Loaʻa iā ʻoe kekahi ʻeha ma ka ʻaoʻao ʻākau o luna o kou ʻōpū? Hiki paha iā Mirizzi Syndrome?

Ua manaʻo paha ʻoe i kahi ʻeha ʻē a i ʻole ka ʻoluʻolu ʻole ma ka ʻaoʻao ʻākau o luna o kou ʻōpū ma hope o ka ʻai ʻana i kahi meaʻai, ʻoi aku hoʻi kahi meaʻai momona? I kekahi manawa hiki ke hele pū kēia ʻeha me nā hōʻailona e like me ka nausea a me ka melemele o nā maka, me ke kuni. ʻO ka hapa nui o ka manawa, pili kēia mau mea i nā pilikia i hoʻokumu ʻia e nā pōhaku gall. Eia nō naʻe, aia kahi maʻi kakaikahi loa a paʻakikī hoʻi, a mākou e kapa nei ʻo Mirizzi Syndrome. I kēia lā, e kamaʻilio mākou e pili ana i kēia me nā kikoʻī a me ka maʻalahi.

He aha ka Mirizzi Syndrome? E hoʻomaopopo maʻalahi kākou.

ʻAe, e nānā mua kākou i ke ʻano o nā pōhaku gall. He ʻeke liʻiliʻi kou gallbladder e hōʻiliʻili a mālama i ka bile, i hana ʻia e ke akepaʻa. Kōkua kēia bile iā mākou e hoʻoheheʻe i ka meaʻai a mākou e ʻai ai, ʻoiai nā momona. I kekahi manawa paʻakikī nā mea o loko o kēia bile i nā ʻano liʻiliʻi e like me ka ʻiliʻili i kapa ʻia he gallstones. ʻAʻohe hōʻailona o ka hapa nui o ka poʻe ke loaʻa iā lākou kēia mau pōhaku. Akā i kekahi manawa hiki i kēia mau pōhaku ke paʻa i loko o nā ʻauwai bile, nā ʻōmole liʻiliʻi e lawe ana i ka bile.

I kēia manawa, ʻo ka Mirizzi Syndrome kahi pilikia i hoʻokumu ʻia e nā pōhaku gallstones, akā ma ke ʻano ʻokoʻa iki. ʻO ka mea e hana ʻia ma ʻaneʻi, ʻo ia ka lilo ʻana o kahi pōhaku i loko o ka gallbladder, a i ʻole ma kahi ʻāpana bile ʻē aʻe, i mea nui loa a kaomi i kahi ʻāpana bile nui ʻē aʻe e holo kokoke ana. E noʻonoʻo, i ka wā e hele kokoke ana nā paipu wai ʻelua, ua paʻa kekahi mea i loko o kekahi paipu a pehu i loko o kēlā paipu, e kaomi ana i waho o kekahi paipu. ʻO ia ka mea e hana ʻia ma ʻaneʻi. Ke ālai nei kēia i ke kahe o ka bile.

Aia kekahi mau ʻano o ka Mirizzi Syndrome?

ʻAe, hoʻokaʻawale nā ​​kauka i ka Mirizzi Syndrome e like me ke ʻano o ke kūlana a me ka nui o ka hōʻino ʻana i nā ʻauwai bile. I ka ʻōlelo maʻalahi, i kekahi mau hihia, aia wale nō ka haiki ʻana o ke ʻauwai bile mai waho. I nā hihia paʻakikī ʻē aʻe, aia paha kahi pilina maʻamau ma waena o ka gallbladder a me ke ʻauwai bile i haiki ʻia, i kapa ʻia he fistula. He mea nui loa kēia hoʻokaʻawale ʻana no nā kauka ʻoki e hoʻolālā i ka mālama ʻana. Inā makemake ʻoe e ʻike hou aʻe e pili ana i kēia, hiki iā ʻoe ke kamaʻilio me kāu kauka.

