Necrotizing pancreatitis natna hlauhawm tak hi i hria em?

Pancreas thenkhat thihna natna khirh tak i hre tawh em ? Hei hi damdawi lam chuan ``Necrotizing Pancreatitis'' kan tih chu a ni. Kan taksa peng pawimawh tak pakhat hloh chu a pawizia hi han ngaihtuah teh. Hei hi ``Acute Pancreatitis '' tih natna a nasat em avangin a thleng thin. Vawiin hian he thu hi chipchiar takin kan sawi dawn a, kan thianpa nen kan inbia ang maiin kan sawi dawn a ni.

``(Necrotizing Pancreatitis)`` tih hi eng nge ni tak tak?

A awlsam zawngin ``Necrotizing Pancreatitis`` chu i ``Pancreas`` (Necrosis) atanga a then thihna a ni. Hei hi ``Pancreatitis`` natna a nasat em avangin a thleng thin. Pancreatitis chu hliam emaw, rulhut ang chi emaw avanga pancreas a hring, a sen, a na a ni. He inflammation hi a nasat lutuk chuan pancreatic tissue-a thisen kal chu ``Ischemia`` a tibuai thei a ni . Tichuan chu tissue te chuan an mamawh oxygen leh nutrients te chu an hmu lo va an thi tan ta a ni . Hei hi ``Necrosis`` an ti a. Hei hi dinhmun hlauhawm tak a ni tak zet a ni.

Chutiang a nih chuan i medical team chuan damdawi inah hun engemaw chen an dah ang che a, harsatna dang i neih leh neih loh chu ngun takin an lo en ang che . Fimkhur tur pawimawh ber chu infection a ni . Bacteriain tissue thi chu ei tan ta se, rang takin a pung thei a, i taksa pum puiah a darh thei ang tih han ngaihtuah teh. Chutiang a nih chuan, taksa peng hrang hrang (organ failure) ang chi dinhmun khirh tak a thlen thei a, chu chuan nunna a tichhe thei a ni. Chutiang hunah chuan doctor-te chuan tissue thi chu operation hmangin an la chhuak a ngai mai thei .

Hetiang dinhmun hi engtiang chiahin nge a awm?

A tlangpuiin acute pancreatitis vei zinga 20% vel chuan necrotizing pancreatitis an vei ang. United States ang ramah chuan kum tin mi sangthum vel chu pancreatitis vangin damdawi inah an awm nia chhut a ni. Chuvangin, 20% hi chu a langsar hle a ni lawm ni?

`(Necrotizing Pancreatitis)` natna lan chhuah dan chu engte nge ni?

A lan chhuah hmasak ber chu acute pancreatitis a ni. Anni chu:

• Pum chunglam natna nasa tak a awm . He natna hi hnungzang thlengin a radiate thei bawk.
• Abdominal distension emaw bloating emaw a ni.
• Nausea leh luak chhuak.

Pancreatitis a na zual zel chuan heng ang symptoms te hi a lo lang thei bawk:

• Khawsik leh khawsik.
• Lung chakna (Tachycardia) a sang.
• Tuihalna nasa tak emaw tui tlakchhamna emaw.

``Necrotizing Pancreatitis'' hi engte nge ni?

Hei hi stage engemaw zatah a thleng thin. Pakhatnaah chuan pancreas inflammation pangngai (Acute Pancreatitis) chu a na hle. Tichuan, thisen supply a tibuai (Ischemia), a tawpah chuan tissue thihna (Necrosis) a lo awm ta a ni. Heng thil thleng hrang hrangte hi chhan hrang hrang a awm a.

Pancreatitis hi engtiang chiahin nge a nasat?

Acute pancreatitis thlentu ber chu gallstone natna a ni. Hei hi gallstone pakhat chu gallbladder-ah a lo awm a, pancreatic duct a block hian a thleng thin. Hei hi gallstone pancreatitis an ti bawk . A chhan ber pahnihna chu zu in tam lutuk vang a ni .

Inflammation hi a takah chuan taksain hliam a chhan dan a ni a, a chhiatna siamthat tumna a ni. Mahse a chang chuan he inflammatory response hi a nasat em avangin chhiatna a thlen tan thin.

He inflammatory response hi mi thenkhatah chuan midang aiin a na zawk chhan hi hriat chian a la ni lo. Mahse, hei hian pancreas chhungah `` snowball effect`` a siam tih a chiang hle.

Inflammation nasa tak avanga pressure sang tak hian pancreatic tissue chhunga pancreatic enzymes te a tichak a ni. A tlangpuiin heng digestive enzymes te hi ei tur digestive system-a a luh hnuah an thawk chhuak thin. Mahse a hmaa an activate chuan pancreas ngei pawh an digesting tan thin. Ngaihtuah teh, nangmah ngeiin i taksa peng pakhat chu nangmah ngeiin i enzyme hmangin i ei chhuak ang!

