Ua lōʻihi paha kou ʻeha ʻana i ka ʻōpū ma muli o nā pōhaku gall. I kou wā i hana ʻia ai ke ʻoki ʻana e wehe i kou gallbladder, ua manaʻo paha ʻoe ua noa loa ʻoe mai kēia ʻeha. Akā pehea inā loaʻa mau iā ʻoe ka ʻeha nui o ka ʻōpū ma hope o ke ʻoki ʻana? He mea hoʻonāukiuki maoli ia. Nui ka poʻe e kū nei i kēia ʻano ʻike. No laila i kēia lā e kamaʻilio mākou e pili ana i kahi kūlana e hiki ai ke hoʻoulu i kēia ʻeha ʻōpū ʻē ma hope o ka wehe ʻia ʻana o ka gallbladder. ʻO ia ka Sphincter o Oddi Dysfunction .
I ka ʻōlelo maʻalahi, he aha ka Sphincter o Oddi Dysfunction?
I mea e hoʻomaopopo ai i kēia, e nānā mua kākou i ke kaʻina hana o kā kākou ʻai ʻana. He mea maʻalahi loa ia. Ke ʻai kākou i ka meaʻai, hoʻopuka ko kākou kino i ʻelua mau wai kūikawā e kōkua i ka ʻai ʻana.
1. Bile: Hana ʻia kēia e ke akepaʻa. Mālama ʻia ia i loko o ka gallbladder. Kōkua ia i ka ʻeli ʻana o nā momona.
2. Wai pancreatic: Hana ʻia kēia e ka pancreas. Kōkua nā enzymes i loko o ia mea i ka hoʻoheheʻe ʻana i nā protein a me nā carbohydrates i ka meaʻai.
Hele kēia mau wai ʻelua i ko kākou ʻōpū liʻiliʻi, kahi e hui pū ai me ka meaʻai e hoʻopau i ke kaʻina hana ʻai.
Eia ka mea nui. Ma kahi e komo ai kēia mau wai ʻelua i loko o ka ʻōpū liʻiliʻi, aia kahi ʻāpana ʻiʻo liʻiliʻi e like me ka puka . Ua like ia me ka valve. ʻO kēia ka mea a mākou e kapa nei ʻo Sphincter o Oddi . ʻO ka maʻamau, ke pono ʻoe e ʻeli i ka meaʻai, wehe ʻia kēia puka, komo nā wai, a laila pani hou.
ʻO ka Sphincter o Oddi Dysfunction ka wā e hana pono ʻole ai kēia puka. ʻO ia hoʻi, ʻaʻole e wehe kēia ʻāpana ʻiʻo i ka wā e pono ai a lilo i paʻa. A laila ʻaʻole hiki i ka bile mai ke akepaʻa a me ka wai mai ka pancreas ke hele i ka ʻōpū liʻiliʻi a paʻa. Ua like ia me ka paʻa kaʻa. Ke paʻa ka wai penei, piʻi ke kaomi ma nā alanui e puka mai ai kēlā mau wai, e hoʻoulu ai i nā ʻehaʻeha nui o ka ʻōpū.
ʻIke pinepine ʻia kēia ʻano i nā poʻe i wehe ʻia ko lākou gallbladder ma ke ʻoki ʻana. No laila, ua kapa ʻia ʻo ia i kekahi manawa he post-cholecystectomy syndrome .
He aha nā ʻano nui o kēia maʻi?
Hiki i ka Sphincter o Oddi Dysfunction ke hoʻopilikia iā ʻoe ma nā ʻano nui ʻelua.
- ʻO Biliary Dyskinesia: He kūlana kēia e ālai ʻia ai nā ala bile. ʻO ka pilikia ma ke ʻano o ke kahe ʻana o ka bile.
- Pancreatitis: ʻO kēia ka wā e ālai ʻia ai ka wai pancreatic, e pehu ai ka pancreas a lilo i mumū.