Pehea ka maʻamau o kēia ʻano?

He maʻi laha ʻole ka Mirizzi Syndrome. He mea laha ʻole loa ia a ʻike ʻia ma lalo o 2.5% o ka poʻe e hana ana i ka cholecystectomy. Hiki ke huikau pinepine ʻia me nā maʻi maʻamau ʻē aʻe, no laila hiki i nā kauka ke hōʻoia wale i ka wā o ke ʻoki kino.

He aha nā hōʻailona o ka Mirizzi Syndrome?

Hiki ke puʻunaue ʻia nā hōʻailona o kēia maʻi i ʻekolu mau ʻano nui:

1. Ka mumū: Hiki iā ʻoe ke ʻike i ka ʻeha a me ka pehu ma ka ʻaoʻao ʻākau o luna o kou ʻōpū. Hiki ke mau kēia ʻeha a hele mai a hele aku paha.

2. Maʻi: Loaʻa pinepine ke kuni . Hiki i nā hōʻailona ke komo pū me ka nausea, ka luaʻi ʻana, a me ka maʻi pākī paha.

3. Jaundice: ʻO ka hōʻailona nui o kēia, ʻo ia kou ʻili e melemele ana, e melemele ana nā keʻokeʻo o kou mau maka. Loaʻa paha iā ʻoe ka mimi melemele/ʻeleʻele a me nā ʻōpala māmā (lepo).

He mea nui: ʻAʻole pili kēia mau hōʻailona i ka Mirizzi Syndrome. Eia nō naʻe, inā loaʻa iā ʻoe kēia mau hōʻailona, ​​​​​​hiki ke hōʻike he hewa kekahi mea me kāu ʻōnaehana biliary. No laila, ʻoi aku ka maikaʻi o ka ʻimi koke ʻana i ke kōkua lapaʻau. ʻAʻole e loaʻa i nā kānaka a pau kēia mau hōʻailona a pau i ka manawa hoʻokahi.

No ke aha e kū mai ai ka Mirizzi Syndrome? He aha ke kumu?

I ka ʻōlelo maʻalahi, hoʻokumu ʻia ka Mirizzi Syndrome e kahi pōhaku gall e kaomi ana ma waho o kahi ʻauwai bile. E wehewehe iki kākou i kēia.

E noʻonoʻo i kou ʻōpū e like me ka pea. Aia kahi ʻāpana momona o ka pea, he lahilahi iki ma luna, he ʻōpuʻu iki aʻe ma ka ʻāʻī, a laila aia ke kumu. No laila, he ʻeke ko ka ʻōpū, he ʻāʻī (ka mea a nā kauka i kapa ai ʻo infundibulum a i ʻole ka ʻeke ʻo Hartmann), a me kahi duct cystic e lawe ana i ka bile i waho o ka gallbladder.

ʻO ka ʻōpū paʻa, ka ʻāʻī, a me ke ala cystic nā wahi haiki loa kahi e paʻa ai ka pōhaku paʻa. Eia kekahi, kokoke loa kēia mau hale kekahi i kekahi. I kekahi poʻe, ʻoi aku ko lākou kokoke ma mua o nā poʻe ʻē aʻe. No laila, ke paʻa ka pōhaku paʻa ma kēia wahi, a ulu a pehu, kaomi ia i ke ala bile nui kokoke (ala bile maʻamau - ʻo ia ka mea e lawe ana i ka bile mai ke akepaʻa a me ka gallbladder i ka ʻōpū liʻiliʻi) a i ʻole ke ala hepatic maʻamau (ʻo ia ka mea e lawe ana i ka bile mai ke akepaʻa) mai waho. ʻO ia ka manawa e kū mai ai ka Mirizzi Syndrome.

He aha nā pilikia ʻē aʻe e hiki ke kū mai ma muli o ka Mirizzi Syndrome?

