He mamae anō hoki tō taha matau o runga o tō puku? Tērā pea ko te Mirizzi Syndrome tēnei?

Kua pāngia koe e te mamae rerekē, te koretake rānei i te taha matau o runga o tō puku i muri i te kai, inā koa he kai momona? I ētahi wā ka haere tahi tēnei mamae me ngā tohu pēnei i te whakapairuaki me te kōwhai o ngā kanohi, me te kirika hoki. I te nuinga o te wā, ka pā ēnei mea ki ngā raruraru e puta mai ana i ngā kōhatu pūkahukahu. Heoi anō, he mate tino onge, he āhua uaua hoki, e kiia nei ko te Mirizzi Syndrome. I tēnei rā, ka kōrerohia tēnei mea me te taipitopito me te ngāwari.

He aha te Mate Mirizzi? Kia mārama tātou ki tēnei mea.

Āe, tuatahi, me titiro tātou ki ngā kōhatu pūkahukahu. He pēke iti tō pūkahukahu e kohi ana, e penapena ana i te au, e hangaia ana e te ate. Mā tēnei au ka āwhina i a tātou ki te nakunaku i ngā kai e kainga ana e tātou, inā koa ngā ngako. I ētahi wā ka whakapakeketia ngā mea o roto o tēnei au hei hanga i ngā hanganga iti, rite ki te kirikiri, e kiia nei ko ngā kōhatu pūkahukahu. Kāore he tohu o te nuinga o te tangata ina pāngia rātou e ēnei kōhatu. Engari i ētahi wā ka piri ēnei kōhatu ki roto i ngā awa au, arā, ngā ngongo iti e kawe ana i te au.

Nā, ko te Mate Mirizzi he raruraru i puta mai i ngā kōhatu pūkahukahu, engari he rerekē te āhua. Ko te mea e tupu ana i konei ko te nui rawa o te kōhatu i roto i te pūkahukahu, i roto rānei i tētahi atu awaawa pūkahukahu, ka pēhi i tētahi atu awaawa pūkahukahu nui e tata ana. Whakaarohia, ina tata ngā paipa wai e rua ki tētahi, ka mau tetahi mea i roto i tētahi paipa ka pupuhi i roto i taua paipa, ka pēhi i te taha o waho o tētahi atu paipa. Koinā anō hoki te mea e tupu ana i konei. Ka ārai tēnei i te rere o te pūkahukahu.

He momo mate Mirizzi anō kei reira?

Ae, ka whakarōpūhia e ngā tākuta te Mate Mirizzi i runga i te āhua o te mate me te nui o te kino o ngā awaawa o te kōpū. He māmā noa iho, i ētahi wā, he whaiti noa iho te awaawa o te kōpū mai i waho. I ētahi atu wā uaua ake, tera pea he hononga rerekē i waenga i te pūkahukahu me te awaawa o te kōpū kua whaiti, e kiia nei ko te fistula. He mea tino nui tēnei whakarōpūtanga mā ngā taote pokanga hei whakamahere maimoatanga. Mēnā kei te hiahia koe ki te mōhio atu mō tēnei, ka taea e koe te kōrero ki tō tākuta.

He pēhea te noa o tēnei āhuatanga?

He tino onge te mate Mirizzi Syndrome. He tino onge, ā, iti iho i te 2.5% o te hunga e tangohia ana te cholecystectomy ka kitea. He maha ngā wā ka pohehe ki ētahi atu mate noa, nō reira ka taea anake e ngā tākuta te whakaū i tēnei mate i te wā pokanga.

He aha ngā tohu o te mate Mirizzi?

Ka taea te wehewehe i ngā tohu o tēnei mate ki ngā wāhanga matua e toru:

1. Mumura: Tērā pea ka pāngia koe e te mamae me te pupuhi i te taha matau o runga o tō puku. Tērā pea ka mau tonu tēnei mamae, ka haere mai, ka haere atu rānei.

