So wɔayɛ wo oprehyɛn de ayi wo gallbladder? So woda so ara te ɛyaw a emu yɛ den wɔ wo yafunu atifi nifa so bere ne bere mu? So ɛte sɛ ɛyaw a wunya fi akisikuru mu no? Nnipa pii susuw sɛ bere a wɔayi wɔn akisikuru akyi no, wɔn yafunu mu yaw no fi hɔ koraa. Nanso ɛtɔ da bi a, ɛnyɛ nea yɛde yaw yi ba, na mmom biribi foforo. Ɛno na yɛrebɛka ho asɛm nnɛ.
Sɛ yɛbɛka no tiawa a, dɛn ne Sphincter of Oddi?
Sɛ yɛbɛte eyi ase a, momma yenni kan nhwɛ sɛnea yɛn nipadua no di aduan mu. Ɛyɛ ade a ɛyɛ den yiye, ɛyɛ nwonwa. Akwaa pii te sɛ yɛn mmerɛbo ne yɛn dwensɔtwaa yɛ adwuma bom ma aduan a yedi no dan ahoɔden.
- Mmɛn: Ɛha na wɔyɛ nnuru a wɔfrɛ no bile. Wɔde sie bere tiaa bi wɔ akisikuru no mu.
- Dwensɔtwaa: Saa ntini yi ma enzyme ahorow a ɛboa ma wɔyam aduan.
Ɛsɛ sɛ bile a efi mmerɛbo no mu ne enzymes a efi dwensɔtwaa mu no nyinaa bom sen kɔ yɛn dwensɔtwaa ketewaa no mu. Wɔfrɛ ntini ketewaa a ɛhwɛ saa akwantu no so a ɛyɛ adwuma te sɛ ɔpon no Sphincter of Oddi .
Sɛ ɛyɛ adwuma yiye a, saa ntini yi a wɔfrɛ no Sphincter of Oddi no bue wɔ bere a ɛfata mu, na ɛma bile ne enzymes tumi kɔ dwensɔtwaa ketewa no mu. Afei ɛto mu bio.
Enti dɛn ne Sphincter of Oddi Dysfunction (SOD)?
Sɛ yɛbɛka no tiawa a, Sphincter of Oddi Dysfunction ne bere a saa apon a yɛkaa ho asɛm no, ntini a wɔfrɛ no Sphincter of Oddi no, mmue yiye bere a ɛsɛ sɛ ebue no. Dɛn na ɛba saa bere no? Saa bile ne pancreatic enzymes no ntumi nkɔ dwensɔtwaa ketewa no mu na ɛkɔhyɛ saa tube no mu. Sɛ ɛkyere saa a, ɛma yafunu mu yɛ wo yaw kɛse, te sɛ nea ɛba bere a wowɔ akisikuru mu abo no.
Wɔtaa hu saa tebea yi wɔ nnipa a wɔayi wɔn akisikuru (cholecystectomy) mu. Esiane eyi nti, ɛtɔ mmere bi a wɔfrɛ no "post-cholecystectomy syndrome."
Dɛn ne tebea yi ahorow ne akuw atitiriw?
Wobetumi akyekyɛ tebea yi mu ayɛ no ahorow atitiriw abien ne akuw abiɛsa. Ɛho hia sɛ wuhu eyi, efisɛ ayaresa gyina saa ɔkwan yi so.
| Ɔkwan / Ɔfa | Wɔakyerɛkyerɛ mu tiawa |
|---|---|
| Nneɛma Ahorow Titiriw Abien | |
| Biliary Dyskinesia a Ɛyɛ Fɛ | Eyi ba bere a ntini a ɛma mogya tu no siw, na ɛmma mogya no nkɔ dwensɔtwaa ketewa no mu no. |
| Pancreatitis a ɛyɛ yare | Wɔ eyi mu no, akwanside no ba wɔ dwensɔtwaa no mu, na ɛma dwensɔtwaa no ho hyehye. |
| Nkyekyɛm Titiriw Abiɛsa | |
| Nkyekyɛm I ne II | Wɔ saa akuw abien yi mu no, nnuruyɛfo betumi anya ɔhaw no ho adanse a emu da hɔ denam nhwehwɛmu ahorow so. Sɛ nhwɛso no, mogya mu nhwehwɛmu a ɛnyɛ ne kwan so anaasɛ ultrasound scan a ɛkyerɛ sɛ mogya ntini a ɛtrɛw anaa dwensɔtwaa mu ntini. |
| Ɔfã III | Eyi ne ɔkwan a ɛyɛ den sen biara sɛ wobehu. Efisɛ eyi ho adanse biara nni hɔ a emu da hɔ wɔ mogya ho amanneɛbɔ, scan, ne nea ɛkeka ho mu Adanse biako pɛ a ɛkyerɛ sɛ yare yi te ne ɔyarefo no yafunu mu yaw. Enti, eyi a wɔbɛsa nso yɛ den kakra. |
Dɛn ne yare yi ho sɛnkyerɛnne?