Inā ʻaʻole mālama pono ʻia kēia maʻi, hiki ke kū mai nā pilikia ʻē aʻe. Eia kekahi mau laʻana:

• Cholestasis: No ka mea, ʻaʻole hiki i ka bile ke holo pono, hoʻihoʻi ia i loko o ke akepaʻa, e hoʻoulu ai i ka mumū o ke ake.
• Cholangitis: Hiki i kahi maʻi bacteria me ka bile ke laha i ke akepaʻa, e hana ana i kahi maʻi koʻikoʻi. He mea weliweli kēia.
• Fistula: Ma muli o ka mumū mau a me ka hōʻiliʻili ʻana o ka bile, hiki i nā paia o ke kahawai bile ke lilo i nāwaliwali, e hana ana i kahi puka kūlohelohe ʻole, a i ʻole lua.
• Jaundice: Ma muli o ka hōʻiliʻili ʻana o ka bile, hōʻiliʻili ka pigment bilirubin i loko o ke koko, e hoʻolilo ana i ka ʻili a me nā maka i melemele.
• Malabsorption: Ke hiki ʻole i ka bile ke hele pono i loko o ka ʻōpū liʻiliʻi, lilo ka ʻai ʻana, ʻoiai nā protein a me kekahi mau meaola, i mea ʻino.

Pehea e ʻike ai nā kauka i ka Mirizzi Syndrome?

E hana nā kauka i kekahi mau hoʻokolohua e ʻike ai i nā pōhaku gall a me nā pilikia e pili ana. ʻO ka mea mua, e hana lākou i kahi hoʻokolohua kino e nānā i kou ʻōpū a nānā i ka pehu ʻana. A laila e nīnau lākou e pili ana i kāu mau hōʻailona a me kou mōʻaukala olakino.

Inā he mau hōʻailona o ka maʻi a i ʻole ka jaundice, hiki i kāu kauka ke kauoha i nā hoʻāʻo koko e like me kēia:

• Helu koko piha (CBC)
• Nā hoʻāʻo hana ate

Eia kekahi, hiki ke hana ʻia kekahi mau hoʻokolohua kiʻi. ʻO kekahi o kēia mau mea:

• ʻO ka ultrasound ʻōpū
• ʻO ke kiʻi CT (scan tomography i helu ʻia)
• ERCP (Endoscopic Retrograde Cholangiopancreatography): Ma kēia kaʻina hana, ua hoʻokomo ʻia kahi endoscope (kahi paipu me kahi kāmela) ma o ka waha e nānā i nā ʻāpana bile.
• HIDA scan: He scan kūikawā kēia e nānā ana i ka hana o ka gallbladder.
• Hoʻāʻo MRI (kiʻi resonance magnetic)

Kōkua kēia mau hoʻokolohua i ka hoʻoholo ʻana i ke kūlana o nā ʻauwai bile, kahi o nā pōhaku, a inā paha he Mirizzi Syndrome.

Pehea e mālama ʻia ai kēia?

ʻO ke ʻoki kino ke ʻano lapaʻau nui no ka Mirizzi Syndrome. Eia nō naʻe, ʻaʻohe ʻoki kino hoʻokahi e kūpono i nā mea āpau. E hoʻopilikino ʻia ke ʻoki kino i kou kūlana kikoʻī.

ʻO ka hapa pinepine, wehe ʻia ka gallbladder (cholecystectomy) a hoʻoponopono ʻia ke ala bile i paʻa. I kekahi mau hihia paʻakikī, hiki ke wehe ʻia ke ala bile i paʻa, a i ʻole e hoʻokomo ʻia kahi ʻōmole liʻiliʻi i kapa ʻia he stent e mālama i ka duct i wehe ʻia. Hiki i ke kauka lapaʻau ke hana i kēia ʻoki kino me ka minimally invasively, ʻo ia hoʻi ka laparoscopically (kahi hana e hoʻohana ana i kahi kāmela a pili i ka hana ʻana i nā ʻoki liʻiliʻi), a i ʻole he hana wehe (laparotomy). E hilinaʻi kēia i ke koʻikoʻi o kou kūlana.