2. Mate pāwera: He maha ngā wā ka pā mai te kirika . Ko ētahi o ngā tohu ko te whakapairuaki, te ruaki, me te mate korere pea.

3. Te mate kiri māwhero: Ko te tohu matua o tēnei ko te kōwhai o tō kiri, te kōwhai o te mā o ō kanohi. Tērā pea he mimi kōwhai/parauri pouri tōu, me ngā tūtae mārama (he paru).

He mea nui: Kāore ēnei tohu e pā ana ki te Mate Mirizzi. Heoi, ki te pāngia koe e ēnei tohu, tera pea he hapa kei roto i tō pūnaha biliary. Nō reira, he pai ake te rapu tohutohu hauora tonu. Kāore e pāngia te katoa e ēnei tohu katoa i te wā kotahi.

He aha te take e puta ai te mate Mirizzi? He aha te take?

I te whakarapopototanga, ko te mate Mirizzi Syndrome te take o te pēhitanga o te kōhatu i te taha waho o te awa au. Me whakamārama ake tēnei.

Whakaarohia tō pūkahukahu he pea. He wāhanga momona kei roto i te pea, he kikokore ake i te tihi, he pupuhi ake i te kaki, ā, kei reira anō te kākano. Nō reira, he putea kei roto i te pūkahukahu, he kaki (e kiia nei e ngā tākuta ko te infundibulum, ko te putea Hartmann rānei), me te awa cystic e kawe ana i te au mai i te pūkahukahu.

Ko te pūhā, te kaki, me te awaawa cystic ngā wāhi whaiti rawa atu e tino tūpono ai te piri o te kōhatu pūhā. Waihoki, he tino tata ēnei hanganga tetahi ki tetahi. Mō ētahi tāngata, he tata ake i ētahi atu. Nō reira, ina piri te kōhatu pūhā ki tēnei wāhi, ā, ka tipu, ka pupuhi, ka pēhi i te awaawa pūhā matua e tata ana (te awaawa pūhā noa - koinei te mea e kawe ana i te pūhā mai i te ate me te pūhā ki te whekau iti) te awaawa ate noa rānei (koinei te mea e kawe ana i te pūhā mai i te ate) mai i waho. Koinā te wā ka puta ai te Mate Mirizzi.

He aha atu ngā raruraru ka pā mai i te Mirizzi Syndrome?

Ki te kore tēnei āhuatanga e rongoatia tika, ka ara ake pea ētahi atu raruraru. Ko ētahi tauira ko:

• Kore-ā-pūngoi: Nā te mea kāore e taea e te au te rere tika, ka hoki whakamuri ki roto i te ate, ka mumura te ate.
• Te mate kōrokoro: Ka horapa te mate huakita ki te ate, ka pā he mate kino. He mea morearea tēnei.
• Puku wai: Nā te mumura tonu me te kohikohinga o te au, ka ngoikore ngā pakitara o te awa au, ka hanga he whakatuwheratanga, he kōhao rānei.
• Te mate kiriuhi: Nā te kohikohinga o te au o te ate, ka kohikohi te tae bilirubin i roto i te toto, ka huri te kiri me ngā kanohi hei kōwhai.
• Te ngoikore o te mimiti: Ina kore e taea e te au te uru tika ki roto i te whekau iti, ka ngoikore te nakunaku, inā koa ko ngā pūmua me ētahi matūkai.

Me pēhea te tautuhi a ngā tākuta i te mate Mirizzi?

Ka whakahaerehia e ngā tākuta ētahi whakamātautau hei tātaritanga i ngā kōhatu o te pūkahukahu me ngā raruraru e pā ana. Tuatahi, ka whakahaerehia e rātou he whakamātautau tinana hei tirotiro i tō puku, hei tirotiro hoki mēnā he pupuhi. Kātahi ka pātai atu rātou mō ō tohu me tō hītori hauora.

