Kei te piri anō hoki ō kōhatu i roto i te awa au? (Choldocholithiasis) Me ako tātou mō tēnei!

I ētahi wā ka pāngia koe e te mamae nui i te taha matau o runga o tō puku i muri i te kai? Ka whakapairuaki koe, ka hiahia rānei koe ki te ruaki? I ētahi wā ka pāngia koe e te kōwhai o ō kanohi me tō kiri? Ehara ēnei i te tohu pai hei wareware noa. Tērā pea he tohu ēnei kei te mau te kōhatu i roto i tō 'Common Bile Duct' . I tēnei rā, ka kōrero tātou mō tēnei mate e kiia nei ko te 'Choledocholithiasis'.

He aha tēnei (choledocholithiasis)?

Ko te Choledocholithiasis he mate e mau ana tētahi, neke atu rānei ngā kōhatu ki roto i tō awa au . Ko "Choldocho" te ingoa Latina mō te awa au. Ko te tikanga o "Lithiasis" he kōhatu. He kōhatu mārō, he rite ki te kirikiri te kōhatu o te au. Ka taea e ēnei kōhatu te hanga i ngā wāhi katoa o tō tātou tinana e rere ana te au.

Tērā pea kei te whakaaro koe he aha tēnei au, ā, he aha hoki ngā awa au. He tino māmā noa iho. Mā tō tātou ate tēnei au e whakaputa. Mā tēnei au e āwhina tātou ki te nakunaku i ngā kai e kainga ana e tātou, inā koa ngā ngako. Ka kohia tēnei au ki roto i te pūkahukahu. Mai i reira, ka haere mā roto i tētahi ngongo iti ki te awa au noa, ka hono atu ki te whekau iti. Nō reira, ki te puta he kōhatu i tētahi wāhi i tēnei haerenga, ko te raruraru.

Nō reira, he rerekē te (Choldocholithiasis) me te (Cholelithiasis)?

Āe, he iti noa te rerekētanga. Kua rongo pea koe i te kupu 'cholelithiasis'. Ko tōna tikanga he kōhatu kei roto i te pūkahukahu . Ka taea e ngā kōhatu te hanga i roto i te pūkahukahu tonu, i roto i ngā awaawa au, i ngā mea e rua rānei. Ahakoa he kōhatu e hanga ana i roto i te pūkahukahu ka taea te neke ki roto i te awaawa au noa i muri mai.

Ki te whakarapopototanga, ko te tikanga o te 'Cholelithiasis' he kōhatu i roto i te pūkahukahu. Ko te tikanga o te 'Choldocholithiasis' he kōhatu (kotahi, neke atu rānei) kua puta mai i te pūkahukahu, ā, kua piri ki roto i te awaawa pūkahukahu noa. Kei te mārama koe?

He aha te rerekētanga i waenga i te Choledocholithiasis me te Biliary Colic?

Mena he choledocholithiasis tōu, ko te tikanga he kōhatu kotahi kei roto i tō awaawa au. Mena he iti rawa te kōhatu, kāore pea he raruraru mōu. Tērā pea ka puta mā roto i ō whekau ka puta ki waho o tō tinana. Engari ki te nui haere te kōhatu ka aukati i te awaawa au, tera pea ka pāngia koe e te mamae puku kino, pumau, me te jaundice.

Ko te kōroke biliary he āhuatanga e puta ana ina piri te kōhatu ki roto i te pūnaha biliary. He mea tino noa tēnei i roto i te hunga whai kōhatu au. Heoi, ki te piri te kōhatu i roto i te awa au noa, ā, ka ārai i te awa, ka pāngia hoki te tangata whai choledocholithiasis e te kōroke biliary. Whakaarohia he kōhatu e piri ana ki roto i te paipa wai, i ētahi wā ka rere te wai, i ētahi wā kāore.

He āhuatanga ohorere tēnei? Me tere tonu taku rongoā?

Ehara i te mea he āhuatanga ohorere tonu te whai kōhatu, ngā kōhatu rānei i roto i te awaawa o te ate. Heoi, he tūponotanga kei reira. E ai ki te kōrero i mua ake nei, ka taea e ngā kōhatu iti te puta atu i te tinana. Heoi, ko te tūponotanga ka piri ngā kōhatu ki reira, ka nui haere i roto i te wā, ā, ka ārai katoa i te awaawa.

