Kua whakaaroaro hohonu koe mō ngā mea e puta ana i roto i ō tātou tinana i muri i tā tātou kai? I muri i te haerenga o te kai e kainga ana e tātou mai i tō tātou mangai ki tō tātou puku, ka puta he tukanga tino uaua hei nakunaku, hei whakaputa pūngao, hei whakarato hoki i ngā matūkai e hiahiatia ana e tō tātou tinana. I roto i tēnei tukanga, ka mahi tahi ia okana hei rōpū. I tēnei rā, ka kōrero tātou mō tētahi wāhi iti rawa, engari he wāhi tino nui i roto i tō tātou pūnaha nakunaku e mahi ana pērā i te hononga tereina nui. Ko te "Ampulla of Vater" tēnā.
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He aha tonu te Ampulla o Vater?
He whakarāpopototanga noa iho, ko te ampulla o Vater he pūaha iti e tuwhera ana ki te wāhanga tuatahi o tō tātou whekau iti (te duodenum). Engari ehara i te mea he pūaha noa iho. Koinei te wāhi matua e huihui ai ngā wai e rua e tika ana mō tā tātou tukanga nakunaku, ā, e whakaranua ana ki te kai.
Whakaarohia pēnei. Ko te awaawa aukume noa, e kawe ana i te aukume mai i tō tātou ate, me te awaawa repeure, e kawe ana i ngā whākōkī mai i tō tātou repeure e āwhina ana i a tātou ki te nakunaku kai, ka honoa ngātahi hei hanga i tētahi pēke iti. Ko taua pēke e kiia ana ko te ampulla o Vater. Kātahi ka whakaranua ngā whākōkī aukume me te repeure ka uru ki roto i te whekau iti.
I ahu mai tēnei ingoa i tētahi mea whakamīharo. I tapaina i muri i te āhua o tētahi pounamu porowhita e kiia nei ko te "ampulla" i whakamahia i ngā wā o Roma . I tapaina hoki ko "of Vater" hei whakahonore i te tohunga hanganga tinana a Abraham Vater, nāna i whakaahua tuatahi.
Hei whakamārama, he "hononga" tino pukumahi tēnei i roto i tā tātou pūnaha nakunaku. Ki te kore tēnei hononga e mahi tika, ka raru pea tā tātou tukanga nakunaku katoa.
Kei hea tēnei okana iti?
Kei roto i te pakitara o te duodenum te ampulla o Vater, te wāhanga tuatahi o tō tātou whekau iti . Ko te duodenum te wāhanga o te whekau iti e haere ana i muri i te puku, tata ki te 10 inihi te roa. Kei waenganui o tēnei duodenum te ampulla o Vater.
He mea tino nui tēnei wāhi i roto i te rongoā. Nā te mea koinei te wāhi e nakunakuhia ai te kai kua pakaruhia, kua pakaruhia hoki i roto i te puku, ā, ka tīmata te tinana ki te mimiti i ngā matūkai o roto. Me te mea nei kei te mahi tahi te puku i tana mahi ki te wawahi i te kai, ka tīmata te duodenum me te toenga o te whekau iti ki te mimiti. Kāore e taea taua tukanga me te kore he wai e puta mai ana i tēnei ampulla o te puku.
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Check Availability →He aha ngā wāhanga me ngā mahi a te Ampulla o te Waiter?
I roto i tēnei hononga iti, he pūnaha tino uaua, he pūnaha whakamiharo hoki. Ko te nuinga o te wā he whatunga uaua e karapoti ana i a ia. Ka kiia ēnei he uaua uaua . Pērā i te takirere wai, ko te whakatuwheratanga me te katinga o ēnei uaua e whakahaere ana i te nui o te au me ngā whākōkī e tomo ana ki te whekau iti, me te wā hoki.
Kāore e taea e tātou te whakahaere i ēnei uaua i runga i tā tātou e hiahia ai. Ka mahi aunoa rātou i runga anō i ngā tohu e riro mai ana i tō tātou pūnaha io. Ina kai tātou i tētahi kai momona, me nui ake te au hei nakunaku. Kātahi ka puta mai he tohu mai i tō tātou roro, ā, ka tuwhera ēnei uaua ka tukuna te nui o te au e hiahiatia ana. He mea whakamiharo?
Mā te ripanga i raro nei tātou e āwhina ki te mārama ake ki ōna wāhanga matua me ā rātou mahi.
| Wāhanga | Mahi Noa |
|---|---|
| Te uaua o Oddi | Koinei te ingoa whānui mō te pūnaha whakahaere katoa. He maha atu anō ngā uaua iti kei roto i tēnei. |
| Te whakapūmautanga o te awa repeure | Ka whakahaere i te rere o ngā whākōkī mai i te repe taiaki. |
| Te aukati i te awaawa waikura | Ka whakahaere i te rere o te au mai i te ate. |
| Tākai ampoule | Ka whakahaerehia te tukunga ngātahi o ngā wai e rua ki roto i te whekau iti. |
| Papilla o Vater | Koinei te pūaha iti e tuwhera ai te ampulla ki roto i te whekau iti. |
He aha ngā mate ka pā ki tēnei wāhanga?
Ki te hē tetahi mea i tēnei wāhi iti engari he mea nui rawa atu, ka pā ki te tinana katoa. Nā te mea ki te kore e taea e te au me ngā whākōkī te puta ki waho, ka mau ki roto, ka hoki anō rātou ki te kino i te ate me te repe taiaki.
