Kungenzeka ukuthi ubuhlushwa ubuhlungu besisu isikhathi eside ngenxa yamatshe enyongo. Lapho ekugcineni uhlinzwa ukuze kususwe inyongo yakho, cishe wawucabanga ukuthi ukhululekile ngokuphelele kulobu buhlungu. Kodwa kuthiwani uma usenobuhlungu obufanayo besisu ngemva kokuhlinzwa? Kuyacasula ngempela. Abantu abaningi babhekana nalolu hlobo lokuhlangenwe nakho. Ngakho-ke namuhla sizokhuluma ngesimo esingabangela lobu buhlungu besisu obungavamile ngisho nangemva kokuba inyongo isusiwe. Leyo yi -Sphincter of Oddi Dysfunction .
Kalula nje, iyini i-Sphincter of Oddi Dysfunction?
Ukuze siqonde lokhu, ake siqale sibheke inqubo yokugaya kwethu ukudla. Kulula kakhulu. Uma sidla ukudla, imizimba yethu ikhiqiza amajusi amabili akhethekile asiza ekugayeni ukudla.
1. Inyongo: Lokhu kwenziwa yisibindi. Kugcinwa enyongweni. Kusiza ekugayweni kwamafutha.
2. Ijusi le-pancreatic: Lokhu kwenziwa yi-pancreas. Ama-enzyme akuyo asiza ekugayeni amaprotheni nama-carbohydrate ekudleni.
Womabili lawa majusi aya emathunjini ethu amancane, lapho ahlangana khona nokudla ukuze kuqedwe inqubo yokugaya ukudla.
Manje nansi into ebalulekile. Lapho lawa majusi amabili engena khona emathunjini amancane, kukhona ucezu lwenyama olufana nesango . Lufana ne-valve. Lokhu yilokho esikubiza ngokuthi i-Sphincter of Oddi . Ngokuvamile, uma udinga ukugaya ukudla, leli sango liyavuleka, amajusi angene, bese livala futhi.
I-Sphincter of Oddi Dysfunction yilapho leli sango lingasebenzi kahle. Okusho ukuthi, le ngxenye yenyama ayivuli ngesikhathi esifanele bese iqina. Bese inyongo evela esibindini kanye nejusi evela ku-pancreas kungakwazi ukungena emathunjini amancane bese kubhajwa. Kufana nokuminyana kwezimoto. Lapho ijusi libhajwa kanje, ingcindezi emigwaqweni evela kulawo majusi iyanda, okubangela ukuqaqamba okukhulu kwesisu.
Lesi simo sivame ukubonakala kubantu abasuswe inyongo ngokuhlinzwa. Ngakho-ke, ngezinye izikhathi sibizwa ngokuthi i-post-cholecystectomy syndrome .
Yiziphi izinhlobo eziyinhloko zalesi simo?
Ukungasebenzi kahle kwe-Sphincter of Oddi kungakuthinta ngezindlela ezimbili eziyinhloko.
- I-Biliary Dyskinesia: Lesi yisimo lapho imisele ye-bile ivaleka khona. Inkinga isendleleni i-bile egeleza ngayo.
- I-Pancreatitis: Lokhu kwenzeka lapho ijusi le-pancreatic livaleka, okubangela ukuthi i-pancreas ivuvuke futhi ivuvuke.
