Uyazazi izimo eziyingozi ze-pancreatitis ebulala amagciwane?

Wake wezwa ngesimo esibucayi lapho ingxenye ye-pancreas ifa khona ? Yilokhu esikubiza ngokwezokwelapha ngokuthi "Necrotizing Pancreatitis". Cabanga ukuthi kuyingozi kangakanani ukulahlekelwa yingxenye yesitho esibalulekile emzimbeni wethu. Lokhu kwenzeka lapho isimo esibizwa ngokuthi "Acute Pancreatitis " siba sibi kakhulu . Namuhla, sizoxoxa ngalokhu ngokuningiliziwe, njengokungathi sikhuluma nomngane.

Kuyini ngempela ``(Necrotizing Pancreatitis)``?

Kalula nje, "I-Necrotizing Pancreatitis" ukufa kwengxenye "ye-Pancreas" yakho (i-Necrosis). Lokhu kwenzeka lapho isimo "se-Pancreatitis" siba sibi kakhulu. I-Pancreatitis yilapho i-pancreas ivuvukala, ibomvu, futhi ibuhlungu ngenxa yokulimala noma into efana nobuthi. Uma lokhu kuvuvukala kuba kubi kakhulu, ukugeleza kwegazi ezicutshini ze-pancreas kungaphazamiseka "i-Ischemia". Khona-ke lezo zicubu azitholi umoya-mpilo nezakhamzimba ezizidingayo bese ziqala ukufa . Lokhu kubizwa ngokuthi "i-Necrosis". Lesi yisimo esiyingozi ngempela.

Uma lokhu kwenzeka, ithimba lakho lezokwelapha lizokugcina esibhedlela isikhashana futhi likuqaphe eduze ukuze uthole ezinye izinkinga . Into ebaluleke kakhulu okufanele uyiqaphele ukutheleleka . Cabanga uma amabhaktheriya eqala ukudla izicubu ezifile, anganda ngokushesha futhi asakazeke emzimbeni wakho wonke. Uma lokho kwenzeka, kungaholela ezimweni ezimbi njengokwehluleka kwezitho zomzimba , okungaba yingozi empilweni. Ezimweni ezinjalo, odokotela kungadingeka basuse izicubu ezifile ngokuhlinzwa .

Sivame kangakanani lesi simo?

Uma sikhuluma nje, cishe abantu abangu-20% abathola i-pancreatitis ebukhali bazohlushwa i-pancreatitis ebulala izinzwa. Ezweni elifana ne-United States, kulinganiselwa ukuthi cishe abantu abayizinkulungwane ezingamakhulu amathathu bangeniswa esibhedlela minyaka yonke ngenxa ye-pancreatitis. Ngakho-ke, u-20% uyinani elibalulekile, akunjalo?

Yiziphi izimpawu ze-`(Necrotizing Pancreatitis)`?

Izimpawu zokuqala ezibonakala yilezo ze-pancreatitis ebukhali. Lezi yizi:

• Ubuhlungu obukhulu esiswini esingaphezulu. Lobuhlungu bungaphinde buphumele emhlane.
• Ukuvuvukala kwesisu noma ukuqunjelwa.
• Isicanucanu nokuhlanza.

Njengoba i-pancreatitis iba nzima kakhulu, izimpawu ezinjalo zingavela:

• Umkhuhlane kanye nokubanda.
• Ukwanda kwesilinganiso senhliziyo (i-Tachycardia).
• Ukoma okukhulu noma ukuphelelwa amanzi emzimbeni.

Yiziphi izimbangela ze-"Necrotizing Pancreatitis"?

Lokhu kwenzeka ngezigaba eziningana. Okokuqala, ukuvuvukala okuvamile kwe-pancreas (i-Acute Pancreatitis) kuba kubi kakhulu. Ngemuva kwalokho, ukuphakelwa kwegazi kuyaphazamiseka (i-Ischemia), bese ekugcineni, ukufa kwezicubu (i-Necrosis) kwenzeka. Kunezimbangela ezahlukene zalesi sigameko ngasinye.

I-pancreatitis iyingozi kangakanani?

Imbangela eyinhloko ye-pancreatitis ebukhali yisifo se -gallstone . Lokhu kwenzeka lapho itshe le-gallstone lihlala enyongweni futhi livimba umgudu we-pancreatic. Lokhu kubizwa nangokuthi i-gallstone pancreatitis . Imbangela yesibili eyinhloko ukuphuza utshwala ngokweqile .

