Ðe ʋuka si me ʋu sina tona xea mɔ na wòa? (Bile Duct Obstruction) - Mina míanya nu tso esia ŋu!

Ðe nèsea veve vevie le ƒodo ƒe akpa si le etame, ŋkuwo ƒe ɣie, kple ŋutigbalẽ ƒe ɣie ɣeaɖewoɣia? Alo ɖe wò aɖuɖɔwo zu amadede dzẽ eye wò aɖuɖɔ do vivitia? Esiawo menye dzesi siwo dzi woaŋe aɖaba aƒu o. Woate ŋu anye nane si xe mɔ na wò ʋukawo ƒe dzesi.

Nukae Nye Bile Duct Obstruction?

Kpuie ko la, ʋumenugbagbeviɣi ƒe xexe nye nɔnɔme si me nane gena ɖe wò ʋukawo me, si wɔnɛ be ʋuka mete ŋu sina toa wo me o.

Fifia ɖewohĩ èle eŋu bum be nukae nye ʋumenugbagbeviɣidɔ kple nukae nye ʋumenugbagbeviɣiwo hã, alo? Enyo, mina míaɖe ema hã me.

Aɖuɖɔtoe nye tsi si kpena ɖe mía ŋu míeɖua ami siwo le nuɖuɖu siwo míeɖuna me. Wowɔnɛ le míaƒe aklã me. Wodzraa ʋumenugbagbeviɣi sia si aklã wɔna ɖo ɖe aɖuɖɔtoea me. Ne míeɖu nu la, ʋumenugbagbeviɣi sia dona le aɖuɖɔtoea me eye wòyia dɔgbo suea me be wòakpe ɖe mía ŋu míaɖu nuɖuɖu. Nu bubu aɖe hã le ʋumenugbagbeviɣi sia me, eye eyae nye gbeɖuɖɔ si woyɔna be bilirubin . Wowɔa bilirubin sia ne ʋumenugbagbevi dzĩ siwo le míaƒe ʋu me gblẽ. Aklãa ɖea bilirubin sia ɖa le ŋutilãa me to ʋumenugbagbeviɣidɔ me.

Ʋumenugbagbeviɣiwo le abe pɔmpi suewo ƒe ɖoɖo ene. Bu wo be wonye pɔmpi sue siwo tsɔa tsi. Pɔmpi siawo tsɔa ʋumenugbagbeviɣi, si dona le aklã me, yia aɖuɖɔtoe me eye emegbe yia dɔgbo suea me. Wokpena ɖe ame ŋu hã be wòatsɔ bilirubin la ado goe le aklãa me.

Eyata ne nane tsi ʋuka siawo me la, ʋumenugbagbeviɣiwo xena, eye ʋumenugbagbeviɣia dzea megbedede gɔme le aklãa me. Esia ate ŋu ana ame nase veve vevie eye ne womewɔ atike nɛ nyuie o la, ate ŋu ahe lãmesẽkuxi sesẽwo vɛ .

Aleke gbegbee nɔnɔme sia bɔe?

Le nyateƒe me la, kuxi si bɔ wu si gblẽa nu le ʋukawo ŋue nye mɔxenuwo . Bu eŋu kpɔ ko, ame siwo ade 5 le 1,000 ɖesiaɖe me xɔa aɖuɖɔtoemekpewo, si ate ŋu axe ʋukawo. Gallstones nye kpe ƒomevi aɖe si dzɔna ne nusiwo le ʋumenugbagbeviɣia me ƒo ƒu eye wosẽ. Aɖuɖɔtoemekpewo koŋue nana ʋumenugbagbeviɣimɔ̃wo xena.

Nukawoe nye ʋumenugbagbeviɣidɔ ƒe xexe ƒe dzesiwo?

Zi geɖe la, dzesiawo ɖia aɖuɖɔtoemekpe kple aɖuɖɔtoedɔ. Jaundice ƒe dzesiwo nye dzesi be bilirubin sɔ gbɔ ɖe wò ʋu me akpa.

