Èbu alesi míeɖua nuɖuɖu siwo me ami le siwo míeɖuna, koklozi sambol si míeɖuna kple bli, alo kirikos tɔmelã vivi siwo le míaƒe ŋutilã me la ŋu kpɔa? Nuɖoanyi wɔnuku aɖe si le míaƒe ŋutilã me kpena ɖe mía ŋu le dɔ sia wɔwɔ me. Nuɖoanyi sia le abe ati si ƒe alɔwo keke ɖe enu ene. Egbea míele nu ƒom tso biliary system (Biliary Tree) sia ŋu, si hiã vevie na míaƒe nuɖuɖumeŋusẽ eye wòwɔa dɔ gã aɖe hã le gbeɖuɖɔ ɖeɖeɖa le míaƒe ŋutilã me.
Kpuie ko la, nukae nye biliary-ti?
Aɖuɖɔtoe ƒe ɖoɖoa nye ŋutinuwo kple ʋuka siwo wɔa ʋumenugbagbeviɣidɔ, dzraa ʋumenugbagbeviɣidɔ ɖo, eye wòtsɔnɛ yia míaƒe ŋutilã me. Wogayɔnɛ be ``Biliary Tract'' alo ``Biliary System'' le Eŋlisigbe me. Woyɔe be ``Biliary Tree'' elabena edze abe ati ene. Woyɔa ati sia ƒe alɔ sueawo be ʋumenugbagbeviɣiwo. Nuɖoanyi sia ƒe ŋutinu veviwoe nye:
- Aklã: Esiae nye dɔwɔƒe vevitɔ si wɔa ʋumenugbagbeviɣidɔ.
- Aɖuɖɔtoe: Esia nye kotoku sue aɖe si dzraa ʋumenugbagbeviɣidɔ si aklãa wɔna la dometɔ aɖewo ɖo.
- Dɔgbo sue: Bile va ɖona mlɔeba eye wòƒoa ƒu ɖe afisia.
Esiawo katã ƒo ƒu doa alɔ míaƒe nuɖuɖumeŋusẽ geɖe.
Nuɖoanyi sia ƒe akpa kawo kple woƒe dɔwɔwɔwo?
Bu eŋu abe tsi ƒe ɖoɖo na du aɖe ene. Dɔ aɖe koŋ le akpa ɖesiaɖe si. Mina míalé ŋku ɖe akpa ɖesiaɖe ŋu ɖekaɖeka.
| Organ / akpa aɖe | Dɔa le bɔbɔe. |
|---|---|
| Aklã | Afi siae nye teƒe vevitɔ si wowɔa ʋumenugbagbeviɣidɔ le. Eƒoa gbeɖuɖɔwo, ʋumemi si womedi o, kple bilirubin nu ƒu tso ʋua me wòzua ʋumenugbagbeviɣidɔ hã. Aklã hã wɔa ʋumenugbagbevi dzĩwo, siwo kpena ɖe mía ŋu míeɖua nuɖuɖu siwo míeɖuna. |
| Ʋuka siwo me ʋu sina tona | Esiawoe nye mɔ̃ sue siwo le abe ati ƒe alɔwo ene. Woƒoa ʋumenugbagbeviɣidɔ si dona le aklã me nu ƒu hetsɔnɛ yia aɖuɖɔtoe kple dɔgbo suea me to mɔ siawo dzi. Mɔ sue siawo dometɔ geɖe ƒoa ƒu wɔa ʋumenugbagbeviɣidɔ si bɔ. Emae nye ati la ƒe ke. |
| Aɖuɖɔtoe | Esia le abe nudzraɖoƒe sue aɖe ene. Wodzraa ʋumenugbagbeviɣidɔ si dona tso aklãa me ƒe ɖewo ɖo ɖe afisia. Ne míeɖu nuɖuɖu si me ami le la, míehiãa ʋumenugbagbeviɣi geɖe hafi wòaɖu. Ɣemaɣi la, aɖuɖɔtoea ƒoa ƒu eye wòɖea ʋumenugbagbeviɣi si wodzra ɖo la ɖe go yia ʋuka gã la me. |
| Dɔgbo ƒe dɔléle | Togbɔ be menye biliary system ƒe akpa aɖekee wònye tẽ o hã la, edo ƒome kplii eye wòwɔa dɔ aduadu kplii. Dɔgboa ɖea enzyme siwo hiã be woatsɔ aɖu nuɖuɖu la doa goe. Woyɔa mɔ̃ si me enzyme siawo tona be dɔgbo ƒe mɔ̃, si ƒoa ƒu kple ʋumenugbagbeviɣimɔ̃ gãtɔ eye wòʋuna yia dɔgbo suea me. |
| Dɔgbo sue aɖe | Aɖuɖɔtoe kple dɔgbo ƒe enzymewo va ɖoa afisia mlɔeba. Afi siae wogbãa ami (ami) siwo le nuɖuɖu me nyuie eye woɖua wo le. Afi siae nunyiame siwo woɖuna la xɔa ŋutilãa le. |
Dɔléle kple kuxi kawoe bɔ siwo gblẽa nu le aɖuɖɔtoe ŋu?
