So wo yafunu no atifi nifa nso yɛ wo yaw? So ebetumi aba sɛ ɛyɛ Mirizzi Syndrome?

So woate ɛyaw anaa ahotɔ bi a ɛyɛ nwonwa nka wɔ wo yafunu nifa so atifi bere a woadi aduan bi awie, titiriw aduan a srade wom pɛn? Ɛtɔ da bi a, ɛyaw yi betumi de sɛnkyerɛnne ahorow te sɛ akisikuru ne aniwa a ɛyɛ kɔkɔɔ, ne atiridiinini aka ho. Mpɛn pii no, saa nneɛma yi fa ɔhaw ahorow a akisikuru de ba ho. Nanso, tebea bi wɔ hɔ a ɛntaa nsi koraa na ɛyɛ den kakra, na yɛfrɛ no Mirizzi Syndrome. Ɛnnɛ, yɛbɛka eyi ho asɛm akɔ akyiri na ɛnyɛ den.

Dɛn ne Mirizzi Syndrome? Momma yɛnte ase tiawa koraa.

Okay, di kan ma yɛnhwɛ nea gallstones yɛ. Wo gallbladder yɛ kotoku ketewaa bi a ɛboaboa bile ano na ɛkora so, na mmerɛbo no na ɛyɛ. Saa bile yi boa yɛn ma yɛyam aduan a yedi, titiriw srade. Ɛtɔ mmere bi a, saa bile yi mu nneɛma yɛ den ma ɛbɛyɛ nneɛma nketenkete a ɛte sɛ abotan a wɔfrɛ no gallstones. Nnipa dodow no ara nni sɛnkyerɛnne biara bere a wɔwɔ saa abo yi. Nanso ɛtɔ mmere bi a saa abo yi betumi akɔhyɛ bile ntini, ntini nketenkete a ɛde bile no mu no mu.

Mprempren, Mirizzi Syndrome yɛ ɔhaw a efi akisikuru mu abo, nanso ɛyɛ soronko kakra. Nea ɛkɔ so wɔ ha ne sɛ ɔbo bi a ɛwɔ akisikuru no mu, anaasɛ ɛwɔ mogya ntini foforo mu no yɛ kɛse araa ma ɛmia mogya ntini kɛse foforo a ɛbɛn hɔ no so. Fa no sɛ, sɛ nsu paipu abien twam bɛn ho a, biribi kɔhyɛ paipu biako mu na ɛhohoro wɔ saa paipu no mu, na ɛmia paipu foforo no akyi. Saa na ɛkɔ so wɔ ha nso. Eyi siw bile no kwan.

So Mirizzi Syndrome ahorow bi wɔ hɔ?

Yiw, nnuruyɛfo kyekyɛ Mirizzi Syndrome mu sɛnea tebea no te ne baabi a asɛe ntini a ɛwɔ mogya mu no kodu. Sɛ yɛbɛka no tiawa a, wɔ tebea horow bi mu no, bile ntini no mu teateaa fi akyi nkutoo. Wɔ nsɛm afoforo a emu yɛ den kɛse mu no, ebia abusuabɔ bi a ɛnteɛ bɛda akisikuru ne mogya ntini a ɛyɛ teateaa a wɔfrɛ no fistula no ntam. Saa nkyekyɛmu yi ho hia paa ma nnuruyɛfo a wɔyɛ oprehyɛn no sɛ wɔbɛyɛ ayaresa ho nhyehyɛe. Sɛ wopɛ sɛ wuhu eyi ho nsɛm pii a, wubetumi ne wo duruyɛfo akasa.

Saa tebea yi abu so dɛn?

Mirizzi Syndrome yɛ tebea a ɛntaa nsi koraa ankasa. Ɛntaa mma araa ma wohu sɛ ɛwɔ nnipa a wɔyɛ cholecystectomy no mu nea ennu 2.5% mu. Mpɛn pii no, wotumi de frafra tebea afoforo a ɛtaa ba, enti bere a wɔreyɛ oprehyɛn nkutoo na nnuruyɛfo betumi asi so dua.

Dɛn ne Mirizzi Syndrome ho sɛnkyerɛnne ahorow?

Yebetumi akyekyɛ tebea yi ho sɛnkyerɛnne mu akuw atitiriw abiɛsa:

1. Ɔfe: Wubetumi ate ɛyaw ne ɔfe wɔ wo yafunu nifa so atifi. Ebia ɛyaw yi kɔ so daa anaasɛ ɛba na ɛkɔ.

2. Nyarewa: Atiridii taa ba. Nsɛnkyerɛnne no betumi ayɛ akisikuru, ɔfe, ne ebia akisikuru.

3. Jaundice: Eyi ho sɛnkyerɛnne titiriw ne sɛ wo honam ani yɛ kɔkɔɔ, w’ani fitaa bɛyɛ kɔkɔɔ. Ebia wowɔ nsu a ɛyɛ kɔkɔɔ/biribiri tuntum ne nsu a ɛyɛ kɔla a ɛyɛ hann (dɔte kɔla) nso.

