Ènya afɔku si le dɔgbo ƒe dɔléle si nye necrotizing pancreatitis mea?

Èse nɔnɔme sesẽ aɖe si me dɔgboa ƒe akpa aɖe kuna le kpɔa ? Esiae nye nusi míeyɔna le atikewɔwɔ me be ``Necrotizing Pancreatitis''. Bu ale si gbegbe wònye nu vevi aɖe ne míebu míaƒe ŋutilã ƒe ŋutinu vevi aɖe ƒe akpa aɖe ŋu kpɔ. Esia dzɔna ne nɔnɔme aɖe si woyɔna be ``Acute Pancreatitis '' va nu sẽ ŋutɔ . Egbea, míaƒo nu tso esia ŋu tsitotsito, abe ɖe míele nu ƒom na mía xɔlɔ̃ aɖe ene.

Nuka tututue nye ``(Necrotizing Pancreatitis)``?

Kpuie ko la, ``Necrotizing Pancreatitis`` nye wò ``Pancreas`` (Necrosis) ƒe akpa aɖe ƒe ku . Esia dzɔna ne nɔnɔme si nye ``Pancreatitis`` va nu sẽ ŋutɔ. Dɔdzẽ nye ne dɔgboa vuvu, biã, eye wòle veve sem le abi alo nane si le abe aɖi ene ta. Ne dɔdzẽ sia nu sẽ ŋutɔ la, woate ŋu agblẽ ʋu ƒe sisi yi dɔgboa ƒe lãkusiwo me ``Ischemia``. Emegbe lãmeka mawo mekpɔa ɔksidzin kple nunyiame siwo wohiã o eye wodzea kuku gɔme . Woyɔa esia be ``Necrosis``. Esia nye nɔnɔme si me afɔku le ŋutɔŋutɔ.

Ne edzɔ alea la, wò atikewɔlawo ƒe ƒuƒoƒoa ana nànɔ kɔdzi hena ɣeyiɣi aɖe eye woalé ŋku ɖe ŋuwò nyuie be kuxi bubu aɖeke nagadze ŋuwò hã . Nu vevitɔ kekeake si ŋu wòle be míakpɔ nyuie le enye dɔlékui aɖe . Bu eŋu kpɔ ne dɔlékuiwo te lãmenugbagbevi kukuawo ɖuɖu la, woate ŋu adzi ɖe edzi kaba eye woakaka ɖe wò ŋutilã katã me. Ne edzɔ alea la, ate ŋu ahe nɔnɔme sesẽwo abe ŋutinuwo ƒe dɔmawɔmawɔ nyuie , si ate ŋu ade ame ƒe agbe afɔku me ene vɛ. Le nɔnɔme mawo me la, ate ŋu ahiã be ɖɔktawo naɖe lãkusi kukua ɖa to amekoko me .

Aleke gbegbee nɔnɔme sia bɔe?

Ne míagblɔe kpuie la, amesiwo xɔa dɔdzẽ sesẽ la dometɔ siwo ade 20% axɔ dɔdzẽ si nye necrotizing pancreatitis. Le dukɔ abe United States ene me la, wobu akɔnta be ame akpe alafa etɔ̃ kloe xɔa kɔdzi ƒe sia ƒe le dɔdzẽ ta. Eyata, 20% nye xexlẽme ɖedzesi aɖe, alo?

Nukae nye `(Necrotizing Pancreatitis)` ƒe dzesiwo?

Dzesi gbãtɔ siwo dzenae nye dɔdzẽ si nu sẽ ŋutɔ. Woawoe nye:

• Vevesese sesẽ le ƒodo ƒe akpa si le etame. Vevesese sia ate ŋu atso akɔta hã.
• Ƒodo ƒe keke alo ʋuʋu.
• Aɖuɖɔtoe kple ʋuʋudedi.

Ne dɔdzẽ le sesẽm ɖe edzi la, dzesiwo abe esiawo ene hã ate ŋu adze:

• Asrã kple vuvɔ.
• Dzi ƒe tsotso ƒe dzidziɖedzi (Tachycardia).
• Tsikɔwuame sesẽ alo tsikuɖiɖi.

Nukae nye nusiwo hea ``Necrotizing Pancreatitis'' vɛ?

Esia dzɔna le afɔɖeɖe vovovowo me. Gbã la, dɔdzẽ si sɔ le dɔgboa me (Acute Pancreatitis) la nu sẽna ɖe edzi. Emegbe, ʋu ƒe sisi me gblẽ (Ischemia), eye mlɔeba la, lãmenugbagbeviwo ƒe ku (Necrosis) dzɔna. Nu vovovowo gbɔe nudzɔdzɔ siawo dometɔ ɖesiaɖe tso.

