng th\u1eb3ng (h\u00ecnh 2B), d\u1ea1ng x\u00edch ma (h\u00ecnh 2C), d\u1ea1ng v\u00f2ng (h\u00ecnh 2D).<\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img loading=\"lazy\" width=\"1024\" height=\"226\" src=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/didang2-1024x226.jpg\" alt=\"\" class=\"wp-image-976\" srcset=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/didang2-1024x226.jpg 1024w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/didang2-300x66.jpg 300w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/didang2-768x169.jpg 768w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/didang2.jpg 1084w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><figcaption><strong>H\u00ecnh 2: C\u00e1c bi\u1ebfn c\u1ee7a \u1ed1ng t\u1ee5y ch\u00ednh<\/strong><\/figcaption><\/figure><\/div>\n\n\n\n<p><strong>C\u00e1c bi\u1ebfn th\u1ec3 kh\u00e1c khau v\u1ec1 h\u00ecnh d\u1ea1ng<\/strong> <strong>\u1ed1ng t\u1ee5y<\/strong> (h\u00ecnh 3):<\/p>\n\n\n\n<ul><li>D\u1ea1ng 1: d\u1ea1ng b\u00ecnh th\u01b0\u1eddng, \u1ed1ng t\u1ee5y chia l\u00e0m 2 nh\u00e1nh Wirsung v\u00e0 Santorini, nh\u00e1nh Wirsung l\u00e0 nh\u00e1nh l\u1edbn.<\/li><li>D\u1ea1ng 2: \u1ed1ng t\u1ee5y chia l\u00e0m 2 nh\u00e1nh Wirsung v\u00e0 Santorini, nh\u00e1nh Santorini l\u00e0 nh\u00e1nh l\u1edbn.<\/li><li>D\u1ea1ng 3: \u1ed1ng t\u1ee5y ch\u1ec9 c\u00f3 1 nh\u00e1nh duy nh\u1ea5t.<\/li><li>D\u1ea1ng 4: t\u1ee5y ph\u00e2n \u0111\u00f4i (pancreas divisum), lo\u1ea1i bi\u1ebfn th\u1ec3 gi\u1ea3i ph\u1eabu \u1ed1ng t\u1ee5y th\u01b0\u1eddng g\u1eb7p nh\u1ea5t.<\/li><li>D\u1ea1ng 5: ansa pancreatica, \u1ed1ng t\u1ee5y chia l\u00e0m 2 nh\u00e1nh Wirsung v\u00e0 Santorini, trong \u0111\u00f3 nh\u00e1nh Santorini c\u00f3 h\u00ecnh ch\u1eef \u201cS\u201d ng\u01b0\u1ee3c.<\/li><\/ul>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img loading=\"lazy\" width=\"993\" height=\"217\" src=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/didang3-1.jpg\" alt=\"\" class=\"wp-image-978\" srcset=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/didang3-1.jpg 993w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/didang3-1-300x66.jpg 300w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/didang3-1-768x168.jpg 768w\" sizes=\"(max-width: 993px) 100vw, 993px\" \/><figcaption><strong>H\u00ecnh 3: C\u00e1c b\u1ea5t th\u01b0\u1eddng h\u00ecnh d\u1ea1ng \u1ed1ng t\u1ee5y<\/strong><\/figcaption><\/figure><\/div>\n\n\n\n<p><strong>T\u1ee5y ph\u00e2n \u0111\u00f4i<\/strong> l\u00e0 l\u00e0 s\u1ef1 th\u1ea5t b\u1ea1i trong qu\u00e1 tr\u00ecnh g\u1eafn k\u1ebft c\u1ee7a n\u1ee5 t\u1ee5y b\u1ee5ng v\u00e0 n\u1ee5 