Aia kekahi mau hopena ʻaoʻao o ka lāʻau lapaʻau?

Hiki i ke ʻoki kino no ka Mirizzi Syndrome ke lilo i mea paʻakikī i kekahi manawa. No ka mea, ʻo ka mumū ka mea e paʻakikī ai ke ʻike maopopo i nā ʻiʻo a puni. No laila, inā hōʻino ʻia nā ʻauwai bile i ka wā o ke ʻoki kino, hiki mai nā pilikia e like me:

• Ka liki ʻana o ka bile
• Ke kahe koko nui
• Ka ʻeha o kāu mau ala bile

Eia kekahi, aia kekahi mau mea i maʻamau i kekahi ʻoki kino:

• ʻEha
• Ke kahe ʻana o ke koko
• Nā maʻi
• Nā hopena i ka anesthesia

E wehewehe kāu kauka i kēia iā ʻoe ma mua o ke ʻoki ʻana.

ʻAʻohe ala e pale aku ai i ka ulu ʻana o kēia Mirizzi Syndrome?

He mea paʻakikī ke pale loa i ka Mirizzi Syndrome. Eia nō naʻe, hiki iā ʻoe ke hōʻemi i kou pilikia i kekahi ʻano ma ka hōʻemi ʻana i nā mea pilikia e kōkua ai i ka hoʻokumu ʻia ʻana o nā gallstones. No ka laʻana, he manaʻo maikaʻi e kaupalena i nā meaʻai a me nā mea inu i kiʻekiʻe i ka cholesterol. E nīnau i kāu kauka inā he mau mea kikoʻī hiki iā ʻoe ke hana e pale aku i ka paʻa ʻana o ka bile duct.

He aha ka mea e hana ʻia ma hope o ka hoʻōla ʻana? He aha ka manaʻo?

ʻO ka wānana no ka poʻe e ho'ōla mai ka Mirizzi Syndrome ma hope o ke ʻoki ʻana he maikaʻi ma ke ʻano laulā. ʻO ka mea nui, ʻo ia ka mālama koke ʻana ma mua o ka hiki ʻana mai o nā hopena lōʻihi.

ʻO ka nui o ka hōʻino ʻana i kou mau kino a me nā ʻauwai bile, ʻo ka ʻoi aku ka paʻakikī o ke ʻoki ʻana. ʻO ka ʻoi aku ka paʻakikī o ke ʻoki ʻana, ʻo ka lōʻihi paha o kou manawa hoʻōla. Akā, ma ke ʻano holoʻokoʻa, hiki i ka hapa nui o ka poʻe ke ola maikaʻi me ka ʻole o ka gallbladder.

Āhea wau e ʻike ai i ke kauka? He aha nā hōʻailona e pono iaʻu?

Inā loaʻa koke iā ʻoe ka ʻeha nui o ka ʻōpū, me ke anu a me ka haʻalulu, ka nausea, ke kuni, a i ʻole nā ​​​​hōʻailona o ka jaundice (e like me ka mimi ʻeleʻele a me nā ʻōpala keʻokeʻo), e ʻike koke i ke kauka .

Eia kekahi, inā loaʻa iā ʻoe nā hōʻailona o kahi maʻi weliweli i kapa ʻia ʻo sepsis (e like me ka puʻuwai wikiwiki, ka hou ʻana, a me ka paʻakikī o ka hanu ʻana) ma hope o ke ʻoki ʻana, he pilikia ia e hoʻoweliweli ana i ke ola. No laila, inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona, ​​e ʻimi koke i ke kōkua lapaʻau.

Aia kekahi pilina ma waena o ka Mirizzi Syndrome a me ke kanesa?

