I-Zollinger-Ellison Syndrome (i-ZES) yisifo esingavamile esibangela ukuba izidumbu ezilodwa noma ngaphezulu zenzeke emanzini noma emaphethelweni amathumbu amancane okuthiwa i-duodenum. Kungabangela nezilonda ukuthuthukisa esiswini kanye ne-duodenum.
Ama-tumors abizwa ngokuthi i-gastrinomas, futhi ayesekela inani elikhulu le-hormone gastrin. Lokhu kubangela ukukhiqizwa ngokweqile kwesisu esiswini, okungabangela izilonda zamapulangwe .
Isifo se-Zollinger-Ellison asivamile, kanti nakuba kungenzeka noma kunini, abantu abaneminyaka engama-30 no-60 banamathuba amaningi okukuthuthukisa. Futhi, kubo bonke abantu abahlushwa isilonda sesilonda, amaphesenti amancane alabo bantu abazoba neZollinger-Ellison.
Amathumba anomdlavuza ngamaphesenti angu-50 amacala. Besebenzisa i-hormone ebizwa ngokuthi i-gastrin eyenza isisu sikhiqize i-asidi eningi kakhulu, okwenza kubangele izilonda zesisu nesisu (izilonda zamapulitiki). Izilonda ezibangelwa yi-ZES azilaleli kangcono ukwelashwa kunezilonda ezivamile ze-peptic ulcers. Yini eyenza abantu abane-ZES ukuba bahlakulele izicubu aziwa, kodwa cishe amaphesenti angu-25 amacala e-ZES ahlotshaniswa nesifo sofuzo esibizwa nge-neoplasia ye-endocrine eminingi.
Izimpawu
- Gnawing, ubuhlungu obuvuthayo esiswini
- Lobuhlungu buvame ukutholakala endaweni emkhatsini wesifuba ne-inkaba.
- Ukuzwa kwengcindezi, ukuqhuma, noma ukugcwala
- Lobuhlungu buvame ukuqala imizuzu engu-30 kuya kwangu-90 emva kokudla futhi kuvame ukukhululeka yi-antacids.
- Ubuhlungu noma ukuzwa okuvuthayo esiswini esisondela phezulu emphinjeni
- Lokhu kubangelwa ukuqubuka kwenhliziyo , noma i- reflux ye-gastroesophageal , futhi kwenzeka uma isisu siphindela phezulu.
- Ukuvota
- Ukuhlanza kungase kube negazi noma kufane nezindawo zekhofi.
- Uhudo
- Izitshalo zingase zibe iphunga elimnandi.
- Amnyama, ama-tarry esitokisini
- Igazi ezigodini lizokwenza libe mnyama obomvu noma omnyama, futhi bawenze bahlale noma bahlale benamathela.
- I-nausea
- Ukukhathala
- Ukungabi namandla
- Ukulahlekelwa kwesisindo
Izimbangela
Isifo se-Zollinger-Ellison sibangelwa isisu (gastrinoma) noma izicubu emaphakasini kanye nesiguli esincane esingaphezulu (duodenum). Lezi zicubu zikhiqiza i-hormone gastrin futhi zibizwa ngokuthi i-gastrinomas. Amazinga aphezulu e-gastrin abangela ukukhulelwa ngokweqile kwesisu esiswini. Lokhu kwanda kwe-acidity kungaholela ekuthuthukiseni izilonda zamapulisi ngaphakathi esiswini nase-duodenum.
Ukuxilongwa
Ukuhlolwa kwegazi
Ukuhlolwa kwegazi kwenziwa ukuze ubone ukuthi kunezinga eliphezulu le-gastrin egazini. Izinga eliphakeme le-gastrin lingase libonise izicubu ku-pancreas noma kwe-duodenum.
I-Barium X-ray
Isiguli siphuza uketshezi oluqukethe i-barium, oluzogqoka izindonga zesisu, isisu, ne-duodenum. I-ray ray iyathathwa ngaleso sikhathi. Udokotela uzobe esebuka ama-X-rays, efuna izibonakaliso zezilonda.
I-Endoscopy Ephezulu
Udokotela uhlola ngaphakathi kwesisu, isisu, ne-duodenum ngensimbi ebizwa ngokuthi i-endoscope, ithini elincane elikhanyayo elikhanyayo elinolwazi olunezibani. I-endoscope ifakwa emlonyeni nasehla emqaleni, futhi ngaphakathi esiswini nase-duodenum. Udokotela angabheka izilonda, futhi angasusa isampula yamathambo, ebizwa ngokuthi i-biopsy, ukuze ahlolwe ebhokisatri ukuthola ukuthi kukhona yini izicubu ezikhiqiza i-gastrin.
Izindlela Zokucabanga
Udokotela angasebenzisa ukuskena kwe-tomography (CT) yekhompyutha, ukuskena kwe-imagination magnetic resonance (MRI), ne-ultrasound, noma ukuskena kwe-nyukliya emzamweni wokukhomba ukuthi izidumbu zingatholakala kuphi.
- I- CT scan iyisimo sokuhlola esisebenzisa i-X-ray ngokusizwa ubuchwepheshe bekhompyutha. Izigxobo ze-X-ray zithathwe emajuba amaningi ahlukene ukuze zenze izithombe ezithintekayo zomzimba wesiguli. Khona-ke ikhompuyutha ihlanganisa lezi zithombe zibe isithombe sesithathu esingaveza izitho, amathambo nezicubu ngokuningiliziwe.
