Kākoʻo pancreatitis

ʻO ka pancreatitis ākea ka pehu koke a me ka mumū o ka pancreas.

ʻO ka pancreas kahi lālā ma hope o ka ʻōpū. Hoʻopuka ia i nā hormones insulin a me ka glucagon. Hoʻopuka pū kekahi ia i nā kemika i kapa ʻia he mau enzyme e pono ai e ʻai i ka meaʻai.

ʻO ka hapanui o ka manawa, hana wale nā ​​enzyme ma hope o ka hiki ʻana i ka ʻōpū liʻiliʻi.

• Inā lilo kēia mau enzyme i mea hana i loko o ka pancreas, hiki iā lākou ke ʻōpala i ka iʻa o ka pancreas. ʻO kēia ke kumu o ka pehu ʻana, ke kahe ʻana o ke koko, a me ka hōʻino ʻana o ka ʻokena a me kāna mau kō koko.
• Kapa ʻia kēia pilikia he pancreatitis huʻi.

Hoʻopilikia ka pancreatitis koʻikoʻi i nā kāne ma mua o nā wahine. ʻO kekahi mau maʻi, nā ʻoki ʻana, a me nā ʻano maʻamau e hoʻomohala i kēia ʻano.

• ʻO ke kuleana o ka waiʻona ke kuleana a hiki i ka 70% o nā hihia i United States. Ma kahi o 5 a 8 mau mea inu i kēlā me kēia lā no 5 a ʻoi paha mau makahiki hiki ke hōʻino i ka pancreas.
• ʻO Gallstones ka kumu maʻamau i hiki mai. Ke hele aku nā gallstones mai ka gallbladder i loko o nā aʻa o ka bile, ālai lākou i ka puka e hoʻokahe i ka bile a me nā enzymes. ʻO ka bile a me nā enzymes "hoʻi i hope" i loko o ka pancreas a hana i ka pehu.
• ʻO Genetics paha ke kumu i kekahi mau hihia. I kekahi manawa, ʻike ʻole ʻia ke kumu.

ʻO nā kūlana ʻē aʻe i pili i ka pancreatitis:

• Nā pilikia Autoimmune (ke hoʻouka ka ʻōnaehana immune i ke kino)
• ʻO ka hōʻino i nā aʻa a me nā pancreas i ka wā o ke ʻoki
• ʻO nā kiʻekiʻe o ke koko kiʻekiʻe o kahi momona i kapa ʻia nā triglycerides - pinepine pinepine ma luna o 1,000 mg / dL
• ʻO ka ʻeha i ka pancreas mai kahi ulia

Nā kumu ʻē aʻe e:

• Ma hope o kekahi mau kaʻina hana e hoʻohana ai i ka diagnose gallbladder a me nā pilikia pancreas (ERCP) a i ʻole ke ultrasound biopsy alakaʻi
• ʻO Cystic fibrosis
• ʻO ke kino kelepaʻi overactive
• Reye maʻi maʻi
• Hoʻohana o kekahi mau lāʻau (ʻo ia hoʻi nā estrogens, corticosteroids, sulfonamides, thiazides, a me azathioprine)
• ʻO kekahi mau maʻi, e like me ka mumps, i pili i ka pancreas

ʻO ka hōʻailona nui o ka pancreatitis ka ʻeha i ʻike ʻia ma ka ʻaoʻao hema hema a i waena paha o ka ʻōpū. ʻO kaʻeha:

• Maikaʻi paha i loko o nā minuke ma hope o ka ʻai ʻana a inu paha i ka mua, ʻoi aku ka nui inā he momona ka momona o nā meaʻai
• Lilo i mau a ʻoi loa hoʻi, lōʻihi no nā lā he nui
• Eʻoi aku paha ka maikaʻi o ka moe ʻana ke kua i ka hope
• Pāhola paha (hoʻomālamalama) i ka hope a i ʻole ma lalo o ka lau poʻohiwi hema

ʻO ka poʻe me ka pancreatitis huʻikuʻi e nānā pinepine i ka maʻi a loaʻa ka maʻi fiva, nausea, luaʻi, a me ka hou.

ʻO nā ʻōuli ʻē aʻe e kū aʻe me kēia maʻi ʻo:

• Nā noho waihoʻoluʻu pālolo
• Bloating a piha
• Hiccups
• Inunaele
• Melemele ʻili o ka ʻili a keʻokeʻo o nā maka (jaundice)
• ʻŌpū pehu

E hana ka mea mālama ola i kahi hoʻokolohua kino, i hōʻike ʻia paha:

• Palupalu ʻōpū a puʻupuʻu paha (nui)
• Fiva
• Kaomi haʻahaʻa
• Helu puʻuwai wikiwiki
• Ka helu hanu wikiwiki (respiratory)

E hana ʻia nā hoʻokolohua lab e hōʻike ana i ka hoʻokuʻu ʻia ʻana o nā enzyme pancreatic. Pākuʻi ʻia kēia mau mea:

• Hoʻonui i ka pae amylase koko
• Hoʻonui i ka pae lipase koko serum (kahi hōʻike kikoʻī ʻoi o ka pancreatitis ma mua o nā pae amylase)
• Hoʻonui i ka pae mimi amylase

ʻO nā hoʻokolohua koko ʻē aʻe e hiki ke kōkua i ka diagnose pancreatitis a i ʻole nā ​​pilikia e pili pū me:

• Helu piha koko (CBC)
• Panela metabolic piha

ʻO nā hoʻokolohua kiʻi ʻana aʻe i hiki ke hōʻike i ka pehu ʻana o ka pancreas e hana ʻia, akā ʻaʻole pono mau ʻia e hana i kahi hōʻailona o ka pancreatitis koʻikoʻi.