Mena kei a koe ngā tohu o te mate pāwera, te jaundice rānei, ka taea e tō tākuta te tono i ngā whakamātautau toto penei:

• Te tatau toto katoa (CBC)
• Ngā whakamātautau mahi ate

Hei tāpiritanga, ka taea te whakahaere i ētahi whakamātautau whakaahua. Ko ētahi o ēnei ko:

• Te tirotiro i te puku
• Matawai CT (matawai tomography rorohiko)
• ERCP (Endoscopic Retrograde Cholangiopancreatography): I tēnei tikanga, ka whakauruhia he endoscope (he ngongo me te kāmera) mā te waha hei tirotiro i ngā awaawa au.
• Matawai HIDA: He matawai motuhake tēnei e tirotiro ana i te mahi a te pūkahukahu.
• Whakamātautau MRI (whakaahua aukume)

Mā ēnei whakamātautau ka taea te whakatau i te āhua o ngā awaawa au, te wāhi kei reira ngā kōhatu, me te mōhio kei te kitea te Mate Mirizzi.

Me pēhea te rongoā mō tēnei?

Ko te pokanga te maimoatanga matua mō te Mate Mirizzi. Heoi, kāore he pokanga kotahi e pai ana mō te katoa. Ka whakaritea te pokanga kia rite ki tō āhua.

I te nuinga o te wā, ka tangohia te pūkahukahu (cholecystectomy) ā, ka whakatikahia te awaawa pūkahukahu kua āraia. I ētahi wā uaua, ka tangohia pea te awaawa pūkahukahu kua āraia, ka whakauruhia rānei he ngongo iti e kiia nei ko te stent hei pupuri i te awaawa kia tuwhera tonu. Ka taea e te taote pokanga te mahi i tēnei pokanga me te iti noa te urunga, arā, he laparoscopically (he tikanga e whakamahi ana i te kāmera me te hanga tapahi iti), he tikanga tuwhera rānei (laparotomy). Ka whakawhirinaki tēnei ki te kaha o tō mate.

He pānga taha kei te rongoā?

He uaua pea te pokanga mō te Mirizzi Syndrome i ētahi wā. Nā te mea he uaua ki te kite mārama i ngā kiko e karapoti ana i te mumura. Nō reira, ki te pakaru ngā awaawa o te ate i te wā o te pokanga, ka puta ngā raruraru pēnei i:

• Te turuturu o te au
• Te toto nui rawa
• Te whara o ō awaawa waikura

Waihoki, tera etahi mea e kitea ana i roto i tetahi pokanga:

• Mamae
• Te toto
• Ngā mate urutā
• Ngā tauhohenga ki te rongoā whakamoe

Mā tō tākuta tēnei e whakamārama ki a koe i mua i te pokanga.

Kāore he huarahi hei ārai i te whanaketanga o tēnei mate Mirizzi?

He uaua ki te ārai katoa i te Mate Mirizzi. Heoi, ka taea e koe te whakaiti i tō tupono ki tētahi taumata mā te whakaiti i ngā āhuatanga tupono e whai wāhi ana ki te hanganga o ngā kōhatu pūkahukahu. Hei tauira, he mea pai kia whakawhāitihia ngā kai me ngā inu he nui te cholesterol. Pātai atu ki tō tākuta mēnā he mea motuhake ka taea e koe te mahi hei ārai i te aukati i te awaawa pūkahukahu.

He aha ngā mea ka tupu i muri i te whakaoranga? He aha te tirohanga?

He pai te āhua o te oranga mō te hunga e ora ake ana i te Mirizzi Syndrome i muri i te pokanga. Ko te mea nui kia tere te rongoā i mua i te puta o ngā pānga mō te wā roa.

Ka nui ake te kino o ō whekau me ō awaawa au, ka uaua ake te pokanga. Ka roa ake pea te wā whakaora i te mea ka uaua ake te pokanga. Engari, i te nuinga o te wā, ka taea e te nuinga o te tangata te ora pai me te kore he au.

