Isifo seZollinger-Ellison

I-Zollinger-Ellison syndrome yisimo lapho umzimba ukhiqiza khona i-hormone gastrin eningi kakhulu. Isikhathi esiningi, isimila esincane (i-gastrinoma) kumanyikwe noma amathumbu amancane kungumthombo we-gastrin eyengeziwe egazini.

I-Zollinger-Ellison syndrome ibangelwa izicubu. Lokhu kukhula kuvame ukutholakala ekhanda lamanyikwe kanye namathumbu amancane aphezulu. Izimila zibizwa ngokuthi ama-gastrinomas. Izinga eliphakeme le-gastrin lidala ukukhiqizwa kwe-asidi eningi esiswini.

I-Gastrinomas ivela njengezicubu ezilodwa noma izicubu eziningana. Ingxenye eyodwa kwezimbili kokuthathu kwama-gastrinomas angashadile anezicubu zomdlavuza (ezimbi). Lezi zicubu zivame ukusabalala ziye esibindini nakuma-lymph node aseduze.

Abantu abaningi abane-gastrinomas banezicubu eziningana njengengxenye yesimo esibizwa nge-endocrine neoplasia type I (MEN I). Izicubu zingakhula ku-pituitary gland (ebuchosheni) nakwindlala ye-parathyroid (entanyeni) nakuma-pancreas.

Izimpawu zingafaka:

• Ubuhlungu besisu
• Uhudo
• Ukuhlanza igazi (kwesinye isikhathi)
• Izimpawu ezinzima ze-esophageal reflux (GERD)

Izimpawu zifaka izilonda esiswini nasemathunjini amancane.

Izivivinyo zifaka:

• Iskena se-CT esiswini
• Ukuhlolwa kokufakwa kwe-calcium
• I-endoscopic ultrasound
• Ukuhlinzwa kokuhlola
• Izinga legazi le-Gastrin
• Ukuskena kwe-Octreotide
• Isivivinyo sokukhuthaza i-Secretin

Izidakamizwa ezibizwa nge-proton pump inhibitors (omeprazole, lansoprazole, nezinye) zisetshenziselwa ukwelapha le nkinga. Le mithi inciphisa ukukhiqizwa kwe-asidi esiswini. Lokhu kusiza izilonda esiswini namathumbu amancane aphole. Le mithi ibuye iqede izinhlungu zesisu nohudo.

Ukuhlinzwa ukususa i-gastrinoma eyodwa kungenziwa uma izicubu zingakasakazeli kwezinye izitho. Ukuhlinzwa esiswini (i-gastrectomy) ukulawula ukukhiqizwa kwe-asidi akuvamile ukuthi kudingeke.

Izinga lokwelashwa liphansi, noma ngabe litholakale kusenesikhathi futhi kususwe isimila. Noma kunjalo, i-gastrinomas ikhula kancane.Abantu abanalesi simo bangaphila iminyaka eminingi ngemuva kokutholakala kwesimila. Imithi ecindezela i-acid isebenza kahle ukulawula izimpawu.

Izinkinga zingafaka:

• Ukwehluleka ukuthola isimila ngesikhathi sokuhlinzwa
• Ukopha emathunjini noma umgodi (ukugcotshwa) okuvela ezilonda esiswini noma e-duodenum
• Uhudo olunamandla nokuncipha kwesisindo
• Ukusabalala kwesimila kwezinye izitho

Shayela umhlinzeki wakho wezokunakekelwa kwezempilo uma unezinhlungu ezinzima zesisu ezingapheli, ikakhulukazi uma kwenzeka ngohudo.

I-ZE syndrome; I-Gastrinoma

• Izindlala ze-Endocrine

UJensen RT, Norton JA, Oberg K. Izicubu ze-Neuroendocrine. Ku: Feldman M, Friedman LS, Brandt LJ, ama-eds. Sleisenger kanye neFordtran's Gastrointestinal and Liver Disease. Umhlaka 10. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 33.

UVella A. Amahomoni emathunjini namathumbu we-endocrine gut. Ku: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, abahleli. Incwadi kaWilliams ye-Endocrinology. Umhlaka 13. IPhiladelphia, PA: Elsevier; 2016: isahluko 38.