Zollinger-Ellison Syndrome (ZES) ndi matenda osowa omwe amachititsa kuti mimba imodzi kapena yambiri ipangidwe mu kansalu kapena kumtunda kwa m'mimba mwachindunji wotchedwa duodenum. Zitha kuchititsanso zilonda kukula m'mimba ndi duodenum.
Ziphuphu zimatchedwa gastrinomas, ndipo zimatulutsa kuchuluka kwa hormone gastrin. Izi zimayambitsa kuchuluka kwa mimba ya asidi, yomwe ingabweretse zilonda zam'mimba .
Matenda a Zollinger-Ellison ndi osowa, ndipo ngakhale angathe kuchitika pa msinkhu uliwonse, anthu a zaka zapakati pa 30 ndi 60 ali ndi mwayi wokhala nawo. Komanso, anthu onse omwe akudwala zilonda zam'mimba, ndizochepa chabe za anthu omwe ali ndi Zollinger-Ellison.
Matendawa ali ndi khansa mu 50 peresenti ya milandu. Amatulutsa mahomoni otchedwa gastrin omwe amachititsa m'mimba kubala acid kwambiri, zomwe zimayambitsa zilonda zam'mimba ndi zilonda zam'mimba (zilonda zam'mimba). Zilonda zomwe zimayambitsidwa ndi ZES zimakhala zosavomerezeka kuchipatala kusiyana ndi zilonda zapadera. Chomwe chimayambitsa anthu okhala ndi ZES kukhala ndi zotupa sichidziwika, koma pafupifupi 25 peresenti ya milandu ya ZES ili ndi matenda a chibadwa otchedwa multiple endocrine neoplasia.
Zizindikiro
- Kuwombera, kupweteka koopsa m'mimba
- Nthawi zambiri ululuwu umakhala pakati pa chifuwa chachikulu.
- Kutengeka kwa kupanikizika, kuphulika, kapena chidzalo
- Nthawi zambiri ululuwu umakhala mphindi 30 mpaka 90 mutatha kudya ndipo nthawi zambiri amamasulidwa ndi antacids.
- Kupweteka kapena kutentha m'mimba kumene kumapita kummero
- Izi zimachitika chifukwa cha kupweteka kwa mtima , kapena reflux ya gastroesophageal , ndipo zimapezeka pamene mimba imabwerera m'mimba.
- Kuthamanga
- Masanzi angakhale ndi magazi kapena amafanana ndi khofi.
- Kutsekula m'mimba
- Zitsulo zingakhale zonunkha.
- Black, tarry stools
- Magazi m'mabowo adzawachititsa kukhala ofiira kapena oda, ndipo amawapangitsa kukhala otetezeka kapena osakaniza.
- Nausea
- Kutopa
- Kufooka
- Kutaya thupi
Zimayambitsa
Matenda a Zollinger-Ellison amayamba chifukwa cha chotupa (gastrinoma) kapena zotupa m'zipinda komanso chapamwamba cham'mimba (duodenum). Ziphuphuzi zimapanga gastrin ya hormone ndipo amatchedwa gastrinomas. MaseĊµera apamwamba a gastrin amachititsa kuti pakhale kuchuluka kwa mimba ya asidi. Kuwonjezeka kwa acidity kungayambitse kukula kwa zilonda zam'mimba m'mimba ndi duodenum.
Kudziwa
Mayeso a Magazi
Kuyezetsa magazi kumachitidwa kuti tiwone ngati pali chiwerengero cha gastrin m'magazi. Gastrin yapamwamba imatha kusonyeza zotupa m'mapangidwe kapena duodenum.
Barium X-ray
Wodwala amamwa madzi omwe ali ndi barium, omwe amavala makoma a mimba, m'mimba, ndi duodenum. Zithunzizi zimatengedwa. Dokotalayo amatha kuona ma X-ray, kufunafuna zizindikiro za zilonda zam'mimba.
Kutsika Kwambiri Kwambiri
Dokotala akufufuza mkati mwa mimba, m'mimba, ndi duodenum ndi chida chotchedwa endoscope, chubu chofewa chophwanyika ndi diso. Endoscope imayikidwa kudzera pakamwa ndi pansi mmero, ndi mmimba ndi duodenum. Dokotala akhoza kuyang'ana zilonda zam'mimba, ndipo amatha kuchotsa zitsulo, zomwe zimatchedwa kuti biopsy, pofuna kukayezetsa mu laboratori kuti adziwe ngati pali kupezeka kwa zotupa za gastrin.
Njira Zoganizira
Dokotala angagwiritse ntchito kanema wa kompyuta (CT) scan, maginito opanga maginito (MRI) scan, ndi ultrasound, kapena scanuclear nyukiliya pofuna kuyang'ana kumene ziphuphu zingakhalepo.
- A CT scan ndi test diagnostic test yomwe imagwiritsa ntchito X-rays mothandizidwa ndi matekinoloje a pakompyuta. Mizere ya X-ray imatengedwa kuchokera kumbali zosiyanasiyana kuti apange zithunzi zosiyana siyana za thupi la wodwalayo. Kenaka makompyuta amasonkhanitsa zithunzizi kukhala chithunzi chokhala ndi zithunzi zitatu zomwe zingasonyeze ziwalo, mafupa, ndi ziphuphu mwatsatanetsatane.