t\u1ee5y l\u01b0ng, \u0111\u00e2y lo\u1ea1i bi\u1ebfn th\u1ec3 gi\u1ea3i ph\u1eabu \u1ed1ng t\u1ee5y th\u01b0\u1eddng g\u1eb7p nh\u1ea5t. T\u1ea7n su\u1ea5t 4-14% d\u00e2n s\u1ed1. Trong t\u1ee5y ph\u00e2n \u0111\u00f4i, \u1ed1ng t\u1ee5y l\u01b0ng (\u1ed1ng Santorini) ch\u1ecbu tr\u00e1ch nhi\u1ec7m d\u1eabn l\u01b0u ph\u1ea7n l\u1edbn t\u1ee5y v\u00e0 \u0111\u1ed5 v\u00e0o nh\u00fa t\u00e1 b\u00e9. Trong khi \u0111\u00f3, \u1ed1ng t\u1ee5y b\u1ee5ng (\u1ed1ng Wirsung) d\u1eabn l\u01b0u d\u1ecbch t\u1ee5y t\u1eeb m\u1ed9t ph\u1ea7n \u0111\u1ea7u t\u1ee5y v\u00e0 m\u1ecfm m\u00f3c \u0111\u1ed5 v\u00e0o nh\u00fa t\u00e1 l\u1edbn c\u00f9ng v\u1edbi \u1ed1ng m\u1eadt ch\u1ee7. T\u1ee5y ph\u00e2n \u0111\u00f4i \u0111\u01b0\u1ee3c chia th\u00e0nh 3 nh\u00f3m nh\u1ecf (h\u00ecnh 4):<\/p>\n\n\n\n<ul><li>Nh\u00f3m 1 (70%): d\u1ea1ng kinh \u0111i\u1ec3n, ph\u00e2n \u0111\u00f4i ho\u00e0n to\u00e0n, hai n\u1ee5 t\u1ee5y th\u1ea5t b\u1ea1i ho\u00e0n to\u00e0n trong qu\u00e1 tr\u00ecnh g\u1eafn k\u1ebft v\u1edbi nhau.<\/li><li>Nh\u00f3m 2 (25%): ch\u1ec9 c\u00f3 \u1ed1ng t\u1ee5y l\u01b0ng ch\u1ecbu tr\u00e1ch nhi\u1ec7m d\u1eabn l\u01b0u t\u1ee5y v\u00e0o nh\u00fa t\u00e1 b\u00e9, kh\u00f4ng c\u00f3 \u1ed1ng Wirsung c\u1ee7a t\u1ee5y b\u1ee5ng.<\/li><li>Nh\u00f3m 3 (5%): ph\u00e2n \u0111\u00f4i kh\u00f4ng ho\u00e0n to\u00e0n, v\u1eabn c\u00f2n nh\u00e1nh th\u00f4ng th\u01b0\u01a1ng nh\u1ecf gi\u1eefa 2 n\u1ee5 t\u1ee5y.<\/li><\/ul>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large is-resized\"><img loading=\"lazy\" src=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/didang4-1024x315.jpg\" alt=\"\" class=\"wp-image-979\" width=\"768\" height=\"236\" srcset=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/didang4-1024x315.jpg 1024w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/didang4-300x92.jpg 300w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/didang4-768x236.jpg 768w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/didang4-1536x472.jpg 1536w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/didang4-2048x630.jpg 2048w\" sizes=\"(max-width: 768px) 100vw, 768px\" \/><figcaption><strong>H\u00ecnh 4: C\u00e1c d\u1ea1ng t\u1ee5y ph\u00e2n \u0111\u00f4i<\/strong><\/figcaption><\/figure><\/div>\n\n\n\n<p><strong>T\u1ee5y nh\u1eabn<\/strong> l\u00e0 t\u00ecnh tr\u1ea1ng t\u00e1 tr\u00e0ng b\u1ecb bao quanh b\u1edfi m\u00f4 t\u1ee5y (h\u00ecnh 5). T\u1ea7n su\u1ea5t 1\/20.000. T\u1ee5y nh\u1eabn c\u00f3 th\u1ec3 g\u00e2y n\u00ean h\u1eb9p ho\u1eb7c t\u1eafc t\u00e1 tr\u00e0ng. B\u00ecnh th\u01b0\u1eddng, n\u1ee5 t\u1ee5y b\u1ee5ng c\u00f3 2 ph\u1ea7n h\u1ee3p