Kua pokangahia koe hei tango i tō pūkahukahu? Kei te mamae tonu koe i te taha matau o runga o tō puku i ētahi wā? He rite ki te mamae e pā mai ana i ngā kōhatu pūkahukahu? He tokomaha te hunga e whakaaro ana kua kore rawa te mamae o te puku i muri i te tangohanga o tō rātou pūkahukahu. Engari i ētahi wā ehara i te mea e whakaarohia ana e tātou te take o tēnei mamae, engari he mea kē atu. Koinei tā tātou e kōrero ai i tēnei rā.
He kupu ngāwari, he aha te Sphincter o Oddi?
Hei mārama ki tēnei, me titiro tuatahi tātou ki te tukanga nakunaku i roto i tō tātou tinana. He mea tino uaua, he mea whakamiharo hoki. He maha ngā whekau, pērā i te ate me te repeure, e mahi tahi ana ki te huri i te kai e kainga ana e tātou hei pūngao.
- Ate: Koinei te wāhi e hangaia ai te matū e kiia nei ko te au. Ka rongoatia mō te wā poto ki roto i te pūkahukahu.
- Pancreas: Ka whakaputahia e tēnei repe ngā whākōkī hei āwhina i te nakunaku kai.
Me rere ngātahi te au mai i te ate me ngā whākōkī mai i te repeure ki roto i tō tātou whekau iti. Ko te uaua iti e whakahaere ana i taua haerenga, e mahi ana pērā i te kūaha, e kiia ana ko te Sphincter o Oddi .
Ina mahi tika, ka huaki tēnei uaua, e kiia nei ko te Sphincter o Oddi, i te wā tika, ka taea ai te au me ngā whākōkī te uru ki roto i te whekau iti. Kātahi ka kati anō.
Nā, he aha te ngoikore o te uaua o te uaua o Oddi (SOD)?
Ki te kī māmā noa, ko te ngoikore o te uaua o te uaua o Oddi ko te kore e tuwhera tika te kuaha i kōrerohia e tātou, te uaua e kiia nei ko te uaua o Oddi. He aha te mea ka tupu? Kāore e taea e ngā whākōkī o te ate me te pancreas te uru ki roto i te whekau iti, ka mau ki roto i taua ngongo. Ina mau pēnei, ka mamae nui te puku, he rite ki te mea ka tupu ina he kōhatu kei roto i te puku.
Ko te nuinga o te wā ka kitea tēnei āhuatanga i roto i te hunga kua tangohia te pūhā (cholecystectomy). Nā konei, ka kiia i ētahi wā ko te "post-cholecystectomy syndrome".
He aha ngā momo me ngā kāwai matua o tēnei mate?
Ka taea te wehewehe i tēnei mate ki ngā momo matua e rua, me ngā wāhanga e toru. He mea nui kia mōhio koe ki tēnei, nā te mea ko te maimoatanga e whakawhirinaki ana ki tēnei momo.
| Momo / Kāwai | He whakamārama ngāwari noa iho |
|---|---|
| Ngā Momo Matua e Rua | |
| Te Dyskinesia Biliary | Ka puta tēnei ina āraia ngā awaawa au, ka kore ai e rere te au ki roto i te whekau iti. |
| Te mate pāwera | I tēnei āhuatanga, ka puta te aukati i roto i te repe taiaki, ka puta te mumura o te repe taiaki. |
| Ngā Kāwai Matua e Toru | |
| Ngā Kāwai I me te II | I roto i ēnei wāhanga e rua, ka kitea e ngā tākuta he taunakitanga mārama mō te raruraru mā roto i ngā whakamātautau. Hei tauira, he whakamātautau toto rerekē, he matawai ultrasound rānei e whakaatu ana i ngā awaawa aukume kua whānui, i ngā awaawa repeure rānei. |
| Kāwai III | Koinei te momo tino uaua ki te kite. Nā te mea kāore he taunakitanga mārama mō tēnei i roto i ngā pūrongo toto, ngā matawai, me ētahi atu. Ko te mamae puku o te tūroro anake te taunakitanga mō tēnei mate. Nō reira, he ahua uaua hoki te rongoā i tēnei. |
He aha ngā tohu o tēnei mate?