Nā tēnei mōrearea, ka rongoāhia e ngā tākuta ngā kōhatu o te awaawa o te ate i te wā tonu ka kitea. E taunaki ana rātou kia whakamahia he endoscopy hei tirotiro me te tango i ngā kōhatu. Ko te tikanga o tēnei, ka whakamahia e te tākuta puku he ngongo iti (catheter) ka whakaurua ki roto i tō korokoro hei tae atu ki ngā awaawa o te ate me te tango i ngā kōhatu. Kaua e manukanuka, ka mahia tēnei i raro i te rongoā whakamoe, nō reira kāore koe e tino mamae.

Ka aha mēnā ka kino rawa atu tēnei āhuatanga (choledocholithiasis)?

Ki te mau te kōhatu ki roto i te awaawa aukume noa, ā, ka aukati i te rere o te aukume, ka pā ki te pūnaha aukume katoa. Arā, ko ngā okana me ngā awaawa katoa e rere ai te aukume. Ka taea e tēnei te whakararu i te mumura, i ngā mate , tae atu ki ngā raruraru e morearea ana ki te ora.

Ko te mea nui ko te rapu tohutohu hauora tonu mēnā ka puta mai ēnei tohu, me te kore e warewarehia.

He pēhea te noa o tēnei āhuatanga?

I te toharite, tata ki te 10 i roto i te 100 tāngata he kōhatu pūkahukahu. Heoi, ko te nuinga o aua kōhatu ka puta i roto i te pūkahukahu. Tata ki te 15% o te hunga he kōhatu pūkahukahu ka puta he kōhatu i roto i te awaawa pūkahukahu noa. Ko te nuinga o te tangata kāore he raruraru ki ēnei kōhatu. Tata ki te 20% anake o te hunga he kōhatu pūkahukahu ka puta he raruraru e hiahia ana kia rongoatia.

He aha ngā tohu o te Choledocholithiasis?

Kāore pea he tohu e pā mai ana ki a koe. Mēnā kāore tō pūkahukahu i āraihia e ngā kōhatu pūkahukahu, kāore pea koe e mōhio kei a koe aua tohu. Heoi, ki te mea kei te pā mai ngā tohu, ko te tikanga kua āraihia tō awaawa pūkahukahu e te kōhatu. Ko ngā tohu tuatahi ka puta mai ina āraihia te awaawa ka kiia ko te biliary colic. Kei roto i ēnei:

• Mamae puku: Ka puta tēnei mamae i muri i te kai. Ka roa pea mai i te kotahi ki te maha hāora. Ka tino kaha te mamae mō ngā meneti 20 tuatahi, kātahi ka memeha haere. Ko te nuinga o te tangata ka rongo i te mamae i te taha matau o runga o te puku. Engari i ētahi wā ka horapa te mamae ki te taha matau, ki te pakihiwi rānei.
• Whakapairuaki me te ruaki: He mea noa te whakapairuaki me te ruaki me te mate puku biliary. Heoi, ka kite koe, kāore te mamae e memeha i muri i te ruaki, he rerekē ki ētahi migraines. Ki te kore e tino kino te mate puku biliary, tera pea ka ngaro noa te hiahia kai.
• Te kiriuhi waikura:Ina kore e rere tika te au o te ate, ā, ka hoki anō ki roto i te toto, ka kōwhai pea tō kiri me te mā o ō kanohi. Ka pōuri hoki tō mimi. Ka puta, ka memeha te waikura, pērā i te kōroke o te ate. Engari ka puta, ka memeha tae noa ki te wā e tangohia ai te aukati i roto i te awaawa.
• Te kirika: Ki te nui te mumura o te pūnaha biliary, tera pea ka pāngia koe e te kirika. He tohu mate pea te kirika. Ina aukatia ngā awa biliary, kāore e taea e ngā huakita te wehe tika i te tinana, ka māmā ake te whanaketanga o ngā mate.

He aha atu ngā raruraru ka pā mai i tēnei?

Ka hoki anō te waikura ki te waikura nā te kōhatu e ārai ana i te awaawa o te ate. Ka pā pea tēnei ki ētahi atu awaawa e hono ana ki reira, tae atu ki ngā whekau pērā i te pūkahukahu, te repeure, me te ate. Ka pā pea tēnei ki te mumura, te mate, me te kino o ngā kiko mō te wā roa. Ko ngā raruraru pea ko:

• Mate urutā: He wāhi ngāwari te urunga mai o ngā mate huakita ki te awaawa wai kua purua. He tino morearea te mate urutā i roto i te pūnaha wai. Ka horapa pea ki te ate me te toto. Ki te horapa te mate urutā ki te toto (septicemia), ka arahi pea ki tētahi mate kino, mōrearea ki te ora (sepsis).
• Te mate kōroke: Ko te tino take o te mumura me te mate o te awaawa kōroke noa ko te 'Kōrokekōroke'. Ka pupuhi te awaawa kōroke nā te kohikohinga whakamuri o te kōroke, ā, ka pōturi ake te rere o te kōroke. Ka horapa pea tēnei mumura me te mate mai i te awaawa kōroke noa ki ētahi atu peka, arā, ki ngā awaawa e haere ana i roto i te ate. Ka pupuhi anō hoki te ate i tēnei.
• Cholecystitis: He mumura tēnei o te pūkahukahu. Ina hoki te au ki roto i te pūkahukahu, ka pupuhi. He mamae tēnei. Ka taea hoki e ia te whakararu i te mahi a te pūkahukahu, ā, i roto i te wā, ka pakaru. Koinei te tino take o te mate pūkahukahu.
• Te Mate Pāwera o te Pūkahukahu: Ka tuwhera te awaawa au me te pūkahukahu ki roto i te whekau iti (te whekau iti). Mēnā ka āraia tēnei ara e ngā kōhatu pūkahukahu, ka mutu te neke o ngā wairewa o te pūkahukahu. He tino kaha ngā whākōkī kei roto i ēnei wairewa, ka taea te hoki anō ki roto i te pūkahukahu, ka puta te mumura nui me te kino o ngā okana. Ka kiia tēnei ko te mate pāwera. Ko ngā kōhatu pūkahukahu te tino take o te mate pāwera kore-waipiro.

He aha tēnei ka puta ai (choledocholithiasis)?

Ka hangaia te au o tō tātou ate mai i ngā matū e tātarihia ana e ia i roto i ō tātou toto. Kei roto i ēnei matū ko te cholesterol, te bilirubin, ngā tote au, me te lecithin. Ka puta ngā kōhatu pūkahukahu ina nui rawa tetahi o ēnei matū – ko te cholesterol te nuinga, ko te bilirubin i ētahi wā. Kātahi ka hanga ēnei matū taikaha pērā i te paru.

Ka kohia tēnei mea rite ki te paru ki raro i te pūkahukahu, ki roto rānei i te awaawa aukume noa, ā, ka mārō haere. I te mea ka nui ake te paru e rere ana ki runga, ka nui haere haere ēnei kōhatu. Ka roa pea tēnei mahi. Ko te nuinga o ngā kōhatu aukume ka puta i roto i te pūkahukahu. Kātahi ka heke iho i te awaawa aukume, ka mutu ki te awaawa aukume noa.

He aha ngā āhuatanga mōrearea e pā ana ki tēnei?

Tērā pea ka nui ake te tūponotanga ka pāngia koe e ngā kōhatu o te awaawa o te ate mō ēnei take e whai ake nei:

• Te mate cholangitis mau tonu: Ko te choledocholithiasis te tino take o te cholangitis. Engari ka taea hoki te puta i te taha ke. Mena kei te mumura ō awaawa aukume mō tētahi atu take, ka pōturi te rere o te aukume, ka puta ai he kōhatu i roto i ngā awaawa aukume.
• Ngā kōhatu pūkahukahu o mua: Ko te nuinga o te hunga he kōhatu pūkahukahu kāore e pāngia e ngā raruraru. Heoi, ko te hunga kua pāngia e ngā kōhatu pūkahukahu o mua ka nui ake te tūponotanga ka pāngia anō e ēnei raruraru. Ahakoa ka tangohia tō pūkahukahu hei rongoā mō ngā kōhatu pūkahukahu, i ētahi wā onge, ka puta pea ngā kōhatu hou i roto i ō awaawa pūkahukahu.

Ko ētahi atu āhuatanga mōrearea e whai wāhi nui ana ki te hanganga o ngā kōhatu kapia ko:

• Ngā Taumata Cholesterol Teitei: Ko te nuinga (tata ki te 75%) o ngā kōhatu pūkahukahu ka hangaia mai i te nui rawa o te cholesterol i roto i te toto. Ko ngā wāhanga kē atu o te au (ngā tote au me te lecithin) e whakaarohia ana hei whakarewa i tēnei cholesterol. Engari ki te kore e taurite te taurite i waenga i ēnei, kāore e mahi tika.
• Ngā homoni wahine: Ka whakanuia e te Ēstrogen te cholesterol. Ka whakaitihia e te Progesterone te whakahekenga o te puku au, ka whakanuia hoki te rere o te au. Ka piki ake ēnei homoni e rua i ētahi wā i ngā tau whānau tamariki o ngā wāhine. Ka taea hoki e te rongoā whakakapinga homoni te whakanui ake i ngā taumata cholesterol.