Aleke gbegbee dɔgbo ƒe dɔléle nu sẽe?

Nusi koŋ gbɔ dɔdzẽ sesẽ tsonae nye ʋumenugbagbeviɣidɔ . Esia dzɔna ne aɖuɖɔtoe me kpe aɖe ge ɖe aɖuɖɔtoea me eye wòxe dɔgboa ƒe mɔ̃a. Wogayɔa esia be gallstone pancreatitis . Nu vevitɔ evelia si gbɔ wòtsoe nye ahanono fũu akpa .

Le nyateƒe me la, dɔdzẽ nye alesi ŋutilãa wɔa nui ne exɔ abi, hedzea agbagba be yeaɖɔ nusiwo gblẽ la ɖo. Gake ɣeaɖewoɣi la, dɔdzẽ ƒe ŋuɖoɖo sia nu sẽna ale gbegbe be wòdzea nu gbegblẽ wɔwɔ gɔme.

Womenya nusitae dɔdzẽ ƒe ŋuɖoɖo sia nu sẽna ɖe ame aɖewo me wu ame bubuwo ŋu haɖe o. Ke hã, eme kɔ ƒã be esia hea `` snowball effect`` vɛ le dɔgboa me.

Nyaƒoɖeamenu sesẽ si dɔdzẽ sesẽ hena vɛ nana dɔgboa ƒe enzyme siwo le dɔgboa ƒe lãkusi me la wɔa dɔ. Zi geɖe la, nuɖuɖumeŋusẽ siawo wɔa dɔ ne nuɖuɖu ge ɖe nuɖuɖumeŋusẽ me vɔ. Gake ne wowɔ dɔ do ŋgɔ la, wodzea dɔgboa ŋutɔ ɖuɖu gɔme. Bu eŋu kpɔ, èle wò ŋutɔ wò ŋutinu ɖum kple wò ŋutɔ wò enzymewo!

Ʋu ƒe agbɔsɔsɔ si dzi ɖe kpɔtɔ hea ``Ischemia`` kple lãmenugbagbeviwo ƒe ku ``Necrosis`` vɛ

Nusiwo gblẽ le dɔgboa ŋu sia si yia edzi la nana dɔgbo ƒe dɔlélea nu sẽna ɖe edzi. Mlɔeba la, dɔgboa ƒe vuvu nana ʋukawo kekena, si wɔnɛ be ʋu si sina yia lãkusiawo me dzi ɖena kpɔtɔna.

Nu bubu si ate ŋu akpɔ ŋusẽ ɖe esia dzi enye Systemic Inflammatory Response Syndrome (SIRS). Esia nye dɔdzẽ ƒe nɔnɔme si dzɔna le ŋutilã bliboa me. Esia ate ŋu ana ʋu ƒe sisi kple ʋu ƒe sisi katã dzi naɖe akpɔtɔ.

Ʋu ƒe sisi ƒe bu (ischemia) nana lãmenugbagbeviwo kuna (necrosis). Dɔgboa ƒe nuɖuɖumeŋusẽ to dɔgboa ƒe enzymewo dzi hã ate ŋu ana lãmenugbagbevi sia naku.

Nukae nye kuxi siwo ate ŋu ado tso `(Necrotizing Pancreatitis)` me?

Nɔnɔme sia ate ŋu ahe kuxi vovovowo vɛ le ɣeyiɣi kpui kple didi me.

Kuxi siwo dona tso eme ɣeyiɣi kpui aɖe:

• Dɔlékuiwo xɔxɔ: Esiae nye afɔku si le Necrotizing Pancreatitis me wu . Esia ateŋu adzɔ le dɔnɔ siwo ade 20% me. Lãmetsi kukuwo le abe nuɖuƒe nyui aɖe na dɔlékui siwo le tsatsam ene. Esesẽna be nàɖu dɔlékui aɖe dzi ne èdze dɔ xoxo. Ne ekaka ɖe ʋukawo me la, ate ŋu ade ame ƒe agbe afɔku me. Dɔlékui aɖe si le ʋukawo me ate ŋu ana dɔlékuiwutikewo naxɔ dɔlékuiwutikewo , si ate ŋu ana ŋutinu geɖe nawɔ dɔ nyuie . Esiae nye nu vevitɔ si wua amesiwo ŋu Necrotizing Pancreatitis le.
• Lãmetsi Siwo Meku: Le dɔdzẽ sesẽ me la, dɔgbo ƒe enzyme siwo wowɔ dɔ ate ŋu ado le dɔgboa me eye woagblẽ nu le lãkusi siwo ƒo xlãe ŋu. Lãmetsi tsɛ aɖe ƒe ƒuƒoƒo aɖe ƒoa xlã dɔgboa me tsi. Ne lãkusi kuku kple dɔlékuiwo le atikekui sia me la, dɔlékui ate ŋu adze egɔme bɔbɔe eye wòakaka. Ƒã hafi atikekui sia ate ŋu alolo ahate ɖe ŋutinu siwo te ɖe eŋu, abe dɔgbo, ʋukawo, alo ʋukawo ene dzi.
• Ʋudodo: Ʋuʋudedi ƒe dɔdzẽ mebɔ o, gake ate ŋu ade ame ƒe agbe afɔku me ne edzɔ. Necrotizing pancreatitis nana ʋudodo sia ƒe afɔkua dzina ɖe edzi. Mɔ ɖeka si dzi esia ate ŋu atoe nye ne dɔdzẽ alo tsi si le dɔgboa me kaka ɖe ʋuka si te ɖe eŋu me, si agblẽ nu le ʋukaa ƒe gli ŋu eye wòna ʋu nado. Mɔ bubue nye ne dɔgbo ƒe enzymewo gbã ʋuka aɖe ƒe gli, si na be pseudoaneurysm , si gbãna eye wònana ʋu dona.
• Ƒodo ƒe Dɔléle: Ʋuʋudedi, ʋu ƒe dodo, kple tsi bubu siwo ƒo ƒu ɖe dɔgboa ƒe dɔléle si nye necrotizing pancreatitis ate ŋu ana ƒodoa ƒe ʋuka me naƒo ɖe ame nu ŋutɔ. Dɔnɔ siwo ƒe lãme gblẽ vevie koŋue wokpɔa esia le. Esia ate ŋu ana ʋu naɖiɖi yi ŋutinuwo me, si ate ŋu ana ʋu natsi , ʋu ƒe sisi na ame, eye ʋu ƒe sisi nagbɔdzɔ . Esia ate ŋu ana ŋutinu geɖe nawɔ dɔ nyuie hã.

Nusiwo ado tso eme ɣeyiɣi didi:

• Dɔgboa ƒe Dɔmawɔmawɔ nyuie: Ne dɔgboa ƒe lãkusi gbogbo aɖe bu la, dɔgboa ƒe dɔwɔwɔ aɖewo ate ŋu abu. Exocrine Pancreatic Insufficiency nye ne dɔgboa mewɔa enzyme siwo sɔ be wòaɖu nuɖuɖu o. Esia ate ŋu ana woaɖu nu nyuie eye nunyuimakpɔɖui . Endocrine Pancreatic Insufficiency nye ne dɔgboa mewɔa lãmetsi siwo sɔ gbɔ si kpɔa sukli ƒe agbɔsɔsɔ dzi le ʋu me o. Esia ate ŋu ahe suklidɔ kple suklidɔ vɛ .
• Dɔdzẽ si me kadodo aɖeke mele o: Ʋuʋudedi sesẽ, ʋu si dona le lãme na ame, lãmenugbagbeviwo ƒe ku, kple dɔgbo ƒe dɔléle si nye necrotizing pancreatitis ƒe kuxi bubuwo ate ŋu ana dɔgboa ƒe ʋukaa ƒe akpa aɖe naɖe eɖokui ɖa tso dɔgboa alo dɔgbo suea gbɔ. Esia ate ŋu ana dɔgboa ƒe enzymewo nayi edzi anɔ dodom. Tsi sia si le dodom ate ŋu ana tsi naƒo ƒu ɣeyiɣi didi kple/alo dɔgbo ƒe dɔléle si nɔa anyi didi.
• Biliary ƒe Sesẽme:Dzoxɔxɔ sesẽ kple esi nɔa anyi didi ateŋu ahe abi vɛ le mɔ̃ siwo doa ka kple dɔgbo kple nuɖuɖumeŋusẽ (dɔgbo ƒe mɔ̃, ʋumenugbagbeviɣimɔ̃, dɔgbo sue - dɔgbo suea ƒe gɔmedzedze) dometɔ ɖesiaɖe. Abi sia nana ʋukaa me tsina le mɔ si mesɔ o nu (stricture). Esia nana ʋumenugbagbeviɣi ƒe sisi dzi ɖena kpɔtɔna, eye ʋumenugbagbeviɣi dzea megbe yina ɖe ʋuka me.
• Splanchnic Vein Thrombosis: Wò splanchnic veins le wò dɔgbo te. Dɔdzẽ sesẽ ate ŋu ana woaxɔ abi. Esia ate ŋu ana ʋu natsi (thrombosis) le ʋuka siawo me. Vein siawo dometɔ aɖewoe nye ʋuka si le ʋuka me, ʋuka si me ʋu sina tona, ʋuka si me ʋu sina tona, kple ʋuka si le ʋuka me. Ne ʋu ƒe sisi le esiawo dometɔ ɖeka me la, kuxi vovovowo ate ŋu ado mo ɖa, abe ʋusɔgbɔdɔ si le agbo nu , dɔgbo ƒe ʋuʋu, dɔgbo me ʋu si dona le dɔgboa me, ʋusɔgbɔdɔ si me ʋu sina tona, kple ʋuka si me ʋu sina tona le ʋuka me ene.