Eia kekahi, ua hoʻokaʻawale nā kauka i ka maʻi i ʻekolu mau māhele (Nā Māhele I, II, a me III). He mea nui loa kēia no ka mea ua hoʻoholo ʻia ka lāʻau lapaʻau ma muli o kēia māhele.
| ʻAno maʻi | Wehewehena |
|---|---|
| Māhele I | ʻEha ka ʻōpū o ka mea maʻi. Eia kekahi, aia nā hōʻike maopopo o kēia pilikia mai nā hoʻāʻo koko a me nā scan (ultrasound) . (e.g., nā enzymes akepaʻa i hoʻonui ʻia, nā ducts bile i hoʻonui ʻia). |
| Māhele II | Ua ʻeha ka ʻōpū o ka mea maʻi, a hoʻokahi wale nō o nā hoʻokolohua koko a i ʻole nā scan e hōʻike ana i kekahi ʻano ʻē. |
| Māhele III | ʻO kēia ke ʻano paʻakikī loa e ʻike. Loaʻa i ka mea maʻi ka ʻeha o ka ʻōpū, akā ʻaʻohe hoʻāʻo koko a i ʻole ke scan e loaʻa ai kekahi mea hewa. ʻO ka hōʻike wale nō ka ʻeha a ka mea maʻi e ʻike nei. |
He aha nā hōʻailona nui o kēia maʻi?
ʻO ka hōʻailona nui a maʻamau ka ʻeha nui o ka ʻōpū, kahi e like me ka ʻeha i loaʻa me nā pōhaku gallstone.
- Hoʻomaka ka ʻeha ma ka ʻaoʻao ʻākau o luna o ka ʻōpū.
- I kekahi manawa hele pū kēia ʻeha i ka poʻohiwi ʻākau a i ke kua paha .
- ʻAʻole mau ka ʻeha. Nalo wale ia ma hope o 30 mau minuke a i ʻole hoʻokahi hola. A laila hiki ke hoʻi hou mai i hoʻokahi lā a i ʻole hoʻokahi pule.
- I kekahi mau lā, he maʻalahi ka ʻeha, aʻo kekahi mau lā, hiki ke hoʻomanawanui ʻole.
Ma waho aʻe o kēia ʻeha nui, hiki ke ʻike ʻia nā hōʻailona penei:
- Ka luaʻi a me ka luaʻi
- Kuni a me nā anu
- Ka maʻi pākī
ʻO ka mea nui, ʻaʻole i loaʻa mau kēia mau hōʻailona. Loaʻa pinepine lākou i ka hele a me ka nalo.
ʻO wai ka mea i ʻoi aku ka pilikia no kēia maʻi?
ʻAʻole i ʻike ʻia ke kumu maoli o kēia, akā naʻe, hoʻonui kekahi mau kumu i ka pilikia o kēia ʻano.
| Kumu pilikia | Wehewehena |
|---|---|
| Ka wehe ʻana i ka ʻōpū gall | ʻO kēia ke kumu pilikia nui a maʻamau. |
| Makahiki a me ke kāne | ʻO kēia maʻi ka mea maʻamau i nā wahine ma waena o 20 a me 50 mau makahiki. |
| Nā ʻoki kino ʻē aʻe | Nā ʻoki kino pohō kaumaha (e like me ke ʻoki kino bypass gastric), nā hoʻoili ʻana o ke ake, a pēlā aku. |
| Nā kūlana olakino ʻē aʻe | Nā kūlana e like me ka pancreatitis hou, hypothyroidism, a me ka irritable bowel syndrome (IBS). |
| Kekahi mau lāʻau lapaʻau | Ka hoʻohana lōʻihi ʻana i kekahi mau mea ʻeha (ʻoiai nā opiates). |
Pehea e ʻike ʻia ai ka maʻi?
Inā kānalua kāu kauka i kēia ma hope o ka lohe ʻana e pili ana i kāu mau hōʻailona, ʻo ka mea mua āna e hana ai, ʻo ia ka hōʻoia ʻaʻohe kumu koʻikoʻi ʻē aʻe no kou ʻeha ʻōpū. ʻO kēia no ka mea ʻo nā kūlana ʻē aʻe e like me nā ʻōpū ʻōpū (nā ʻōpū peptic), nā pōhaku gallstones, a me ke kanesa pancreatic a i ʻole bile duct hiki ke hana i nā hōʻailona like. I kekahi manawa, hiki i ka ʻeha maʻi puʻuwai (angina) ke like me ka ʻeha ʻōpū.
Ma hope o ka hōʻoia ʻana ʻaʻole i loaʻa kēia mau mea, hiki ke hana ʻia nā hoʻokolohua aʻe e nānā ai no ka Sphincter o Oddi Dysfunction:
- Nā hoʻāʻo koko:E nānā i ke kiʻekiʻe o nā enzyme o ka ate a me ka pancreas.
- Nā scan: Hoʻohana ʻia nā scan e like me ka ultrasound ʻōpū, CT scan, a me MRCP e nānā inā ua pehu/hoʻonui ʻia ke ala bile a i ʻole ke ala pancreatic.
