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Przetoki – główne rodzaje i etiologia

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Przetoka, czyli patologiczne połączenie między dwoma lub więcej organami, może powstać na skutek urazu, powikłań po zabiegu operacyjnym lub choroby. Jakie wyróżnia się główne typy przetok?

Klasyfikacja przetok jest organizowana na podstawie wyznaczników anatomicznych, fizjologicznych i etiologicznych. Uwzględnienie w typologii wszystkich tych czynników pozwala uzyskać całościowe zrozumienie tego schorzenia i dobrać odpowiednie procedury terapeutyczne do indywidualnego przypadku.

Pod względem anatomicznym przetoki rozróżnia się na podstawie organów, pomiędzy którymi utworzyło się patologiczne połączenie. Wyróżnia się przetoki w obrębie układu krążenia, układu oddechowego, trawiennego, moczowo-płciowego oraz mięśniowo-szkieletowego.

Można także wskazać podział na przetoki wewnętrzne (pomiędzy organami wewnętrznymi) oraz zewnętrzne (pomiędzy organem a powierzchnią skóry).

Etiologia przetok

Wśród przyczyn powstawania tego schorzenia można wskazać trzy główne grupy: urazy, powikłania po zabiegach oraz choroby.

Przetoki mogą powstawać jako powikłanie rozległych zabiegów operacyjnych, związanych m.in. z terapią nowotworu oraz operacji pęcherzyka żółciowego. Stosowanie radioterapii również może skutkować wytworzeniem u pacjenta przetoki.

Wśród chorób, które mogą być powikłane wykształceniem przetoki, wymienia się nowotwory (szczególnie trzustki i układu rozrodczego), choroby zapalne jelit, w tym przede wszystkim chorobę Leśniowskiego-Crohna oraz wrzodziejące zapalenie jelita grubego, zapalenie wyrostka robaczkowego, zapalenie trzustki, chorobę wrzodową, a także trądzik odwrócony.

Do powstania przetoki mogą doprowadzić urazy w obrębie brzucha (np. rany postrzałowe, kłute), a także rany tłuczone i miażdżone powstałe np. w wyniku wypadków komunikacyjnych. Częstą przyczyną wykształcenia przetoki odbytniczo-pochwowej jest także powikłany, skomplikowany poród.

Główne rodzaje przetok

Przetoki w obrębie żołądka i jelita cienkiego w większości przypadków mają jatrogenne podłoże. Mogą się rozwinąć na skutek przerwania szwu zespalającego albo wystąpienia niewielkiego urazu tkanki podczas zamykania rany operacyjnej. Zaburzenie integralności zespoleń chirurgicznych skutkujące wykształceniem przetoki może także wystąpić z powodu niewystarczającego przepływu krwi lub nadmiernego napięcia szwu zespalającego.

Resekcja żołądka z powodu nowotworu, choroby wrzodowej lub w wyniku operacji bariatrycznej może prowadzić do wycieku soków żołądkowych lub treści jelita, w następstwie czego dochodzi do rozwoju miejscowego zakażenia i wytworzenia ropnia. Skutkiem tego procesu może być wykształcenie przetoki.

Do głównych przyczyn przetok okołoodbytniczych należą choroby zapalne (choroba Leśniowskiego-Crohna, wrzodziejące zapalenie jelita grubego, zapalenie uchyłków jelita grubego). Przyczyną wykształcenia przetoki może być także gruźlica, nowotwór (zwłaszcza jelita grubego), wcześniejsze wystąpienia ropnia odbytu. Przyczyną powstania przetoki okołoodbytniczej mogą być także powikłane operacje ginekologiczne i proktologiczne.

Przetoki naczyniowe, czyli nieprawidłowe połączenia tętniczo-żylne, tętniczo-tętnicze i żylno-żylne, mogą mieć różną etiologię. Powstają zarówno w wyniku urazów, jak i chorób oraz na podłożu jatrogennym. Mogą także wynikać z wad wrodzonych. Do częstych przyczyn powstawania tego rodzaju przetok są zaburzenia hemodynamiczne, niewydolność serca, niedokrwienie mięśnia sercowego, incydenty zatorowe.

W obrębie układu oddechowego mogą wystąpić przetoki tchawiczo-przełykowe. Ich przyczyną są wady wrodzone (atrezja przełyku). Przetoka tchawiczo-przełykowa może być także powikłaniem powstałym wskutek zabiegu tracheostomii.