Aleke wowɔna dea dzesi Necrotizing Pancreatitis?

Ðɔktawo dea dzesi nɔnɔme sia `(Necrotizing Pancreatitis)` le esi wokpɔ `(Acute Pancreatitis) zi gbãtɔ vɔ megbe.` Dzesi siwo dze ƒã be lãmenugbagbeviwo ku `(Necrosis)` medzena o vaseɖe ŋkeke etɔ̃ va ɖo atɔ̃ le dɔdzẽ ƒe gɔmedzedze megbe. Ne dɔdzẽ sesẽ ƒe dzesiwo le ŋuwò le ŋkeke ʋee aɖewo le dɔdzẽ gbãtɔa megbe la, wò ɖɔkta azã CT scan si me fluorescent dye `(Contrast-enhanced CT scan)` alo MRI.` (MRI - Magnetic Resonance Imaging)` atsɔ adi lãmenugbagbeviwo ƒe ku sia. Woadi kuxi bubuwo hã, abe tsi ƒe ƒoƒo ɖe lãme na ame ene.

Nukawoe nye atike siwo wozãna na esia?

Wò atikewɔwɔ anɔ te ɖe nenye be dɔlékui aɖe le ŋuwò alo kuxi bubuwo le ŋuwò dzi. Ne dɔdzẽ si me dɔdzẽ mele o eye dzesi aɖeke mele eŋu o la, zi geɖe la, ɖɔktawo atsɔ beléle si akpe ɖe eŋu adae . Ne dɔlékuiwo ƒe dzesiwo alo kuxi bubuwo do mo ɖa la, ɖɔktawo ade nu nyaa me ne ehiã. Woadze agbagba aɖe lãmenugbagbevi kukuawo ɖa to mɔnu siwo me womezãa nu boo aɖeke le o zazã me hafi awɔ dɔ na wo.

Dzɔdzɔmeŋusẽŋununya ƒe Dɔwɔnawo Dzikpɔkpɔ

Kpekpeɖeŋunana na ``Sterile Necrotizing Pancreatitis`` si me dɔlékui mele o dometɔ aɖewoe nye:

• Vevesesenutsitikewo.
• Tsi siwo wodona ɖe ʋuka me `(IV Fluids)`.
• Nunyiame le Dɔgbo me.

Dɔléle siwo mesesẽ o ƒe akpa gãtɔ akpɔ wo gbɔ to beléle si akpe ɖe wo ŋu ɖeɖeko me. Le ɣeyiɣi sia me la, wò atikewɔlawo ƒe ƒuƒoƒoa alé ŋku ɖe wò nɔnɔmea ŋu nyuie. Woalé ŋku ɖe wò dzesi veviwo , ƒodo ƒe sisi, kple ʋu ƒe xexlẽme bliboa ŋu.Woalé ŋku ɖe nuwo abe Ʋumenugbagbevi dzĩwo Xexlẽme Blibo (CBC) ene ŋu eye woalé ŋku ɖe kuxi siwo ate ŋu ado mo ɖa ŋu. Ne nane abe dɔlékui alo ŋutinuwo ƒe dɔmawɔmawɔ nyuie ene dzɔ la, woana agbemenuhiahiãwo alo nu bubuwo wɔwɔ ne ehiã.