Ua ʻike ʻia e ka noiʻi ʻana he ʻoi aku ka nui o ka pilikia o ka poʻe me ka Mirizzi Syndrome i ka loaʻa ʻana o ke kanesa o ka ʻōpū. Eia naʻe, ʻaʻole kēia manaʻo ʻo Mirizzi Syndrome ponoʻī ke kumu o ke kanesa.

Manaʻo nā loea ʻo nā kūlana like e hoʻoulu ai i ka maʻi Mirizzi (ʻo ia hoʻi, ka mumū mau, ka paʻa ʻana o ka bile i loko o ka gallbladder) e kōkua pū i ka ulu ʻana o ka maʻi kanesa. Ma ke ʻano helu, ma waena o 5% a me 28% o ka poʻe me ka maʻi Mirizzi ua ʻike ʻia he maʻi kanesa gallbladder.

Hiki i kēia kūlana ke make?

Hiki ke mālama ʻia ka Mirizzi Syndrome.kūlana. Eia nō naʻe, ʻo ka hoʻomaka ʻana o ka lāʻau lapaʻau ma hope, ʻoi aku ka kiʻekiʻe o ka pilikia. Ua hōʻike ʻia ka nui o ka make e pili ana i kēia kūlana ma waena o 5% a me 30%. Hiki ke hana ʻia e nā mea e like me ka sepsis, ka hāʻule ʻana o ke ake, a i ʻole ke kanesa o ka gallbladder.

Hiki paha iā ʻoe ke ʻeha ʻōpū i kekahi manawa ma hope o ka ʻai ʻana. Akā inā ala ʻoe i ke kakahiaka me ka ʻeha mau o ka ʻōpū, ke kuni, a i ʻole ka luaʻi, he hōʻailona paha ia o kahi pilikia nui aʻe. ʻAʻole paha ʻoe e ʻike he mau pōhaku gall kou. Eia nō naʻe, i ka wā e ulu nui ai lākou e ālai i kahi ʻauwai bile, hiki i nā hōʻailona ke lilo i mea koʻikoʻi a pinepine. Inā manaʻo ʻoe ua hewa kekahi mea, mai kali. ʻO ka wikiwiki o kou ʻimi ʻana i ke kōkua lapaʻau, ʻoi aku ka maikaʻi.

ʻO ka mea hope loa, nā mea nui e hoʻomanaʻo

No laila, ke lana nei koʻu manaʻo ua ʻike maikaʻi ʻoe i ke ʻano laha ʻole i kapa ʻia ʻo Mirizzi Syndrome a mākou i kūkākūkā ai i kēia lā. E hoʻomanaʻo:

• Inā loaʻa iā ʻoe nā hōʻailona e like me ka ʻeha mau ma ka ʻaoʻao ʻākau o luna o kou ʻōpū, ke kuni, a i ʻole ka jaundice, mai hoʻowahāwahā iā lākou .
• E ʻimi koke i ke kōkua lapaʻau . ʻO ka wikiwiki o ka ʻike ʻia ʻana a me ka mālama ʻia ʻana o ka maʻi, ʻo ka emi ʻana o nā pilikia e loaʻa iā ʻoe a ʻo ka wikiwiki o kou hoʻōla ʻana.
• Inā ʻike ʻoe he mau gallstones kou, e hahai pololei i nā ʻōlelo a kāu kauka.
• ʻO ka mālama ʻana i kahi meaʻai olakino e hiki ke kōkua i ka hōʻemi ʻana i ka pilikia o ka hoʻomohala ʻana i nā gallstones.

Inā he mau nīnau hou aku kāu, mai kānalua e kamaʻilio me kāu kauka ʻohana a i ʻole kekahi loea. E noho olakino!

ʻO ka Mirizzi Syndrome, nā pōhaku gallstones, ka bile duct, ka jaundice, ka ʻeha o ka ʻōpū, ke ʻoki kino, ka cholecystectomy