Āhea ahau me toro atu ki te tākuta? He aha ngā tohu e tika ana kia pā mai ki ahau?

Ki te pāngia koe e te mamae nui o te puku, me te makariri me te wiri, te whakapairuaki, te kirika, ngā tohu rānei o te jaundice (pēnei i te mimi pouri me ngā tūtae mā), me toro atu ki te tākuta tonu .

Waihoki, ki te puta mai ngā tohu o tētahi mate kino e kiia nei ko te sepsis (pērā i te tere o te ngakau, te werawera, me te uaua ki te manawa) i muri i te pokanga, he āhuatanga ohorere tēnei e morearea ana ki te ora. Nō reira, ki te puta mai tētahi o ēnei tohu, rapua tonutia he awhina hauora.

He hononga kei waenganui i te Matepukupuku Mirizzi me te matepukupuku?

Kua kitea e ngā rangahau he paku piki ake te tūponotanga o te hunga whai Matepukupuku Mirizzi ki te pāngia e te matepukupuku pūkahukahu. Heoi, ehara tēnei i te kī ko te Matepukupuku Mirizzi tonu te take o te matepukupuku.

E whakapono ana ngā tohunga ko ngā āhuatanga e puta ai te mate Mirizzi (arā, te mumura mau tonu, te pupuri i te au i roto i te pūkahukahu) ka whai wāhi atu ki te whanaketanga o te mate pukupuku. E ai ki ngā tatauranga, i waenga i te 5% me te 28% o te hunga e pāngia ana e te mate Mirizzi kua kitea he mate pukupuku pūkahukahu.

Ka taea te whakamate i tēnei āhuatanga?

Ka taea te rongoā i te mate Mirizzi.āhuatanga. Heoi, ki te tōmuri koe ki te tīmata i te maimoatanga, ka nui ake te mōrearea. Ko te reiti mate e pā ana ki tēnei āhuatanga e kīia ana kei waenga i te 5% me te 30%. Ka puta pea i ngā mea pēnei i te sepsis, te ngoikore o te ate, te mate pukupuku pūkahukahu rānei.

Tērā pea ka mamae tō puku i ētahi wā i muri i te kai. Engari ki te ara ake koe i te ata me te mamae puku tonu, te kirika, te whakapairuaki rānei, he tohu pea tēnei mō tētahi raruraru nui ake. Kāore pea koe e mōhio he kohatu tōu. Heoi, ina tupu nui ana hei aukati i te awaawa au, ka kaha ake ngā tohu, ka maha ake hoki. Ki te mea kei te whakaaro koe kei te hē tetahi mea, kaua e tatari. Ko te tere o tō rapu awhina hauora, ko te pai ake.

Hei whakamutunga, ko ngā mea tino nui hei maumahara

Nō reira, ko tāku tumanako kua mārama ake koe ki te mate onge e kiia nei ko te Mirizzi Syndrome i kōrerohia e tātou i tēnei rā. Kia maumahara:

• Mena kei a koe ngā tohu pēnei i te mamae tonu i te taha matau o runga o tō puku, te kirika, te kōwhai rānei, kaua e warewaretia .
• Rapua tonutia he tohutohu hauora . Mā te tere o te kitenga me te rongoā i te mate, ka iti ake ngā raruraru ka pā mai, ā, ka tere ake tō ora.
• Ki te mōhio koe he kohatu tōu, me whai i ngā tohutohu a tō tākuta.
• Mā te pupuri i tētahi kai hauora ka āwhina i te whakaiti i te mōrearea o te whakawhanake i ngā kohatu pūkahukahu.

Mena he pātai anō āu, kaua e mangere ki te kōrero ki tō tākuta whānau, ki tētahi tohunga rānei. Kia ora tonu koe!

Te Mate Mirizzi , ngā kohatu o te pūhā, te awa o te waikura, te jaundice, te mamae o te puku, te pokanga, te tango i te cholecyst