Tsi Siwo Trɔna Kple Eƒe Debridement

Ne ènya dze dɔlékui ƒe dzesiwo kpɔkpɔ gɔme ko la, wò atikewɔlawo adze dɔlékuiwutikewo zazã gɔme na wò eye woawɔ ɖoɖo be yewoaɖe lãkusi kuku ɖesiaɖe ɖa ne anya wɔ. Woadze egɔme kple mɔnu si me womedea ame dzi boo o, emegbe woadzi eƒe sesẽme ɖe edzi vivivi ne ehiã.

Mɔnu siawo dometɔ aɖewoe nye:

• Tsi si dona to ŋutigbalẽ me: Tsi to ŋutigbalẽ me fia to ŋutigbalẽa me. Kekeliŋutinunyala si dea nu nyaa me zãa nɔnɔmetatawo ɖeɖe ƒe mɔnuwo (zi geɖe la, ultrasound alo CT scan) tsɔ dia teƒe si lãkusi kukuawo le eye wòdea mɔ̃ aɖe to wò ŋutigbalẽ me. Wogblẽa mɔ̃a ɖe teƒea eye wotsɔa dze klɔnɛ zi geɖe gbesiagbe be tsi si le eme la nado. Esia koe nye tiatia si dɔnɔ siwo ade akpa etɔ̃lia ate ŋu awɔ. Le ame bubuwo gome la, ekpena ɖe ame ŋu be woaɖu dɔlékuia dzi vaseɖe esime woate ŋu awɔ lãɖeɖe ƒe mɔnu bubuwo dedie.
• Endoscopic Debridement: Dɔwɔwɔ aɖe si woyɔna be endoscopy nana dɔgboŋutinunyala te ŋu ɖoa lãkusi kuku siwo le wò ŋutilã me gbɔ evɔ metsoa wò ŋutigbalẽ o. Ato endoscope, si me ultrasound probe le , ato wò dɔgbo ƒe akpa si le etame be wòake ɖe dɔgboa ƒe akpa si wòle ŋu. Emegbe wotsɔa dɔwɔnuwo toa dɔlékuiwutikea me be woawɔ mɔ aɖe le lãkusi kukua kple wò dɔgboa dome. Wotoa mɔ ma dzi ɖea lãkusi kukua ɖa.
• Video-assisted Retroperitoneal Debridement (VARD): Esia hã nye amekoko si me womewɔa nu boo aɖeke le o. Esia bia be nàde amekoko dɔwɔnuwo to lãɖeɖe ma ke si nèɖe le wò ŋutigbalẽ me xoxo si woyɔna be Percutaneous Drainage Portal me eye nàyi teƒe si lãkusi kukua le. Amekola zãa aŋenu, tsidedee kple nu mimi tsɔ ɖea lãkusi kukua ɖa to lãɖeɖea me. Ne ehiã la, woate ŋu akeke afisi wotsoe la ɖe enu eye woatsɔ mɔ̃ aɖe si me fotoɖemɔ̃ le si woyɔna be laparoscope ade eme. Emegbe wozãa mɔnu aɖe si woyɔna be amekoko to dɔgboa me tsɔ ɖea lãkusi si susɔ la ɖa.
• Amekoko le Gaglãgbe - Necrosectomy: Necrosectomy nye lãmeka kukuwo ɖeɖe ɖa. Amekoko le gaglãgbe bia be woaʋu ƒodoa me eye woake ɖe lãkusi kukua ŋu (Laparotomy). Esia gakpɔtɔ nye mɔ si dzi woato adi kuxi kpatawo ahada wo kabakaba wu. Togbɔ be amekoko hea afɔku aɖewo vɛ hã la, enye mɔnu mamlɛtɔ na nɔnɔme kpatawo kple ne mɔnu siwo mewɔa nuvevi ame boo o do kpo nu.

Nukae nye ku ƒe agbɔsɔsɔ kple hayahaya ƒe agbɔsɔsɔme na `(Necrotizing Pancreatitis)`?

Mɔnukpɔkpɔ si li be nàhaya nɔ te ɖe wò dɔgbo ƒe akpa si ku, nenye be dɔlékui aɖe le ŋuwò alo ŋutinuwo ƒe dɔmawɔmawɔ nyuie, kple alesi nèwɔa nu ɖe ​​atikewɔwɔ ŋu nyuie dzi. Ne wò dɔgbo ƒe akpa si mede 30% o la, ke ame siwo kuna la mede 15% o . Ne lãmekawo ƒe ku koe li dɔlékui aɖeke manɔmee la, ke enyo. Gake ne wò dɔgbo ƒe akpa si wu 50% gblẽ, eye dɔlékui alo ŋutinuwo ƒe dɔmawɔmawɔ nyuie dze ŋuwò la, ame siwo kuna la dzina ɖe edzi va ɖoa 30% kple edzivɔ .

