Wake wacabanga ngokujulile ngalokho okwenzekayo emizimbeni yethu ngemva kokudla? Ngemva kokuba ukudla esikudlayo kusuke emlonyeni wethu kuye esiswini sethu, kwenzeka inqubo eyinkimbinkimbi kakhulu yokukugaya, ukukhiqiza amandla, nokuhlinzeka ngokudla okudingwa yimizimba yethu. Kule nqubo, isitho ngasinye sisebenza ndawonye njengeqembu. Namuhla, sizokhuluma ngendawo encane kakhulu, kodwa ebaluleke kakhulu ohlelweni lwethu lokugaya ukudla esebenza njengendawo enkulu yokuhlangana kwesitimela. Leyo "yi-Ampulla of Vater".
Iyini ngempela i-Ampulla yaseVater?
Kalula nje, i-ampulla ye-Vater iyimbobo encane evulekela engxenyeni yokuqala yamathumbu ethu amancane (i-duodenum). Kodwa akuyona nje noma yimuphi umbobo. Yindawo eyinhloko lapho uketshezi olubili olubalulekile enqubweni yethu yokugaya ukudla luhlangana khona futhi luxubane nokudla.
Cabanga ngale ndlela. Umsele wenyongo ovamile, othwala inyongo esibindini sethu, kanye nomsele wenyongo, othwala ama-enzyme avela kumanyikwe ethu asiza ekugayeni ukudla, ahlangana ndawonye ukuze akhe isikhwama esincane. Leso sikhwama sibizwa ngokuthi i-ampulla ye-Vater. Ama-enzyme enyongo kanye nenyongo ahlangana ndawonye bese edlula emathunjini amancane.
Leli gama lisuselwa eqinisweni elimangalisayo. Liqanjwe ngesimo sebhodlela eliyindilinga elibizwa ngokuthi "i-ampulla" elalisetshenziswa ngezikhathi zamaRoma . Liphinde liqanjwe ngokuthi "likaVater" ukuhlonipha isazi sezakhi zofuzo u-Abraham Vater, owalichaza okokuqala.
Uma sikhuluma iqiniso, lokhu "kuyindawo ematasa kakhulu" ohlelweni lwethu lokugaya ukudla. Uma lokhu kuhlangana kungasebenzi kahle, yonke inqubo yethu yokugaya ukudla ingaphazamiseka.
Ikuphi le nto encane?
I-ampulla ye-Vater itholakala ngaphakathi kodonga lwe-duodenum, ingxenye yokuqala yamathumbu ethu amancane . I-duodenum yingxenye yamathumbu amancane edlula ngemva kwesisu, cishe amasentimitha ayi-10 ubude. I-ampulla ye-Vater itholakala maphakathi nale duodenum.
Le ndawo ibaluleke kakhulu kwezokwelapha. Ngoba yilapho ukudla okuye kwaphulwa futhi kwaphulwa esiswini kugaywa khona futhi izakhamzimba ezikuso ziqala ukumuncwa ngumzimba. Njengokungathi kwabelana ngomsebenzi, ngenkathi isisu senza umsebenzi waso wokuphula ukudla, i-duodenum kanye namanye amathumbu amancane aqala ukumunca. Leyo nqubo ayinakwenzeka ngaphandle koketshezi oluvela kule ampulla yesisu.
Yiziphi izingxenye nemisebenzi ye-Ampulla of Waiter?
Ngaphakathi kwale ndawo encane yokuhlangana, kukhona uhlelo oluyinkimbinkimbi kakhulu nolumangalisayo. Ngokuyinhloko lwakhiwe inethiwekhi yemisipha ezungezile. Sibiza lezi ngokuthi ama-sphincters . Njengevalvu yamanzi, le misipha iyavuleka futhi ivaleke ukuze ilawule ukuthi ingakanani i-bile nama-enzyme angena emathunjini amancane, nokuthi nini.