Me pēhea te tautuhi i tēnei mate (choledocholithiasis)?

Ka kitea ngā kōhatu o te awa wai i muri i te puta o ngā tohu. Ki te rapu awhina hauora koe mō ngā tohu pēnei i te kōroke o te awa wai, te jaundice rānei, ka whakahaerehia e tō tākuta he whakamātautau toto me ngā whakamātautau whakaahua . Ka taea e ngā whakamātautau toto te whakaatu i te nui o te awa wai kua kohia. Ka taea e ngā whakamātautau whakaahua te āwhina ki te whakatau kei hea te aukati.

He aha ngā whakamātautau e mahia ana mō tēnei?

Ngā whakamātautau toto:

• Te tatau toto katoa (CBC)
• Whakamātautau bilirubin
• Ngā whakamātautau mahi a te repeure
• Ngā whakamātautau mahi ate

Hei whakamātautau whakaahua:

• Te tirotiro i te puku mā te whakamahi i te ultrasound:He whakamātautau māmā noa iho tēnei, kāore he mamae. Ka taea e ia te hoatu he whakaaro tuatahi mō tō āhua. Ka taea e ia te whakaatu mēnā he kōhatu kei roto i tō pūhā. Ahakoa kāore e tino kitea te awaawa pūhā noa, ka taea e ia te whakaatu mēnā kua whānui te awaawa. He tohu tēnei kei reira he aukati. Tērā pea ka rite te aukati ki te atarangi.
• Te whakamātautau oro-ā-roto endoscopic: Ka whakakotahi tēnei whakamātautau i te hangarau oro-ā-roto me te endoscopy o runga hei whakaputa whakaahua mārama o ngā awaawa o te ate. Ko te whakauru i tētahi ngongo iti kei roto i te kāmera (endoscope) ki raro i tō korokoro, ki roto hoki i tō puku me tō whekau iti o runga. Ka whakamahia e te taputapu oro-ā-roto kei te pito o te endoscope ngā ngaru oro hei hanga whakaahua o te pūnaha oro-ā-roto.
• MRCP (Aunekehanga Aukume Cholangiopancreatography): He momo MRI (Aunekehanga Aukume Whakaahua). Ka tangohia motuhaketia ngā pikitia o ngā awaawa o te kōpū. Kāore e kino ki te tinana. Ka taea te tango pikitia tino mārama o te pūnaha kōpū katoa, tae atu ki te awaawa o te kōpū noa. Tērā pea ka mahi tuatahi te tākuta i tēnei whakamātautau mēnā kei te whakapae ia he kōhatu kei roto i te awaawa o te kōpū noa. Heoi, mēnā he nui te tūponotanga kei reira he kōhatu, tērā pea ka haere tika ia ki te ERCP.
• ERCP (Endoscopic Retrograde Cholangiopancreatography): He ahua kaha ake te mahi a tēnei whakamātautau i ērā atu. Engari he tino whai hua mō te kimi i ngā kōhatu pūkahukahu. Ka taea hoki te tango i ngā kōhatu. Ka whakamahia ngā hihi-X me te endoscopy. Kia eke te endoscope ki roto i te whekau iti, ka whakauruhia e te tohunga hangarau tētahi atu ngongo iti mā roto, ka ārahi ki roto i ngā awaawa au. Kātahi ka werohia he wai motuhake (tae) mā roto i te ngongo, ā, ka tangohia ngā hihi-X ataata (fluoroscopy) i te wā e haere ana te tae mā roto i ngā awaawa. Mena ka kitea ngā kōhatu, ka taea te rongoā.

Me pēhea te tango a ngā tākuta i ngā kōhatu i roto i te awaawa kōpū noa?

He maha ngā wā ka tangohia ēnei kōhatu i te wā o te tikanga ERCP. Ka taea e ngā tākuta te whakamahi i ngā taputapu motuhake kua piri ki te pito o te endoscope hei wawahi me te tango i ngā kōhatu ina kitea. I ētahi wā, ka mahia he tapahi iti ki te uaua o te awaawa (sphincterotomy) hei whakawhānui i te awaawa me te tuku i te kōhatu kia puta.

He mea tika te pokanga mō te Choledocholithiasis?