Lé ŋku ɖe nɔnɔme siawo ŋu nyuie:

• Ƒodo si le etame ƒe vevesese: Esia ate ŋu ase le eɖokui me abe vevesese vivivi, si le ƒoƒom, si nu mesẽna o ene. Edzina ɖe edzi vivivi le aɖabaƒoƒo geɖe me.
• Ŋutilã ƒe ɣie alo ŋku ƒe ɣie:Esiae míeyɔna hã be jaundice.
• Aɖuɖɔ si ƒe amadede le abe anyi ene kple aɖuɖɔ si do viviti: Ne ʋumenugbagbeviɣi mele dodom ɖe dɔgboa me nyuie o la, aɖuɖɔa ƒe amadede trɔna. Azɔ hã, aɖuɖɔa doa viviti elabena bilirubin geɖe dona le aɖuɖɔa me.
• Asrã kple vuvɔ.
• Aɖuɖɔtoe kple ʋuʋudedi.
• Ŋutilã si le ʋuʋum (pruritus): Esia ate ŋu atso ʋumenugbagbeviɣidɔ siwo le ŋutigbalẽa dzi gbɔ.
• Nuɖuɖua mevivina o.
• Be woanye ame tsɛ le susu aɖeke manɔmee.
• Sese le eɖokui me be ɖeɖi te ye ŋu ŋutɔ (ɖeɖiteameŋu).

Nukae nana ʋumenugbagbeviɣimɔ̃wo xena?

Nu geɖe li siwo ate ŋu ana ʋumenugbagbeviɣidɔ naxe. Mina míalé ŋku ɖe wo dometɔ vevitɔwo ŋu:

• Aɖuɖɔtoemekpe siwo xea mɔ na wò ʋumenugbagbeviɣiwo: Esiae nye nusi gbɔ wòtsona wu.
• Choledochal cysts: Esia nye dɔléle si mebɔ o, si wodzina. Aɖuɖɔtoe siawo nana ʋumenugbagbeviɣi ƒe sisi blewu.
• Bile duct strictures: Esia nye ʋuka ƒe ʋuʋu le mɔ si mesɔ o nu. Esia ate ŋu atso atikewɔwɔ ƒe nɔnɔme aɖe alo abixɔxɔ le amekoko megbe gbɔ.

Bile duct strictures ate ŋu atso nu vovovowo gbɔ (kansa kple esiwo menye kansa o). Le kpɔɖeŋu me, woate ŋu atso abi siwo woxɔ le amekoko si woɖe le ʋuka me (cholecystectomy) megbe gbɔ.

Nu bubu aɖewo siwo hea ʋuka siwo me ʋu sina tona ƒe ʋuʋu vɛ siwo ate ŋu ana ʋukawo naxe lae nye esi:

• Kansa: Dɔdzẽ si le dɔgboa me, dɔdzẽ si le ʋuka me, aklã me kansa, kple kansa si kaka ɖe teƒe bubuwo.
• Nɔnɔme siwo wodzina: Kpɔɖeŋu aɖewoe nye nɔnɔmewo abe `(Biliary atresia)` kple `(Alagille syndrome)`.
• Ʋumenugbagbeviɣidɔ si nɔa anyi didi: Dɔlélewo abe `(Primary biliary cholangitis)` kple `(primary sclerosing cholangitis)`.
• Dɔlélenutsiŋutete ƒe dɔdzẽ kple dɔgbo ƒe dɔléle si nɔa anyi didi.
• Dzoxɔxɔ si tso abi, dɔlékui alo dɔlékuiwo ƒe dɔléle gbɔ.
• Nɔnɔme aɖe si woyɔna be `Mirizzi syndrome`.
• Amekoko be woaɖe aɖuɖɔtoewo ɖa (Cholecystectomy).
• Kekeli ƒe atikewɔwɔ.

Kuxi kawoe ate ŋu ado tso ʋukawo ƒe xexe me?

Abe alesi míegblɔe va yi ene la, xexe sia ate ŋu ana ʋumenugbagbeviɣi naƒo ƒu ɖe aklãa me. Esia ate ŋu ana ame naxɔ abi vevie eye ne womewɔ atike nɛ o la, ate ŋu ana wòaxɔ dɔlékui siwo ate ŋu ade ame ƒe agbe afɔku me.Ateŋu ana aklã naxɔ abi tegbee hã, si ateŋu ahe nɔnɔme aɖe si woyɔna be `(aklã ƒe ʋusɔgbɔdɔ)` vɛ. Esia hã, ne womekpɔ egbɔ nyuie o la, ate ŋu ana aklã nawɔ dɔ nyuie o.

Bu eŋu kpɔ, ne ʋumenugbagbeviɣidɔ tsi ʋuka siwo te ɖe wò ʋuka me ŋu la, àte ŋu axɔ ʋuka me dɔlékui (cholecystitis).

Azɔ hã, ne ʋumenugbagbeviɣi mesɔ gbɔ o la, wò dɔgbo sue la mate ŋu aɖu ami o. Esia ate ŋu ahe nunyuimakpɔɖu hã vɛ .