Asikwazi ukulawula le misipha ngendlela esifisa ngayo. Isebenza ngokuzenzakalelayo ngokwezibonakaliso esizithola ohlelweni lwethu lwezinzwa. Uma sidla ukudla okunamafutha, sidinga i-bile eyengeziwe ukuze siyigaye. Bese kuthi, kuvele isignali ebuchosheni bethu, bese le misipha ivuleka futhi ikhulule inani elidingekayo le-bile. Akumangalisi yini?
Ithebula elingezansi lizosisiza siqonde izingxenye zalo eziyinhloko kanye nemisebenzi yazo kalula.
| Ingxenye | Umsebenzi Olula |
|---|---|
| I-Sphincter yase-Oddi | Leli igama elijwayelekile lalo lonke uhlelo lokulawula. Kuneminye imisipha emincane embalwa ngaphakathi kwalena. |
| I-pancreatic duct stenosis | Ilawula ukugeleza kwama-enzyme avela ku-pancreas. |
| Ukuvaleka kwepayipi lenyongo | Ilawula ukugeleza kwenyongo esibindini. |
| Ukupakishwa kwe-ampoule | Ukukhishwa okuhlangene kwalezi zinto zombili eziwuketshezi emathunjini amancane kuyalawulwa. |
| I-Papilla ye-Vater | Lona umgodi omncane lapho i-ampulla ivulekela khona emathunjini amancane. |
Yiziphi izifo ezingathinta le ngxenye?
Uma kukhona okungahambi kahle kule ndawo encane kodwa ebaluleke kakhulu, kungathinta wonke umzimba wethu. Ngoba uma i-bile nama-enzyme engakwazi ukuphuma futhi abhajwe ngaphakathi, angabuyela emuva futhi alimaze isibindi kanye ne-pancreas.
Okulandelayo yizimo zezokwelapha eziyinhloko ezingase zenzeke ezihambisana ne-ampulla ye-Vater.
| Isimo sezokwelapha | Incazelo elula |
|---|---|
| I-Adenoma | Lokhu akuwona umdlavuza, kodwa ukukhula okungavamile kwamangqamuzana (isimila) okungenzeka sibe umdlavuza. Njengoba sikhula, singavimba imithambo yegazi futhi sibangele izinkinga. |
| Umdlavuza We-Ampullary | I-adenoma okukhulunywe ngayo ngaphambili ingaba yi-carcinoma. Lokhu kungaba kubi kakhulu futhi ngokuvamile kudinga ukususwa ngokuhlinzwa. |
| Ukungasebenzi kahle kwe-Sphincter ka-Oddi | Lokhu kusho ukuthi umsipha, ofana nesango, awuvuli kahle ngesikhathi esifanele. Bese uketshezi luvaleleka ngaphakathi bese lubangela izinkinga. |
| Ukuvinjelwa | Lokhu kuhlangana kungavinjelwa ngezinye izizathu. Imbangela evame kakhulu amatshe enyongo abhajwa kule ndawo encane. Ngezinye izikhathi, le ndawo ingavinjelwa ngenxa yamanxeba amadala nezibazi. |
Ngingazi kanjani ukuthi kunenkinga nge-ampulla yami ye-waiter? Ziyini izimpawu?
Uma i-ampulla ye-Vater ivinjwa yi-tumor, itshe, noma enye inkinga, i-bile nama-enzyme awakwazi ukuphuma. Lolu ketshezi luyanqwabelana ngaphakathi kwe-bile ducts kanye ne-pancreas, okwandisa ingcindezi futhi kuphazamise lonke uhlelo. Lokhu kungabangela izimpawu ezilandelayo:
- Ubuhlungu besisu: Ubuhlungu, ikakhulukazi engxenyeni ephezulu kwesokudla yesisu.
- I-biliary colic: Ubuhlungu obukhulu obuvela ngokuzumayo bese buphela ngemva kwesikhashana.