Kāore e hiahiatia he tapahi i te puku mō te endoscopic retrograde cholangiopancreatography (ERCP) hei uru atu ki ngā awaawa o te kōpū. Heoi, i muri i te tango i ngā kōhatu mai i ngā awaawa o te kōpū, he maha ngā tākuta e taunaki ana kia pokangahia te tango i te pūkahukahu . Ko te take o tēnei, kia kore ai e puta anō ngā kōhatu mai i te pūkahukahu, ā, kia puta ai te choledocholithiasis.

Me hiahia atu ahau ki ētahi atu maimoatanga?

I runga i tō āhua, me hiahia pea koe ki ētahi atu maimoatanga i mua i te tango i ō kōhatu pūkahukahu. Hei tauira:

• Mena he mate pāwera , ka tohua he rongoā paturopi .
• Ngā tikanga tātari waipara hei tango i te waipara kua kohia.

He aha ngā raruraru ka puta i muri i te maimoatanga?

Ko ngā raruraru e whai ake nei ka puta pea i roto i te wā poto i muri i te tango i te kohatu endoscopic:

• Te toto
• Mate pāwera
• Te mate pāwera

I muri i te maimoatanga roa, ka puta pea ēnei āhuatanga:

• Te hokinga mai o ngā kōhatu o te pūkahukahu: Ahakoa ka tangohia ngā kōhatu katoa i roto i ngā awaawa pūkahukahu, ka puta pea he kōhatu hou i muri mai. Ko te hunga kua pāngia e ngā kōhatu i mua, ka nui ake te tūponotanga ka puta anō ēnei kōhatu.
• Te mate pukupuku o te awaawa o te wai au: Ka puta he kiko whara ina tapahia te awaawa o te wai au. I ētahi wā ka whaiti te awaawa o tēnei kiko whara (te aukati o te awaawa o te wai au). Ka puta he momo aukati rerekē i roto i te awaawa o te wai au noa. Tērā pea me rongoā motuhake.

Ka taea te aukati i te whanaketanga o te choledocholithiasis?

Ko te nuinga o ngā kōhatu pūkahukahu e puta mai ana i te cholesterol, ā, ka taea e koe te whakaheke i ngā taumata cholesterol o tō toto mā te huri i tō kai me tō momo noho. Ka āwhina tēnei ki te whakaiti i tō mōrearea. E kī ana ngā tākuta kia karohia te kai "yo-yo", arā, te whakaiti i te taumaha i te wā kotahi, kātahi ka hoki mai anō. Ki te ngaro tō taumaha, me mahi mārire . Mā te whakaiti i te taumaha nui i te wā kotahi ka nui ake te mōrearea ki te whakawhanake i ngā kōhatu pūkahukahu.

Kei te pēhea te āhua i muri i te maimoatanga?

Mō te nuinga o te tangata, he māmā noa iho te maimoatanga, ā, he angitu hoki. Mēnā ka puta he raruraru i muri i te maimoatanga, ka taea te rongoā i aua raruraru. I roto i te wā 10 ki te 20 tau, i waenga i te 5 ki te 25 tāngata i roto i te 100 ka puta he kōhatu hou i roto i ngā awaawa o te au. Ka iti ake tēnei mōrearea mēnā kua tangohia te au o te au.

He tino mamae, he tino whakamataku hoki te whakaekenga o te kōhatu i roto i te pūkahukahu, inā koa mēnā kāore koe i mōhio he kōhatu tōu i mua. Mā te wawe o te maimoatanga ka tere ake tō pai ake. Ahakoa ka puta, ka ngaro te kōhatu o te pūkahukahu, ā, kāore i te tino kino, kaua rawa e warewarehia. Ka kino haere tonu kia tangohia rā anō te aukati i roto i te awa kōhatu.

Ngā mea tino nui hei maumahara (Karere hei kawe ki te kāinga)

Āe, ko tāku tumanako kua mārama ake koe ki te 'choledocholithiasis' i kōrerohia e tātou i tēnei rā.

Ko te mea nui, ki te pā mai ngā tohu pēnei i te mamae nui i te taha matau o runga o tō puku, te whakapairuaki, te ruaki, me te kōwhai o ngā kanohi, kaua e wareware noa, engari me toro atu ki te tākuta tonu.

He pai ngā maimoatanga mō tēnei mate. Mēnā ka kitea wawe, ka taea te whakaora i mua i te puta mai o ngā raruraru nui. Kaua e mataku, whai i ngā tohutohu a tō tākuta. Kia tiakina hoki tō kai me tō momo noho. Kātahi ka taea e koe te noho haumaru mai i ēnei raruraru.

` Ngā kōhatu o te puku, te awaawa o te ate noa, te choledocholithiasis, te jaundice, te mamae o te puku, te endoscopy, te ERCP