Ko te tohu matua me te tohu tino kitea o tēnei mate ko te mamae nui o te puku, he rite ki te mamae e pā ana ki te hanganga o ngā kōhatu pūkahukahu.
- Te pūtake mai o te mamae: Te mamae wera e tīmata ana i te taha matau o runga o te puku.
- Te horapa o te mamae: I ētahi wā ka rite te mamae ki te pakihiwi matau, ki te tuara rānei.
- Te roa o te mamae: Ka memeha haere te mamae i muri i te 30 meneti ki te haora. Heoi, ka hoki mai anō pea i tētahi rā.
Hei tāpiri atu ki tēnei mamae matua, ka kitea pea ētahi atu tohu:
- Whakapairuaki me te ruaki
- Kirika
- Ngā makariri
- Korere
Ko te mea nui, kāore ēnei tohu e ōrite tonu i ngā wā katoa. I ētahi rā ka haere mai, ka haere atu, i ētahi rā ia ka uaua rawa te manawanui.
He aha tēnei ka tupu ai? He aha ngā āhuatanga mōrearea?
Kāore he take kotahi mō tēnei. I ētahi wā ka ārai te rere o te au i te whara, i te mumura rānei o ngā awaawa au. I ētahi wā anō, me te kore he aukati, ka puta mai i te raruraru o te uaua o Oddi.
Engari he maha ngā rōpū he nui ake te mōrearea o tēnei mate.
- Te mea tino kitea: Ngā wāhine i waenga i te 20-50 tau te pakeke kua tangohia te pūkahukahu.
- Ētahi atu āhuatanga mōrearea:
- Ngā tāngata kua oti te pokanga whakaiti taumaha (pokanga taha puku).
- Ngā tāngata e pāngia ana e te pancreatitis anō.
- Ngā tāngata he kōhatu waikura tō rātou.
- Ngā tāngata kua whiwhi i te whakawhitinga ate.
- Ngā tāngata he ngoikore te mahi a te tairoi (Hypothyroidism).
- Ngā tāngata e pāngia ana e te Mate Puku Whakararuraru (IBS).
- Ngā tāngata e inu nui ana i te waipiro.
- Ngā tāngata e whakamahi ana i ētahi rongoā whakamamae mamae (ina koa ko ngā opiates).
Ka taea te noho mōrearea mēnā kāore e rongoatia?
Ehara tēnei i te mate e morearea ana ki te ora, ā, he onge ngā raruraru nui. Heoi, ko te mamae nui e pā mai ana ka waiho hei arai nui ki tō kaha ki te mahi noa.
Engari ki te haere tonu me te kore maimoatanga, kāore pea e puta pinepine ēnei āhuatanga:
- Te mate pāwera mau tonu: Te kino kore e taea te whakaora ki te repe taiaki i puta mai i te mumura tonu.
- Te kiri mākūkū: He kōwhai te kiri me te mā o ngā kanohi nā te kohikohinga o te bilirubin, he wāhanga o te au, i roto i te tinana.
Me pēhea te tautuhi a te tākuta i tēnei mate?
Mena kei a koe ēnei tohu, ko te mea tuatahi ka mahia e tō tākuta he tirotiro mō ētahi atu āhuatanga e mamae ai tō puku, nā te mea he maha atu anō ngā āhuatanga ka pā mai ai tēnei momo mamae.
Hei tauira, me whakarite koe kāore he mate kino pērā i te mate pukupuku peptic, te choledocholithiasis, te mate pukupuku pancreatic, te mate pukupuku awa wai rānei. He mea whakamiharo, ko te mamae o ētahi mate ngakau (pērā i te angina) ka rite ki te mamae o te puku.
I muri i te whakakorenga i ēnei mea katoa, ka tono pea tō tākuta kia mahia e koe ēnei whakamātautau:
- Ngā whakamātautau toto: Tirohia mēnā he nui ake ngā taumata whākōkī o te ate me te repe taiaki.
- Ngā whakamātautau whakaahua:Tirohia mēnā he hapa kei roto i te uaua, i ngā awa rānei o Oddi. Tērā pea kei roto i tēnei ko ngā whakamātautau pēnei i te Ultrasound Abdominal, te CT scan, te Endoscopic Ultrasound (EUS), te Upper Endoscopy, me te Magnetic Resonance Cholangiopancreatography (MRCP).
