Insulinoma

I-insulinoma isisu esikwipancreas esivelisa i-insulin eninzi kakhulu.

Ipancreas lilungu esiswini. Ipancreas yenza ii-enzyme kunye neehomoni, kubandakanya nehomoni insulin. Umsebenzi we-insulin ukunciphisa inqanaba leswekile (iswekile) egazini ngokunceda iswekile ingene kwiiseli.

Uninzi lwexesha xa iswekile yegazi lakho incipha, ipancreas iyeka ukwenza i-insulin ukuze iqiniseke ukuba iswekile yegazi lakho ihlala kuluhlu oluqhelekileyo. Izidumba zepancreas ezivelisa i-insulin eninzi zibizwa ngokuba yi-insulinomas. I-Insulinomas iqhubeka nokwenza i-insulin, kwaye inokwenza ukuba iswekile yegazi lakho liphantsi kakhulu (i-hypoglycemia).

Inqanaba le-insulin egazini ephezulu ibangela inqanaba leswekile esezantsi yegazi (hypoglycemia). I-Hypoglycemia inokuba nobulali, ekhokelela kwiimpawu ezinje ngoxinzelelo kunye nendlala. Okanye kunokuba nzima, okukhokelela ekubanjweni, i-coma, kunye nokufa.

I-insulinomas zizinto ezinqabileyo kakhulu. Ngokuqhelekileyo zenzeka njengezinye, izicubu ezincinci. Kodwa kunokubakho amathumba amancinci amaninzi.

Uninzi lwe-insulinomas alunomhlaza (benign) tumors. Abantu abaneengxaki ezithile zemfuza, ezinjenge-endocrine neoplasia yohlobo I, basemngciphekweni omkhulu we-insulinomas.

Iimpawu zixhaphake kakhulu xa uzila ukutya okanye weqa okanye ulibazisa ukutya. Iimpawu zingabandakanya:

• Ixhala, utshintsho kwindlela yokuziphatha, okanye ukudideka
• Umbono osibekele
• Ukuphulukana nokuqonda okanye isiqaqa
• Ukuxhuzula okanye ukungcangcazela
• Ukuba nesiyezi okanye intloko ebuhlungu
• Indlala phakathi kokutya; ukutyeba kuqhelekile
• Ukukhawuleza kwentliziyo okanye ukubetha kwentliziyo
• Ukubila

Emva kokuzila ukutya, igazi lakho linokuvavanywa:

• Inqanaba legazi le-C-peptide
• Inqanaba leswekile yegazi
• Inqanaba le-insulin yegazi
• Iziyobisi ezibangela ukuba udakada akhuphe i-insulin
• Impendulo yomzimba wakho kwimpu yeglucagon
  

I-CT, i-MRI, okanye i-PET yokuvavanywa kwesisu inokwenziwa ukukhangela ithumba kwi-pancreas. Ukuba ithumba alibonwanga kwizikena, kungenziwa enye yezi mvavanyo zilandelayo:

• I-endoscopic ultrasound (uvavanyo olusebenzisa ubungakanani bendawo eguqukayo kunye namaza esandi ukujonga amalungu okwetyisa)
• Uvavanyo lwe-Octreotide (uvavanyo olukhethekileyo olujonga iiseli ezithile zokuvelisa iihomoni emzimbeni)
• I-arteriography yePancreatic (uvavanyo olusebenzisa idayi ekhethekileyo ukujonga imithambo kwi-pancreas)
• Isampulu yepancreatic venous yesampulu ye-insulin (uvavanyo olunceda ukufumana indawo ekuyo ithumba ngaphakathi kwepancreas)

Utyando lonyango oluqhelekileyo lwe-insulinoma. Ukuba kukho ithumba elinye, liya kususwa. Ukuba kukho amathumba amaninzi, inxenye yepancreas iya kufuna ukususwa. Ubuncinci i-15% yepancreas kufuneka ishiywe ukuvelisa amanqanaba e-enzymes okwetyisa.

Kwiimeko ezinqabileyo, yonke ipancreas iyasuswa ukuba zininzi ii-insulinomas okanye ziyaqhubeka ukubuya. Ukususa ipancreas kukhokelela kwisifo seswekile kuba akusekho insulin iveliswayo. I-insulin shots (inaliti) ziyafuneka.

Ukuba akukho lithumba lifunyanwa ngexesha lotyando, okanye ukuba awukwazi ukwenza utyando, unokufumana iyeza le-diazoxide lokunciphisa imveliso ye-insulin kunye nokukhusela i-hypoglycemia. Ipilisi yamanzi (umchamo) inikwa kunye neli yeyeza ukukhusela umzimba ekugcineni ulwelo. I-Octreotide lelinye iyeza elisetyenziselwa ukunciphisa ukukhutshwa kwe-insulin kwabanye abantu.

Kwiimeko ezininzi, eli thumba alinomhlaza (benign), kwaye utyando luyasinyanga isifo. Kodwa ukusabela ngamandla kwi-hypoglycemic reaction okanye ukusasazeka kwesifo somhlaza kwamanye amalungu kunokubusongela ubomi.

Iingxaki zinokubandakanya:

• Impendulo enkulu ye-hypoglycemic
• Ukusasazeka kwesifo somhlaza (metastasis)
• Iswekile ukuba yonke ipancreas iyasuswa (inqabile), okanye ukutya kungafakwanga ukuba uninzi lwepancreas luyasuswa
• Ukudumba kunye nokudumba kwepancreas

Fowunela umboneleli wakho wokhathalelo lwempilo ukuba uvelisa naziphi na iimpawu ze-insulinoma. Ukuhlutha kunye nokulahleka kwengqondo kungxamisekileyo. Tsalela u-911 okanye inombolo yongxamiseko yalapho kwangoko.

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

• Amadlala endocrine
• Ukutya kunye nokukhutshwa kwe-insulin

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Iwebhusayithi yeNethiwekhi yeCancer epheleleyo yoMhlaza. Isikhokelo sokusebenza kweeklinikhi ze-NCCN kwi-oncology (izikhokelo ze-NCCN): I-Neuroendocrine kunye ne-adrenal tumors. Inguqulelo 2.2020. www.nccn.org/professionals/physician_gls/pdf/neuroendocrine.pdf. Ukuhlaziywa ngoJulayi 24, 2020. Ifikeleleke ngoNovemba 11, 2020.

I-Strosberg JR, Al-Toubah T. Neuroendocrine tumors. Ku: UFeldman M, uFriedman LS, uBrandt LJ, ii-eds. Sleisenger kunye neFordtran's Gastrointestinal and Liver Disease. Ngomhla we-11. IPhiladelphia, PA: Elsevier; 2021: isahluko 34.