nh\u1ea5t l\u1ea1i tr\u01b0\u1edbc khi di chuy\u1ec3n v\u00f2ng ra sau t\u00e1 tr\u00e0ng \u0111\u1ebfn b\u00ean d\u01b0\u1edbi n\u1ee5 t\u1ee5y l\u01b0ng. Khi ph\u1ea7n b\u00ean ph\u1ea3i c\u1ee7a n\u1ee5 t\u1ee5y b\u1ee5ng di chuy\u1ec3n theo l\u1ed9 tr\u00ecnh b\u00ecnh th\u01b0\u1eddng c\u00f2n ph\u1ea7n b\u00ean tr\u00e1i di chuy\u1ec3n theo chi\u1ec1u ng\u01b0\u1ee3c l\u1ea1i th\u00ec t\u00e1 tr\u00e0ng s\u1ebd b\u1ecb v\u00e2y quanh b\u1edfi m\u00f4 t\u1ee5y v\u00e0 ph\u00e1t sinh n\u00ean t\u1ee5y nh\u1eabn.<\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img loading=\"lazy\" width=\"371\" height=\"284\" src=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/didang5.jpg\" alt=\"\" class=\"wp-image-980\" srcset=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/didang5.jpg 371w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/didang5-300x230.jpg 300w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/didang5-80x60.jpg 80w\" sizes=\"(max-width: 371px) 100vw, 371px\" \/><figcaption><strong>H\u00ecnh 5: T\u1ee5y nh\u1eabn<\/strong><\/figcaption><\/figure><\/div>\n\n\n\n<p><strong>B\u1ea5t th\u01b0\u1eddng k\u00eanh chung m\u1eadt t\u1ee5y<\/strong>: l\u00e0 t\u00ecnh tr\u1ea1ng \u1ed1ng t\u1ee5y ch\u00ednh c\u1eafm v\u00e0o \u0111\u01b0\u1eddng m\u1eadt ngo\u00e0i th\u00e0nh t\u00e1 tr\u00e0ng g\u00e2y n\u00ean k\u00eanh chung d\u00e0i. C\u00f3 4 d\u1ea1ng b\u1ea5t th\u01b0\u1eddng k\u00eanh chung m\u1eadt t\u1ee5y (h\u00ecnh 6):<\/p>\n\n\n\n<ul><li>D\u1ea1ng A (d\u1ea1ng h\u1eb9p): c\u00f3 h\u1eb9p \u0111o\u1ea1n cu\u1ed1i \u1ed1ng m\u1eadt ch\u1ee7 v\u1ecb tr\u00ed \u0111\u1ed5 v\u00e0o k\u00eanh chung, th\u01b0\u1eddng k\u00e8m theo nang \u1ed1ng m\u1eadt ch\u1ee7 (xem th\u00eam b\u00e0i Nang \u1ed1ng m\u1eadt ch\u1ee7)<\/li><li>D\u1ea1ng B (d\u1ea1ng kh\u00f4ng h\u1eb9p): kh\u00f4ng h\u1eb9p \u0111o\u1ea1n cu\u1ed1i \u1ed1ng m\u1eadt ch\u1ee7 v\u1ecb tr\u00ed \u0111\u1ed5 v\u00e0o k\u00eanh chung,<\/li><li>D\u1ea1ng C (d\u1ea1ng k\u00eanh chung d\u00e3n): k\u00eanh chung m\u1eadt t\u1ee5y d\u00e3n \u0111\u1ed9t ng\u1ed9t k\u00e8m h\u1eb9p \u0111o\u1ea1n cu\u1ed1i \u1ed1ng m\u1eadt ch\u1ee7 n\u01a1i \u0111\u1ed5 v\u00e0o k\u00eanh chung.<\/li><li>D\u1ea1ng D: (d\u1ea1ng ph\u1ee9c t\u1ea1p): b\u1ea5t th\u01b0\u1eddng k\u00eanh chung k\u00e8m theo c\u00e1c d\u1ecb d\u1ea1ng kh\u00e1c c\u1ee7a t\u1ee5y nh\u01b0 t\u1ee5y ph\u00e2n \u0111\u00f4i, t\u1ee5y nh\u1eabn\u2026<\/li><\/ul>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large is-resized\"><img