Źródła: https://www.woundsource.com/, https://emedicine.medscape.com/, https://www.medonet.pl/

Przeczytaj także: Membrana z komórek ludzkiego łożyska może pomóc w terapii ran przewlekłych

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  234. PG SLOT ฝากถอน ระบบออโต้ ไม่มีขั้นต่ำ สล็อต บริการเกมสล็อตออนไลน์ที่ดีที่สุด

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  237. ค่ายเกมชั้นหนึ่งที่ไม่เคยทำให้ผิดหวัง 50รับ100 ยังคงสร้างความเพลิดเพลินให้ท่านตลอด

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  240. รวมเกม SLOT ที่โบนัสแตกง่ายมาให้คุณลูกค้าได้ลองสัมผัสกัน ทางเข้าpg ทุนน้อยก็แตกง่ายกว่าเว็บอื่นเพราะเราคือ สล็อต PG SLOT เว็บใหม่

  241. รับทรัพย์กันไปแบบเต็ม ๆ pg เราการันตีเลยว่าคุณจะได้รับประสบการณ์ที่ไม่เคยเจอที่ไหนมาก่อน

  242. ฝากครั้งแรกของวัน รับเพิ่ม 10รับ100 สล็อตเว็บตรงแตกหนักไลน์ใหม่ตลอดเวลา มีพนักงานบริการตลอด 24 ชั่วโมง

  243. สมัครสล็อตPG เว็บตรงใหม่รับโบนัส superslot pgของจริงต้องดูที่ มีเกมให้เลือกเยอะ ฝากถอนไม่มีขั้นต่ำ

  244. เว็บตรงโปรโมชั่นมากมาย pgslot และเอฟเฟกต์ที่สร้างความตื่นเต้นให้กับผู้เล่นได้

  245. เว็บสล็อตออนไลน์ใจป้ำคืนยอดเสียให้ทุกท่านทุกวัน pg เล่นได้ทั้งสล็อตออนไลน์ และยิงปลา

  246. เว็บตรงไม่ผ่านเอเยนต์เว็บตรงที่ดี จะต้องมีความปลอดภัย pg ระบบออโต้ที่รวดเร็ว ใช้เวลาฝนการทำงานไม่นาน

  247. เว็บสล็อตpg เว็บตรง ฝากถอนด้วยระบบอัตโนมัติ สล็อตวอเลท ฝาก ถอน แบบอัตโนมัติ ทำให้คุณไม่ต้องใช้เวลานานในการฝาก

  248. ความโดดเด่นที่สร้างความแตกต่าง ให้เกมสล็อต pg slot แตกง่าย สร้างสรรค์ขึ้นมา ในรูปแบบ 3D ที่สวยงามตระการตา

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  250. เกมยอดฮิตอันดับหนึ่ง pgdragon เรียกได้ว่าได้รับความนิยมอย่างมาก ในบรรดานักลงทุนผู้แสวงหาผลกำไร

  251. อยากแนะนำให้ลองเข้ามาเล่นที่เกมนี้ดู แล้วจะรู้ว่าเกมสล็อตทำเงินได้เป็นอย่างไร เครดิตฟรี50 ทดลองเล่นสล็อตเว็บตรง ได้ผ่านมือถือ จัดหนักจัดเต็มได้แล้ววันนี้!

  252. สล็อตpg ออนไลน์ ที่ทำเงินสูงให้ผู้เล่นมากที่สุด pgslot เกมที่สร้างสีสันในการเล่นและเป็นเกมที่โบนัสแตกง่ายที่สุด

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  254. เว็บสล็อตเปิดใหม่ สุดยอดเว็บเกมสล็อตที่ดีที่สุด pgzeed สามารถเล่นผ่านระบบ ios และ android เล่นได้หลายแพลตฟอร์ม

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  256. เครดิตฟรี ไม่ต้องฝาก เป็นสิ่งที่เว็บพนันออนไลน์ สล็อตเครดิตฟรี50 มีไว้ตอบแทนแก่สมาชิกของเว็บ

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  259. สล็อตออนไลน์ไม่เพียงแต่สนุกและตื่นเต้น pgzeedแต่ยังมีความเป็นมืออาชีพและน่าเชื่อถือด้วย

