Faamaʻi Whipple

O le faʻamaʻi o le Whipple o se tulaga e seasea tupu e afaina ai le tootoo laiti. Lenei taofia le laʻau laʻititi mai le faʻatagaina o meaʻai e alu i totonu o le totoe o le tino. E taʻua lea ole malabsorption.

O le maʻi fulafula e mafua mai i faʻamaʻi pipisi ma se ituaiga siama ua taʻua Tropheryma whipplei. O le faʻamaʻi e masani lava ona aʻafia ai aliʻi papaʻe o le matua o tausaga.

E seasea lava maua se faʻamaʻi Whipple. E le o iloa ni tulaga lamatia.

Faʻailoga e masani ona amata lemu. Soʻoga soʻofaʻatasi o le masani masani a vave faʻailoga. Faʻailoga o le gastrointestinal (GI) faʻamaʻi pipisi masani ona tupu i ni tausaga mulimuli ane. O isi faʻailoga e mafai ona aofia ai:

• Tiga o le manava
• Manava tata
• Fiva
• Faʻapogisaina o paʻu i vaega malamalama o le tino faʻaalia
  
• Tiga soʻoga i tapuvae, tulivae, tulilima, tamailima, poʻo isi vaega
• Leiloa mea
• Suiga o le mafaufau
• Paʻu pauna

E faʻataʻitaʻi e le tausi soifua le suʻega o le tino. Atonu e faʻaalia lenei:

• Faalauteleina lymph glands
• Muimui fatu
• Fula i tino tino (edema)

Suʻega e faʻamaonia ai le faʻamai o le Whipple e ono aofia ai:

• Faitau atoa le toto (CBC)
• Polymerase chain reaction (PCR) suʻega e siaki ai siama e mafua ai le faʻamaʻi
• Biopsy laititi o le manava
• Luga GI endoscopy (vaʻaia o manava ma se fetuutuunai, faʻamalamalamaina paipa i se gaioiga faʻaigoaina enteroscopy)

O lenei faʻamaʻi ono mafai foi ona suia iʻuga o suʻesuʻega nei:

• Albumin tulaga i le toto
• Le gaʻo le gaʻo i totonu o faʻataʻavale (gaʻo o le gaʻo)
• Mitiia manava o se ituaiga suka (mitiia d-xylose)

O tagata e maua ile faʻamaʻi Whipple e manaʻomia le inu o vailaʻau faʻafuaseʻi mo se taimi umi e faʻamalolo ai soʻo se faʻamaʻi o le faiʻai ma le tino tutotonu. O se vailaʻau e taʻu o le ceftriaxone e avatua i se alatoto (IV). E mulimuli mai leisi vailaʻau (pei ole trimethoprim-sulfamethoxazole) ave e le gutu e oʻo ile 1 tausaga.

Afai e toe foʻi mai faʻailoga i le taimi e faʻaaoga ai vailaʻau, e mafai ona suia vailaʻau.

E tatau ona mulimulitaʻi lau tautua i lau alualu i luma. Faʻailoga o le faʻamaʻi mafai ona toe foʻi pe a maeʻa ou togafitiga. O tagata e tumau pea le leai o se meaʻai, o le a manaʻomia foi ona latou taumafaina meaʻai e fai ma meaʻai.

Afai e le togafitia, o le tulaga e masani ona afaina. Togafitiga faʻamamaina faʻailoga ma mafai ona faʻamalolo le maʻi.

Faʻafitauli e ono aofia ai:

• Faʻaleagaina o faiʻai
• Ua afaina le alatoto fatu (mai le endocarditis)
• Leai ni meaʻai
• Faʻailoga e toe foʻi (atonu e mafua ona o le faʻafitauli o fualaʻau)
• Paʻu pauna

Valaʻau lau tautua peʻa iai sau:

• Tiga soʻofaʻatasi e le aluese
• Tiga o le manava
• Manava tata

Afai o loʻo togafitia oe mo faʻamaʻi Whipple, valaʻau lau tautua pe a fai:

• Faʻailoga e atili leaga pe le faʻaleleia
• Ua aliaