Kei te mamae tonu tō puku i muri i te tango i te pūhā? Tērā pea nā te ngoikore o te mahi a te uaua puku o Oddi!

Tērā pea kua roa koe e mamae ana i te mamae o te puku nā te mea kua tangohia te pūhā. I tō pokanga tango i tō pūhā, i whakaaro pea koe kua kore rawa tēnei mamae. Engari, me pēhea mēnā kei te mau tonu te mamae nui o te puku i muri i te pokanga? He tino hoha. He maha ngā tāngata e pāngia ana e tēnei momo wheako. Nō reira, i tēnei rā ka kōrero tātou mō tētahi āhuatanga ka puta ai tēnei mamae puku rerekē ahakoa kua tangohia te pūhā. Koia te Sphincter of Oddi Dysfunction .

He aha te ngoikore o te uaua o te uaua o te uaua o Oddi?

Hei mārama ki tēnei, me titiro tuatahi tātou ki te tukanga o tā tātou nakunaku. He tino māmā noa iho. Ina kai tātou i te kai, ka whakaputahia e ō tātou tinana ētahi wai motuhake e rua hei āwhina i te nakunaku.

1. Au: Ka hangaia tēnei e te ate. Ka rongoatia ki roto i te pūkahukahu. Ka āwhina i te nakunaku o ngā ngako.

2. Wai repeure: Ka hangaia tēnei e te repeure. Ka āwhina ngā whākōkī i roto i te nakunaku i ngā pūmua me ngā warowaihā i roto i te kai.

Ka haere ēnei wai e rua ki tō tātou whekau iti, ka honoa ki te kai hei whakaoti i te tukanga nakunaku.

Anei te mea nui. I te wāhi e tomo ai ēnei wai e rua ki te whekau iti, kei reira tētahi wahi mīti iti e rite ana ki te kēti . He rite ki te takirere. Koinei te mea e kiia nei e mātou ko te Sphincter o Oddi . I te nuinga o te wā, ina hiahia koe ki te nakunaku i te kai, ka tuwhera tēnei kēti, ka tomo ngā wai ki roto, kātahi ka kati anō.

Ko te ngoikore o te uaua o te uaua o Oddi ko te wā kāore tēnei kuaha e mahi tika. Arā, kāore tēnei wahi mīti e tuwhera i te wā e tika ana, ā, ka piri. Kātahi ka kore e taea e te au o te ate me te wai o te repeure te haere ki te whekau iti, ā, ka piri. He rite ki te waka e tūpono ana. Ina piri te wai pēnei, ka piki ake te pēhanga i ngā rori e puta mai ana aua wai, ka puta he mamae nui ki te puku.

He maha ngā wā ka kitea tēnei āhuatanga i roto i te hunga kua tangohia te pūhā i te pokanga. Nō reira, i ētahi wā ka kiia ko te post-cholecystectomy syndrome .

He aha ngā momo matua o tēnei āhuatanga?

E rua ngā āhuatanga matua e pāngia ai koe e te ngoikore o te uaua uaua o Oddi.

• Te Tākirikiri o te Puku Au: He āhuatanga tēnei e āraia ai ngā awa au. Ko te raru kei te ara e rere ai te au.
• Pancreatitis: Koinei te wā ka aukatia te wai repeure, ka pupuhi, ka mumura hoki te repeure.

Hei tāpiritanga, ka wehea e ngā tākuta te mate kia toru ngā wāhanga (Ngā Wāhanga I, II, me III). He mea tino nui tēnei nā te mea ka whakatauhia te maimoatanga i runga i tēnei wāhanga.

He aha ngā tohu matua o tēnei mate?

Ko te tohu matua, ko te tohu tino kitea, ko te mamae nui o te puku, he rite ki te mamae e pā ana ki ngā kohatu o te pūkahukahu.

• Ka tīmata te mamae i te taha matau o runga o te puku.
• I ētahi wā ka haere hoki tēnei mamae ki te pakihiwi matau, ki te tuara rānei .
• Kāore te mamae e pumau. Ka memeha haere i muri i te 30 meneti, i te haora rānei. Kātahi ka hoki mai anō i roto i te rā, i te wiki rānei.
• I ētahi rā ka ngawari te mamae, i ētahi atu rā ka uaua te manawanui.