- I-Jaundice: Ukuphuzi kwamhlophe emehlweni nasesikhumbeni. Lokhu kwenzeka lapho inyongo ingenakukwazi ukuphuma, futhi i-bilirubin ephuzi iqoqana egazini.
- Isicanucanu nokuhlanza: Lesi simo singabangelwa ukungagayi kahle kokudla.
Into ebaluleke kakhulu ukuthi, uma uzizwa sengathi unalezi zimpawu, ikakhulukazi ukuphuzi kwamehlo nesikhumba, ungakuzibi. Kungaba uphawu lwesimo esibucayi. Ngakho-ke bonana nodokotela wakho ngokushesha.
Odokotela bakuhlola futhi bakwelaphe kanjani lokhu?
Ngenhlanhla, ngobuchwepheshe bezokwelapha obuthuthukisiwe banamuhla, akudingekile ukwenza ukuhlinzwa okukhulu ukuze kuhlolwe futhi kwelashwe le ampulla ye-Vater. Odokotela bavame ukusebenzisa inqubo ebizwa ngokuthi i-endoscopy ngale njongo.
Kalula nje, lokhu kuhilela ukufaka ipayipi elincane elinekhamera encane ekugcineni ngomlomo, lidlule esiswini, bese lifinyelela i-ampulla ye-Vater enyongweni. Le nqubo siyibiza ngokuthi i-ERCP (Endoscopic Retrograde Cholangiopancreatography) .
Isici esikhethekile sale ndlela yile:
1. Ukuhlolwa: Udokotela angabheka kahle le ndawo ngekhamera bese ethola ukuthi inkinga iyini ngempela.
2. Ukwelashwa: Ngaleso sikhathi, amathuluzi amancane angadluliselwa ngepayipi ukuze kususwe noma yimaphi amatshe enyongo anamathele enyongweni, kwandiswe ukuvaleka, noma kuthathwe ingxenye encane yezicubu (i-biopsy) ukuze ihlolwe. Ngisho nezinye izimila ezincane zingasuswa ngale ndlela.
Lokhu kusho ukuthi kunethuba lokwenza kokubili ukuxilongwa kanye nokwelashwa ngenqubo eyodwa. Lokhu kulula kakhulu ezigulini.
I-ampulla ye-Vater ingaba yichashaza elincane emzimbeni wethu, kodwa yenza umsebenzi omkhulu. Iyisango elikhulu eliya ohlelweni lwethu lokugaya ukudla. Futhi iyisango elifanayo odokotela abalisebenzisayo ukubheka ngaphakathi kwemigudu yethu ye-bile kanye ne-pancreas. Ungase ungalokothi ulizwe leli gama, kodwa uma udokotela elikhuluma ngelinye ilanga, ungesabi. Izinkinga eziningi zalo manje sezingelashwa ngamasu athuthukile.
Umlayezo Wokuya Nawe Ekhaya
- I-Ampulla ye-Vater iyindawo eyinhloko lapho ama-enzyme e-bile kanye ne-pancreatic, abalulekile enkambisweni yethu yokugaya ukudla, angena khona emathunjini amancane.
- Ukuvaleka kwale ndawo kungabangela izimpawu ezifana nokuqaqamba kwesisu, isicanucanu, futhi ikakhulukazi i-jaundice (ukuphuzi kwesikhumba).
- Uma ubona amehlo noma isikhumba sakho siphenduka siphuzi, kubalulekile ukuthi ungasinaki futhi ufune iseluleko sezokwelapha ngokushesha.
- Amatshe enyongo ayimbangela evamile yokuvaleka kule ndawo.
- Amasu esimanje e-endoscopic, njenge-ERCP, enza kube nokwenzeka ukuxilonga nokwelapha izimo eziningi ezenzeka kule ndawo ngaphandle kokuhlinzwa okukhulu.
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