Pogwiritsa ntchito MRI , zizindikiro zamaginito zimagwiritsidwa ntchito m'malo mwa X-rays kupanga mapangidwe a thupi la munthu. Zithunzi izi zimasonyeza kusiyana pakati pa mitundu ya ma tishu.
An ultrasound imatumiza mafunde amphamvu kwambiri omwe amapita kumalo omwe akufufuzidwa ndi kubwezeretsanso pamene agunda limba. Izi zimakonzedwa ndi makompyuta, omwe amapanga mapu a malo omwe akuwonedwa.
Pogwiritsa ntchito zida za nyukiliya , zinthu zotulutsa radioactive zimalowa m'thupi lomwe limalola kamera kamera kuti ione zotupa.
Zovuta za Zollinger-Ellison Syndrome
Pa 50 peresenti ya Zollinger-Ellison, zotupazo ndi khansa (zovuta). Ngati zotupazo zili ndi khansa, kadoyo imafalikira ku chiwindi, nthenda zam'mimba pafupi ndi ziphuphu komanso m'mimba.
Zovuta Zina za Zollinger-Ellison Syndrome
- Zilonda zoopsa zomwe zingayambitse chitukuko m'matumbo
- Kutaya magazi
- Kutsegula m'mimba
- Kutaya thupi
Chithandizo
Chithandizo cha matenda a Zollinger-Ellison chimayang'ana mbali ziwiri: Kuchiza matenda ndi kuchiza zilonda.
Kuchiza kwa Mafupa mu Zollinger-Ellison Syndrome
Nthawi zambiri opaleshoni imachitika ngati pali chotupa chimodzi chokha. Ngati zotupa zili m'chiwindi, dokotala wa opaleshoni amachotsa chifuwa cha chiwindi monga momwe angathere (debulking).
Pamene opaleshoni pamatenda sizingatheke, mankhwala ena amagwiritsidwa ntchito:
- Kuyesera kuthetsa chotupacho mwa kudula magazi (kupanga).
- Kuyesera kuwononga maselo a khansa pogwiritsa ntchito mphamvu yamagetsi (abasi-frequency ablation).
- Kugwiritsa ntchito mankhwala osokoneza bongo mu chifuwa kuti athetse zizindikiro za khansa.
- Kugwiritsa ntchito chemotherapy kuyesa kuchepetsa kupweteka kwa chifuwa.
Kuchiza kwa Ulcers mu Zollinger-Ellison Syndrome
Proton Pump Inhibitors
Awa ndi mankhwala othandiza kwambiri pa matenda a Zollinger-Ellison. Proton pump inhibitors ali amphamvu kwambiri ndipo amalepheretsa kupanga acid ndi kupititsa patsogolo machiritso. Zitsanzo za proton pump inhibitors zikuphatikizapo Prilosec , Prevacid , Nexium , Aciphex , ndi Protonix .
Amadzimadzi a Acid
Izi zimatchedwanso kuti histamine (H-2). Mankhwalawa amachepetsa kuchuluka kwa hydrochloric acid yomwe imatulutsidwa m'magazi. Izi zimathandiza kuthetsa ululu wa zilonda ndikulimbikitsa machiritso. Acid blockers amagwira ntchito mwa kusunga mbiri ya histamine kuti asafike ku histamine receptors. Zolemba za mbiri yakale zimatulutsa maselo osungira asidi m'mimba kuti atulutse asidikloric acid. Zitsanzo za acid blockers ndi Tagamet , Pepcid , Zantac , ndi Axid .
Acid blockers sagwira ntchito komanso proton pump inhibitors amachita, ndipo sangalamulidwe ndi dokotala. Kwa anthu omwe amagwiritsa ntchito acider blockers, amafunika mlingo wapamwamba, kawirikawiri kuti iwo agwire ntchito.
Kuthamangitsani
Monga tafotokozera pamwambapa, 50 peresenti ya Zollinger-Ellison, zotupa ndi khansa. Kufufuza koyambirira kwa matendawa komanso njira yopangira opaleshoniyo imatha kupeza chithandizo chochiza cha 20% mpaka 25%. Komabe, chidziwitso cha zachipatala chimanena kuti gastrinomas ikukula mofulumira, ndipo odwala angakhale ndi moyo zaka zambiri chifuwa chikupezeka. Mankhwala osokoneza bongo ndi othandiza kwambiri poletsa zizindikiro za acid kwambiri.
Zonse zafotokozedwa m'nkhaniyi zakhala zikuperekedwa pazinthu zophunzitsa zokha. Kuti mudziwe, muyenera kuwona wothandizira zaumoyo wanu. Panthawiyi zonse zomwe zili mmoyo uno, pamodzi ndi njira zosamalidwa ndi chithandizo chokhazikika ndi kuyang'anira chikhalidwe, ziyenera kukambidwa ndi dokotala wanu. Mutatha kupeza matenda, ngati mukuyenera kuwona ndi zizindikiro zatsopano kapena zowonjezereka, izi ziyenera kuuzidwa kwa dokotala wanu.