Aleke nàwɔ anya ne ʋuka si me ʋu sina tona xe mɔ na wò?

Ne èyi ɖɔkta gbɔ la, abia wò atikewɔwɔ ŋutinya, si me wò dzesiwo kple atike siwo nènona hã le. Emegbe, woawɔ ŋutilãmedɔdada akpɔe ɖa be dzesi siwo fia be woxe mɔ ɖe enu, abe ƒodo ƒe veve alo ʋuʋudedi ene hã.

Ðo ŋku edzi be ne dzesi siawo tɔgbe le ŋuwò la, ele vevie ŋutɔ be nàkpɔ ɖɔkta kaba ale si nàte ŋui.

Emegbe, ahiã be woado ʋu kpɔ kple nɔnɔmetatawo dodokpɔ tɔxɛwo atsɔ aɖo kpe edzi be xexea xe mɔa eye nànya nusi tututu gbɔ wòtso.

Ʋudodokpɔwo

Ʋudodokpɔ ate ŋu aɖe dzesi siwo fia be ʋua xe mɔ na ʋua. Wò ɖɔkta ate ŋu adɔ be woawɔ dodokpɔwo abe esiawo ene:

• Ʋu ƒe xexlẽme blibo (CBC): Ʋudodo blibo (CBC) ate ŋu ana nàkpɔ wò lãmesẽ bliboa.
• Aklã ƒe dɔwɔwɔ dodokpɔ: Ne bilirubin ƒe agbɔsɔsɔ le wò ʋu me sɔ gbɔ la, ate ŋu anye dzesi be aklã xe mɔ na wò. Azɔ hã, ne aklã me dɔlékuiwutikewo abe alkaline phosphatase (ALP) kple gamma-glutamyltransferase (GGT) sɔ gbɔ wu alesi wòle dzɔdzɔmee la, ate ŋu afia be aklãa mele dɔ wɔm nyuie o le esi wòxe ta.
• Dɔgbo ƒe ʋudodokpɔ: Ne dɔgboa ƒe enzymewo abe ``(Amylase)`` kple ``(lipase)`` dzi ɖe edzi la, ateŋu anye dɔgbo ƒe kuxi si do ƒome kple ʋumenugbagbeviɣi ƒe xexe ƒe dzesi.

Nɔnɔmetatawo ɖeɖe ƒe dodokpɔwo

Ne ʋudodokpɔ me tsonu ɖee fia be ʋu xe mɔ na wò la, ke ɖewohĩ ahiã be woawɔ nɔnɔmetatawo dodokpɔ. Woate ŋu awɔ dodokpɔ siawo dometɔ ɖeka alo esi wu nenema:

• Ultrasound: Ultrasound zãa gbeɖiɖi ƒe ƒutsotsoewo tsɔ wɔa wò ŋutilã ƒe akpa si le eme ƒe nɔnɔmetatawo. Esia ate ŋu akpe ɖe ame ŋu woade dzesi nusiwo mesɔ o siwo ate ŋu afia be woxe mɔ ɖe enu. Ðewohĩ ahiã be woawɔ endoscopic ultrasound, ƒodo me ultrasound, alo aklã me ultrasound.
• Abdominal computed tomography (CT scan): CT scan zãa X-ray kple kɔmpiuta tsɔ wɔa nɔnɔmetata tsitotsito. Ate ŋu agbe nu bubu siwo gbɔ wò dzesiawo tsona siwo ɖewohĩ womakpɔ le ultrasound me o hã.
• Endoscopic retrograde cholangiopancreatography (ERCP): Dodokpɔ si woyɔna be ERCP ate ŋu akpe ɖe ame ŋu woake ɖe nusi gbɔ mɔxenu aɖe tso ŋu ahadae. Le dodokpɔ sia me la, wò ɖɔkta tsɔa mɔ̃ aɖe si te ŋu trɔna bɔbɔe (endoscope) si me akaɖi kple fotoɖemɔ̃ le la dea wò ʋumenugbagbeviɣiwo me. Woate ŋu azã dɔwɔnuwo atsɔ aɖe lãkusi (biopsy) alo atsɔ adzra nusi xe la ɖo. Woana atike si naa ame ƒe dzi dzea eme le dodokpɔ sia me.
• Magnetic resonance cholangiopancreatography (MRCP): Esia nye MRI dodokpɔ deŋgɔ aɖe. Wodoa amadede tɔxɛ aɖe wò ʋumenugbagbeviɣiwo me ne wole etom to wo me. Abe ERCP ene la, ate ŋu aɖe nusi gbɔ xexea tso, abe aɖuɖɔtoe me kpewo alo ʋuka siwo me ʋu sina tona ene afia. Gake mewɔa nuvevi ame boo o wu ERCP.
• Hepatobiliary iminodiacetic acid (HIDA) scan: Le HIDA scan me la, wozãa radioactive tracer tsɔ wɔa nɔnɔmetatawo ne ele mɔ zɔm to wò ʋukawo me. Esia ate ŋu aɖe nusi gbɔ wòtso be ʋua xe, abe aɖuɖɔtoe me kuxiwo alo dɔléle siwo wodzina si nana ʋukawo xaxa ene afia.
• Percutaneous transhepatic cholangiography (PTC): Le ``PTC'' dodokpɔ me la, wozãa ultrasound alo X-ray tsɔ ɖea amadede tɔxɛ aɖe si wotsɔna toa wò ʋumenugbagbeviɣiwo me vaseɖe esime wòɖoa wò dɔgbo suea gbɔ la ƒe foto. Amadedea ɖea nu ɖesiaɖe si xe mɔ na ʋukaawo me fiana.

