Zollinger-Ellison Syndrome (ZES) chirwere chisina kujairika chinokonzera imwe kana kupfuura zviremara kuti zviumbe mupancre kana kuti chikamu chepamusoro chemukati muduku unonzi duodenum. Inogonawo kuita kuti ulcers ibude mudumbu uye duodenum.
Maviri acho anonzi gastrinomas, uye anonyora boka guru rehomoni gastrin. Izvo zvino zvinokonzera kugadzirwa kwakanyanyisa kwemuviri acid, izvo zvinogona kutungamirira kune zvipembenene zveputi .
Zollinger-Ellison syndrome haigoni, uye kunyange inogona kuitika chero ipi zvayo, vanhu vari pakati pemakore makumi matatu nemakumi matanhatu vanowanzoita kuti ive nayo. Uyewo, kune vanhu vose vanotambura nechirwere cheputi, chete zvishoma zvishoma zvevanhu ivavo vachava neZollinger-Ellison.
Maviri acho ane kenza muna 50 muzana yematambudziko. Vanoshandisa hormone inonzi gastrin inokonzera mudumbu kubudisa yakawandisa asidi, iyo inokonzera dumbu uye zveodenal ulcers (peptic ulcers). Zvironda zvinokonzerwa neZES hazvirevi kubvuma kurapwa kupfuura zvipembenene zvinowanzoitika. Chikonzero chinokonzera vanhu vane ZES kuti vashandise tumarara hazvizivikanwi, asi inenge 25 muzana yematambudziko eZES anowanikwa nehutano hwema genetic inonzi multiple endocrine neoplasia.
Zviratidzo
- Gnawing, kurwadziwa kupisa mudumbu
- Iyo kurwadziwa inowanzowanikwa munzvimbo iri pakati pemafupa uye narava.
- Kunzwa kwekumanikidzika, kuputika, kana kuzara
- Iyo kurwadziwa inowanzotanga maminitsi makumi matatu nemakumi matatu mushure mekudya uye kazhinji inodururwa nemasikirasi.
- Nhamo kana kutsva kunzwa mumudumbu kunofamba kuenda kumutsipa
- Izvi zvinokonzerwa nokuputika, kana gastroesophageal reflux , uye inoitika apo dumbu riri mukati maro kusvika mudenga.
- Kudzora
- Muchirwe angave ane ropa kana kufanana nefivha.
- Diarrhea
- Zvigadziro zvinogona kunge zvinyangadza.
- Dema, tarry mashizha
- Ropa muzvigaro richaita kuti rive rima rakatsvuka kana rima, uye vanoita kuti varare kana kunamatira.
- Nausea
- Kuneta
- Kushaya simba
- Kuonda
Zvinokonzera
Zollinger-Ellison syndrome inokonzerwa nechirwere (gastrinoma) kana matumire mupakreas uye nechepamusoro madiki (duodenum). Izvi zvinokonzera hormone gastrin uye inonzi gastrinomas. High mazinga e gastrin anokonzera kupererwa kwemuviri acid. Iko kukura mu acidity kunogona kutungamirira kukura kwezviputi zvepptic mudumbu uye duodenum.
Kuziva
Blood Test
Kuongororwa kweropa kunoitwa kuti uone kana pane gastrin yakawedzera muropa. Nhamba yakakwirira yegastrin inogona kuratidza matumbo mupancreas kana duodenum.
Barium X-ray
Murwere anonwa mvura ine bhayoum, iyo ichapfekedza masvingo ehutu, dumbu, uye duodenum. X-ray inotorwa. Chiremba achazoona ma X-rays, achitsvaga zviratidzo zvezvironda.
Pamusoro Endoscopy
Chiremba anoongorora mukati mechiri, mudumbu, uye duodenum ane chiridzwa chinonzi endoscope, tsvina yakajeka yakagadzika tube ine lens. Endoscope inowanikwa mumuromo uye pasi pasi pomutsipa, uye mukati mudumbu uye duodenum. Chiremba anokwanisa kutsvaga maronda, uye anogonawo kubvisa mhando yemaoko, inonzi biopsy, yekuongororwa mu laboratori kuti aone kana kune kuvepo kwemakumbo anogadzira gastrin.
Imaging Techniques
Chiremba angashandisa kombiyuta inonzi tomography (CT) scan, magnetic resonance imaging (MRI) scan, uye ultrasound, kana kuti nyukliya scan mukuedza kutsvaga kuti mamota angave ari kupi.
- A CT scan ndiyo chirwere chekuongorora chinoshandisa X-rays achibatsirwa nekombiyuta yekombiyuta. I-X-ray mapuranga anotorwa kubva kumativi akawanda akasiyana-siyana kuti aite zvikamu zvemuchinjikwa wemuviri wemurwere. Ipapo kombiyuta inounganidza mifananidzo iyi mufananidzo wechitatu-iyo inogona kuratidza nhengo, mapfupa, uye matukisi zvakanyatsotsanangura.
