So woasusuw sɛnea yɛyam aduan a srade wom a yedi, akutu sambol a yɛde aburow di, anaa kirikos mpataa a wɔasiesie no dɛ a ɛwɔ yɛn nipadua mu no ho pɛn? Nhyehyɛe bi a ɛyɛ nwonwa wɔ yɛn nipadua mu boa ma yɛyɛ adwuma yi. Saa nhyehyɛe yi te sɛ dua bi a ne nkorabata atrɛw. Ɛnnɛ yɛreka saa biliary system (Biliary Tree) yi ho asɛm, a ɛho nhia ma yɛn aduane mu dwumadie na ɛsan nso yɛ adwuma kɛseɛ wɔ nwura a wɔyi firi yɛn nipadua mu no mu.
Sɛ yɛbɛka no tiawa a, dɛn ne biliary dua no?
Nsu a ɛma mogya tu no yɛ akwaa ne ntini ahorow a ɛma mogya tu, ɛkora so, na ɛde kɔ yɛn nipadua mu. Wɔsan frɛ no ``Biliary Tract'' anaa ``Biliary System'' wɔ Borɔfo kasa mu. Wɔfrɛ no ``Biliary Tree'' efisɛ ɛte sɛ dua. Wɔfrɛ dua yi nkorabata nketewa no bile ducts. Saa nhyehyɛe yi akwaa atitiriw ne:
- Mmɛn: Eyi ne adwumayɛbea titiriw a wɔyɛ bile.
- Gallbladder: Eyi yɛ kotoku ketewaa bi a ɛkora bile a mmerɛbo no yɛ no bi so.
- Dwensɔtwaa ketewaa: Awiei koraa no, akisikuru ba na ɛboaboa ano wɔ ha.
Eyi nyinaa bom boa yɛn aduan a yɛpɛ no kɛse.
Dɛn ne nhyehyɛe yi afã horow ne ne dwumadi ahorow?
Fa no sɛ ɛyɛ nsu nhyehyɛe ma kurow bi. Ɔfã biara wɔ adwuma pɔtee bi. Momma yɛnhwɛ ɔfã biara mmiako mmiako.
| Organ / ɔfã bi | Adwuma no yɛ mmerɛw. |
|---|---|
| Brɛboɔ | Eyi ne beae titiriw a wɔyɛ bile. Ɛsan nso boaboa nneɛma a wɔsɛe no, srade a wɔmpɛ, ne bilirubin ano fi mogya no mu kɔ bile mu. Mmɛn no nso yɛ bile acid, na ɛboa yɛn ma yɛyam aduan a yedi no. |
| Nsu a ɛma mogya tu | Eyinom ne nsukorade nketewa a ɛte sɛ dua nkorabata. Wɔboaboa bile a ɛba mmerɛbo no mu ano na wɔde fa saa ntini ahorow yi mu kɔ akisikuru ne dwensɔtwaa ketewaa no mu. Saa ntini nketewa yi pii bom yɛ ntini a ɛtaa ba no. Ɛno ne dua no dua. |
| Akisikuru a ɛwɔ akisikuru mu | Eyi te sɛ ade ketewa bi a wɔde nneɛma gu mu. Wɔde bile a efi mmerɛbo no mu ba no bi sie ha. Sɛ yedi aduan a srade wom a, yehia bile pii na ama yɛatumi ayam. Saa bere no, akisikuru no twetwe na ɛma mogya a wɔde asie no kɔ ntini kɛse no mu. |
| Pancreas a ɛwɔ nipadua no mu | Ɛwom sɛ ɛnyɛ biliary nhyehyɛe no fã tẽẽ de, nanso ɛne no wɔ abusuabɔ na ɛne no bom yɛ adwuma. Dwensɔtwaa no ma enzyme ahorow a ehia na ama wɔatumi ayam aduan no fi hɔ. Wɔfrɛ ntini a saa enzymes yi fa mu ba no sɛ pancreatic duct, a ɛka bile duct titiriw no ho na ebue kɔ dwensɔtwaa ketewa no mu. |
| Dwensɔtwaa ketewaa bi | Awiei koraa no, akisikuru ne dwensɔtwaa mu enzymes du ha. Ɛha na wɔpaapae srade (ngo) a ɛwɔ aduan mu no mu yiye na wɔyam. Ɛha na aduannuru a wɔayam no kɔ nipadua no mu. |
Dɛn ne nyarewa ne ɔhaw ahorow a ɛtaa ba a ɛka akisikuru no?