Nea ɛho hia: Saa sɛnkyerɛnne ahorow yi nyɛ Mirizzi Syndrome ho asɛm pɔtee. Nanso, sɛ wowɔ saa sɛnkyerɛnne ahorow yi a, ebetumi akyerɛ sɛ biribi asɛe wɔ wo biliary system no ho. Enti, ɛbɛyɛ papa sɛ wobɛhwehwɛ aduruyɛfo afotu ntɛm ara. Ɛnyɛ obiara na obenya saa sɛnkyerɛnne ahorow yi nyinaa prɛko pɛ.

Dɛn nti na Mirizzi Syndrome ba? Dɛn na ɛde ba?

Sɛ yɛbɛka no tiawa a, Mirizzi Syndrome fi akisikuru bi a ɛmia bile ntini bi akyi. Momma yɛnkyerɛkyerɛ eyi mu kakra.

Fa wo gallbladder no sɛ pear. Pear fã bi a srade wɔ hɔ, ɛyɛ teateaa kakra wɔ soro, ɛyɛ mmerɛw kakra wɔ ne kɔn mu, na afei dua no nso wɔ hɔ. Enti, akisikuru no wɔ kotoku, kɔn (a nnuruyɛfo frɛ no infundibulum anaa Hartmann kotoku), ne cystic duct a ɛde bile fi akisikuru no mu.

Akisikuru, kɔn, ne cystic duct no ne mmeae a ɛyɛ teateaa sen biara a ɛda adi sɛ akisikuru bi bɛkyere. Afei nso, saa adan yi bɛn wɔn ho wɔn ho yiye. Wɔ nnipa binom mu no, wɔbɛn wɔn ho sen afoforo. Enti, sɛ akisikuru bi kɔhyɛ saa beae yi, na enyin na ɛhoa a, ɛmia bile duct titiriw a ɛbɛn hɔ (common bile duct - eyi ne nea ɛde bile fi mmerɛbo ne gallbladder mu kɔ dwensɔtwaa ketewa no mu) anaasɛ common hepatic duct (eyi ne nea ɛde bile fi mmerɛbo mu) fi abɔnten. Ɛno ne bere a Mirizzi Syndrome ba.

Nsɛnnennen afoforo bɛn na ebetumi aba esiane Mirizzi Syndrome nti?

Sɛ wɔansa saa tebea yi yiye a, ɔhaw afoforo betumi asɔre. Nhwɛso ahorow bi ne:

• Cholestasis: Esiane sɛ bile ntumi nkɔ yiye nti, ɛsan kɔ mmerɛbo no mu, na ɛma mmerɛbo no ho hyehye.
• Cholangitis: Mmoawa bi a ɛde mogya ba no betumi atrɛw akɔ mmerɛbo no mu, na ɛde ɔyare mmoawa a emu yɛ den aba. Eyi yɛ nea asiane wom.
• Fistula: Esiane ɔfe a ɛkɔ so ne bile a ɛboaboa ano nti, bile ntini no afasu betumi ayɛ mmerɛw, na ama wɔabue, anaasɛ tokuru a ɛnyɛ abɔde mu de aba.
• Jaundice: Esiane sɛ bile a ɛboaboa ano nti, bilirubin a ɛwɔ mu no boaboa ano wɔ mogya no mu, na ɛma honam ani ne aniwa yɛ kɔkɔɔ.
• Malabsorption: Sɛ bile ntumi nkɔ dwensɔtwaa ketewa no mu yiye a, aduan a wɔyam, titiriw protein ne aduannuru bi no sɛe.

Ɔkwan bɛn so na nnuruyɛfo hu Mirizzi Syndrome?

Nnuruyɛfo bɛyɛ nhwehwɛmu ahorow pii de ahu akisikuru ne ɔhaw ahorow a ɛfa ho. Nea edi kan no, wɔbɛyɛ nipadua mu nhwehwɛmu de ahwɛ wo yafunu mu na wɔahwɛ sɛ ɛho ahonhon anaa. Afei wobebisa wo yare no ho sɛnkyerɛnne ne w’akwahosan ho abakɔsɛm.