loading=\"lazy\" src=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/didang6-1024x317.jpg\" alt=\"\" class=\"wp-image-983\" width=\"768\" height=\"238\" srcset=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/didang6-1024x317.jpg 1024w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/didang6-300x93.jpg 300w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/didang6-768x237.jpg 768w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/didang6-1536x475.jpg 1536w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/didang6-2048x633.jpg 2048w\" sizes=\"(max-width: 768px) 100vw, 768px\" \/><figcaption><strong>H\u00ecnh 6: C\u00e1c d\u1ea1ng b\u1ea5t th\u01b0\u1eddng k\u00eanh chung m\u1eadt t\u1ee5y<\/strong><\/figcaption><\/figure><\/div>\n\n\n\n<p class=\"has-medium-font-size\"><strong>Nh\u1eefng v\u1ea5n \u0111\u1ec1 c\u00f3 th\u1ec3 g\u00e2y ra c\u1ee7a d\u1ecb d\u1ea1ng \u1ed1ng t\u1ee5y<\/strong><\/p>\n\n\n\n<ul><li>C\u00f3 th\u1ec3 kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng v\u00e0 ch\u1ec9 \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n t\u00ecnh c\u1edd.<\/li><li>M\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p c\u00f3 th\u1ec3 li\u00ean quan \u0111\u1ebfn c\u00e1c v\u1ea5n \u0111\u1ec1<ul><li>\u0110au b\u1ee5ng th\u01b0\u1eddng xuy\u00ean<\/li><li>Vi\u00eam t\u1ee5y t\u00e1i ph\u00e1t nhi\u1ec1u l\u1ea7n<\/li><li>Vi\u00eam t\u1ee5y m\u1ea1n<\/li><li>Nang \u1ed1ng m\u1eadt ch\u1ee7<\/li><li>Nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng m\u1eadt<\/li><li>T\u1eafc t\u00e1 tr\u00e0ng<\/li><li>Vi\u00eam lo\u00e9t th\u00e0nh sau t\u00e1 tr\u00e0ng<\/li><li>Ung th\u01b0<\/li><\/ul><\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>Tri\u1ec7u ch\u1ee9ng chung c\u00f3 th\u1ec3 g\u1eb7p c\u1ee7a b\u1ec7nh l\u00fd d\u1ecb d\u1ea1ng \u1ed1ng t\u1ee5y<\/strong><\/p>\n\n\n\n<ul><li>Th\u01b0\u1eddng hay \u0111au b\u1ee5ng<\/li><li>N\u00f4n \u00f3i, \u0111\u1eb7c bi\u1ec7t khi \u00f3i ra d\u1ecbch xanh, v\u00e0ng<\/li><li>V\u00e0ng da<\/li><li>Vi\u00eam t\u1ee5y t\u00e1i ph\u00e1t<\/li><li>\u0102n u\u1ed1ng k\u00e9m, ch\u1eadm l\u00ean c\u00e2n<\/li><\/ul>\n\n\n\n<p>Khi b\u1ec7nh nhi c\u00f3 nh\u1eefng d\u1ea5u hi\u1ec7u, v\u1ea5n \u0111\u1ec1 tr\u00ean c\u1ea7n \u0111\u01b0\u1ee3c kh\u00e1m v\u00e0 ch\u1ec9 \u0111\u1ecbnh c\u1eadn l\u00e2m s\u00e0ng th\u00edch h\u1ee3p nh\u1eb1m ph\u00e1t hi\u1ec7n s\u1edbm v\u00e0 \u0111i\u1ec1u tr\u1ecb k\u1ecbp th\u1eddi cho b\u1ec7nh nhi.<\/p>\n\n\n\n<p class=\"has-medium-font-size\"><strong>C\u1eadn l\u00e2m s\u00e0ng<\/strong><\/p>\n\n\n\n<ul><li>X\u00e9t nghi\u1ec7m m\u00e1u: AST, ALT, Bilirubin, ALP, GGT, Lipase, Amylase\u2026<\/li><li>XQ b\u1ee5ng \u0111\u1ee9ng<\/li><li>Si\u00eau \u00e2m b\u1ee5ng<\/li><li>MRCP (ch\u1ee5p c\u1ed9ng h\u01b0\u1edfng t\u1eeb \u0111\u01b0\u1eddng m\u1eadt) l\u00e0 m\u1ed9t trong nh\u1eefng ph\u01b0\u01a1ng ti\u1ec7n h\u00ecnh \u1ea3nh h\u1ecdc \u00edt x\u00e2m l\u1ea5n c\u00f3 gi\u00e1 tr\u1ecb v\u00e0 th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong ch\u1ea9n \u0111o\u00e1n c\u00e1c b\u1ec7nh l\u00fd v\u1ec1 m\u1eadt t\u1ee5y \u1edf tr\u1ebb em. MRCP c\u00f3 th\u1ec3 gi\u00fap ph\u00e1t hi\u1ec7n c\u00e1c b\u1ea5t th\u01b0\u1eddng v\u1ec1 \u0111\u01b0\u1eddng m\u1eadt v\u00e0 \u0111\u01b0\u1eddng t\u1ee5y \u1edf tr\u1ebb em. C\u00f3 gi\u00e1 tr\u1ecb t\u01b0\u01a1ng \u0111\u01b0\u01a1ng v\u1edbi ERCP.<\/li><li>ERCP: Ch\u1ee5p m\u1eadt t\u1ee5y ng\u01b0\u1ee3c d\u00f2ng qua n\u1ed9i soi ti\u00eau h\u00f3a l\u00e0 ti\u00eau chu\u1ea9n v\u00e0ng trong ch\u1ea9n \u0111o\u00e1n c\u00e1c b\u1ec7nh l\u00fd \u1ed1ng t\u1ee5y v\u00e0 vi\u00eam t\u1ee5y m\u1ea1n. Tuy nhi\u00ean \u0111\u00e2y l\u00e0 m\u1ed9t c\u00e2n l\u00e2m s\u00e0ng x\u00e2m l\u1ea5n v\u00e0 kh\u00f3 th\u1ef1c hi\u1ec7n \u1edf tr\u1ebb em.<\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>Ch\u1ea9n \u0111o\u00e1n<\/strong><\/p>\n\n\n\n<ul><li>K\u1ebft h\u1ee3p gi\u1eefa l\u00e2m s\u00e0ng, c\u1eadn l\u00e2m s\u00e0ng (MRCP).<\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>\u0110i\u1ec1u tr\u1ecb<\/strong><\/p>\n\n\n\n<p>T\u00f9y theo b\u1ea5t th\u01b0\u1eddng c\u1ee7a \u1ed1ng t\u1ee5y v\u00e0 b\u1ec7nh l\u00fd g\u00e2y ra m\u00e0 c\u00f3 nh\u1eefng h\u01b0\u1edbng can thi\u1ec7p kh\u00e1c nhau<\/p>\n\n\n\n<p><strong>N\u1ed9i khoa<\/strong><\/p>\n\n\n\n<ul><li>Vi\u00eam t\u1ee5y c\u1ea5p<\/li><li>Nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng m\u1eadt<\/li><li>Vi\u00eam t\u1ee5y m\u1ea1n<\/li><\/ul>\n\n\n\n<p><strong>Ph\u1eabu thu\u1eadt<\/strong><\/p>\n\n\n\n<ul><li>Vi\u00eam t\u1ee5y m\u1ea1n c\u00f3 d\u00e3n \u1ed1ng t\u1ee5y<\/li><li>Nang \u1ed1ng m\u1eadt ch\u1ee7<\/li><li>T\u1eafc t\u00e1 tr\u00e0ng (do t\u1ee5y nh\u1eabn)<\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>Ti\u00ean l\u01b0\u1ee3ng theo d\u00f5i<\/strong><\/p>\n\n\n\n<p>T\u00f9y theo b\u1ec7nh l\u00fd kh\u00e1c nhau m\u00e0 tr\u1ebb s\u1ebd \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb v\u00e0 c\u00f3 ch\u1ebf \u0111\u1ed9 theo d\u00f5i kh\u00e1c nhau. Nh\u01b0ng nh\u00ecn chung, nh\u1eefng tr\u1ebb c\u00f3 b\u1ea5t th\u01b0\u1eddng v\u1ec1 \u1ed1ng t\u1ee5y (\u0111\u1eb7c bi\u1ec7t l\u00e0 nh\u1eefng tr\u01b0\u1eddng h\u1ee3p c\u00f3 tri\u1ec7u ch\u1ee9ng) c\u1ea7n \u0111\u01b0\u1ee3c t\u00e1i kh\u00e1m v\u00e0 theo d\u00f5i theo l\u1ecbch h\u1eb9n c\u1ee7a b\u00e1c s\u0129.