Ngaphezu kwalokho, odokotela bahlukanisa lesi sifo ngezigaba ezintathu (Izigaba I, II, kanye ne-III). Lokhu kubaluleke kakhulu ngoba ukwelashwa kunqunywa ngokusekelwe kulesi sigaba.
| Uhlobo lwesifo | Incazelo |
|---|---|
| Isigaba I | Isiguli sinobuhlungu besisu. Ngaphezu kwalokho, kunobufakazi obucacile bale nkinga kusukela ekuhlolweni kwegazi kanye nokuskenwa (i-ultrasound) . (isib., ama-enzyme esibindi aphezulu, imigudu ye-bile evulekile). |
| Isigaba II | Isiguli sinobuhlungu besisu, futhi ukuhlolwa kwegazi okukodwa noma okuskeniwe okubonisa noma yikuphi ukungahambi kahle. |
| Isigaba III | Lolu uhlobo olunzima kakhulu ukuluxilonga. Isiguli sinobuhlungu besisu, kodwa akukho ukuhlolwa kwegazi noma ukuskena okutholakele okungalungile. Ubufakazi obuwukuphela kobuhlungu isiguli esibuzwayo. |
Yiziphi izimpawu eziyinhloko zalesi sifo?
Uphawu oluyinhloko noluvame kakhulu ubuhlungu obukhulu besisu, obufana nobuhlungu obuzwiwa ngamatshe enyongo.
- Ubuhlungu buqala ohlangothini oluphezulu kwesokudla lwesisu.
- Ngezinye izikhathi lobu buhlungu buya ehlombe noma emhlane wesokudla .
- Ubuhlungu abuhlali njalo. Buyaphela bodwa ngemva kwemizuzu engaba ngu-30 noma ihora. Bese bungabuya futhi ngosuku noma ngesonto.
- Ngezinye izinsuku ubuhlungu buncane, kanti kwezinye izinsuku bungaba nzima ukububekezelela.
Ngaphezu kwalokhu kubuhlungu okuyinhloko, izimpawu ezilandelayo zingase zivele:
- Isicanucanu nokuhlanza
- Umkhuhlane kanye nokubanda
- Uhudo
Into ebalulekile ukuthi lezi zimpawu azihlali zikhona. Zivame ukufika zidlule.
Ubani osengozini enkulu yalesi simo?
Imbangela eqondile yalokhu ayikatholakali okwamanje, kodwa izici ezithile zandisa ingozi yalesi simo.
| Isici sengozi | Incazelo |
|---|---|
| Ukususwa kwenyongo | Lesi yisici esiyinhloko nesivame kakhulu sengozi. |
| Ubudala nobulili | Lesi simo sivame kakhulu kwabesifazane abaneminyaka ephakathi kuka-20 no-50. |
| Okunye ukuhlinzwa | Ukuhlinzwa kokunciphisa isisindo (isib. ukuhlinzwa kwesisu), ukufakelwa kwesibindi, njll. |
| Ezinye izimo zezokwelapha | Izimo ezifana ne-recurrent pancreatitis, i-hypothyroidism, kanye ne-irritable bowel syndrome (IBS). |
| Eminye imithi | Ukusetshenziswa kwesikhathi eside kwemithi ethile yokudambisa izinhlungu (ikakhulukazi ama-opioid). |
Sitholakala kanjani lesi sifo?
Uma udokotela wakho esola lokhu ngemva kokuzwa ngezimpawu zakho, into yokuqala azokwenza ukuqinisekisa ukuthi ayikho enye imbangela enkulu yobuhlungu besisu sakho. Lokhu kungenxa yokuthi ezinye izimo ezifana nezilonda zesisu (izilonda ze-peptic), amatshe enyongo, kanye nomdlavuza we-pancreatic noma we-bile duct nazo zingabangela izimpawu ezifanayo. Ngezinye izikhathi, ubuhlungu besifo senhliziyo (i-angina) bungazwakala njengobuhlungu besisu.
Ngemva kokuqinisekisa ukuthi lezi zinto azikho, kungenziwa izivivinyo ezilandelayo ukuhlola ukungasebenzi kahle kwe-Sphincter of Oddi:
- Ukuhlolwa kwegazi:Hlola amazinga aphezulu esibindi kanye nama-enzyme e-pancreatic.
- Ama-scan: Ama-scan anjenge-ultrasound yesisu, i-CT scan, kanye ne-MRCP asetshenziselwa ukuhlola ukuthi i-bile duct noma i-pancreatic duct ivuvukele/ivulekile yini.