Sɛ wowɔ sɛnkyerɛnne ahorow a ɛkyerɛ sɛ wowɔ ɔyare mmoawa anaa jaundice a, wo duruyɛfo betumi ahyɛ sɛ wɔnyɛ wo mogya mu nhwehwɛmu te sɛ eyinom:

• Mogya dodow a wɔde ma a edi mũ (CBC) .
• Mmɛn dwumadi ho nhwehwɛmu

Nea ɛka ho no, wobetumi ayɛ mfoninitwa sɔhwɛ ahorow pii. Eyinom bi ne:

• Yafunu mu ultrasound a wɔde yɛ nhwehwɛmu
• CT scan (kɔmputa so mfoninitwa afiri) .
• ERCP (Endoscopic Retrograde Cholangiopancreatography): Wɔ saa adeyɛ yi mu no, wɔde endoscope (afiri a mfoninitwa afiri wom) fa ano no mu de hwɛ ntini a ɛwɔ mogya mu no.
• HIDA scan: Eyi yɛ scan titiriw a ɛhwɛ sɛnea akisikuru no yɛ adwuma.
• MRI (magnetic resonance imaging) sɔhwɛ

Saa nhwehwɛmu ahorow yi boa ma wohu sɛnea bile ntini no te, baabi a abo wɔ, ne sɛ ebia Mirizzi Syndrome wɔ hɔ anaa.

Ɔkwan bɛn so na wɔsa eyi?

Ayaresa titiriw a wɔde sa Mirizzi Syndrome ne oprehyɛn . Nanso, oprehyɛn biara nni hɔ a ɛyɛ nea ɛfata obiara. Wɔbɛyɛ oprehyɛn no ma ɛne wo tebea pɔtee no ahyia.

Mpɛn pii no, woyi akisikuru no (cholecystectomy) na wosiesie bile ntini a asiw no. Wɔ tebea horow bi a emu yɛ den mu no, wobetumi ayi bile ntini a asiw no, anaasɛ wɔde afiri ketewaa bi a wɔfrɛ no stent ahyɛ mu na ama ntini no abue. Oduruyɛfo a ɔyɛ oprehyɛn no betumi ayɛ oprehyɛn yi a ɔmfa biribiara nhyɛ mu, a ɛyɛ laparoscopically (oprehyɛn a wɔde mfoninitwa afiri di dwuma na ɛhwehwɛ sɛ wɔyɛ oprehyɛn nketenkete), anaasɛ sɛ oprehyɛn a wɔabue mu (laparotomy). Eyi begyina sɛnea wo tebea no mu yɛ den so.

So ayaresa no mu nsunsuanso bɔne bi wɔ hɔ?

Ɛtɔ mmere bi a, oprehyɛn a wɔyɛ ma Mirizzi Syndrome no betumi ayɛ den kakra. Efisɛ ɔfe no ma ɛyɛ den sɛ wubehu ntini a atwa ho ahyia no yiye. Enti, sɛ mogya ntini no sɛe wɔ akwanhyia mu bere a wɔreyɛ oprehyɛn no a, nsɛnnennen te sɛ:

• Bile a ɛretu
• Mogya a ɛtɔ dodo
• Wo bile ntini mu akuru a ɛbɛba

Afei nso, nneɛma bi wɔ hɔ a ebia ɛtaa ba wɔ oprehyɛn biara mu:

• Yeaw
• Mogya a ɛretu
• Nyarewa a wɔde nyarewa ba
• Nneyɛe a wɔyɛ wɔ aduru a wɔde kum nipadua no ho

Wo duruyɛfo bɛkyerɛkyerɛ eyi mu akyerɛ wo ansa na wɔayɛ oprehyɛn no.

So ɔkwan biara nni hɔ a wɔbɛfa so asiw Mirizzi Syndrome yi a ɛbɛba no ano?

Ɛyɛ den sɛ wobesiw Mirizzi Syndrome ano koraa. Nanso, wubetumi atew asiane a ɛwɔ hɔ no so akodu baabi denam asiane ahorow a ɛma akisikuru mu abo ba a wobɛtew so. Sɛ nhwɛso no, ɛyɛ papa sɛ wobɛto nnuan ne anonne a srade dɔɔso wom ano. Bisa wo duruyɛfo sɛ nneɛma pɔtee bi wɔ hɔ a wubetumi ayɛ de asiw bile duct a esiw ano anaa.

Dɛn na ɛbɛba bere a obi ho atɔ no akyi? Dɛn ne adwene a ɛwɔ hɔ?

Mpɛn pii no nkɔmhyɛ a ɛwɔ hɔ ma nnipa a wɔn ho tɔ wɔn wɔ Mirizzi Syndrome mu wɔ oprehyɛn akyi no ye . Ade a ɛho hia ne sɛ wobɛsa no ntɛm ansa na nkɛntɛnso a ɛtra hɔ kyɛ aba.

Dodow a w’akwaa ne ntini a ɛma mogya tu no sɛe no, dodow no ara na oprehyɛn no bɛyɛ den. Dodow a oprehyɛn no yɛ den no, dodow no ara na bere a wo ho bɛtɔ wo no betumi akyɛ. Nanso, ne nyinaa mu no, nnipa dodow no ara tumi tra ase yiye a wonni akisikuru.

Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn? Nsɛnkyerɛnne bɛn na ɛsɛ sɛ minya?

Sɛ mpofirim ara wo yafunu mu yɛ wo yaw kɛse, ne awɔw ne wo ho popo, akisikuru, atiridiinini, anaasɛ jaundice ho sɛnkyerɛnne (te sɛ nsu a ɛyɛ tumm ne nsu a ɛyɛ mmerɛw) a, kɔ oduruyɛfo nkyɛn ntɛm ara .

Afei nso, sɛ wunya ɔyare mmoawa a ɛyɛ hu a wɔfrɛ no sepsis (te sɛ koma bɔ ntɛmntɛm, fifiri, ne ɔhome a ɛyɛ den) ho sɛnkyerɛnne wɔ oprehyɛn akyi a, ɛyɛ ntɛmpɛ a ɛde wo nkwa to asiane mu. Enti, sɛ wuhu saa sɛnkyerɛnne ahorow yi bi a, kɔ ayaresabea ntɛm ara.

So abusuabɔ bi wɔ Mirizzi Syndrome ne kokoram ntam?

Nhwehwɛmu ada no adi sɛ nnipa a wɔwɔ Mirizzi Syndrome no wɔ asiane a ɛkɔ soro kakra sɛ wobenya kokoram wɔ akisikuru mu. Nanso, eyi nkyerɛ sɛ Mirizzi Syndrome ankasa na ɛde kokoram no ba.

Abenfo gye di sɛ tebea koro no ara a ɛde Mirizzi yare ba (i.e., ɔfe a enni sabea, bile a ɛtra akisikuru mu) nso boa ma kokoram nya. Akontaabu mu no, wɔahu sɛ nnipa a wɔwɔ Mirizzi syndrome no mu 5% kosi 28% anya kokoram wɔ akisikuru mu.

So tebea yi betumi akum obi?

Mirizzi Syndrome yɛ nea wotumi sa .tebea. Nanso, dodow a wufi ase sa yare akyiri yi no, dodow no ara na asiane no yɛ kɛse. Wɔbɔ amanneɛ sɛ nnipa dodow a wowuwu a ɛbata saa tebea yi ho no yɛ 5% kosi 30%. Ebetumi afi nneɛma te sɛ sepsis, mmerɛbo a entumi nyɛ adwuma yiye, anaa akisikuru mu kokoram na ɛde aba.

Ebia bere ne bere mu no, wo yafunu bɛyɛ wo yaw bere a woadi awie no. Nanso sɛ wosɔre anɔpa a wo yafunu mu yɛ wo yaw, wo ho yɛ wo hyew, anaa wo ho yɛ wo yaw bere nyinaa a, ebetumi ayɛ ɔhaw kɛse bi ho sɛnkyerɛnne. Ebia wunnim mpo sɛ wowɔ akisikuru. Nanso, sɛ wonyin kɛse ma wosiw bile ntini bi a, yare no ho sɛnkyerɛnne betumi ayɛ kɛse na ɛtaa ba. Sɛ wote nka sɛ biribi anyɛ yiye a, ntwɛn. Dodow a wokɔ aduruyɛ mu ntɛm no, dodow no ara na eye.

Nea etwa to no, nneɛma a ɛho hia sen biara a ɛsɛ sɛ yɛkae

Enti, mewɔ anidaso sɛ afei de moanya ntease pa wɔ tebea a ɛntaa nsi a wɔfrɛ no Mirizzi Syndrome a yɛkaa ho asɛm nnɛ no ho. Kae:

• Sɛ wowɔ sɛnkyerɛnne ahorow te sɛ ɛyaw a ɛkɔ so tra wo yafunu nifa so atifi, atiridiinini, anaa jaundice a, mmu w’ani ngu so .
• Hwehwɛ nnuruyɛfo afotu ntɛm ara. Dodow a wohu yare no ntɛm na wɔsa no, dodow no ara na nsɛnnennen a wubetumi anya no sua na wo ho tɔ wo ntɛmntɛm.
• Sɛ wunim sɛ wowɔ gallstones a, di wo duruyɛfo akwankyerɛ akyi pɛpɛɛpɛ.
• Aduan pa a wubekura mu no betumi aboa ma asiane a ɛwɔ hɔ sɛ obi benya akisikuru no so atew.

Sɛ wowɔ nsɛmmisa foforo biara a, ntwentwɛn wo nan ase sɛ wo ne w’abusua oduruyɛfo anaa oduruyɛfo titiriw bi bɛkasa. Kɔ so nya apɔwmuden!

Mirizzi Syndrome, akisikuru mu abo, bile duct, jaundice, yafunu mu yaw, oprehyɛn, cholecystectomy