NeMRI scan , magnetic zviratidzo zvinoshandiswa panzvimbo ye X-rays kuti zvive nemifananidzo yemuviri womunhu. Iyi mifananidzo inoratidza kusiyana pakati pemhando dze tishu.
An ultrasound inotumira mazwi-e-sound waves anosvika munzvimbo iyo iri kuongororwa uye inoputika kana ichirova nhengo. Izvi zvinoshandiswa nekombiyuta, iyo inogadzira mapu ezvimbo iri kuongororwa.
Ne nyukireya scan , radioactive zvinhu zvinowanikwa mumuviri unobvumira gamma kamera kuti aone tumarara.
Matambudziko eZollinger-Ellison Syndrome
Muchikamu makumi mashanu zvezviitiko zveZollinger-Ellison, maronda aya ane kenza (yakaipa). Kana zvipembenene zvine kenza, kune ngozi yokuti kenza inopararira kuchiropa, maitiro ane lymph node pedyo nepancreas uye musikana muduku.
Zvimwe Zvinetso zveZollinger-Ellison Syndrome
- Zvironda zvakanyanya izvo zvinogona kutungamirira kukura kwehongo muhomwe
- Kurasikirwa neropa
- Kuramba kwezuva
- Kuonda
Kurapa
Mushonga weZollinger-Ellison syndrome unotarisa pane zvikamu zviviri: Kurapa maronda uye kubata zvironda.
Kurapa Kwemishonga muZollinger-Ellison Syndrome
Kuvhiya kunowanzoitwa kana kune dumbu rimwe chete. Kana zvipembenene zviri muropa, chiremba anovhiya achabvisa chiremera chikuru cheropa (debulking).
Apo kuvhiyiwa pamakumbo hazvibviri, dzimwe mishonga inoshandiswa:
- Kuedza kuparadza tumarara kuburikidza nekugura ropa rekushandisa (embolization).
- Kuedza kuparadza masero emukenza nekushandisa magetsi (radio-frequency ablation).
- Injecting drugs in the tumor to relieve the symptoms of cancer.
- Kushandisa chemotherapy kuedza kunonoka kuora kwekukura.
Kurapa kweUlcers muZollinger-Ellison Syndrome
Proton Pump Inhibitors
Iyi ndiyo mishonga inobatsira zvikuru yeZollinger-Ellison syndrome. Proton pump inhibitors vane simba uye vanodzvinyirira kushandiswa kweAsiri uye vanokurudzira kuporesa. Mienzaniso yeproton pump inhibitors inosanganisira Prilosec , Prevacid , Nexium , Aciphex , uye Protonix .
Acid Blockers
Izvi zvinonziwo histamine (H-2). Iyi mishonga inoderedza huwandu hwehydrochloric acid yakabudiswa mumugwagwa wekudya. Izvi zvinobatsira kubvisa marwadzo ekuonda uye kukurudzira kuporesa. Acid blockers inoshanda nekuchengeta histamine kubva pakufikira histamine receptors. Histamine receptors inoratidza mashizha e-acid-secreting mudumbu kuti asunungure hydrochloric acid. Mienzaniso yeAid block blockers inosanganisira Tagamet , Pepcid , Zantac , uye Axid .
Acid blockers haishande pamwe neproton pump inhibitors, uye haigoni kurongerwa nachiremba. Kune vanhu avo vanoshandisa acid blockers, vanoda ruzivo rwepamusoro, kazhinji kuti ivo vabudirire.
Prognosis
Sezvakataurwa pamusoro apa, mu50 muzana yezviitiko zveZollinger-Ellison, zvipembenene zvine kenza. Kutanga kuongororwa uye kushandiswa kwakagadzirwa kunogona kupedza chirwere chepurasi ye 20% kusvika 25% chete. Zvisinei, ruzivo rwezvechiremba runotaura kuti gastrinomas inokura zvishoma, uye varwere vanogona kurarama kwemakore akawanda mushure mekunge bundu rakawanikwa. Acid-suppressing mishonga inoshanda zvikuru mukudzivirira zviratidzo zve acid asiri kupfuura.
Zvose zviri munyaya ino zvakapiwa zvidzidzo zvekudzidzisa chete. Kana uchida kuziva, iwe unoda kuona mutengi wako wehutano. Panguva ino zvikamu zvose zvechiitiko ichi, pamwe chete nekusarudzwa kwekurapa uye kuchengetwa kwakasimba uye kutarisa kwemamiriro acho ezvinhu, kunofanira kukurukurwa nachiremba wako. Mushure mekunge uongororwa, kana iwe uchifanira kuve nekuona zviratidzo zvitsva kana kuti zvinowedzera, izvi zvinofanira kuudzwa kune chiremba wako.