<\/p>\n\n\n\n<p><strong><em>T\u00e0i li\u1ec7u tham kh\u1ea3o<\/em><\/strong><\/p>\n\n\n\n<ul><li>https:\/\/radiopaedia.org\/articles\/pancreatic-ducts<\/li><li>Urushihara N, Hamada Y, Kamisawa T, and et al. Classification of pancreaticobiliary maljunction and clinical features in children. J Hepatobiliary Pancreat Sci. 2017 Aug;24(8):449-455. doi: 10.1002\/jhbp.485. Epub 2017 Jul 31. PMID: 28639336.<\/li><li>T\u00fcrkvatan A, Erden A, T\u00fcrko\u011flu MA, Yener \u00d6.\u00a0Congenital Variants and Anomalies of the Pancreas and Pancreatic Duct: Imaging by Magnetic Resonance Cholangiopancreaticography and Multidetector Computed Tomography.\u00a0\u00a0 Korean J Radiol. 2013 Nov-Dec;14(6):905-913. https:\/\/doi.org\/10.3348\/kjr.2013.14.6.905<\/li><li>Adibelli ZH, Adatepe M, Imamoglu C, and et al. Anatomic variations of the pancreatic duct and their relevance with the Cambridge classification system: MRCP findings of 1158 consecutive patients. Radiol Oncol. 2016 Sep 8;50(4):370-377. doi: 10.1515\/raon-2016-0041. PMID: 27904444; PMCID: PMC5120578.<\/li><\/ul>\n","protected":false},"excerpt":{"rendered":"<div class=\"mh-excerpt\"><p>\u0110\u1ea1i c\u01b0\u01a1ng D\u1ecb d\u1ea1ng t\u1ee5y v\u00e0 \u1ed1ng t\u1ee5y bao g\u1ed3m nhi\u1ec1u d\u1ea1ng b\u1ea5t th\u01b0\u1eddng li\u00ean quan \u0111\u1ebfn t\u1ee5y v\u00e0 \u1ed1ng t\u1ee5y x\u1ea3y ra do bi\u1ebfn c\u1ed1 trong qu\u00e1 tr\u00ecnh ph\u00e1t tri\u1ec3n c\u1ee7a t\u1ee5y th\u1eddi k\u1ef3 <a class=\"mh-excerpt-more\" href=\"http:\/\/phauthuatnhi.vn\/vi\/cacloaibenh\/di-dang-tuy-va-ong-tuy\/\" title=\"D\u1ecb d\u1ea1ng t\u1ee5y v\u00e0 \u1ed1ng t\u1ee5y\">[&#8230;]<\/a><\/p>\n<\/div>","protected":false},"author":4,"featured_media":975,"comment_status":"open","ping_status":"open","sticky":false,"template":"template-full.php","format":"standard","meta":[],"categories":[4,16],"tags":[],"_links":{"self":[{"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/posts\/970"}],"collection":[{"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/comments?post=970"}],"version-history":[{"count":7,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/posts\/970\/revisions"}],"predecessor-version":[{"id":987,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/posts\/970\/revisions\/987"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/media\/975"}],"wp:attachment":[{"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/media?parent=970"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/categories?post=970"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/tags?post=970"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}