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| Saletinger R, Kotnik-Kevorkijan B, Gadžijev E, Skok P. Med Mes 2007; 3:310-7. |
Okužbe hepatobiliarnega trakta in pristop k zdravljenjuOkužbe hepatobiliarnega trakta predstavljajo, kljub napredku v kirurških in nekirurških metodah zdravljenja, še vedno pomemben vzrok umrljivosti in obolevnosti. Najpomembnejše med njimi so piogeni jetrni absces, akutno vnetje žolčnika in akutno bakterijsko vnetje žolčevodov. Piogeni jetrni absces je redka, življenjsko ogrožujoča bolezen, ki je danes povezana predvsem z boleznimi žolčevodov. Med najpogostejšimi parazitarnimi okužbami, ki prizadenejo jetra, sta ameboza in ehinokokoza. Akutno vnetje žolčnika se kaže z bolečinami v desnem zgornjem kvadrantu trebuha, vročino, siljenjem na bruhanje in bruhanjem. Pri večini bolnikov to vnetje spremljajo žolčni kamni. Akutno bakterijsko vnetje žolčevodov se kaže z zelo petro klinično sliko od vročine in zlatenice do septičnega šoka. Zdravljenje okužb hepatobiliarnega trakta je pogosto kombinirano - kirurško in antibiotično. Tak pristop pa zahteva dobro sodelovanje specialistov različnih strok, kot so kirurg, radiolog, gastroenterolog in infektolog. |
Hepatobiliary infections and approach to the treatmentHepatobiliary infections remain a significant cause of morbidity and mortality despite major advances in surgical and nonsurgical therapy. Among most common hepatobiliary infections are pyogenic liver abscess, acute cholecystitis and acute bacterial cholangitis. Pyogenic liver abscess is rare and lifethreatening disease. Vast majority of pyogenic abscesses are nowdays associated with diseases of biliary tract. Among parasitic infections, commonly affecting liver are amebiasis and echinococcosis. Acute cholecystitis refers to the clinical syndrome of right upper quadrant pain usually accompanied by fever, nausea and vomiting. In most cases the inflammation of the gallbladder is associated with gallstones. Acute cholangitis is infectious disease of the biliary tract with wide spectrum of presentation ranging from fever and jaundice to septic shock. Treatment of hepatobiliary infections is in majority of cases surgical in combination with different antibiotic regimes. Therefore good cooperation of surgeons, radiologists, gastroenterologists and infectious disease doctors is necessary. |
Ključne besede:jetrni absces, akutno vnetje žolčnika, akutno vnetje žolčevodov. |
Key words:pyogenic liver abscess, acute cholecystitis, acute bacterial cholangitis. |
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