Esiane sɛ nhyehyɛe yi afã horow nyinaa wɔ abusuabɔ nti, sɛ ɔhaw bi ba ɔfã biako a, ebetumi aka afã afoforo no nso. Te sɛ nea sɛ nsu paipu nhyehyɛe bi fã biako siw a, saa ara na nsu a ɛwɔ nhyehyɛe no nyinaa mu no gyae sen.
Nea ɛho hia ne sɛ, sɛ biribi siw nhyehyɛe yi mu a, bile no gyae. Afei saa bile no betumi asan akɔ akyi na aboaboa ano wɔ mogya no mu. Eyi betumi de akwahosan ho haw a emu yɛ den aba.
Ɔhaw ahorow a ɛtaa ba no bi ni:
- Akisikuru: Eyi yɛ tebea a abu so a nnipa pii ate ho asɛm. Nneɛma te sɛ srade a ɛwɔ bile no mu no yɛ den ma ɛbɛyɛ abo nketenkete. Sɛ abo yi kɔhyɛ bile ntini mu a, ebetumi asiw bile no kwan, na ɛde ɛyaw a emu yɛ den , ɔyare mmoawa, ne nsɛnnennen afoforo aba.
- Cholestasis: Eyi ne bere a bile a ɛsen no yɛ brɛoo kɛse anaasɛ egyae koraa. Ɛtɔ mmere bi a, saa tebea yi betumi aba bere a wɔyem.
- Biliary stricture a ɛyɛ den:Ɔyare mmoawa, kokoram, anaa aduruyɛ mu tebea foforo betumi ama akuru ntini ayɛ wɔ bile ntini no mu, na asiw ntini no ano. Eyi ma ɛyɛ den sɛ bile bɛsen.
- Mmɛn mu yare: Mmɛn no dwumadi sɛe esiane sɛ bere kɔ so no, mmerɛbo no sɛe nti. Eyi ma wontumi nnya bile yiye.
Eyinom akyi no, kokoram (Bile duct cancer, Gallbladder cancer, Pancreatic cancer) ne aduruyɛ mu tebea pɔtee afoforo nso betumi aka biliary nhyehyɛe no.
Wobɛyɛ dɛn ahu sɛ wowɔ saa ɔhaw yi? Dɛn ne sɛnkyerɛnne ahorow no?
Sɛ ɔhaw bi wɔ wo bile nhyehyɛe no mu a, wo nipadua no bɛma wo ho nsɛnkyerɛnne ahorow. Sɛ wowɔ eyinom mu biako anaa nea ɛboro saa a, ɛho hia paa sɛ wobɛkɔ oduruyɛfo nkyɛn akɔhwehwɛ afotu.
| Nsɛnkyerɛnne a ɛkyerɛ | Wɔakyerɛkyerɛ mu tiawa |
|---|---|
| Jaundice a ɛyɛ mmerɛw | Aniwa ne honam ani fitaa dan kɔ kɔkɔɔ. Nea enti a ɛte saa ne sɛ mogya no ntumi nkɔ nipadua no mu yiye, na bilirubin a ɛyɛ kɔkɔɔ a ɛwɔ mu no boaboa ano wɔ mogya no mu. |
| Yafunu atifi yaw | Ɛyaw wɔ yafunu no fã nifa, mpampam ase. Ebia mmerɛbo, akisikuru, anaa ntini a ɛma mogya tu no na ɛde ɛyaw yi ba. |
| Yafunu mu yaw a emu yɛ den (Biliary colic) . | Eyi nyɛ yafunu mu yaw a ɛfata. Ɛyɛ ɛyaw a ɛba mpofirim a wontumi nnyina ano a ɛba bere a akisikuru bi akɔhyɛ akisikuru no mu no. Ebia akisikuru ne ɔfe nso bɛka ho. |
| Nsu a srade wom na ɛyɛ mmerɛw (Steatorrhea) . | Sɛ bile ntumi nkɔ dwensɔtwaa ketewa no mu yiye a, srade a ɛwɔ aduan mu no ntumi nnye. Eyi betumi ama nsu a ɛwɔ nsu mu no ayɛ fitaa, ayɛ srade, na asensɛn nsu no mu. |
Nsɛnkyerɛnne afoforo
- Nsu a ne kɔla yɛ tuntum (te sɛ tii nsu) .