• CT scan o ka ʻōpū
• MRI o ka ʻōpū
• Ultrasound o ka ʻōpū

Pono ka lapaʻau ʻana i ka noho ʻana i ka haukapila. Pili paha ia:

• Nā lāʻau ʻeha
• Nā Fluids i hāʻawi ʻia ma o kahi aa (IV)
• Ke kū nei i ka meaʻai a wai paha e ka waha e palena ai i ka hana o ka pancreas

Hoʻokomo ʻia kahi paipu ma o ka ihu a waha paha e hemo ai i nā mea o ka ʻōpū. Hana ʻia kēia inā ʻaʻole e hoʻomaikaʻi ka luaʻi a me ka ʻehaʻeha. E noho ka paipu i 1 a 2 mau lā i 1 a 2 mau pule.

ʻO ka mālama ʻana i ke ʻano i hiki i ka pilikia ke pale i nā hoʻouka hou ʻana.

I kekahi mau hihia, pono ka lāʻau e:

• Hoʻopili ka wai hoʻoliʻiliʻi i hōʻiliʻili i loko a i ʻole puni ka pancreas
• Wehe i nā kāhili
• Hōʻoluʻolu i nā palaka o ke kuʻi pancreatic

I nā hihia ʻoi loa, pono ke kīpē e wehe i nā mea i make, i make a i ʻole maʻi maʻi maʻi maʻi.

Hōʻalo i ka puhipaka, nā mea inu ʻona, a me nā mea momona momona ma hope o ka hoʻomaikaʻi ʻana.

Hele ka hapa nui o nā hihia i hoʻokahi pule a i ʻole emi. Eia nō naʻe, ulu aʻe kekahi mau hihia i kahi maʻi hoʻoweliweli.

Kiʻekiʻena ka make ma ke:

• ʻO ka maʻi koko i loko o ka pancreas i kū.
• Aia pū kekahi nā pilikia o ka ake, ka puʻuwai, a me ka hakuʻala.
• Hana kahi abscess i ka pancreas.
• Aia ka make a i ʻole nekrosis o nā nui o nā mea i loko o ka pancreas.

I kekahi manawa ʻaʻole hoʻōla pono ka ʻōhū a me ka maʻi. E hana hou i nā ʻāpana o ka pancreatitis. Hiki i kekahi o kēia mau mea ke alakaʻi i ka hōʻino wā lōʻihi o ka pancreas.

Hiki i ka Pancreatitis ke hoʻi. Aia ka manawa o ka hoʻi ʻana i ka kumu, a pehea e hiki ai ke mālama ʻia. Komo pū kekahi nā pilikia o ka pancreatitis huehue:

• Hewa kōwi koʻikoʻi
• ʻO ka hōʻino lung lōʻihi (ARDS)
• Kūkulu o ka wai i loko o ka ʻōpū (ascites)
• ʻO Cist a i ʻole abscesses i ka pancreas
• Hewa puʻuwai

Kāhea i kāu mea hāʻawi inā:

• Loaʻa iā ʻoe ka ʻeha o ka ʻōpū ikaika.
• Hoʻolālā ʻoe i nā ʻōuli ʻē aʻe o ka pancreatitis koʻikoʻi.

Hiki iā ʻoe ke hoʻohaʻahaʻa i kou makaʻu i nā ʻāpana hou a hou o ka pancreatitis ma o ka hana ʻana i nā hana e pale ai i nā kūlana olakino e hiki ai i ka maʻi.

• Mai inu i ka waiʻona inā ʻo ia ke kumu o ka hoʻouka kaua nui.
• E ʻike pono i nā keiki i nā lāʻau lapaʻau e pale aku ai iā lākou mai nā puʻupuʻu a me nā maʻi kamaliʻi.
• Hana i nā pilikia olakino e alakaʻi i nā kiʻekiʻe o ke koko o triglycerides.

Gallstone pancreatitis; Pancreas - pehu

• Pancreatitis - hoʻokuʻu

• ʻŌnaehana Digestive
• Nānā Endocrine
• Pancreatitis, huʻi - CT scan
• Pancreatitis - moʻo

Forsmark ce ʻO Pancreatitis. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 135.

ʻO Paskar DD, Marshall JC. Kākoʻo pancreatitis. I: Parrillo JE, Dellinger RP, eds. Lapaʻau mālama koʻikoʻi: nā loina o ka ʻike a me ka hoʻokele i ka makua. 5th lā. Piladelapia, PA: Elsevier; 2019: chap 73.

Tenner S, Baillie J, DeWitt J, Vege SS; Ke KulanuiʻAmelika o Gastroenterology. Ke Kulanui ʻAmelika o Gastroenterology alakaʻi: ka hoʻokele o ka pancreatitis koʻikoʻi. ʻO Am J Gastroenterol. 2013; 108 (9): 1400-1415. PMID: 23896955 www.ncbi.nlm.nih.gov/pubmed/23896955.

Tenner S, Steinberg WM. Kākoʻo pancreatitis. I: Feldman M, Friedman LS, Brandt LJ, eds. ʻO Sleisenger a me Fordtran's Gastrointestinal a me ka maʻi Liver: Pathophysiology / Diagnosis / Management. 10 o ka lā. Piladelapia, PA: Elsevier Saunders; 2016: chap 58.