Esi nuɖoanyi sia ƒe akpawo katã do ƒome kple wo nɔewo ta la, ne kuxi aɖe do mo ɖa le akpa ɖeka la, ate ŋu agblẽ nu le akpa bubuawo hã ŋu. Abe alesi ko ne tsi ƒe pɔmpi ƒe akpa ɖeka xe ene la, tsi si le mɔ̃ bliboa me dzudzɔa sisi.
Nu vevitɔe nye be ne xexe aɖe xe le ɖoɖo sia me la, ʋumenugbagbeviɣia nu tsona. Emegbe ʋumenugbagbeviɣi ma ate ŋu agbugbɔ aƒo ƒu ɖe ʋua me. Esia ate ŋu ahe lãmesẽkuxi sesẽwo vɛ.
Kuxi siwo bɔ wu dometɔ aɖewoe nye esi:
- Gallstones: Esia nye nɔnɔme si bɔ si ŋu ame geɖe se nu tsoe. Nuwo abe ʋumemi si le ʋumenugbagbeviɣi me ene sesẽna zua kpe suewo. Ne kpe siawo tsi ʋukawo me la, woate ŋu axe mɔ na ʋumenugbagbeviɣi ƒe sisi, si ana woase veve vevie , woaxɔ dɔlékuiwo, eye woahe kuxi bubuwo vɛ.
- Cholestasis: Esia nye esime ʋumenugbagbeviɣi ƒe sisi va nɔa blewu ŋutɔ alo tɔ te keŋkeŋ. Nɔnɔme sia ate ŋu adzɔ ɣeaɖewoɣi le fufɔɣi.
- Biliary ƒe ʋuʋu:Dɔlékui, kansa, alo atikewɔwɔ me nɔnɔme bubu aɖe ate ŋu ana abi ƒe lãkusi nadzɔ ɖe ʋumenugbagbeviɣia me, si axe mɔa. Esia wɔnɛ be ʋumenugbagbeviɣidɔ sesẽna.
- Aklãdɔ: Aklã ƒe dɔwɔwɔ megagblẽna o le esi wògblẽa nu le aklã ŋu le ɣeyiɣi aɖe megbe ta. Esia wɔnɛ be womete ŋu wɔa ʋumenugbagbeviɣidɔ nyuie o.
Tsɔ kpe ɖe esiawo ŋu la, kansa (Bile duct cancer, Gallbladder cancer, Pancreatic cancer) kple atikewɔwɔ me nɔnɔme tɔxɛ bubuwo hã ate ŋu akpɔ ŋusẽ ɖe biliary system dzi.
Aleke nàwɔ anya ne kuxi sia le ŋuwò? Nukawoe nye dzesiawo?
Ne kuxi aɖe le wò ʋumenugbagbeviɣidɔ ŋu la, wò ŋutilã ana dzesi vovovowo wò tso eŋu. Ne esiawo dometɔ ɖeka alo esi wu nenema le asiwò la, ele vevie ŋutɔ be nàyi ɖɔkta gbɔ aɖaɖo aɖaŋu na wò.
| Dzesi si dzena | Woɖe eme kpuie |
|---|---|
| Jaundice ƒe dɔléle | Ŋku kple ŋutigbalẽ ƒe ɣiwo trɔna zua ɣie. Esia le alea elabena womeɖea ʋumenugbagbeviɣidɔa doa goe nyuie o, eye amadede ɣi si nye bilirubin si le eme la ƒoa ƒu ɖe ʋua me. |
| Ƒodo si le etame ƒe vevesese | Vevesese le ƒodo ƒe ɖusime, le akɔta te. Vevesese sia ate ŋu atso aklã, aɖuɖɔtoe, alo ʋuka siwo me ʋu sina tona gbɔ. |
| Dɔgbo ƒe vevesese sesẽ (Biliary colic) . | Esia menye dɔgbo ƒe vevesese si sɔ o. Enye vevesese kpata si womate ŋu ado dzi atsɔ o, si dona ne aɖuɖɔtoemekpe aɖe tsi aɖuɖɔtoea me. Ate ŋu akplɔe hã kple ʋuʋudedi kple ʋuʋudedi. |
| Aɖuɖɔ si me ami le, si ƒe amadede nye aŋutiɖiɖi (Steatorrhea) . | Ne ʋumenugbagbeviɣi meɖo dɔgbo suea gbɔ nyuie o la, ami siwo le nuɖuɖu me la meɖua o. Esia ate ŋu ana aɖuɖɔ natsi, ami nanɔ eŋu, eye wòanɔ tsia me. |
Dzesi bubuwo
- Aɖuɖɔ si ƒe amadede nye viviti (abe tii tsi ene) .
- Ŋutilãa ƒoƒo
- Ðeɖi te eŋu ŋutɔ.