Whakamātautau motuhake: ERCP me te Manometri
I ētahi wā, mēnā kāore e taea te whakatau tika i ēnei whakamātautau katoa, ka tukuna pea koe e te tākuta ki tētahi whakamātautau motuhake e kiia nei ko te Endoscopic Retrograde Cholangiopancreatography (ERCP) me te manometry .
Ko te tikanga o tēnei ko te haere ki te Sphincter o Oddi mā te whakamahi i tētahi endoscope, te whakauru i tētahi ngongo kirihou iti rawa, me te ine i te pēhanga kia kite i te pai o te whakakōpiri me te whakawhānui o taua uaua.
Engari he iti noa te mōrearea o tēnei whakamātautau ERCP. Ka pāngia ētahi tāngata, tata ki te 15 ki te 30 i roto i te 100, e te mate pāwera i muri i tēnei whakamātautau. Nō reira, ka mahia tēnei e ngā tākuta i muri i te whakaaroaro tupato, ā, mēnā he tino tika anake.
He aha ngā maimoatanga mō tēnei?
Ko te tikanga maimoatanga e whakawhirinaki ana ki te kaha o ō tohu me te kāwai kei roto koe.
1. Ki te kore te mamae e tino kino (ina koa mō te kāwai III):
Ka tohua e te tākuta ngā rongoā whakamamae mamae (ehara i te opioid) me ngā rongoā whakangāwari uaua ki a koe.
2. Mena he nui te mamae (mō ngā kāwai I me II):
Mena he uaua ki te whakahaere mā te rongoā, ka tukuna pea koe e te tākuta ki tētahi maimoatanga e kiia nei ko te ERCP me te sphincterotomy . Ka mahia tēnei i raro i te mate whakamoe, i raro rānei i te mate whakamoe. Ka whakamahia e te taote pokanga he endoscope hei haere ki te Sphincter o Oddi, ka tapahia he wāhanga iti o te uaua e mau ana, ka wetekina. I taua wā anō, ka tirohia e rātou ngā kōhatu i roto i ngā awaawa o te aukume.
Ngā mōrearea o te maimoatanga sphincterotomy
Ka āwhina tēnei maimoatanga ki te whakaiti i te mamae i roto i te nuinga o ngā tūroro e pāngia ana e te momo I me te momo II. Heoi, he tikanga uaua anō hoki tēnei me ētahi mōrearea.
- Tata ki te 10% - 15% o ngā tūroro ka pāngia e ngā raruraru pēnei i te pancreatitis.
- Ahakoa he ngawari noa iho tēnei mumura, i ētahi wā ka kino rawa atu, ā, ka mōrearea pea te ora.
- I roto i ēnei āhuatanga, me noho pea koe ki te hōhipera mō te wā roa hei rongoā.
Nō reira, ka whakamahia noa tēnei maimoatanga e ngā tākuta mēnā kāore e taea te whakahaere mā te whakamahi i ētahi atu maimoatanga.
Karere Tangohia ki te Kāinga
- Ki te mamae tonu tō puku i muri i te tango i tō pūkahukahu, kaua e warewaretia. Me toro atu ki te tākuta.
- Tērā pea ko te Sphincter of Oddi Dysfunction (SOD) te take o tēnei mamae, he āhuatanga ka puta ahakoa kāore he pūkahukahu.
- He maha ngā momo o tēnei mate. Ko ētahi ka kitea ngāwari mā ngā whakamātautau, engari ko ētahi (ina koa ko te momo III) he uaua ki te kite.
- Kei reira ngā maimoatanga pēnei i te pire me te ERCP me te sphincterotomy, ka mahia anake mēnā e tika ana. Heoi, kia maumahara he mōrearea anō hoki kei roto i ēnei tikanga.
- Kōrero ki tō tākuta mō ō tohumate, te āhua o te puta mai, me te āhua o tō mamae. Mā tēnei koe e āwhina ki te whiriwhiri i te maimoatanga tino tika, tino haumaru hoki māu.
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