- Endoscopy: Hoʻokomo ʻia kahi ʻōmole me kahi kāmela ma o ka waha e nānā i ka ʻōpū a me ka ʻōpū liʻiliʻi.
Hoʻāʻo ERCP
I kekahi mau hihia, ʻoiai inā kānalua ʻia ke ʻano I a i ʻole II, hana ʻia kahi hoʻāʻo kūikawā i kapa ʻia ʻo ERCP (Endoscopic Retrograde Cholangiopancreatography) . Ma kēia, hoʻokomo ʻia kahi paipu kāmela, e like me ka endoscope, i loko o ka sphincter o Oddi, a hoʻokomo ʻia kahi paipu liʻiliʻi e ana i ke kaomi i loko o kēlā ʻiʻo (manometry). A laila hiki i kēia ke hoʻoholo pololei inā e wehe pono ana a pani pono paha.
Eia nō naʻe, he hoʻāʻo pilikia liʻiliʻi kēia hoʻāʻo ERCP. Hiki i kahi pakeneka liʻiliʻi o ka poʻe i loaʻa iā ia ke loaʻa i ka pancreatitis ma hope o ka hoʻāʻo. No laila, paipai ke kauka i kēia hoʻāʻo ma hope o ke kaupaona pono ʻana i ka pono a me ka pilikia.
Pehea e mālama ʻia ai?
Aia nā koho lapaʻau i ke ʻano (māhele) o ka Sphincter o Oddi Dysfunction āu e loaʻa ai.
- No ka Māhele III: He paʻakikī ke ʻike ʻia kēia, no laila ʻaʻole ʻōlelo ʻia ke ʻoki ʻana. E kuhikuhi ke kauka i nā lāʻau ʻeha a me nā lāʻau lapaʻau e hoʻomaha ai i ka ʻeha e kāohi i ka ʻeha.
- No ka Māhele I & II: Inā koʻikoʻi ka ʻeha a paʻakikī ke kāohi me ka lāʻau lapaʻau, hiki i kāu kauka ke kuhikuhi i kahi lāʻau i kapa ʻia ʻo sphincterotomy me ERCP .
He aha kēia Sphincterotomy?
ʻO kēia ke ʻoki ʻana i kahi ʻāpana liʻiliʻi o ka ʻiʻo i kapa ʻia ʻo Sphincter o Oddi me kahi mea hana liʻiliʻi e hoʻokomo ʻia ma o ka ʻōmole kāmela i ka wā o ka hoʻokolokolo ERCP. A laila, wehe mau ʻia ka puka paʻa. A laila, kahe nā wai ʻai i loko o ka ʻōpū liʻiliʻi me ka ʻole o ke keʻakeʻa. Hoʻopau loa kēia i ka ʻeha.
Akā he lāʻau lapaʻau kēia e lawe mai ana i kekahi pilikia. Aia kekahi pilikia o ka pancreatitis. No laila, hoʻohana ʻia kēia lāʻau lapaʻau ke ʻole i loaʻa nā hopena kūleʻa i nā lāʻau lapaʻau ʻē aʻe.
Leka Lawe-Home
- Inā ʻeha mau kou ʻōpū ma hope o ka wehe ʻia ʻana o kou ʻōpū gallbladder, mai hoʻowahāwahā iā ia. He Sphincter o Oddi Dysfunction paha ia.
- ʻOiai ʻaʻole kēia kūlana e hoʻoweliweli i ke ola, hiki i ka ʻeha ke lilo i mea hoʻopilikia nui i kou ola o kēlā me kēia lā.
- ʻAʻole mau nā hōʻailona, ʻo ke ʻano o kēia maʻi ke hele mai a hele aku i kēlā me kēia manawa.
- Na kāu kauka e hoʻoholo i ke ʻano (I, II, a i ʻole III) o ka maʻi āu i loaʻa ai ma o nā hoʻokolohua a nāna e hāʻawi i ka lāʻau kūpono loa.
- Hiki i kekahi poʻe ke hoʻokele i ko lākou ʻeha me ka lāʻau lapaʻau wale nō. Pono paha kekahi i ka lāʻau lapaʻau e like me ka sphincterotomy.
- Ma mua o kekahi lāʻau lapaʻau, e kamaʻilio ākea me kāu kauka e pili ana i nā pōmaikaʻi a me nā pōʻino.
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