Tebea yi ho sɛnkyerɛnne titiriw ne nea ɛtaa ba ne yafunu mu yaw a emu yɛ den, a ɛte sɛ ɛyaw a ɛba bere a akisikuru mu abo no.
- Baabi a ɛyaw no fi: Ɛyaw a ɛyɛ hyew a efi ase wɔ yafunu no atifi nifa so.
- Ɛyaw a ɛtrɛw: Ɛtɔ mmere bi a, ɛyaw yi tumi te nka sɛ ɛrekɔ mmati nifa anaa akyi.
- Bere tenten a ɛyaw no di: Ɛyaw no taa fi hɔ wɔ bɛyɛ simma 30 kosi dɔnhwerew biako akyi. Nanso, ebetumi asan aba da bi.
Ɛyaw titiriw yi akyi no, wobetumi ahu sɛnkyerɛnne afoforo pii:
- Akisikuru ne ɔfe
- Huraeɛ
- Awɔw a ɛyɛ nwini
- Ayamtuo
Nea ɛho hia ne sɛ ɛnyɛ bere nyinaa na saa sɛnkyerɛnne ahorow yi yɛ pɛ. Nna bi wɔ hɔ a wɔba na wɔkɔ, na nna bi nso tumi yɛ nea wontumi nnyina ano.
Dɛn nti na eyi ba? Dɛn ne nneɛma a ɛde asiane ba?
Biribiara nni hɔ a ɛde eyi ba. Ɛtɔ mmere bi a, akuru anaa ɔfe a ɛwɔ ntini a ɛma mogya tu no mu no betumi asiw bile no kwan. Mmere foforo nso, sɛ biribiara nsiw ano a, ebetumi afi ɔhaw bi a ɛwɔ Oddi ntini no ankasa sphincter no mu na ɛde aba.
Nanso akuw pii wɔ hɔ a asiane kɛse wom sɛ wobenya saa tebea yi.
- Nea ɛtaa ba: Mmea a wɔadi fi mfe 20-50 a wɔayɛ wɔn oprehyɛn ayi wɔn akisikuru.
- Nneɛma afoforo a ɛde asiane ba:
- Nnipa a wɔayɛ wɔn oprehyɛn a wɔde tew wɔn mu duru so (Gastric bypass surgery).
- Nnipa a wonya dwensɔtwaa mu yare a ɛsan ba bio.
- Nnipa a na wɔwɔ gallstones.
- Nnipa a wɔayɛ wɔn mmerɛbo foforo.
- Nnipa a wɔn thyroid nyɛ adwuma yiye (Hypothyroidism).
- Nnipa a wɔwɔ Irritable Bowel Syndrome (IBS).
- Nnipa a wɔnom nsa boro so.
- Nnipa a wɔde nnuru bi a wɔde kum ɛyaw (titiriw opiate) di dwuma.
Sɛ wɔansa a, ebetumi ayɛ nea asiane wom?
Eyi nyɛ tebea a ɛde nkwa to asiane mu, na nsɛnnennen atitiriw ntaa mma. Nanso, ɛyaw a emu yɛ den a ɛde ba no betumi ayɛ akwanside kɛse a ɛbɛma woatumi ayɛ adwuma sɛnea ɛsɛ.
Nanso sɛ ɛkɔ so a wɔansa a, ebia tebea horow a edidi so yi ntaa mma:
- Pancreatitis a enni sabea: Ɔsɛe a wontumi nsakra a ɛba dwensɔtwaa no so esiane ɔfe a ɛkɔ so nti.
- Jaundice: Honam ani yɛ kɔkɔɔ ne aniwa fitaa a ɛnam bilirubin a ɛyɛ bile mu fã bi a ɛboaboa ano wɔ nipadua no mu nti.
Ɔkwan bɛn so na oduruyɛfo no hu yare yi?
Sɛ wowɔ saa sɛnkyerɛnne ahorow yi a, ade a edi kan a wo duruyɛfo bɛyɛ ne sɛ ɔbɛhwɛ tebea afoforo a ebetumi ama wo yafunu ayɛ wo yaw, efisɛ ɛyaw a ɛte sɛɛ betumi afi tebea afoforo pii mu aba.
Sɛ nhwɛso no, ɛsɛ sɛ wohwɛ hu sɛ tebea horow a emu yɛ den te sɛ yafunu mu akisikuru, choledocholithiasis, anaa dwensɔtwaa anaa bile ntini mu kokoram biara nni hɔ. Nea ɛyɛ nwonwa no, ɛyaw a ɛwɔ komayare ahorow bi mu (te sɛ angina) nso betumi ayɛ te sɛ yafunu mu yaw.
Sɛ wopow eyinom nyinaa wie a, ebia wo duruyɛfo bɛka akyerɛ wo sɛ yɛ nhwehwɛmu ahorow yi:
- Mogya mu nhwehwɛmu: Hwɛ sɛ mmerɛbo ne dwensɔtwaa mu enzyme dodow akɔ soro anaa.