Thisen supply tlahniam hian ``Ischemia`` leh tissue thihna ``Necrosis`` a thlen thin

Hetianga pancreas chhiatna kal zel hian pancreatitis a ti na zual sauh sauh a ni. A tawpah chuan pancreas swelling hian thisen kalna kawng a tizau a, tissue-a thisen kal zat a ti tlem a ni.

Hei hi tibuaitu dang chu Systemic Inflammatory Response Syndrome (SIRS) a ni. Hei hi taksa pum puia awm thin inflammation condition a ni. Hei hian thisen sang zawng zawng leh thisen kal dan a ti tlahniam thei a ni.

Thisen kal dan hloh (ischemia) hian tissue thihna (necrosis) a thlen thin. Pancreatic enzymes hmanga pancreas digestion hian he tissue thihna hi a thlen thei bawk.

`(Necrotizing Pancreatitis)` avanga harsatna awm thei te chu engte nge ni?

Hetiang dinhmun hian hun rei lote leh hun rei tak chhungin harsatna hrang hrang a thlen thei a ni.

Hun rei lote chhunga harsatna awm thei:

• Infection: Hei hi Necrotizing Pancreatitis hlauhawm ber a ni. Hei hi damlo 20% vel ah a thleng thei. Tissue thi hi bacteria vak kual vel te ei tur tha tak ang a ni. I damloh tawh chuan infection control a harsa hle. Thisenah a darh chuan nunna atana hlauhawm a ni thei. Thisenah natna hrik a awm chuan sepsis a thlen thei a , chu chuan taksa peng hrang hrang a tichhe thei a ni . Hei hi Necrotizing Pancreatitis vei te thihna thlentu ber a ni.
• Necrotic Fluid Collections: Pancreatitis natna khirh takah chuan activated pancreatic enzymes te chu pancreas atang hian a leak chhuak thei a, a chhehvel tissue te a tichhia thei bawk. Pancreatic fluid chhehvelah hian tissue te tak te capsule a lo awm a. He capsule-ah hian tissue thi leh bacteria a awm chuan awlsam takin natna a intan thei a, a darh thei bawk. A tlem berah chuan he capsule hian a lian thei a, a bul hnaia taksa peng hrang hrang, pum, thisen kalna kawng emaw, bile duct emaw te chu a press thei a ni.
• Hemorrhage: Hemorrhagic pancreatitis hi a awm lo hle a, mahse a lo awm chuan nunna atana hlauhawm tak a ni thei. Necrotizing pancreatitis hian he thisen chhuahna hi a tipung a ni. Hei hi a thlen theih dan pakhat chu pancreas chhunga inflammation emaw fluid emaw chu a bul hnaia thisen kalnaah a darh a, thisen kalna kawng a tichhia a, thisen a chhuak a nih chuan a ni. Kawng dang chu pancreatic enzymes te hian artery wall a tichhia a, pseudoaneurysm , a ti chhe a, thisen a chhuah tir a nih chuan a ni.
• Abdominal Compartment Syndrome: Necrotizing pancreatitis nena inzawm, hliam, thisen chhuah leh tui dang tam lutuk hian pum chhunga pressure sang tak a thlen thei. Hei hi damlo na tak takah hmuh tur a awm ber. Hei hian taksa peng hrang hranga thisen kal a tihtlem phah thei a, chu chuan thisen zam , ischemia, leh hypoxia a thlen thei a ni. Hei hian multiple organ failure a thlen thei bawk.

Hun rei tak chhunga a rah chhuah turte:

• Pancreatic Insufficiency: Pancreatic tissue tam tak a bo chuan pancreas hnathawh thenkhat a bo thei. Exocrine Pancreatic Insufficiency chu pancreas-in chaw ei tur ei tur enzyme a siam chhuah tlem vang a ni. Hei hian malabsorption leh malnutrition a thlen thei a ni . Endocrine Pancreatic Insufficiency chu pancreas-in thisen sugar level control thei hormone a siam chhuah tlem vang a ni. Hei hian hyperglycemia leh diabetes a thlen thei a ni .
• Disconnected Pancreatic Duct Syndrome: Necrotizing pancreatitis avanga natna nasa tak, thisen chhuak, tissue thihna leh harsatna dangte chuan pancreatic duct chu pancreas emaw small intestine emaw atanga a then a inthen thei a ni. Hei hian pancreatic enzymes te a leak chhunzawm thei a ni. He leakage hian hun rei tak chhung tui a khawlkhawm thei a,/ emaw chronic pancreatitis a thlen thei bawk.
• Biliary lam hawi zawng: 1.1.Inflammation na tak leh rei tak a awm chuan pancreas leh digestive system inzawmkhawmtu duct (pancreatic duct, bile duct, duodenum - small intestine bul tanna) eng pawhah hliam a awm thei. He scarring hian duct chu a pangngai lo takin a ti tawi (stricture). Hei hian bile kal dan a tikhawlo a, bile chu biliary system-ah a back up tan ta a ni.
• Splanchnic Vein Thrombosis: I splanchnic vein te hi i pancreas hnuaiah a awm a. Pancreatitis na tak chuan a ti na thei a ni. Hei hian heng vein-ah hian thisen zam (thrombosis) a thlen thei a ni. Heng vein te hi splenic vein, mesenteric vein, hepatic vein leh portal vein te an ni. Chung zinga pakhatah thisen zam a lo awm chuan harsatna hrang hrang a awm thei a, chu chu portal hypertension , gastrointestinal varices, gastrointestinal bleeding, ischemic colitis, leh mesenteric ischemia te hi a ni.

Engtin nge Necrotizing Pancreatitis hi an hriat theih?

Doctor-te chuan he natna `(Necrotizing Pancreatitis)` hi `(Acute Pancreatitis) an hmuhchhuah hmasak ber hnuah an hmuchhuak thin.` Tissue thihna chhinchhiahna langsar tak `(Necrosis)` hi pancreatitis a lo chhuah atanga ni thum atanga ni nga hnuah chauh a lang lo. A tir lama i inflammation atanga ni engemaw zat hnuah pancreatitis na tak symptom i neih chuan i doctor chuan CT scan hmangin fluorescent dye `(Contrast-enhanced CT scan)` emaw MRI.` (MRI - Magnetic Resonance Imaging)` hmangin he tissue thihna hi a zawng ang. Tin, harsatna dang, tui awm zat (fluid accumulation) te pawh an zawng dawn a ni.

Hei hi eng enkawlna nge ni?

I enkawlna chu infection emaw, harsatna dang emaw i neih leh neih lohah a innghat ang. Pancreatic necrosis hi sterile a nih a, a lan chhuahna a awm loh chuan doctor-te chuan supportive care hmangin an enkawl tlangpui ang . Infection chhinchhiahna emaw, harsatna dang emaw a lo awm chuan doctor-te chuan a tul angin an rawn inrawlh ang. Surgery an hman hmain minimally invasive method hmangin tissue thi chu lakchhuah an tum ang.

Conservative Management lam hawi

Hri kai lo ``Sterile Necrotizing Pancreatitis`` te tanpuitu enkawlnaah hian:

• Natna tihdamna damdawi.
• Thisen chhunga tui `(IV Fluids)`.
• Enteral Nutrition a awm bawk.

Case buaithlak lo tam zawk chu supportive care chauh hmangin a chinfel ang. Hemi chhung hian i medical team te chuan i dinhmun hi uluk takin an enfiah ang. Anni chuan i vital signs , pum pressure, leh thisen chhiar kimchang te an enfiah ang.Complete Blood Cell Count (CBC) ang chi thilte an enfiah a, harsatna awm thei tur an enfiah bawk. Infection emaw organ failure ang chi thil a awm chuan a tul angin life support emaw intervention dang emaw an pe ang.

Drainage leh Debridement te a awm bawk

Infection chhinchhiahna i hmuh tan veleh i medical team chuan antibiotics an pe tan ang che a, a theih chuan tissue thi zawng zawng chu paih chhuah an tum ang. Invasive tlem ber hmangin an tan ang a, a tul chuan zawi zawiin an chakna an tipung ang.

Heng hmanrua te hi:

• Percutaneous drainage: Percutaneous tih awmzia chu vun kaltlangin a ni. Interventional radiologist chuan imaging technique (a tam zawkah chuan ultrasound emaw CT scan emaw) hmangin tissue thi awmna hmun chu a zawng a, i vun kaltlangin tube a dah lut thin. Tube chu a hmunah dahin ni khatah vawi tam tak saline hmangin an silfai a, chu chuan tui chu a chhuah tir thin. Hei hi damlo hmun thuma ṭhena hmun khat vel tan chuan duhthlan tur awmchhun a ni. Midang tan chuan debridement dan dang him taka tih theih a nih hma chuan natna hrik chu a thunun thei a ni.
• Endoscopic Debridement: Endoscopy an tih hian gastroenterologist chuan i taksa chhunga tissue thi chu i vun tikehsawm lovin a thleng thei a ni. Amah hian endoscope, ultrasound probe hmanga thuam chu i upper gastrointestinal tract kaltlangin pancreas awmna hmun chu a zawng chhuak ang. Tichuan, instruments te chu endoscope kaltlangin an pass a, chu chuan tissue thi leh i gastrointestinal tract inkarah channel a siam a ni. Chu channel kaltlangin tissue thi chu lakchhuah a ni.
• Video-assisted Retroperitoneal Debridement (VARD): Hei hi surgery tih dan tur a ni bawk. Hei hian i vunah i incision neih tawh ang chiah kha Percutaneous Drainage Portal an tih hmangin surgical instruments te dah luh a, tissue thi awmna hmunah kal a ngai a ni. Surgeon chuan forceps, irrigation leh suction hmangin incision hmangin tissue thi chu a paih chhuak thin. A tul chuan incision chu a zau thei a, camera hmanga siam tube laparoscope an tih chu dah theih a ni bawk. Chumi hnuah chuan tissue la awm chu laparoscopic procedure hmangin laparoscopic surgery an tih hmangin an la chhuak leh thin.
• Open Surgery - Necrosectomy: Necrosectomy tih hian tissue thi te paih chhuah a ni. Open surgery-ah hian pum chhung (abdominal cavity) hawn a, tissue thi (Laparotomy) hmuhchhuah a ni. Hei hi emergency complication zawng chhuak leh enkawl dan awlsam ber a la ni reng a ni. Surgery hian hlauhawm engemaw zat keng tel mahse, emergency leh less invasive methods a hlawhchham hunah chuan a tawp ber a ni.

`(Necrotizing Pancreatitis)` vanga thihna rate leh dam leh zat hi engzat nge ni?

I dam theihna chance chu i pancreas thi zat te, infection emaw organ failure emaw i neih leh neih loh leh enkawlna i dawn danah a innghat a ni. I pancreas 30% aia tlem lo a nghawng chuan thihna rate chu 15% aia tlem a ni . Infection nei lo tissue thihna chauh a awm chuan a tha. Mahse i pancreas 50% aia tam a nghawng a, infection emaw organ failure emaw i neih chuan thihna chu 30% aia tam a ni .

Heng statistics te hian hlauthawng suh. Hengte hi thu tlangpui chauh a ni. I dinhmun leh i dam leh theihna tur chu i enkawltu medical team chauhvin an hrilh thei ber che a ni.

Enkawl hnuah eng nge thleng?

Enkawlna hnua i follow-up appointment-ah chuan i doctor chuan natna lan chhuahna awm mek emaw, a thar emaw a zawt ang che. Necrotizing Pancreatitis hian enkawl hnuah pawh harsatna rei tak a nei thei a ni. Symptoms i neih chuan thisen test emaw, lab test emaw, imaging test emaw nei turin an ti thei che a, chu chu enfiah turin an ti thei bawk. Complication a awm chuan enkawlna dang a ngai thei a, chu chu hun rei lote chhung emaw, hun rei tak emaw pawh a ni thei.

Necrotizing pancreatitis hi acute pancreatitis natna hlauhawm tak a ni. Mi tam zawk chu supportive care chauh hmanga acute pancreatitis atanga an dam leh laiin, pancreatitis na tak leh necrosis nei te chuan hun rei tak, intensive care an mamawh a ni. I dinhmun leh harsatna lo awm thei zawng zawng enfiah turin doctor hrang hrang multidisciplinary team i mamawh ang. Intervention emaw surgery emaw i mamawh thei a, follow-up care pawh i mamawh thei bawk.

He thawnthu atanga kan hriat reng tur pawimawh tak tak (Take-Home Message) .

• Necrotizing Pancreatitis hi natna khirh tak a ni a, pancreas hmun thenkhat a thi thin.
• Hei hi acute pancreatitis na tak avanga lo awm a ni fo. A chhan ber chu gallstones leh zu in tam lutuk vang a ni .
• Pum natna nasa tak, khawsik, luak chhuak, leh luak chhuak ang chi symptoms i neih chuan doctor lam pan nghal rawh.
• He natna thlentu ber leh hlauhawm ber chu natna hrik hi a ni.
• Damlo dinhmun a zirin enkawlna kawng hrang hrang a inang lo. Enkawlna hrang hrang a awm a , supportive care atanga surgery thlengin .
• Hei hi natna khirh tak ni mah se, mi tam tak chu damdawi lam enkawlna leh enkawlna dik tak an neih chuan an dam leh ṭhin . Chuvangin beiseina bansan suh.

Nangmah emaw, i hriat miin emaw heng symptoms te hi i neih chuan doctor pan nghal tur a ni. Inenkawl hmasak hian nunna a chhanhim thei!

` Necrotizing Pancreatitis, Pancreatitis, Pancreatic thihna, Pum na, Pancreatic infection, Pancreatitis Sinhala, Pancreatic natna