Kua whakaaro kē koe me pēhea tā tātou nakunaku i ngā kai hinuhinu e kainga ana e tātou, te sambol kokonati e kainga ana e tātou me te raihi, te ika kirikos reka rānei i roto i ō tātou tinana? He pūnaha whakamiharo i roto i tō tātou tinana e āwhina ana i tēnei mahi. He rite tēnei pūnaha ki tētahi rākau e horapa ana ōna manga. I tēnei rā kei te kōrero tātou mō tēnei pūnaha biliary (Biliary Tree), he mea nui mō tā tātou tukanga nakunaku, ā, he mahi pai hoki tana ki te tango i ngā para mai i ō tātou tinana.
He aha te rākau biliary?
Ko te pūnaha biliary he whatunga o ngā okana me ngā awaawa e whakaputa ana, e penapena ana, e kawe ana hoki i te au i roto i ō tātou tinana. E kiia ana hoki ko te "Biliary Tract" ko te "Biliary System" rānei i te reo Pākehā. E kiia ana ko te "Biliary Tree" nā te mea he āhua rite ki te rākau. Ko ngā manga iti o tēnei rākau e kiia ana ko ngā awaawa au. Ko ngā okana matua o tēnei pūnaha ko:
- Ate: Koinei te wheketere matua e hanga ana i te au.
- Pūngāwerewere: He pēke iti tēnei e pupuri ana i ētahi o te au i hangaia e te ate.
- Te whekau iti: Ka tae mai te au, ka kohia ki konei.
He tino tautoko tēnei katoa i tā tātou tukanga nakunaku.
He aha ngā wāhanga o tēnei pūnaha me ā rātou mahi?
Whakaarohia he pūnaha wai mō tētahi tāone. He mahi motuhake tā ia wāhanga. Me titiro takitahi tātou ki ia wāhanga.
| Okana / wāhanga | He māmā noa iho te mahi. |
|---|---|
| Ate | Koinei te wāhi matua e puta ai te au. Ka kohia hoki e ia ngā para, te cholesterol kāore e hiahiatia, me te bilirubin mai i te toto ki roto i te au. Ka hangaia hoki e te ate ngā waikawa au, e āwhina ana i a tātou ki te nakunaku i te kai e kainga ana e tātou. |
| Ngā awaawa au | Koinei ngā ngongo iti e āhua rite ana ki ngā manga o te rākau. Ko te au e puta mai ana i roto i te ate ka kohia, ka haria ki te pūkahukahu me te whekau iti mā roto i ēnei awaawa. He maha o ēnei awaawa iti ka honoa tahi hei hanga i te awaawa au noa. Koinei te take o te rākau. |
| Pūngāwerewere | He rite tēnei ki tētahi tāke rokiroki iti. Kei konei te wāhi e rongoatia ai te au o te ate. Ina kai tātou i tētahi kai momona, me nui ake te au hei nakunaku. I taua wā, ka whakawhāiti te pūkahukahu ka tukuna te au kua rongoatia ki roto i te awa au matua. |
| Pancreas | Ahakoa ehara i te wāhanga tika o te pūnaha biliary, e hono ana ki a ia, ā, e mahi tahi ana me ia. Ka tukuna e te repe taiaki ngā whākōkī e hiahiatia ana hei nakunaku i te kai. Ko te awaawa e puta mai ai ēnei whākōkī ka kiia ko te awaawa pancreatic, e hono ana ki te awaawa bile matua ka tuwhera ki roto i te whekau iti. |
| Puku iti | Ka tae mai ngā whākōkī o te ate me te repeure ki konei. Koinei te wāhi e pakaru tika ai, e nakunaku ai hoki ngā ngako (hinu) o te kai. Koinei te wāhi e mimiti ai ngā matūkai kua nakunaku ki roto i te tinana. |
He aha ngā mate me ngā raruraru e pā ana ki te pūkahukahu?
Nā te mea he hononga ngā wāhanga katoa o tēnei pūnaha, ki te puta he raruraru i tētahi wāhanga, ka pā pea ki ngā wāhanga kē atu. Pērā i te mea ka purua tētahi wāhanga o te pūnaha paipa wai, ka mutu te rere o te wai i roto i te pūnaha katoa.
Ko te mea nui, ki te mea he aukati kei roto i tēnei pūnaha, ka mutu te rere o te au. Kātahi ka hoki anō taua au ka kohia ki roto i te toto. Ka pā mai pea he raruraru hauora nui.
Anei ētahi o ngā raruraru tino kitea:
- Ngā Kōhatu Au: He āhuatanga noa tēnei kua rongohia e te tini tāngata. Ka whakapakeketia ngā mea pēnei i te cholesterol i roto i te au ka waiho hei kōhatu ririki. Mēnā ka mau ēnei kōhatu ki roto i ngā awa au, ka ārai i te rere o te au, ka puta he mamae nui , he mate, me ētahi atu raruraru.
- Kore-pūngao: Koinei te wā ka tino puhoi te rere o te au, ka mutu rānei. Ka puta pea tēnei āhuatanga i ētahi wā i te wā e hapu ana.
- Te whakawhāititanga o te biliary:Ka taea e te mate pāwera, te mate pukupuku, tētahi atu āhuatanga hauora rānei te hanga kiko whara i roto i te awaawa o te au, ka aukati i te awaawa. Nā tēnei ka uaua te rere o te au.
- Mate ate: Ka ngoikore te mahi a te ate nā te kino o te ate i roto i te wā. Ka hua ake tēnei i te kore e taea te whakaputa tika i te au.