- Mfoninitwa sɔhwɛ ahorow:Hwɛ sɛ ebia biribiara a ɛnteɛ wɔ Oddi ntini anaa ntini a ɛwɔ ntini no mu no mu anaa. Ebia eyi bɛka nhwehwɛmu ahorow te sɛ Yafunu mu Ultrasound, CT scan, Endoscopic Ultrasound (EUS), Upper Endoscopy, ne Magnetic Resonance Cholangiopancreatography (MRCP) ho.
Sɔhwɛ titiriw: ERCP a ɛwɔ Manometry
Ɛtɔ mmere bi a, sɛ nhwehwɛmu ahorow yi nyinaa ntumi nwie a, oduruyɛfo no betumi de wo akɔ nhwehwɛmu titiriw bi a wɔfrɛ no Endoscopic Retrograde Cholangiopancreatography (ERCP) a wɔde manometry .
Nea ɛka eyi ho ne sɛ wobɛkɔ Sphincter of Oddi denam endoscope mmoa so, de plastic afiri ketewaa bi ahyɛ mu, na woasusuw nhyɛso no de ahu sɛnea saa ntini no twetwe na ɛtrɛw yiye.
Nanso asiane ketewaa bi na ɛba saa ERCP sɔhwɛ yi mu. Nnipa binom, bɛyɛ 100 biara mu 15 kosi 30, betumi anya dwensɔtwaa mu yare wɔ nhwehwɛmu yi akyi. Enti, bere a nnuruyɛfo susuw ho yiye akyi nkutoo na wɔyɛ eyi, na sɛ ɛho hia koraa nkutoo a.
Dɛn ne ayaresa ahorow a wɔde sa eyi?
Ɔkwan a wɔfa so sa yare no gyina sɛnea wo sɛnkyerɛnne ahorow no mu yɛ den ne ɔfã a wowɔ mu so.
1. Sɛ ɛyaw no mu nyɛ den dodo (titiriw ma ɔfã III):
Oduruyɛfo no bɛkyerɛw wo nnuru a wɔde kum ɛyaw (a ɛnyɛ opioid) ne nnuru a ɛma ntini mu dwo.
2. Sɛ ɛyaw no mu yɛ den (ma ɔfã I ne II):
Sɛ ɛyɛ den sɛ wode nnuru bedi so a, oduruyɛfo no betumi de wo akɔ ayaresa bi a wɔfrɛ no ERCP a wɔde sphincterotomy . Wɔyɛ eyi wɔ aduru a wɔde kum nipadua no mu anaasɛ wɔde aduru a wɔde kum nipadua no mu. Oduruyɛfo a ɔyɛ oprehyɛn no de endoscope kɔ Sphincter of Oddi, twa ntini a ɛkyere no no fã ketewaa bi, na ɔsansan. Bere koro no ara mu no, wɔhwɛ sɛ abo wɔ bile ntini no mu anaa.
Asiane ahorow a ɛwɔ sphincterotomy ayaresa mu
Saa ayaresa yi boa ma ɛyaw so tew wɔ ayarefo dodow no ara a wɔwɔ kuw I ne II mu. Nanso, ɛyɛ adeyɛ a ɛyɛ den nso a asiane ahorow bi wɔ mu.
- Ayarefoɔ bɛyɛ 10% - 15% betumi anya nsɛnnennen te sɛ pancreatitis.
- Ɛwom sɛ saa ɔfe yi taa yɛ mmerɛw de, nanso ɛtɔ mmere bi a ebetumi ayɛ kɛse na ɛde ne nkwa mpo ato asiane mu.
- Wɔ nsɛm a ɛtete saa mu no, ebia ɛho behia sɛ wotra ayaresabea hɔ kyɛ ansa na wɔasa wo yare.
Enti, sɛ wontumi mfa ayaresa afoforo nni so nkutoo a, nnuruyɛfo de wɔn ho to saa ayaresa yi so.
Nkrasɛm a Wɔde Kɔ Fie
- Sɛ wokɔ so nya yafunu mu yaw bere a wɔayi wo gallbladder akyi a, mmu w’ani ngu so. Akyinnye biara nni ho sɛ wobɛkɔ oduruyɛfo nkyɛn.
- Ebia Sphincter of Oddi Dysfunction (SOD), tebea a ebetumi aba sɛ akisikuru no nni hɔ mpo a, ɛde ɛyaw yi ba.
- Saa yare yi ahorow pii wɔ hɔ. Ɛnyɛ den sɛ wɔde sɔhwɛ behu ebinom, nanso ɛyɛ den sɛ wobehu ebinom (titiriw type III).
- Ayaresa ahorow bi wɔ hɔ te sɛ nnuru a wɔde kum ɔyare mmoawa ne ERCP a wɔde sphincterotomy yɛ, a sɛ ɛho hia nkutoo a wɔyɛ. Nanso, ma ɛntra w’adwenem sɛ akwan horow yi nso wɔ asiane ahorow bi.
- Wo ne wo duruyɛfo nka wo yare no ho sɛnkyerɛnne, sɛnea ɛba, ne sɛnea wo yaw no te ho asɛm. Eyi bɛboa wo ma woapaw ayaresa a ɛfata na ahobammɔ wom sen biara ama wo.
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