Ukuvuvukala empeleni kuyindlela yomzimba yokusabela ekulimaleni, uzama ukulungisa umonakalo. Kodwa ngezinye izikhathi lokhu kusabela kokuvuvukala kuba kubi kakhulu kangangokuthi kuqala ukudala umonakalo.

Akukacaci okwamanje ukuthi kungani le mpendulo yokuvuvukala inzima kakhulu kwabanye abantu kunabanye. Kodwa-ke, kusobala ukuthi lokhu kudala " umphumela we-snowball" ngaphakathi kwe-pancreas.

Ukucindezeleka okuphezulu okubangelwa ukuvuvukala okukhulu kushukumisa ama-enzyme e-pancreatic ngaphakathi kwezicubu ze-pancreatic. Ngokuvamile, la ma-enzyme okugaya asebenza ngemva kokuba ukudla kungene ohlelweni lokugaya ukudla. Kodwa uma esebenze kusenesikhathi, aqala ukugaya i-pancreas uqobo. Cabanga nje, ukugaya isitho sakho ngama-enzyme akho!

Ukuncipha kokunikezwa kwegazi kuholela ku-"Ischemia" kanye nokufa kwezicubu "Necrosis"

Lokhu kulimala okuqhubekayo kwe-pancreas kubangela ukuba i-pancreatitis ibe yimbi kakhulu. Ekugcineni, ukuvuvukala kwe-pancreas kubangela ukuthi imithambo yegazi ivuleke, kunciphisa inani legazi eligeleza ezicutshini.

Esinye isici esingathinta lokhu yi- Systemic Inflammatory Response Syndrome (SIRS). Lesi yisimo sokuvuvukala okwenzeka kuwo wonke umzimba. Lokhu kungabangela ukucindezeleka kwegazi kanye nokugeleza kwegazi kwehle.

Ukulahlekelwa ukugeleza kwegazi (ischemia) kubangela ukufa kwezicubu (necrosis). Ukugaya kwe-pancreas ngama-enzyme e-pancreatic nakho kungaba nomthelela ekufeni kwalesi zicubu.

Yiziphi izinkinga ezingaba khona ze-`(Necrotizing Pancreatitis)`?

Lesi simo singadala izinkinga ezahlukahlukene esikhathini esifushane neside.

Izinkinga zesikhashana:

• Ukutheleleka: Lena ingozi eyingozi kakhulu ye-Necrotizing Pancreatitis. Lokhu kungenzeka cishe kuma-20% eziguli. Izicubu ezifile zifana nendawo enhle yokondla amabhaktheriya azulazula. Kunzima ukulawula ukutheleleka uma usuvele ugula. Uma kusakazekela egazini, kungaba yingozi empilweni. Ukutheleleka egazini kungabangela i-sepsis , okungaholela ekuhlulekeni kwezitho eziningi . Lena imbangela enkulu yokufa kubantu abane-Necrotizing Pancreatitis.
• Ukuqoqwa Koketshezi Olune-Necrotic: Ku-pancreatitis enzima, ama-enzyme e-pancreatic asebenzayo angavuza ku-pancreas futhi alimaze izicubu ezizungezile. I-capsule yezicubu ezincane yakha nxazonke koketshezi lwe-pancreas. Uma le capsule iqukethe izicubu ezifile namagciwane, ukutheleleka kungaqala futhi kusakazeke kalula. Akuvamile, le capsule ingakhula futhi icindezele izitho eziseduze, njengesisu, imithambo yegazi, noma imisele ye-bile.
• Ukopha: I-pancreatitis ebangelwa ukopha ayivamile, kodwa ingaba yingozi empilweni uma ivele. I-pancreatitis ebulala amangqamuzana ikhulisa ingozi yokopha. Enye indlela lokhu okungenzeka ngayo uma ukuvuvukala noma uketshezi oluku-pancreas lusakazekela emthanjeni oseduze, kulimaze udonga lwe-artery futhi kubangele ukopha. Enye indlela iwukuba ama-enzyme e-pancreas abhidliza udonga lwe-artery, adale i- pseudoaneurysm , eqhuma futhi ibangele ukopha.
• I-Abdominal Compartment Syndrome: Ukuvuvukala, ukopha, kanye nokunye ukunqwabelana koketshezi okuhambisana ne-necrotizing pancreatitis kungabangela ukucindezeleka okuphezulu ngaphakathi kwesisu. Lokhu kubonakala kakhulu ezigulini ezigula kakhulu. Lokhu kungaholela ekunciphiseni ukugeleza kwegazi ezithweni zomzimba, okungaholela ekuqhekekeni kwegazi , ischemia, kanye ne -hypoxia . Lokhu kungaholela nasekuhlulekeni kwezitho eziningi.