Aleke nàwɔ ada ʋumenugbagbeviɣidɔ sia ƒe xexe?

Atikewɔwɔ na ʋuka si me ʋu sina tona ƒe xexe nɔ te ɖe alesi nèhiã atikewɔwɔ kaba kple nusi na ʋukaa xe dzi.

Atikewɔwɔmɔnu vovovowo li:

• ERCP (Endoscopic retrograde cholangiopancreatography): Le ERCP me la, ɖɔkta ate ŋu aɖe aɖuɖɔtoemekpewo ɖa le ʋumenugbagbeviɣiwo me. Woate ŋu azã dɔwɔnu siwo le mɔ̃ si míeyɔ va yi (endoscope) me atsɔ agbã kpeawo ahaɖe wo ɖa.
• Dɔwɔwɔ na wò be woaɖe aɖuɖɔtoe ɖa: Ne kpewo le ŋuwò enuenu siwo xea mɔ na wò ʋukawo la, ahiã be woaɖe wò ʋukawo ɖa. Zi geɖe la, wowɔa esia to amekoko si me womewɔa nu boo aɖeke le o si woyɔna be laparoscopy dzi. Àte ŋu anɔ agbe le lãmesẽ me aɖuɖɔtoe manɔmee.
• Stents: Wò ɖɔkta ate ŋu ade mɔ̃ sue aɖe si wotsɔ ga alo plastic wɔ, si woyɔna be ``stent,'' wò ʋuka me be wòakeke alo ana wòaʋu. Ne mɔxexea tso strictures gbɔ la, ahiã be nàde ``stent.''
• Kansa ƒe atikewɔwɔwo:Ne ƒunukpeƒetetedɔ gbɔe wòtso la, ahiã be woawɔ dɔ na wò alo awɔ kansadɔ bubuwo abe atikewɔmɔnu kple keklẽŋusẽdɔdamɔnu ene.

Mɔnukpɔkpɔ kawoe li be woahaya le nɔnɔme sia megbe?

Wò ŋgɔdonya nɔ te ɖe nusi gbɔ mɔxenua tso dzi. Le kpɔɖeŋu me, ne aɖuɖɔtoemekpewo gbɔe wòtso la, dɔlélea didi kaba kple edada ate ŋu akpe ɖe ame ŋu be woaxe mɔ ɖe kuxiwo nu. Ne wowɔ atike na ame akpa gãtɔ la, wohayana bliboe.

Gake ʋumenugbagbeviɣidɔ siwo kansa alo aklãdɔ si nɔa anyi didi hena vɛ dzi kpɔkpɔ ate ŋu asesẽ vie.

Menye ame sia ame ƒe nɔnɔmee nye ɖeka o. Wò ɖɔkta aɖe nusi nàte ŋu akpɔ mɔ na tso atikewɔwɔ me na wò le nusi gbɔ mɔxenua tso kple alesi wòkpɔa ŋusẽ ɖe wò lãmesẽ dzii nu.

Ðe woate ŋu axe mɔ ɖe ʋumenugbagbeviɣiwo ƒe xexe nua?

Womate ŋu axe mɔ ɖe ʋukawo ƒe xexe nu ɣesiaɣi o.