Ko ngā mate hauora matua e whai ake nei ka pā mai e pā ana ki te ampulla o Vater.
| Āhuatanga hauora | He whakamārama māmā |
|---|---|
| Adenoma | Ehara tēnei i te mate pukupuku, engari he tipu rerekē o ngā pūtau ) ka taea te huri hei mate pukupuku. I a ia e tipu ana, ka ārai i ngā oko toto, ka puta he raruraru. |
| Matepukupuku Āmipi | Ka taea e te adenoma kua whakahuatia ake nei te whanake hei carcinoma. He tino kino tēnei, ā, me tango pokanga i te nuinga o te wā. |
| Te ngoikore o te uaua o Oddi | Ko te tikanga o tēnei, kāore te uaua, he rite ki te kēti, e tuwhera tika ana i te wā e tika ana. Kātahi ka mau ngā wai ki roto, ka puta he raruraru. |
| Ārai | Tērā pea ka āraia tēnei hononga mō ētahi atu take. Ko te tino take ko ngā kōhatu o te pūkahukahu e piri ana ki tēnei wāhi whaiti. I ētahi wā, ka āraia hoki tēnei wāhi nā ngā patunga tawhito me ngā kōhatu. |
Me pēhea taku mōhio mēnā he raruraru kei taku ampulla o te waiter? He aha ngā tohu?
Ki te āraia te ampulla o Vater e te pukupuku, te kōhatu, te raruraru rānei, kāore e taea te rere o te au me ngā whākōkī ki waho. Kātahi ka kohikohi tēnei wai ki roto i ngā awa au me te repeure, ka piki ake te pēhanga, ka whakararuraru hoki i te pūnaha katoa. Ka puta pea ēnei tohu e whai ake nei:
- Mamae puku: Mamae, inā koa ki te taha matau o runga o te puku.
- Te mamae o te puku: He mamae nui e puta whakarere mai ana, ā, ka memeha haere i muri i tētahi wā.
- Te kiri māwhero: Te kōwhai o ngā mā o ngā kanohi me te kiri. Ka puta tēnei ina kore e taea te whakaputa i te au o te ate, ā, ka nui haere te tae kōwhai o te bilirubin i roto i te toto.
- Whakapairuaki me te ruaki: Ka puta pea tēnei āhuatanga nā te koretake o te kai.
Ko te mea nui, ki te mea kei te pāngia koe e ēnei tohu, inā koa te kōwhai o ngā kanohi me te kiri, kaua e warewarehia. He tohu pea tēnei mō tētahi mate kino. Nō reira, me toro atu ki tō tākuta tonu.
Me pēhea te whakamātautau me te rongoā a ngā tākuta i tēnei?
He waimarie, nā te hangarau hauora matatau o ēnei rā, kāore e hiahiatia he pokanga nui hei tirotiro me te rongoā i tēnei ampulla o Vater. He maha ngā wā ka whakamahia e ngā tākuta he tikanga e kiia nei ko te endoscopy mō tēnei kaupapa.
Hei whakarāpopototanga, ko te whakaurunga o tētahi ngongo angiangi me tētahi kāmera iti i te pito mā roto i te waha, ka haere mā roto i te puku, ka tae ki te ampulla o Vater i roto i te pūhā. Ka kiia tēnei tikanga ko te ERCP (Endoscopic Retrograde Cholangiopancreatography) .
Ko te āhuatanga motuhake o tēnei tikanga ko:
1. Whakamātautau: Ka taea e te tākuta te tirotiro pai i tēnei wāhi me te kāmera, ā, ka kitea he aha te raruraru.
2. Maimoatanga: I taua wā, ka tukuna pea ngā taputapu iti mā roto i te ngongo hei tango i ngā kōhatu pūkahukahu e piri ana ki te pūkahukahu, hei whakawhānui i te aukati, hei tango rānei i tētahi wahi kiko iti (biopsy) hei tirotiro. Ahakoa ētahi pukupuku iti ka taea te tango i tēnei ara.
Ko te tikanga o tēnei, he whai wāhitanga ki te mahi i te tātaritanga me te maimoatanga i roto i te tikanga kotahi. He tino watea tēnei mō ngā tūroro.
Ahakoa he iti noa te ampulla o Vater i roto i tō tātou tinana, he tino rawe tana mahi. He kuwaha nui tēnei ki tō tātou pūnaha nakunaku. Koinei anō hoki te kuwaha e whakamahia ana e ngā tākuta hei tirotiro i roto i ō tātou awaawa au me te repeure. Kāore pea koe e rongo i tēnei ingoa, engari ki te whakahuatia e te tākuta i tētahi rā, kaua e wehi. He maha o ōna raruraru ka taea te rongoā mā ngā tikanga matatau.
Karere Tangohia ki te Kāinga
- Ko te Ampulla o Vater te hononga matua e uru ai ngā whākōkī au me te repeure, arā, ngā mea nui mō tā tātou tukanga nakunaku, ki te whekau iti.
- Ka puta pea ngā tohu pēnei i te mamae o te puku, te whakapairuaki, inā koa te jaundice (te kōwhai o te kiri) i ngā ārai i tēnei wāhi.
- Ki te kite koe i ō kanohi, i tō kiri rānei e kōwhai ana, he mea nui kia kaua e warewarehia, me rapu tohutohu hauora tonu atu.
- Ko ngā kōhatu o te puku he tino take o te aukati i tēnei wāhi.
- Mā ngā tikanga endoscopic hou, pērā i te ERCP, ka taea te tautuhi me te rongoā i ngā āhuatanga maha e pā ana ki tēnei wāhi, kāore he pokanga nui.
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