Ngesisindo se- MRI , izimpawu zamagnetic zisetshenziswa esikhundleni se-X-ray ukudala izithombe zomzimba womuntu. Lezi zithombe zibonisa umehluko phakathi kwezinhlobo zezicubu.
I- ultrasound ithumela amagagasi omsindo ophezulu oya endaweni ehlolwayo futhi avuselele lapho ehlasela isitho. Lokhu kusetshenzwa yikhompyutha, eveza ibalazwe yendawo ekhishwayo.
Ngenkinga ye- nyukliya , izinto ezinomsakazo zifakwa emzimbeni ovumela ikhamera ye-gamma ukuthola izicubu.
Izinkinga ze-Zollinger-Ellison Syndrome
Emaphesenti angu-50 eZollinger-Ellison, izicubu zinomdlavuza (okubi kakhulu). Uma izicubu zinomdlavuza, kunengozi ukuthi umdlavuza uzosakazeka esibindi, i-lymph nodes eduze ne-pancreas nomathumbu amancane.
Ezinye izinkinga ze-Zollinger-Ellison Syndrome
- Izilonda ezinamandla ezingaholela ekuthuthukiseni imbobo emathunjini
- Ukulahleka kwegazi
- Uhudo olungapheliyo
- Ukulahlekelwa kwesisindo
Ukwelapha
Ukwelashwa kwe-Zollinger-Ellison syndrome kugxile ezindaweni ezimbili: Ukwelapha izicubu nokuphatha izilonda.
Ukwelashwa Kwamathambo E-Zollinger-Ellison Syndrome
Kuvame ukuhlinzwa uma kunesifo esisodwa kuphela. Uma izicubu zisesibindi, udokotela ohlinzayo uzosusa isifo sofuba esingenakwenzeka ngangokunokwenzeka (ukuxoshwa).
Lapho ukuhlinzeka ngezidumbu kungenakwenzeka, ezinye izindlela zokwelapha zisetshenziswa:
- Ukuzama ukubhubhisa lesi sifo ngokunqamula ukunikezwa kwegazi (ukuhlanganiswa).
- Ukuzama ukubhubhisa amangqamuzana omdlavuza ngokusebenzisa i-electric current (ablation-frequency ablation).
- Ukujova izidakamizwa emzimbeni ukuze kutholakale izimpawu zomdlavuza.
- Ukusebenzisa i-chemotherapy ukuzama ukuphuza ukukhula kwe-tumor.
Ukwelashwa kwama-Ulcers ku-Zollinger-Ellison Syndrome
I-Proton Pump Inhibitors
Lena yimithi ephumelela kakhulu ye-Zollinger-Ellison syndrome. I-proton pump inhibitors inamandla kakhulu futhi igxila ukukhiqizwa kwe-asidi futhi ikhuthaza ukuphulukiswa. Izibonelo zeproton pump inhibitors zihlanganisa Prilosec , Prevacid , Nexium , Aciphex , ne- Protonix .
Ama-block Blockers
Lezi zibizwa nangokuthi abavimba be-histamine (H-2). Le mithi inciphisa inani le- hydrochloric acid elikhishwe ngaphakathi kwendlela yokugaya. Lokhu kusiza ukukhulula ubuhlungu besilonda nokukhuthaza ukuphulukiswa. Ama-acid blockers asebenza ngokugcina i-histamine ekufinyeleleni i-histamine receptors. I-Histamine receptors ibonakalisa amangqamuzana e-asidi-ukuvimbela esiswini ukuze akhiphe i-hydrochloric acid. Izibonelo ze-acid blockers zifaka i- Tagamet , i- Pepcid , i- Zantac , ne- Axid .
Ama-block blockers asebenzi kanye ne-proton pump inhibitors enza, futhi angeke amiswe udokotela. Kulabo bantu abasebenzisa ama-acid blockers, badinga amanani aphezulu, avamile ukuba asebenze.
Isibikezelo
Njengoba kushiwo ngenhla, ngamaphesenti angu-50 eZollinger-Ellison, izicubu zinomdlavuza. Ukuxilongwa kokuqala kanye nokuvulwa kwezinto ezihlinzekwayo kungafeza izinga lokuphulukisa lokuphela kwe-20% kuya kuma-25% kuphela. Kodwa-ke, ulwazi lwezokwelapha luthi gastrinomas ikhula kancane, futhi iziguli zingaphila iminyaka eminingi ngemuva kokuthola isisu. Imithi yokucindezela i-acid iphumelela kakhulu ekulawuleni izimpawu ze-acid ngaphezulu kokukhiqiza.
Lonke ulwazi kulesi sihloko luhlinzekelwe ngezinhloso zemfundo kuphela. Ukuze uthole ukuxilongwa, udinga ukubona umhlinzeki wakho wezempilo. Ngalesi sikhathi zonke izici zalesi simo, kanye nezinketho zokwelapha nokunakekela okuqhubekayo nokuqapha isimo, kufanele zixoxwe nodokotela wakho. Ngemva kokuxilongwa, uma kufanele uhlangabezane nezimpawu ezintsha noma ezimbi, lezi zimele zibikwe kudokotela wakho.