Boloetse ba whipple

Lefu la Whipple ke boemo bo sa tloaelehang bo amang mala a manyane haholo. Sena se thibela mala a manyane ho lumella limatlafatsi ho fetela 'meleng kaofela. Sena se bitsoa malabsorption.

Lefu la Whipple le bakoa ke ts'oaetso ea mofuta oa libaktheria tse bitsoang Tropheryma whipplei. Boloetse bona bo ama haholo banna ba makhooa ba lilemong tse mahareng.

Lefu la Whipple ha le fumanehe hangata. Lisosa tsa kotsi ha li tsejoe.

Matšoao hangata a qala butle. Mahlaba a kopaneng ke letšoao le tloaelehileng ho fetisisa la pele. Matšoao a tšoaetso ea mala (GI) hangata a hlaha lilemo tse 'maloa hamorao. Matšoao a mang a kenyeletsa:

• Bohloko ba mpeng
• Letšollo
• Feberu
• Ho fifala ha letlalo libakeng tse pepesitsoeng ke 'mele
  
• Mahlaba a kopantsoeng maqaqailaneng, mangoleng, lilomong, menoaneng kapa libakeng tse ling
• Ho lahleheloa ke mohopolo
• Liphetoho tsa kelello
• Ho fokotsa boima ba 'mele

Mofani oa tlhokomelo ea bophelo o tla etsa tlhahlobo ea 'mele. Sena se ka bontša:

• Litšoelesa tsa lymph tse atolositsoeng
• Ho korotla ha pelo
• Ho ruruha ka lisele tsa 'mele (edema)

Liteko tsa ho fumana lefu la Whipple li ka kenyelletsa:

• Palo e felletseng ea mali (CBC)
• Teko ea Polymerase chain reaction (PCR) ho lekola libaktheria tse bakang lefu lena
• Biopsy e nyane ea mala
• Endoscopy e kaholimo-limo ea GI (ho shebella mala ka pompo e tenyetsehang, e bonesitsoeng ka mokhoa o bitsoang enteroscopy)

Lefu lena le ka fetola sephetho sa liteko tse latelang:

• Maemo a albamo maling
• Mafura a sa koaeloang ka setuloaneng (mafura a mantle)
• Mofuta oa tsoekere oa mofuta oa tsoekere (absorption ea d-xylose)

Batho ba nang le lefu la Whipple ba hloka ho nka lithibela-mafu tsa nako e telele ho phekola ts'oaetso efe kapa efe ea boko le sistimi e bohareng ea methapo. Lithibela-mafu tse bitsoang ceftriaxone li fanoa ka mothapo (IV). E lateloa ke lithibela-mafu tse ling (joalo ka trimethoprim-sulfamethoxazole) e nkiloeng ka molomo ho fihlela selemo se le seng.

Haeba matšoao a khutla nakong ea ts'ebeliso ea lithibela-mafu, meriana e ka fetoloa.

Mofani oa hau o lokela ho latela tsoelo-pele ea hau haufi-ufi. Matšoao a lefu lena a ka khutla ha o qeta kalafo. Batho ba lulang ba haelloa ke phepo e nepahetseng le bona ba tla hloka ho noa li-supplement.

Haeba e sa phekoloe, hangata lefu leo ​​lea bolaea. Kalafo e kokobetsa matšoao 'me e ka folisa lefu lena.

Mathata a ka kenyelletsa:

• Tšenyo ea boko
• Tšenyo ea valve ea pelo (ho tloha endocarditis)
• Ho haelloa ke phepo e nepahetseng
• Matšoao a khutla (ekaba ka lebaka la ho hana lithethefatsi)
• Ho fokotsa boima ba 'mele

Bitsa mofani oa hau haeba u na le:

• Mahlaba a kopaneng a sa tloheng
• Bohloko ba mpeng
• Letšollo

Haeba u alafshoa ke lefu la Whipple, letsetsa mofani oa hau haeba:

• Matšoao a mpefala kapa ha a ntlafale
• Matšoao a hlaha hape
• Ho hlaha matšoao a macha

Lipodystrophy ea mala

Maiwald M, von Herbay A, Relman DA. Boloetse ba whipple. Ka: Feldman M, Friedman LS, Brandt LJ, bahlophisi. Sleisenger le Fordtran's Mpeng le Mafu a Sebete. 11th ed. Philadelphia, PA: Elsevier; 2021: khaolo ea 109.

Marth T, lefu la Schneider T. Whipple. Ka: Bennett JE, Dolin R, Blaser MJ, bahlophisi. Mandell, Douglas, le Bennett's Principles and Practice of Infectious Diseases. La 9th. Philadelphia, PA: Elsevier; 2020: khaolo ea 210.

Bophirimela SG. Ts'oaetso ea systemic moo ramatiki e leng karolo. Ka: Goldman L, Schafer AI, li-eds. Phekolo ea Goldman-Cecil. La 26th. Philadelphia, PA: Elsevier; 2020: khaolo ea 259.