Haunga ēnei, ka pāngia hoki te pūnaha biliary e ngā mate pukupuku (te mate pukupuku o te awa ate, te mate pukupuku o te pūkahukahu, te mate pukupuku o te repeure) me ētahi atu āhuatanga hauora.
Me pēhea koe e mōhio ai mēnā kei a koe tēnei raruraru? He aha ngā tohu?
Mena he raruraru kei roto i tō pūnaha au, ka tukuna e tō tinana ngā tohu maha ki a koe mō taua raruraru. Mena kei a koe tētahi, neke atu rānei o ēnei, he mea tino nui kia toro atu koe ki tētahi tākuta mō ētahi tohutohu.
| Tohu | He whakamārama ngāwari noa iho |
|---|---|
| Te kiriuhi | Ka huri te mā o ngā kanohi me te kiri hei kōwhai. Nā te mea kāore i te tika te whakaputanga o te au, ā, ka kohia te tae kōwhai o te bilirubin i roto i te toto. |
| Mamae o te puku o runga | Te mamae i te taha matau o te puku, i raro i ngā rara. Tērā pea nā te ate, te pūkahukahu, ngā awa wai rānei tēnei mamae. |
| Mamae nui o te puku (Biliary colic) | Ehara tēnei i te mamae puku noa. He mamae ohorere, kāore e taea te whakamanawanui, ka puta ohorere mai ina piri te kōhatu au ki roto i te au. Tērā pea ka haere tahi me te whakapairuaki me te ruaki. |
| He tūtae hinuhinu, he mā (Steatorrhea) | Ina kore te au e tae tika ki te whekau iti, kāore ngā ngako o te kai e nakunakuhia. Ka taea e tēnei te whakamā, te hinuhinu, me te mānu i roto i te wai. |
Ētahi atu tohu
- He mimi pouri (pērā i te wai tī)
- Te rakuraku i te kiri
- Tino ngenge.
- Te ngaronga taumaha mō te kore take
- Kirika
Ki te pā mai tētahi o ēnei tohu ki a koe, kaua e warewaretia. Tirohia tō tākuta tonu.
Me pēhea te tautuhi a ngā tākuta i ēnei āhuatanga?
Ina haere koe ki te tākuta, ka pātai ia mō ō tohumate, ā, ka tirotirohia koe. Kātahi ka tonoa pea e ia ētahi whakamātautau hei whakaū i te mate.
- Ngā whakamātautau toto: Ka taea e ēnei te tirotiro i ngā taumata o ngā whākōkī i roto i te ate me te repeure hei whakatau mēnā he kino kei aua whekau.
- Ngā whakamātautau whakaahua:
- Matawai Ultrasound: Ka taea e tēnei te kite ngāwari i ngā mea pēnei i te kohatu o te pūkahukahu me te pupuhi.
- Matawai CT: Ka taea e tēnei te whakarato i tētahi pikitia mārama ake o roto o te tinana.
- Ngā whakamātautau motuhake:
- MRCP (Aukumete Resonance Cholangiopancreatography): He momo matawai MRI tēnei. Ka whakamahia hei tiki whakaahua taipitopito o ngā awaawa au me ngā awaawa repeure.
- ERCP (Endoscopic Retrograde Cholangiopancreatography): He whakamātautau, he maimoatanga hoki tēnei. Ka whakaurua he endoscope (he ngongo me te kāmera e piri ana) mā te waha, ka werohia he tae ki roto i ngā awaawa au, ā, ka tangohia he hihi-X. Mena ka mau tetahi mea pēnei i te kōhatu i tēnei wā, ka taea hoki te tango.
He aha tāu e mahi nei hei maimoatanga?
Ka whakawhirinaki te maimoatanga ki tō āhua hauora.
- Te rerenga wai o te ate: Mena ka āraia te awaawa o te ate, i ētahi wā ka whakauruhia he ngongo iti mā roto i te puku hei tango i te wai nui kua kohia.
- Maimoatanga endoscopic: I te wā o te ERCP, ka whakauruhia pea he ngongo iti (stent) hei tango i te aukati, hei tango tauira kiko (biopsy), hei pupuri rānei i te awaawa kia tuwhera.
- Pokanga: Mena he kohatu tōu i roto i te pūkahukahu, ko te maimoatanga tino noa ko te tango pokanga i te pūkahukahu.
Nō reira, ehara tō pūnaha au i te pūnaha e neke haere ana i te au. He pūnaha nui e āwhina ana i a koe ki te nakunaku i te kai, te mimiti i ngā matūkai, tae atu ki te horoi i ō toto.
Ki te kore tēnei pūnaha e mahi tika ana, ka pā ki tō hauora whānui, nō reira he mea tino nui kia tiakina.
Karere Tangohia ki te Kāinga
- He whatunga nui te rākau biliary o ngā whekau e āwhina ana i te tinana ki te nakunaku kai me te whakakore i ngā para.
- Mena kei te kōwhai tō kiri, tō kanohi rānei (jaundice), kei te mamae nui koe i te taha matau o runga o tō puku, kua rerekē rānei te tae o ō tūtae, he tohu pea tēnei kei te raru te pūnaha au.
- Kaua e warewarehia ēnei tohu. He tohu pea ēnei mō tētahi mate hauora nui, nō reira me toro atu ki tō tākuta i te wā e taea ai mō ētahi tohutohu hauora.
- Ka taea hoki e koe te pupuri i te hauora o tō pūnaha au mā te pupuri i tētahi kai hauora me te whakahaere i tō taumaha tinana.
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