Matenda a Zollinger-Ellison

Matenda a Zollinger-Ellison ndimkhalidwe womwe thupi limatulutsa mahomoni ambiri a gastrin. Nthawi zambiri, chotupa chaching'ono (gastrinoma) m'mapapo kapena m'matumbo ang'onoang'ono ndimomwe mumachokera gastrin yowonjezera m'magazi.

Matenda a Zollinger-Ellison amayamba chifukwa cha zotupa. Kukula kumeneku kumapezeka m'mutu wa kapamba komanso m'matumbo ang'onoang'ono. Zotupa zimatchedwa gastrinomas. Kuchuluka kwa gastrin kumapangitsa kupanga asidi m'mimba kwambiri.

Gastrinomas amapezeka ngati zotupa m'modzi kapena zotupa zingapo. Gawo limodzi mpaka magawo awiri mwa atatu aliwonse a gastrinomas amodzi ndi zotupa za khansa (zoyipa). Zotupazi nthawi zambiri zimafalikira ku chiwindi komanso ma lymph node apafupi.

Anthu ambiri omwe ali ndi gastrinomas ali ndi zotupa zingapo ngati gawo la vuto lotchedwa multiple endocrine neoplasia mtundu I (MEN I). Zotupa zimatha kutuluka m'matumbo (pituitary gland) ndi ubongo wa parathyroid (khosi) komanso m'mapapo.

Zizindikiro zimaphatikizapo:

• Kupweteka m'mimba
• Kutsekula m'mimba
• Kusanza magazi (nthawi zina)
• Zizindikiro zazikulu za esophageal reflux (GERD)

Zizindikiro zimaphatikizapo zilonda zam'mimba ndi matumbo ang'onoang'ono.

Mayeso ndi awa:

• M'mimba mwa CT scan
• Kuyesedwa kwa calcium
• Endoscopic ultrasound
• Opaleshoni yofufuza
• Mulingo wamagazi wa Gastrin
• Kujambula kwa Octreotide
• Mayeso okondoweza a Secretin

Mankhwala otchedwa proton pump inhibitors (omeprazole, lansoprazole, ndi ena) amagwiritsidwa ntchito pochiza vutoli. Mankhwalawa amachepetsa kupanga asidi m'mimba. Izi zimathandiza zilonda zam'mimba ndi matumbo ang'onoang'ono kuchira. Mankhwalawa amathandizanso kupweteka m'mimba ndi kutsegula m'mimba.

Kuchita opaleshoni yochotsa gastrinoma imodzi kumatha kuchitidwa ngati zotupa sizinafalikire ku ziwalo zina. Kuchita opaleshoni pamimba (gastrectomy) kuwongolera kupanga acid sikofunikira kwenikweni.

Mankhwala ake ndi ochepa, ngakhale atapezeka msanga ndipo chotupacho chimachotsedwa. Komabe, gastrinomas imakula pang'onopang'ono.Anthu omwe ali ndi vutoli atha kukhala zaka zambiri chotupacho chikupezeka. Mankhwala opondereza acid amagwira ntchito bwino kuti athetse vutoli.

Zovuta zingaphatikizepo:

• Kulephera kupeza chotupacho panthawi ya opaleshoni
• Kutuluka m'mimba kapena dzenje (zotsekemera) kuchokera ku zilonda zam'mimba kapena duodenum
• Kutsekula m'mimba kwambiri ndi kuchepa thupi
• Kufalikira kwa chotupacho ku ziwalo zina

Itanani okhudzana ndi zaumoyo wanu ngati muli ndi ululu wam'mimba womwe sukutha, makamaka ukachitika ndi kutsekula m'mimba.

Matenda a Z-E; Mimba

• Matenda a Endocrine

Jensen RT, Norton JA, Oberg K. Zotupa za Neuroendocrine. Mu: Feldman M, Friedman LS, Brandt LJ, olemba. Sleisenger ndi Matenda a Mimba ndi a Fordtran Amatenda a Chiwindi. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016: chap 33.

Vella A. Mahomoni am'mimba ndi zotupa m'matumbo. Mu: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, olemba. Buku la Williams la Endocrinology. Wolemba 13. Philadelphia, PA: Elsevier; 2016: chap 38.