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  279. โปรโมชั่นสุดฮิต โบนัสแตกดี ถอนได้จริง 10 รับ100ซึ่งเป็นเกมที่เติบโตอย่างเร็วในตอนหลายปีล่วงมาแล้ว

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  282. ความหลากหลายในเกม เว็บสล็อตตรงมักมีเกมสล็อต 19 รับ 100ที่หลากหลายให้เลือกเล่นสนุกและเพิ่มโอกาสในการชนะ

  283. ความหลากหลายของเกมและการเดิมพันpgzeedgameไม่พลาดทุกกีฬาและกิจกรรมที่นักพนันสนใจ

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  287. นักพนันสามารถเข้าร่วมเพื่อสนุกกับเกม 10รับ100สล็อตความบันเทิงอย่างไม่มีที่สิ้นสุด

  288. ปัจจุบันเป็นเกมรูปแบบใหม่ที่ทำเงินให้ผู้เล่นได้เงินจริง 29รับ100ารเล่นเกมง่าย มีแนวทางสอนการเล่นเกมสล็อตออนไลน์

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  291. กมสล็อตที่หลากหลายนี้ตอบสนองได้ทุกความต้องการpgzeedgame เป็นเว็บตรงอันดับ1ที่เหมาะสำหรับนักพนันทุกคน

  292. ทุกเกมทำให้ไม่น่าเบื่อแล้วก็ตื่นเต้น ฝาก 10 รับ 100เว็บไซต์ตรง โค้ด เครดิตฟรีแตกหนัก แต่ละเกมจะมีสิ่งที่น่าสนใจล้นหลาม

  293. โอกาสที่จะชนะแจ็คพ็อตที่สูงและคุ้มค่า 25 รับ 100ความพิเศษ คือ ไม่มีขั้นต่ำ และ ไม่ผ่านเอเย่นต์

  294. สล็อตสนุกและเพิ่มโอกาสในการชนะน่าสนุกที่นักพนัน 30รับ100สามารถเข้าร่วมเพื่อสนุกกับเกมสล็อตความบันเทิงอย่างไม่มีที่สิ้นสุด

  295. สล็อตศูนย์รวมความเพลิดเพลินตลอดเวลา เครดิตฟรี30ที่จะทำให้คุณไปสู่โลกของการเดิมพันที่ยอดเยี่ยม

  296. สล็อตมีโปรโมชั่นและเครดิตฟรีมากมาย รับได้ง่ายๆ 25รับ100 แตกหนัก เดิมพันและชนะใหญ่ได้ง่ายขึ้น

  297. ความหลากหลายของเกม เลือกสล็อตเว็บที่มีความหลากหลาย 39 รับ 100เพื่อให้คุณสามารถเล่นเกมที่ชื่นชอบและตรงตามความต้องการได้

  298. สล็อตเว็บตรงไม่ผ่านเอเย่นต์ที่มีความน่าเชื่อถือ50 รับ 100 แจ็คพอตมีโอกาสชนะรางวัลโบนัสใหญ่ที่สุด

  299. ทดลองเล่นสล็อตไม่สะดุด การเล่น 20รับ100เกมอย่างไร้ขีดจำกัดและระบบเกมที่เฉลียวฉลาด

  300. เว็บตรงล่าสุด ปลอดภัยและน่าเชื่อถือbrazil999 เป็นอีกหนึ่งคุณสมบัติที่โดดเด่น ทำให้การฝากและถอนเงินเป็นเรื่องที่ง่ายและรวดเร็ว

  301. เว็บสล็อตออนไลน์นี้มีความหลากหลายในเกม HYDRA888ที่น่าตื่นเต้น รูปแบบที่สร้างความตื่นเต้นในการเล่น

  302. พื่อให้นักพนันสามารถเลือกเล่นตามความชอบของตนเอง ktv789ความตื่นเต้นและโอกาสในการชนะ

  303. มอบโปรโมชั่นและโบนัสต่างๆ ที่น่าสนใจlockdown168 ทำให้การเล่นเกมมีความสนุกสนานและคุ้มค่ามากยิ่งขึ้น

  304. มีตัวอปิ้งการชนะที่มีความมากมายและมีเกมให้เลือกอย่างจุใจtangtem168 สล็อตโปรโมชั่นแจกจริงทำเทริน์น้อย