Mègavɔ̃ na akɔntabubu siawo o. Nyatakaka siwo ku ɖe nusianu ŋu koe esiawo nye. Atikewɔlawo ƒe ƒuƒoƒo si le dɔ dam na wò koe ate ŋu agblɔ wò nɔnɔmea kple mɔnukpɔkpɔ siwo li be nàhaya na wò nyuie wu.

Nukae dzɔna le atikewɔwɔ vɔ megbe?

Le wò kplɔkplɔ ɖo le atikewɔwɔ vɔ megbe la, wò ɖɔkta abia nya wò tso dzesi ɖesiaɖe si yi edzi alo yeye ŋu. Necrotizing Pancreatitis ate ŋu ahe kuxiwo vɛ ɣeyiɣi didi le atikewɔwɔ vɔ megbe gɔ̃ hã. Ne dzesiwo le ŋuwò la, woate ŋu abia tso asiwò be nàwɔ ʋudodokpɔ, dodokpɔxɔ, alo nɔnɔmetatawo dodokpɔ atsɔ akpɔe ɖa. Kuxiawo ate ŋu abia be woawɔ atike bubuwo na wo, si ate ŋu anɔ anyi ɣeyiɣi kpui aɖe alo ɣeyiɣi didi aɖe.

Necrotizing pancreatitis nye dɔgbo ƒe dɔléle sesẽ aɖe ƒe kuxi sesẽ aɖe ŋutɔ. Togbɔ be ame akpa gãtɔ hayana tso dɔgbo ƒe dɔléle sesẽ me to beléle si kpena ɖe wo ŋu ɖeɖeko me hã la, amesiwo ŋu dɔgbo ƒe dɔléle sesẽ kple necrosis dzena le la hiã beléle vevie ɣeyiɣi didi. Àhiã ɖɔktawo ƒe ƒuƒoƒo si me dɔwɔla vovovowo le be woalé ŋku ɖe wò nɔnɔmea kple kuxi ɖesiaɖe si ate ŋu ado mo ɖa ŋu. Ðewohĩ ahiã be woawɔ nu ɖe ​​ŋuwò alo awɔ dɔ na wò, eye ɖewohĩ beléle na wò akplɔe ɖo.

Nu vevitɔ kekeake siwo dzi wòle be míaɖo ŋkui tso ŋutinya sia me (Take-Home Message) .

• Necrotizing Pancreatitis nye dɔléle sesẽ aɖe si me dɔgboa ƒe akpa aɖe kuna le.
• Zi geɖe la, dɔgbo ƒe dɔléle sesẽ si nu sẽ gbɔe esia tsona. Nusiwo koŋ gbɔ wòtsonae nye aɖuɖɔtoemekpewo kple ahanono fũu akpa .
• Ne dzesiwo abe dɔgbo ƒe veve sesẽ, asrã, ʋuʋudedi, kple ʋuʋudedi ene le ŋuwò la, di atikewɔlawo ƒe aɖaŋuɖoɖo enumake.
• Dɔlékuiwo xɔxɔe nye dɔléle sia ƒe kuxi vevitɔ kple esi me afɔku le wu.
• Atikewɔwɔ ƒe tiatia vovovowo le dɔnɔa ƒe nɔnɔme nu. Atikewɔwɔ vovovowo li tso beléle si kpena ɖe ame ŋu dzi va ɖo amekoko dzi .
• Togbɔ be esia nye nɔnɔme sesẽ aɖe hã la, ame geɖe hayana ne wowɔ atike na wo nyuie eye wokpɔ wo dzi nyuie , eyata mègana mɔkpɔkpɔ o.

Ne dzesi siawo dometɔ aɖe le wò alo ame aɖe si nènya ŋu la, taflatse yi ɖɔkta gbɔ enumake. Atikewɔwɔ kaba ate ŋu aɖe amewo ƒe agbe!

` Necrotizing Pancreatitis, Dɔdzẽ, Dɔgbo ƒe ku, Dɔgbo ƒe vevesese, Dɔgbo ƒe dɔléle, Dɔgbo ƒe dɔléle Sinhala, Dɔgbo ƒe dɔlélewo