- Lolo dzi ɖeɖe kpɔtɔ le susu aɖeke manɔmee
- Asrã
Ne dzesi siawo dometɔ aɖe le ŋuwò la, mègaŋe aɖaba ƒu wo dzi o. Kpɔ wò ɖɔkta enumake.
Aleke ɖɔktawo wɔa dea dzesi nɔnɔme siawoe?
Ne èyi ɖɔkta gbɔ la, abia wò dzesiwo eye wòado wò kpɔ. Emegbe ate ŋu aɖe gbe be woawɔ dodokpɔ geɖe atsɔ aɖo kpe dɔlélea dzi.
- Ʋudodokpɔ: Esiawo ate ŋu alé ŋku ɖe enzyme siwo le aklã kple dɔgbo me ƒe agbɔsɔsɔ ŋu akpɔe ɖa be nu gblẽ le ŋutinu mawo ŋu hã.
- Nɔnɔmetatawo ɖeɖe ƒe dodokpɔwo:
- Ultrasound scan: Esia ate ŋu ade dzesi nuwo abe aɖuɖɔtoemekpewo kple aɖuɖɔtoewo ene bɔbɔe.
- CT scan: Esia ate ŋu ana woakpɔ ŋutilãa ƒe akpa si le eme la nyuie wu.
- Dodokpɔ tɔxɛwo:
- MRCP (Magnetic Resonance Cholangiopancreatography): Esia nye MRI-dɔdamɔnu ƒomevi aɖe. Wozãnɛ tsɔ xɔa ʋumenugbagbeviɣiwo kple dɔgbo ƒe ʋukawo ƒe nɔnɔmetata tsitotsito.
- ERCP (Endoscopic Retrograde Cholangiopancreatography): Esia nye dodokpɔ kple atikewɔwɔ siaa. Wotsɔa endoscope (mɔ̃ si me fotoɖemɔ̃ le) dea nu me, wodoa amadede ɖe ʋumenugbagbeviɣiwo me, eye woɖea X-ray. Ne nane abe kpe ene tsi le ɣeyiɣi sia me la, woate ŋu aɖee hã ɖa.
Nuka wɔm nèle abe atikewɔwɔ ene?
Atikewɔwɔ nɔ te ɖe wò atikewɔwɔ ƒe nɔnɔme dzi.
- Biliary drainage: Ne ʋuka si me ʋu sina tona la xe la, ɣeaɖewoɣi la, wotsɔa mɔ̃ sue aɖe toa ƒodoa me be wòaɖe ʋuka si sɔ gbɔ si ƒo ƒu la ɖa.
- Dɔdamɔnu si me wokpɔa dɔlékuiwo le: Le ERCP wɔɣi la, woate ŋu ade mɔ̃ sue aɖe (stent) eme be woaɖe nusi xe mɔ na wo ɖa, atsɔ lãkusi aɖe (biopsy), alo ana ʋukaa nanɔ ʋuʋu ɖi.
- Amekoko: Ne aɖuɖɔtoemekpe le ŋuwò la, atikewɔwɔ si bɔ wue nye be woawɔ dɔ na wò be nàɖe aɖuɖɔtoea ɖa.
Eyata, wò ʋumenugbagbeviɣidɔ menye ɖoɖo si ʋãa ʋumenugbagbeviɣidɔ ko o. Enye ɖoɖo vevi aɖe si kpena ɖe ŋuwò nèɖua nuɖuɖu, xɔa nunyiamewo, eye wòkɔa wò ʋu gɔ̃ hã ŋu.
Ne ɖoɖo sia mele dɔ wɔm nyuie o la, ate ŋu akpɔ ŋusẽ ɖe wò lãmesẽ bliboa dzi, eyata ele vevie ŋutɔ be nàlé be nɛ.
Gbedasi si Wotsɔ Yi Aƒeme
- Aɖuti nye ŋutinu vevi aɖe si kpena ɖe míaƒe ŋutilã ŋu wòɖua nuɖuɖu eye wòɖea gbeɖuɖɔ ɖa.
- Ne wò ŋutigbalẽ alo ŋkuwo le ɣie (jaundice), èle veve sem vevie le wò dɔgbo ƒe ɖusime ƒe akpa si le etame, alo wò aɖuɖɔ ƒe amadede trɔ la, ate ŋu anye kuxi aɖe si le ʋumenugbagbeviɣidɔ ŋu ƒe dzesi.
- Mègaŋe aɖaba ƒu dzesi siawo dzi o. Esiawo ate ŋu anye atikewɔwɔ me dɔléle sesẽ aɖe ƒe dzesiwo, eyata yi ɖɔkta gbɔ kaba ale si nàte ŋui nàxɔ atikewɔlawo ƒe aɖaŋuɖoɖo.
- Àte ŋu akpe asi ɖe wò ʋumenugbagbeviɣidɔ ƒe lãmesẽ hã ŋu to nuɖuɖu nyui ɖuɖu kple wò kpekpeme dzi ɖuɖu me.
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