- Wora a wɔtwetwe
- Ɔbrɛ paa.
- Mu duru a wɔtew so a ntease biara nnim
- Huraeɛ
Sɛ wowɔ saa sɛnkyerɛnne yi bi a, mmu w’ani ngu so. Hwɛ wo duruyɛfo ntɛm ara.
Ɔkwan bɛn so na nnuruyɛfo hu saa tebea horow yi?
Sɛ wokɔ oduruyɛfo nkyɛn a, obebisa wo yare no ho sɛnkyerɛnne na wahwɛ wo. Afei obetumi ahyɛ sɛ wɔnyɛ nhwehwɛmu pii mfa nkyerɛ sɛ wɔahu yare no.
- Mogya mu nhwehwɛmu: Eyinom tumi hwɛ enzyme dodow a ɛwɔ mmerɛbo ne dwensɔtwaa mu de hu sɛ ebia saa akwaa no asɛe anaa.
- Mfoninitwa sɔhwɛ ahorow:
- Ultrasound scan: Ɛnyɛ den sɛ eyi betumi ahu nneɛma te sɛ akisikuru ne akisikuru.
- CT scan: Eyi betumi ama woahu nipadua no mu yiye.
- Sɔhwɛ ahorow titiriw:
- MRCP (Magnetic Resonance Cholangiopancreatography): Eyi yɛ MRI nhwehwɛmu bi. Wɔde nya bile ntini ne dwensɔtwaa ntini ho mfonini a ɛkɔ akyiri.
- ERCP (Endoscopic Retrograde Cholangiopancreatography): Eyi yɛ sɔhwɛ ne ayaresa nyinaa. Wɔde endoscope (tube a mfoninitwa afiri abata ho) fa ano no mu, de aduru bi gu bile ntini no mu, na wɔyɛ X-ray. Sɛ biribi te sɛ ɔbo bi akyea saa bere yi a, wobetumi ayi nso afi hɔ.
Dɛn na woreyɛ sɛ ayaresa?
Ayaresa no gyina w’ayaresa tebea so.
- Biliary drainage: Sɛ bile duct no siw a, ɛtɔ mmere bi a wɔde tube ketewaa bi fa yafunu no mu de yi bile a ɛboro so a aboaboa ano no fi mu.
- Endoscopic ayaresa: Bere a wɔreyɛ ERCP no, wobetumi de afiri ketewaa bi (stent) ahyɛ mu de ayi biribi a asiw no afi hɔ, agye ntini bi (biopsy), anaasɛ wɔama duct no abue.
- Oprehyɛn: Sɛ wowɔ akisikuru mu abo a, ayaresa a wɔtaa yɛ ne sɛ wɔbɛyɛ oprehyɛn ayi akisikuru no afi hɔ.
Enti, wo bile nhyehyɛe no nyɛ nhyehyɛe a ɛma bile di akɔneaba kɛkɛ. Ɛyɛ nhyehyɛe a ɛho hia a ɛboa wo ma woyam aduan, twetwe aduannuru, na mpo tew wo mogya ho.
Sɛ saa nhyehyɛe yi ntumi nyɛ adwuma yiye a, ebetumi aka w’akwahosan nyinaa, enti ɛho hia yiye sɛ wohwɛ so yiye.
Nkrasɛm a Wɔde Kɔ Fie
- Biliary dua no yɛ akwaa ahorow a ɛho hia a ɛboa yɛn nipadua ma ɛyam aduan na eyi nwura fi hɔ.
- Sɛ wo honam ani anaa w’ani reyɛ kɔkɔɔ (jaundice), ɛyɛ wo yaw kɛse wɔ wo yafunu no atifi nifa so, anaasɛ wo nsu kɔla asesa a, ebetumi ayɛ ɔhaw bi a ɛwɔ bile nhyehyɛe no ho sɛnkyerɛnne.
- Mma w’ani ngu saa sɛnkyerɛnne ahorow yi so. Eyinom betumi ayɛ aduruyɛ mu tebea a emu yɛ den ho sɛnkyerɛnne, enti kɔ wo duruyɛfo nkyɛn ntɛm ara na woanya aduruyɛ mu afotu.
- Wubetumi nso aboa ma wo bile nhyehyɛe no anya akwahosan pa denam aduan pa a wubedi ne wo nipadua mu duru a wobɛhwɛ so no so.
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