Gake àte ŋu aɖe afɔku si le wò ʋumenugbagbeviɣidɔ me, si nye nu vevitɔ si gbɔ wòtsona , xɔxɔ dzi akpɔtɔ ne èɖe ʋumemi si le wò nuɖuɖu me dzi kpɔtɔ. Àte ŋu aɖe aklãdɔ geɖe siwo ate ŋu ana aklã ƒe ʋuʋu nate ŋu axɔ wò hã dzi akpɔtɔ:

• Kamedede si sɔ xɔxɔ.
• Nuɖuɖu siwo me nunyiame le siwo me ami mesɔ gbɔ ɖo o ɖuɖu.
• Kpekpeme si sɔ na wò la me léle ɖe asi.
• Ƒo asa na ahanono, alo ahanono le agbɔsɔsɔ sue aɖe ko me.

Ɣekaɣie wòle be makpɔ ɖɔkta?

Ne ʋumenugbagbeviɣidɔ ƒe xexe ƒe dzesiwo le ŋuwò la, kpɔ egbɔ be yeyi ɖɔkta gbɔ . Dzesi geɖe siwo bɔ, abe ƒodo ƒe veve, aɖuɖɔtoe, kple aɖuɖɔtoe ene, ate ŋu atso nɔnɔme vovovowo gbɔ. Eyata ele vevie be woakpɔe kaba nenye be kuxia nye mɔxexe ŋutɔŋutɔ – hafi kuxiwo nado mo ɖa le ʋumenugbagbeviɣi ƒe ƒuƒoƒo ta.

Ðe ʋumenugbagbeviɣidɔ si xe la nye nusi dzɔ kpataa?

Ẽ, ate ŋu anye nudzɔdzɔ kpata. Vevietɔ ne ʋumenugbagbeviɣidɔa na dɔdzẽ sesẽ kple dɔlékuiwo dze ame dzi. Nu nyuitɔ si nàwɔe nye be nàyi ɖɔkta gbɔ ne ènya de dzesi dzesiwo zi gbãtɔ ko be esia nagadzɔ o.

Aɖuɖɔtoe le vevie be ʋumenugbagbeviɣiwo nate ŋu azɔ nyuie, si kpena ɖe míaƒe ŋutilã ŋu wòɖua nuɖuɖu eye wòɖea bilirubin (si nye gbeɖuɖɔ) ɖa. Esia tae wòle vevie ŋutɔ be woawɔ mɔxenu siawo ɖo. Ele be ʋumenugbagbeviɣi nasi ayi wò dɔgbo suea me be wòagbã amiwo. Ele be bilirubin hã nado le wò aklã me be wòaxe mɔ ɖe kuxiwo abe aklãdɔ alo dɔlékuiwo ene nu. Ne nu aɖe xe mɔ na wò la, wò ɖɔkta ate ŋu agblɔ mɔnu nyuitɔ siwo dzi nàto aɖee ɖa la na wò.

Mlɔeba la, nu vevitɔ kekeake siwo dzi wòle be woaɖo ŋkui

Enyo, míeƒo nu geɖe tso Bile Duct Obstruction ŋu. Nu vevi siwo dzi wòle be nàɖo ŋkui le ŋutinya sia me lae nye esi:

• Bile duct ƒe xexe nye nɔnɔme si ŋu wòle be woalé ŋku ɖo . Ne dzesiwo abe ƒodo ƒe akpa si le etame ƒe vevesese, ŋkuwo ƒe ɣie, alo aɖuɖɔ ƒe amadede ƒe tɔtrɔ ene le ŋuwò la, yi ɖɔkta gbɔ ɣeyiɣi aɖeke magblẽmagblẽ.
• Zi geɖe la, aɖuɖɔtoemekpewo gbɔe esia tsona , gake nu vevi bubuwo hã ate ŋu anɔ anyi, abe kansa ene.
• Ne wokpɔ dɔlélea dze sii kaba eye wodae nyuie la, zi geɖe la, woate ŋu ahaya bliboe.
• Agbenɔnɔ nyui me léle ɖe asi (nuɖuɖu nyui, kamedede, ahanono dzi ɖuɖu) ate ŋu aɖe afɔku aɖewo dzi akpɔtɔ.
• Ne ɖikeke alo nyabiase aɖewo le mewò la, mègakpe ŋu be yeabia wò ɖɔkta o. Wole afima be yewoakpe ɖe ŋuwò.

Wò lãmesẽ le vevie na wò ŋutɔ. Eyata lé be nɛ. Mègatsi dzi o, kuxi ɖesiaɖe gbɔ kpɔnu li!

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