Imiphumela yesikhathi eside:

• Ukuntuleka Kwe-Pancreatic: Uma inani elikhulu lezicubu ze-pancreatic lilahleka, eminye yemisebenzi ye-pancreas ingase ilahleke. Ukuntuleka Kwe-Pancreatic Exocrine kwenzeka lapho i-pancreas ingakhiqizi ama-enzyme anele okugaya ukudla. Lokhu kungaholela ekungamuncweni kahle kanye nokungondleki kahle . Ukuntuleka Kwe-Pancreatic Endocrine kwenzeka lapho i-pancreas ingakhiqizi ama-hormone anele alawula amazinga kashukela egazini. Lokhu kungaholela ku-hyperglycemia kanye nesifo sikashukela .
• I-Disconnected Pancreatic Duct Syndrome: Ukuvuvukala okukhulu, ukopha, ukufa kwezicubu, kanye nezinye izinkinga ze-necrotizing pancreatitis kungabangela ukuthi i-pancreatic duct ihlukane kancane ne-pancreas noma emathunjini amancane. Lokhu kungabangela ukuvuza okuqhubekayo kwama-enzyme e-pancreatic. Lokhu kuvuza kungaholela ekuqongeleleni koketshezi isikhathi eside kanye/noma i-pancreatitis engapheli.
• Ukuqina Kwe-Biliary:Ukuvuvukala okukhulu nokwesikhathi eside kungabangela izibazi kunoma yimiphi imigudu exhumanisa i-pancreas nohlelo lokugaya ukudla (i-pancreatic duct, i-bile duct, i-duodenum - ukuqala kwamathumbu amancane). Lokhu kuzibazi kubangela ukuthi i-duct ibe mncane ngendlela engavamile (i-stricture). Lokhu kunciphisa ukugeleza kwe-bile, bese i-bile iqala ukubuyela emuva ohlelweni lwe-biliary.
• I-Splanchnic Vein Thrombosis: Imithambo yakho ye-splanchnic itholakala ngaphansi kwe-pancreas yakho. I-pancreatitis enzima ingabangela ukuthi ivuvuke. Lokhu kungaholela ekuqhekekeni kwegazi (thrombosis) kule mithambo. Le mithambo ihlanganisa i-splenic vein, i-mesenteric vein, i-hepatic vein, kanye ne-portal vein. Uma kwakheka i-blood clot kwenye yalezi, kungaba nezinkinga ezahlukahlukene, njenge- portal hypertension , i-gastrointestinal varices, ukopha kwamathumbu, i-ischemic colitis, kanye ne-mesenteric ischemia.

I-Necrotizing Pancreatitis itholakala kanjani?

Odokotela baxilonga lesi simo `(Necrotizing Pancreatitis)` ngemva kokuxilonga okokuqala `(Acute Pancreatitis).` Izimpawu ezisobala zokufa kwezicubu `(Necrosis)` azibonakali kuze kube yizinsuku ezintathu kuya kwezinhlanu ngemuva kokuqala kwe-pancreatitis. Uma unezimpawu ze-pancreatitis enzima ezinsukwini ezimbalwa ngemva kokuvuvukala kokuqala, udokotela wakho uzosebenzisa i-CT scan enedayi ye-fluorescent `(Contrast-enhanced CT scan)` noma i-MRI.` (MRI - Magnetic Resonance Imaging)` ukuze afune lokhu kufa kwezicubu. Bazophinde bafune nezinye izinkinga, njengokuqongelela koketshezi.

Yiziphi izindlela zokwelapha lokhu?

Ukwelashwa kwakho kuzoncika ekutheni unesifo noma ezinye izinkinga. Uma i-pancreatic necrosis ingenazo izimpawu futhi kungekho zimpawu, odokotela bavame ukuyiphatha ngokunakekelwa okusekelayo . Uma kuvela izimpawu zokutheleleka noma ezinye izinkinga, odokotela bazongenela njengoba kudingeka. Bazozama ukususa izicubu ezifile besebenzisa izindlela ezingangenisi kakhulu ngaphambi kokusebenzisa ukuhlinzwa.

Ukuphathwa Kokugcina

Ukunakekelwa okusekelayo kwe-"Sterile Necrotizing Pancreatitis" engathelelani kuhlanganisa:

• Izibulali-zinhlungu.
• Uketshezi olufakwa emthanjeni `(IV Fluids)`.
• Ukudla Okunomsoco Kwangaphakathi.

Iningi lamacala alula azoxazululeka ngokunakekelwa okusekelayo kuphela. Phakathi nalesi sikhathi, ithimba lakho lezokwelapha lizoqapha isimo sakho eduze. Lizoqapha izimpawu zakho ezibalulekile , umfutho wesisu, kanye nenani eliphelele legazi.Bazoqapha izinto ezifana ne-Complete Blood Cell Count (CBC) futhi babheke izinkinga ezingaba khona. Uma kwenzeka okuthile okufana nokutheleleka noma ukwehluleka kwezitho zomzimba, bazohlinzeka ngokusekelwa kokuphila noma ezinye izindlela zokungenelela njengoba kudingeka.

Ukukhipha Amanzi kanye Nokungcoliswa Kwendle

Uma nje uqala ukubona izimpawu zokutheleleka, ithimba lakho lezokwelapha lizokuqala ngama -antibiotic futhi lihlele ukususa noma yiziphi izicubu ezifile uma kungenzeka. Bazoqala ngendlela engangenisi kakhulu ngangokunokwenzeka, bese bekhulisa kancane kancane amandla uma kudingeka.

Lezi zindlela zifaka:

• Ukugeleza kwamanzi ngesikhumba: Izindlela zokukhipha amanzi ngesikhumba. Udokotela we-radiologist ongenelelayo usebenzisa amasu okuthwebula izithombe (ngokuvamile i-ultrasound noma i-CT scans) ukuthola indawo yezicubu ezifile bese efaka ipayipi ngesikhumba sakho. Ipayipi lishiywa endaweni yalo bese lihlanzwa nge-saline izikhathi eziningana ngosuku ukuze kukhishwe uketshezi. Lena yindlela kuphela yeziguli ezingaba yingxenye yesithathu. Kwabanye, kusiza ukulawula ukutheleleka kuze kube yilapho ezinye izindlela zokususa ukungcola zingenziwa ngokuphephile.
• Ukususwa kwe-Endoscopic: Inqubo ebizwa ngokuthi i-endoscopy ivumela udokotela we-gastroenterologist ukuthi afike ezicutshini ezifile emzimbeni wakho ngaphandle kokusika isikhumba sakho. Uzodlula i-endoscope, efakwe i-ultrasound probe, ngendlela yakho engenhla yokugaya ukudla ukuze athole indawo ye-pancreas. Ngemuva kwalokho, amathuluzi adlula nge-endoscope ukuze adale umzila phakathi kwezicubu ezifile nomzila wakho wokugaya ukudla. Izicubu ezifile zisuswa ngaleyo ndlela.
• Ukususwa Kwe-Retroperitoneal Okusizwa Yividiyo (i-VARD): Lokhu futhi kuyindlela yokuhlinzwa engangenisi kakhulu. Lokhu kuhilela ukufaka amathuluzi okuhlinzwa nge-incision efanayo onayo kakade esikhumbeni sakho ebizwa ngokuthi i-Percutaneous Drainage Portal bese uya endaweni lapho kukhona khona izicubu ezifile. Udokotela ohlinzayo usebenzisa i-forceps, ukunisela kanye nokumunca ukuze asuse izicubu ezifile nge-incision. Uma kudingeka, i-incision inganwetshwa bese kufakwa ithubhu elifakwe ikhamera elibizwa ngokuthi i-laparoscope. Izicubu ezisele zisuswa kusetshenziswa inqubo ye-laparoscopic ebizwa ngokuthi i-laparoscopic surgery.
• Ukuhlinzwa Okuvulekile - I-Necrosectomy: I-Necrosectomy ukususwa kwezicubu ezifile. Ukuhlinzwa okuvulekile kuhilela ukuvula umgodi wesisu nokuthola izicubu ezifile (i-Laparotomy). Lena kuseyindlela esheshayo yokuthola nokwelapha izinkinga eziphuthumayo. Nakuba ukuhlinzwa kunezingozi ezithile, kuyindlela yokugcina yokwelapha izimo eziphuthumayo nalapho izindlela ezingangenisi kakhulu zihlulekile.

