Zollinger Ellison Syndrome

Zollinger-Ellison syndrome chirwere chinoitika apo imwe kana dzakawanda zvironda zvinokura mu pancreas kana mumatumbu maduku. Zvironda izvi, zvinonzi gastrinomas, zvinogadzira mahomoni akawanda e gastrin. Gastrin inokonzera kuti mudumbu ugadzire asidhi yakawanda, izvo zvinoita kuti pave nemaronda emudumbu. Kuwanda kwe gastrin kunogona kukonzera manyoka, kurwadziwa mudumbu nezvimwe zviratidzo. Zollinger-Ellison syndrome chirwere chisingawanzoitika. Kunyange zvazvo chingangoitika chero nguva muhupenyu, vanhu vanowanzozviziva pakati pemakore makumi maviri nemakumi mashanu. Mishonga inoderedza asidhi yemudumbu uye inorapisa maronda ndiyo kurapwa kunoita kazhinji. Vamwe vanhu vangadawo kuvhiyiwa kuti vabviswe zvironda.

'Zviratidzo zveZollinger-Ellison syndrome zvinogona kusanganisira: Kurwadziwa kwemudumbu. Kuenda kunyoro. Kupisa, kurwadziwa kana kusagadzikana mudumbu repakati. Acid reflux neheartburn. Kuburitsa gasi. Kusvotwa nekurutsa. Kubuda ropa munzira yako yekudya. Kurasikirwa uremu pasina kuedza. Kurasikirwa nechido chekudya. Ona nyanzvi yehutano kana iwe uine kupisa, kurwadziwa mudumbu repakati kunoramba kuripo - kunyanya kana iwe uinewo kusvotwa, kurutsa uye kuenda kunyoro. Udza nyanzvi yako yekutarisira kana iwe wakange uchishandisa mishonga inowanikwa pasina chinyorwa chekurapa kuderedza asidhi yemudumbu. Izvi zvinosanganisira omeprazole (Prilosec, Zegerid), cimetidine (Tagamet HB) kana famotidine (Pepcid AC). Mishonga iyi inogona kuvharira zviratidzo zvako, izvo zvinogona kukanganisa kuongororwa kwako.'

Ona chiremba kana iwe uchinge uine kurwadziwa kunopfuta, kunorwadza mudumbu rako rekumusoro, kunoramba kuripo—kunyanya kana iwe uinewo manyoka, kurutsa, uye manyoka. Udza chiremba wako kana wakange uchishandisa mishonga yekutengesa kuti udzivise asidhi yemudumbu. Idzi dzinosanganisira omeprazole (Prilosec, Zegerid), cimetidine (Tagamet HB) kana famotidine (Pepcid AC). Mishonga iyi inogona kuvharira zviratidzo zvako, izvo zvingadai zvakakanganisa kuongororwa kwako.

Chikonzero chaicho cheZolinger-Ellison syndrome hachizivikanwi. Asi maitiro e zviitiko zvinoitika muZolinger-Ellison syndrome kazhinji anotevera nhanho imwe chete. Syndrome iyi inotanga kana imwe kana dzakawanda zvipembenene zvikaunda mu pancreas kana chikamu cheura duku chinonzi duodenum. Duodenum ndicho chikamu chakabatana nechibhakera. Dzimwe nguva zvipembenene izvi zvinoumba kune dzimwe nzvimbo, dzakadai sema lymph nodes ari pedyo ne pancreas. Pancreas inogara kumashure kwechibhakera. Inogadzira enzymes dzinoshandiswa pakugaya chikafu. Pancreas inogadzirawo mahomoni mazhinji, kusanganisira insulin. Insulin ndiyo hormone inobatsira kudzora shuga yeropa, inonziwo glucose. Zvinwiwa zvekugeza kubva ku pancreas, ropa uye gallbladder zvinosanganiswa mu duodenum. Ndokuzviitika kwakawanda kwekugaya. Zvipembenene zvinoumba neZolinger-Ellison syndrome zvakagadzirwa nema cell anoburitsa mahomoni mazhinji e gastrin. Nechikonzero ichi, dzimwe nguva zvinonzi gastrinomas. Kuwedzera kwe gastrin kunokonzera kuti chibhakera chigadzire asidhi yakawanda kwazvo. Asidhi yakawandisa inoita kuti pave ne peptic ulcers uye dzimwe nguva kuenda kudiarrhoea. Kunze kwekukonzera kuwedzera kwekuita kwe asidhi, zvipembenene izvi kazhinji zvine cancer. Kunyange zvazvo zvipembenene izvi zvinowanzo kukura zvishoma nezvishoma, cancer inogona kupararira kune dzimwe nzvimbo - kazhinji ku lymph nodes iri pedyo kana ropa. Zollinger-Ellison syndrome inogona kukonzerwa nechirwere chinonzi multiple endocrine neoplasia, rudzi 1 (MEN 1). Vanhu vane MEN 1 vanewo zvipembenene mu parathyroid glands. Vangave nezvipembenene mu pituitary glands zvakare. Anenge 25% yevanhu vane gastrinomas vane sechikamu cheMEN 1. Vangavewo nezvipembenene mu pancreas nedzimwe nhengo.

Kana uine hama yepedyo, sehama kana mubereki, ane MEN 1, zvinonyanya kuita kuti uve neZollinger-Ellison syndrome.

