Insulinoma

Insulinoma bundu riri mupancreas rinogadzira insulin yakawandisa.

Iyo pancreas inhengo iri mudumbu. Iyo pancreas inogadzira enzyme akati wandei uye mahormone, kusanganisira iyo hormone insulin. Insulin basa rake kudzikisa huwandu hweshuga (glucose) muropa nekubatsira shuga kufamba mumaseru.

Kazhinji yenguva apo shuga yako yeropa inoderera, rwatata rinomira kugadzira insulini kuti uve nechokwadi chekuti shuga yako yeropa inogara mune yakajairwa renji. Tumota dzepancreas dzinoburitsa yakawanda insulini inonzi insulinomas. Insulinomas inoramba ichigadzira insulin, uye inogona kuita kuti shuga yako yeropa ive yakaderera kwazvo (hypoglycemia).

Ropa repamusoro insulin rinokonzera huwandu hweshuga yeropa shoma (hypoglycemia). Hypoglycemia inogona kunge iri nyoro, zvichitungamira kuzviratidzo sekushushikana uye nzara. Kana inogona kuve yakaoma, ichitungamira kubatwa, kufenda, uye kunyange kufa.

Insulinomas akanyanya zvisingawanzo mamota. Ivo anowanzoitika seasina kuroorwa, madiki mamota. Asi panogona zvakare kuve nemamota mashoma akati wandei.

Mazhinji insulinomas ari asina kenza (benign) mamota. Vanhu vane mamwe matambudziko egene, akadai seakawanda endocrine neoplasia mhando I, vari pangozi yakanyanya ye insulinomas.

Zviratidzo zvinowanzoitika kana iwe uchitsanya kana kusvetuka kana kunonoka kudya. Zviratidzo zvinogona kusanganisira:

• Kuzvidya mwoyo, maitiro anochinja, kana kuvhiringidzika
• Makore akazara
• Kurasikirwa kwekuziva kana coma
• Kugwinha kana kudedera
• Dzungu kana musoro
• Nzara pakati pekudya; kurema kuwedzera kunowanzoitika
• Kukurumidza kurova kwemoyo kana kurovera moyo
• Kudikitira

Mushure mekutsanya, ropa rako rinogona kuongororwa kuti:

• Ropa C-peptide chikamu
• Ropa glucose level
• Ropa insulin mwero
• Zvinodhaka zvinoita kuti pancreas ibudise insulin
• Mhinduro yemuviri wako kupfuti yeglucagon
  

CT, MRI, kana PET scan yemudumbu inogona kuitwa kutsvaga bundu mupancreas. Kana bundu risingaonekwe mumatanho, imwe yeiyi bvunzo inogona kuitwa:

• Endoscopic ultrasound (bvunzo inoshandisa inoshanduka chiyero uye mafungu ezwi kuona nhengo dzekugaya)
• Octreotide scan (yakakosha bvunzo inoongorora mamwe maseru-anogadzira maseru mumuviri)
• Pancreatic arteriography (bvunzo inoshandisa chaiyo dhayi kuti utarise arteri mupancreas)
• Pancreatic venous sampling ye insulini (bvunzo inobatsira kuwana iko kungofungidzirwa kwaro bundu mukati mepancreas)

Kuvhiya ndiko kwakajairwa kurapwa kwe insulinoma. Kana paine bundu rimwe chete, rinobviswa. Kana paine mamota mazhinji, chikamu chepancreas chinoda kubviswa. Angangoita gumi neshanu muzana epancreas anofanira kusiiwa kuti agadzire akaenzana enzyme ekugaya.

Muzviitiko zvisingawanzoitika, iyo pancreas yese inobviswa kana paine akawanda insulinoma kana ivo vachiramba vachidzoka. Kubvisa rwatata rwese kunotungamira kuchirwere cheshuga nekuti hapachina insulin inogadzirwa. Insulin kupfura (majekiseni) anobva adikanwa.

Kana pasina bundu rinowanikwa panguva yekuvhiyiwa, kana kana usingakwanise kuvhiyiwa, unogona kuwana mushonga diazoxide kudzikisa kugadzirwa kwe insulin uye kudzivirira hypoglycemia. Piritsi remvura (diuretic) rinopihwa nemushonga uyu kudzivirira muviri kubva mukuchengetedza mvura. Octreotide mumwe mushonga unoshandiswa kudzora insulin kuburitswa mune vamwe vanhu.

Muzviitiko zvakawanda, bundu iri harina cancer (benign), uye kuvhiyiwa kunogona kuporesa chirwere. Asi zvakanyanya hypoglycemic reaction kana kupararira kwechirwere chegomarara kune dzimwe nhengo zvinogona kutyisidzira hupenyu.

Zvinetso zvinogona kusanganisira:

• Yakakura hypoglycemic reaction
• Kupararira kwechirwere checancer (metastasis)
• Chirwere cheshuga kana rwatata rwese rwabviswa (zvisingawanzoitika), kana chikafu chisiri kutorwa kana rwakawanda rwabviswa
• Kuzvimba uye kuzvimba kwepancreas

Fonera wako mupi wezvehutano kana iwe ukaita chero zviratidzo zve insulinoma. Kufenda uye kurasikirwa nekuziva ndezvekukurumidzira. Fonera 911 kana iyo yemuno emergency emergency ipapo ipapo.

Insulinoma; Islet cell adenoma, Pancreatic neuroendocrine bundu; Hypoglycemia - insulinoma

• Endocrine masero
• Kudya uye insulin kusunungurwa

Asban A, Patel AJ, Reddy S, Wang T, Balentine CJ, Chen H. Cancer yeiyo endocrine system. Mune: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff's Clinical Oncology. 6th ed. Philadelphia, PA: Elsevier; 2020: chitsama 68.

National Yakakwana Cancer Network webhusaiti. NCCN kiriniki yekudzidzira maitiro mune oncology (NCCN nhungamiro): Neuroendocrine uye adrenal tumors. Shanduro 2.2020. www.nccn.org/professionals/physician_gls/pdf/neuroendocrine.pdf. Yakagadziridzwa Chikunguru 24, 2020. Yakasvika munaNovember 11, 2020.

Strosberg JR, Al-Toubah T. Neuroendocrine mamota. Muna: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger uye Fordtran's Gastrointestinal uye Chirwere Chiropa. 11th ed. Philadelphia, PA: Elsevier; 2021: chitsauko 34.