Haunga te mamae nui, ka puta pea ēnei tohu e whai ake nei:

• Whakapairuaki me te ruaki
• Te kirika me te makariri
• Korere

Ko wai kei te nui ake te mōrearea mō tēnei mate?

Kāore anō kia kitea te tino pūtake o tēnei āhuatanga, engari kei ētahi āhuatanga ka piki ake te mōrearea o tēnei mate.

Me pēhea te tautuhi i te mate?

Ki te whakapae tō tākuta i tēnei i muri i te rongonga mō ō tohu, ko te mea tuatahi ka mahia e ia ko te whakarite kia kore he take nui kē atu mō te mamae o tō puku. Nā te mea ka taea hoki e ētahi atu āhuatanga pēnei i te mate puku (ngā mate puku), ngā kohatu au, me te mate pukupuku repeure, te mate pukupuku awa wai rānei te whakaputa i ngā tohu rite. I ētahi wā, ka rite te mamae o te mate manawa (angina) ki te mamae puku.

I muri i te whakaū kāore ēnei mea e kitea ana, ka taea te whakahaere i ngā whakamātautau e whai ake nei hei tirotiro i te ngoikore o te uaua o te mahi a te uaua o te uaua o Oddi:

• Ngā whakamātautau toto:Tirohia mēnā he nui ake ngā taumata whākōkī o te ate me te repe taiaki.
• Ngā Matawai: Ka whakamahia ngā matawai pēnei i te ultrasound o te puku, te matawai CT, me te MRCP hei tirotiro mēnā kei te pupuhi/kua whānui te awaawa au, te awaawa repeure rānei.
• Endoscopy: Ka whakauruhia he ngongo me te kāmera mā te waha hei tirotiro i te puku me te whekau iti.

Whakamātautau ERCP

I ētahi wā, inā koa mēnā e whakapaetia ana he momo I, he momo II rānei, ka mahia he whakamātautau motuhake e kiia nei ko te ERCP (Endoscopic Retrograde Cholangiopancreatography) . I roto i tēnei, ka whakauruhia he ngongo kāmera, he rite ki te endoscope, ki roto i te sphincter o Oddi, ā, ka whakauruhia he ngongo iti hei ine i te pēhanga i roto i taua uaua (manometry). Mā tēnei ka taea te whakatau mēnā kei te tuwhera, kei te kati rānei.

Me pēhea te rongoā?

Ko ngā kōwhiringa maimoatanga e whakawhirinaki ana ki te momo (kāwai) o te ngoikore o te uaua o te uaua o te uaua o Oddi kei a koe.

• Mō te Kāwai III: He uaua ki te tautuhi i tēnei, nō reira kāore i te tūtohutia te pokanga. Ka tohua e te tākuta ngā rongoā whakamamae mamae me ngā rongoā whakamamae i te mamae hei whakahaere i te mamae.
• Mō te Kāwai I me te II: Mena he nui te mamae, ā, he uaua ki te whakahaere mā te rongoā, ka tūtohu pea tō tākuta i tētahi maimoatanga e kiia nei ko te sphincterotomy me te ERCP .

He aha tēnei Sphincterotomy?

Ko te tikanga o tēnei ko te tapahi i tētahi wahi iti o te kiko e kiia nei ko te Sphincter o Oddi mā te whakamahi i tētahi taputapu iti ka tukuna mā roto i te ngongo kāmera i te wā o te whakamātautau ERCP. Kātahi ka whakatuwheratia te pūaha piri tonu. Kātahi ka rere ngā wai nakunaku ki roto i te whekau iti, kāore he ārai. Mā tēnei ka tata kore te mamae e puta.

Engari he maimoatanga anō tēnei e mau ana i ētahi mōrearea. Tērā anō hoki te mōrearea o te mate pāwera. Nō reira, ka whakamahia tēnei maimoatanga ina kore ētahi atu maimoatanga e puta he hua angitu.