Nyanzvi yehutano inowanzotora chirwere chacho ichibva pane zvinotevera: Nhoroondo yezvokurapa. Nyanzvi yezvokurapa kazhinji inobvunza nezve zviratidzo uye inotarisa nhoroondo yezvokurapa. Kuongororwa kweropa. Sampuli yeropa inotarwa kuti ione kana mazinga e gastrin akakwirira. Kunyange zvazvo mazinga e gastrin akakwirira angaratidza zvironda mumatumbo kana duodenum, mazinga e gastrin akakwirira anogonawo kukonzerwa nezvimwe zvirwere. Semuenzaniso, gastrin inogona kukwira kana mudumbu rako risisiri kugadzira acid kana wakamboita opresheni yemudumbu. Kutora mishonga inoderedza acid inogonawo kukwidza mazinga e gastrin. Unofanira kushamba usati waita bvunzo iyi. Unogonawo kuoda kurega kutora mushonga unoderedza acid. Nekuti mazinga e gastrin anogona kuchinja, bvunzo iyi inogona kudzokororwa kanopfuura kamwe. Unogonawo kuita bvunzo yekukurudzira secretin. Secretin ihormone inodzora acid yemudumbu. Bvunzo iyi, nyanzvi yezvokurapa inotanga kuyera mazinga ako e gastrin. Ipapo uchapihwa jekiseni re secretin. Mazinga ako e gastrin achayerwa zvakare. Kana uine Zollinger-Ellison, mazinga ako e gastrin achakwira zvakanyanya. Ropa rako rinogonawo kuongororwa kuti rione puroteni inonzi chromogranin A, iyo yakakwirira muvanhu vazhinji vane gastrinomas. Kuongororwa kwematumbo epamusoro. Bvunzo iyi inoda kupisirwa. Kuongororwa kwematumbo kunosanganisira kuisa chishandiso chakacheka, chinopindika mumhino uye mudumbu nemu duodenum. Chishandiso ichi chinonzi endoscope. Chine chiedza nekamera kumucheto kwacho. Inobvumira nyanzvi yezvokurapa kuti itarise maronda. Panguva yekuongororwa kwematumbo, zvikamu zve tishu zvinogona kubviswa. Izvi zvinonzi biopsy. Tishu ichatarwa kuti ione zvironda zvinogadzira gastrin. Kuongororwa kwematumbo kunogonawo kuwana kana mudumbu richiri kugadzira acid. Kana mudumbu richiri kugadzira acid uye mazinga e gastrin akakwirira, saka chirwere che Zollinger-Ellison chinogona kusimbiswa. Uchabvunzwa kuti usadye chinhu kubva pakati pousiku usiku hwavasati vaita bvunzo. Ultrasound yematumbo. Maitiro aya anoshandisa endoscope ine ultrasound probe. Probe inonyanya kuita kuti zvive nyore kuona zvironda mudumbu rako, duodenum nepancreas. Nyanzvi yako yehutano inogona kubvisa sampuli yetishu kuburikidza ne endoscope. Bvunzo iyi inodawo kushamba kubva pakati pousiku uye kupisirwa. Kuongororwa kwemifananidzo. Matekiniki ekufananidza anogona kushandiswa kutsvaga zvironda, senge CT scans, MRI imaging uye Ga-DOTATATE PET-CT scanning. Rumwe ruzivo CT scan Ultrasound yematumbo MRI Ultrasound Kuongororwa kwematumbo epamusoro Ratidza rumwe ruzivo rwakabatana

Kurapa chirwere cheZollinger-Ellison kunonyanya kukoshesa kurapa zvimwe zvinokonzera hormone pamwe chete nemaronda zvinokonzera. Kurapa zvirwere Kuita opresheni yekubvisa gastrinomas kunoda nyanzvi yezvekurapa nekuti zvirwere izvi kazhinji zvidiki uye zvakaoma kuwana. Kana uine chirwere chimwe chete, nyanzvi yezvekurapa inogona kukubvisa nekuvhiya. Asi kuvhiya kungave kusina sarudzo kana uine zvirwere zvakawanda kana zvirwere zvakapararira kuuropi hwako. Kune rumwe rutivi, kunyangwe uine zvirwere zvakawanda, chiremba wekuvhiya anogona kukurudzira kubvisa chirwere chikuru chimwe chete. Muzviitiko zvimwe, vanopa mazano ekurapa mamwe marapirwo kudzora kukura kwechirwere, kusanganisira: Kubvisa zvakawanda sezvinobvira zvechirwere chechiropa, nzira inozivikanwa se debulking. Kuedza kuparadza chirwere nekucheka ropa, rinonzi embolization. Kushandisa kupisa kuparadza masero ekanser nechirongwa chinonzi radiofrequency ablation. Kuisa mishonga mukati mechirwere kuderedza zviratidzo zvekenza. Kushandisa chemotherapy kuedza kudzora kukura kwechirwere. Kuita kupandikirwa kwechiropa. Kurapa acid yakawandisa Kugadzirwa kweacid yakawandisa kunogona kudzorwa nguva dzose. Mishonga inozivikanwa se proton pump inhibitors ndiyo yekutanga kurapwa. Aya mishonga inoshanda pakudzora kugadzirwa kweacid muZollinger-Ellison syndrome. Proton pump inhibitors mishonga ine simba yekuderedza acid. Inoshanda nekudzivirira basa re "mapampu" madiki mukati memasero anogadzira acid. Mishonga inowanzorayirwa inosanganisira lansoprazole (Prevacid), omeprazole (Prilosec, Zegerid), pantoprazole (Protonix), rabeprazole (Aciphex) uye esomeprazole (Nexium). Taura nachiremba wako nezve njodzi dzekutora mishonga iyi kwenguva refu. Octreotide (Sandostatin), mushonga wakafanana nehomoni somatostatin, inogona kurwisa migumisiro yegastrin uye inobatsira kune vamwe vanhu. Rumwe ruzivo Chemotherapy Kupanda chirwere kwechiropa Radiofrequency ablation ye cancer Kumbira nguva yekuonana nachiremba