- I-Endoscopy: Ipayipi elinekhamera lifakwa ngomlomo ukuhlola isisu namathumbu amancane.
Ukuhlolwa kwe-ERCP
Kwezinye izimo, ikakhulukazi uma kusolwa uhlobo I noma II, kwenziwa ukuhlolwa okukhethekile okubizwa ngokuthi i-ERCP (Endoscopic Retrograde Cholangiopancreatography) . Kulokhu, kufakwa ithubhu lekhamera, elifana ne-endoscope, ku-sphincter ka-Oddi, bese kufakwa ithubhu elincane ukuze kulinganiswe ingcindezi kulowo musipha (i-manometry). Lokhu kunganquma kahle ukuthi ivuleka noma ivala kahle yini.
Kodwa-ke, lokhu kuhlolwa kwe-ERCP kuwukuhlolwa okuncane kobungozi. Iphesenti elincane labantu abanakho lingahlakulela i-pancreatitis ngemuva kokuhlolwa. Ngakho-ke, udokotela uncoma lokhu kuhlolwa ngemuva kokuhlola ngokucophelela isidingo kanye nengozi.
Iphathwa kanjani?
Izinketho zokwelapha zincike ekutheni uhlobo luni (isigaba) lwe-Sphincter of Oddi Dysfunction onayo.
- KuSigaba III: Lokhu kunzima ukukuxilonga, ngakho-ke ukuhlinzwa ngokuvamile akukhuthazwa. Udokotela uzokunikeza imithi yokuqeda izinhlungu kanye nemithi yokuqeda izinhlungu ukuze kulawulwe ubuhlungu.
- Kwesigaba I no-II: Uma ubuhlungu bukhulu futhi kunzima ukulawula ngemithi, udokotela wakho angase asikisele ukwelashwa okubizwa ngokuthi i-sphincterotomy kanye ne-ERCP .
Iyini le Sphincterotomy?
Lokhu kuhilela ukusika ingxenye encane yezicubu ebizwa ngokuthi i-Sphincter of Oddi ngethuluzi elincane elidluliselwa ngethubhu yekhamera ngesikhathi sokuhlolwa kwe-ERCP. Ngemuva kwalokho, ukuvulwa okuqinile kuyavulwa unomphela. Ngemuva kwalokho, amajusi okugaya ukudla ageleza emathunjini amancane ngaphandle kokuvinjelwa. Lokhu cishe kuqeda ubuhlungu ngokuphelele.
Kodwa lokhu futhi kuyindlela yokwelapha enobungozi obuthile. Kukhona nengozi ye-pancreatitis. Ngakho-ke, lokhu kwelashwa kusetshenziselwa lapho ezinye izindlela zokwelapha zingaphumelelanga.
Umlayezo Wokuya Nawe Ekhaya
- Uma usenezinhlungu esiswini ngemva kokususwa kwenyongo yakho, ungakuzibi. Kungaba yi-Sphincter ye-Oddi Dysfunction.
- Nakuba lesi simo singasongeli impilo, ubuhlungu bungaba ukuphazamiseka okukhulu empilweni yakho yansuku zonke.
- Izimpawu azihlali zikhona, ngokwemvelo yalesi sifo ukuthi sibuye sidlule ngezikhathi ezithile.
- Udokotela wakho uzonquma ukuthi yiluphi uhlobo (I, II, noma III) lwesifo onaso ngokuhlolwa futhi uzokunikeza ukwelashwa okufanele kakhulu.
- Abanye abantu bangalawula ubuhlungu babo ngemithi kuphela. Abanye bangadinga ukwelashwa njengokuhlinzwa kwe-sphincterotomy.
- Ngaphambi kwanoma yikuphi ukwelashwa, khuluma nodokotela wakho ngokukhululekile ngezinzuzo kanye nokungalungi.
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