Liyini izinga lokufa kanye nezinga lokululama kwe-`(Necrotizing Pancreatitis)`?

Ithuba lokululama lincike ekutheni ingakanani i-pancreas yakho efile, ukuthi unesifo noma ukwehluleka kwezitho zomzimba, nokuthi usabela kahle kangakanani ekwelashweni. Uma kungaphansi kwama-30% e-pancreas yakho ethintekile, izinga lokufa lingaphansi kwama-15% . Uma kukhona ukufa kwezicubu kuphela ngaphandle kokutheleleka, kulungile lokho. Kodwa uma kungaphezu kwama-50% e-pancreas yakho ethintekile, futhi unesifo noma ukwehluleka kwezitho zomzimba, izinga lokufa likhuphuka libe ngaphezu kwama-30% .

Ungakhathazeki ngalezi zibalo. Lezi ziwulwazi olujwayelekile nje. Ithimba lezokwelapha kuphela elingakutshela kangcono ngesimo sakho kanye namathuba akho okululama.

Kwenzekani ngemva kokwelashwa?

Ngesikhathi sokuhlolwa kwakho kokulandela ngemva kokwelashwa, udokotela wakho uzokubuza nganoma yiziphi izimpawu eziqhubekayo noma ezintsha. I-Necrotizing Pancreatitis ingaba nezinkinga zesikhathi eside ngisho nangemva kokwelashwa. Uma unezimpawu, ungase ucelwe ukuba uhlolwe igazi, uhlolwe elebhu, noma uhlolwe ngezithombe ukuze uzihlole. Izinkinga zingadinga ukwelashwa okwengeziwe, okungaba okwesikhathi esifushane noma eside.

I-necrotizing pancreatitis iyinkinga enkulu kakhulu ye-acute pancreatitis. Nakuba abantu abaningi belulama kwi-acute pancreatitis ngokunakekelwa okusekelayo kuphela, labo abathola i-pancreatitis enzima kanye ne-necrosis badinga ukunakekelwa okujulile kwesikhathi eside. Uzodinga ithimba lodokotela elihlanganisa imikhakha eminingi ukuqapha isimo sakho kanye nanoma yiziphi izinkinga ezingase zivele. Ungadinga ukungenelela noma ukuhlinzwa, kanye nokunakekelwa okulandelayo.

Izinto ezibaluleke kakhulu okudingeka sizikhumbule kule ndaba (Umyalezo Ohamba Nawo Ekhaya)

• I-Necrotizing Pancreatitis yisimo esibi lapho ingxenye ye-pancreas ifa khona.
• Lokhu kuvame ukubangelwa yi-pancreatitis ebukhali kakhulu. Izimbangela eziyinhloko amatshe enyongo kanye nokuphuza utshwala ngokweqile .
• Uma unezimpawu ezifana nobuhlungu obukhulu besisu, umkhuhlane, isicanucanu, nokuhlanza, funa iseluleko sezokwelapha ngokushesha.
• Ukutheleleka kuyinkinga eyinhloko neyingozi kakhulu yalesi simo.
• Izinketho zokwelapha ziyahlukahluka kuye ngesimo sesiguli. Kunezinhlobo ezahlukene zokwelapha , kusukela ekunakekelweni okusekelayo kuya ekuhlinzweni .
• Nakuba lesi kuyisimo esibucayi, abantu abaningi bayalulama ngokwelashwa nokunakekelwa okufanele kwezokwelapha . Ngakho-ke ungalilahli ithemba.

Uma wena noma othile omaziyo enanoma yiziphi zalezi zimpawu, sicela ubonane nodokotela ngokushesha. Ukwelashwa kusenesikhathi kungasindisa izimpilo!

I- Pancreatitis Ebulala Isisu, I-Pancreatitis, Ukufa Kwesisu, Ubuhlungu Besisu, Ukutheleleka Kwesisu, I-Pancreatitis, Izifo Zesisu