Maʻi Whipple

ʻO ka maʻi Whipple kahi ʻano laha ʻole e hoʻopili nui i ka ʻōpū liʻiliʻi. Pale kēia i ka ʻōpū liʻiliʻi mai ka ʻae ʻana i nā mea momona e hele i ke koena o ke kino. Kapa ʻia kēia malabsorption.

Hoʻokumu ʻia ka maʻi Whipple e ka maʻi me kahi ʻano o nā bacteria i kapa ʻia ʻO Tropheryma whipplei. Hoʻopili ka maʻi i nā kāne keʻokeʻo o ka makahiki waena.

Kākaʻikahi loa ka maʻi whipple. ʻAʻole ʻike ʻia nā mea weliweli.

Hoʻomaka e hoʻomaka mālie nā ʻōuli. ʻO kaʻeha hui ka hōʻailona maʻamau o ka wanaʻao. Hōʻike pinepine ʻia nā ʻōuli o ka maʻi ʻōpū (GI) i kekahi mau makahiki i hala. Hiki i nā ʻōuli ʻē aʻe ke:

• Abdominal eha
• Pohā
• Fiva
• ʻEleʻele o ka ʻili i nā wahi mālamalama o ke kino
  
• ʻO kaʻeha hoʻohui i nā kuʻekuʻe wāwae, nā kuli, nā kuʻe lima, nā manamana lima, a me nā wahi ʻē aʻe
• Poho hoʻomanaʻo
• Hoʻololi manaʻo
• Kaumaha emi

E hana ka mea mālama ola i kahi hoʻokolohua kino. Hōʻike paha kēia:

• Hoʻonui ʻia nā gland lymph
• Ohumu puuwai
• ʻO ka pehu ʻana i nā kino o ke kino (edema)

Hiki i nā hoʻokolohua ke kuhikuhi i ka maʻi Whipple:

• Helu piha koko (CBC)
• ʻO ka hopena Polymerase chain reaction (PCR) e hōʻoia ai e ʻike i nā koʻohune i kumu i ka maʻi
• Biopsy ʻōpū liʻiliʻi
• ʻO ka endoscopy GI kiʻekiʻe (ke nānā nei i nā ʻōpū me kahi ʻōwili maʻalahi, kukui i kahi hana i kapa ʻia enteroscopy)

Hoʻololi paha kēia maʻi i nā hopena o nā hōʻike aʻe:

• Nā pae Albumin i ke koko
• ʻO ka momona i unabsorbed ʻole i nā noho (fecal fat)
• Hoʻopau ka Intestinal o kahi ʻano kō (d-xylose absorption)

Pono nā poʻe me ka maʻi Whipple e lawe i nā lāʻau antibiotic lōʻihi e hoʻōla i nā maʻi o ka lolo a me nā ʻōnaehana waena. Hāʻawi ʻia kahi antibiotic i kapa ʻia ʻo ceftriaxone ma o kahi aa koko (IV). Hahai ʻia e kekahi lāʻau ʻalopika (e like me trimethoprim-sulfamethoxazole) i lawe ʻia e ka waha a hiki i 1 makahiki.

Inā hoʻi mai nā ʻōuli i ka wā o ka lāʻau antibiotic, hiki ke hoʻololi ʻia nā lāʻau.

Pono kāu mea lawelawe e ukali pono i kāu holomua. Hiki i nā ʻōuli o ka maʻi ke hoʻi ma hope o kou hoʻopau ʻana i nā lāʻau. ʻO ka poʻe e noho mau ana i ka maʻi palapū e pono nō hoʻi e lawe i nā mea hoʻopiha papaʻai.

Inā ʻaʻole mālama ʻia, make pinepine ke kūlana. Hoʻomaha ka mālama ʻana i nā ʻōuli a hiki ke hoʻōla i ka maʻi.

Komo pū nā pilikia:

• Poino lolo
• Poino puʻuwai puʻuwai (mai endocarditis)
• Nā hemahema ʻaiaola
• Hoʻi nā ʻōuli (ʻo ia paha ma muli o ke kūpaʻa lāʻau)
• Kaumaha emi

Kāhea i kāu mea hāʻawi inā loaʻa iā ʻoe:

• ʻEha hui e hele ʻole
• Abdominal eha
• Pohā

Inā mālama ʻia ʻoe no ka maʻi Whipple, kāhea i kāu mea hāʻawi inā:

• Hele a maikaʻi ʻole nā ​​ʻōuli a hoʻomaikaʻi ʻole paha
• Hōʻike hou ʻia nā ʻōuli
• Hoʻolālā nā ʻōuli hou

Lipodystrophy ʻōpū

Maiwald M, von Herbay A, Relman DA. Maʻi Whipple. I: Feldman M, Friedman LS, Brandt LJ, eds. ʻO Sleisenger a me Fordtran's Gastrointestinal a me ka maʻi ate. 11th hua. Piladelapia, PA: Elsevier; 2021: chap 109.

ʻO Marth T, ʻo Schneider T. ʻO ka maʻi Wh whipple. I: Bennett JE, Dolin R, Blaser MJ, hua pā. ʻO Mandell, Douglas, a me Bennett's Principle a me ka hoʻomaʻamaʻa ʻana i nā maʻi kūpilikiʻi. 9th ed. Piladelapia, PA: Elsevier; 2020: chap 210.

SG Komohana Nā maʻi ʻōnaehana i kahi hiʻohiona kahi hiʻohiʻona. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 259.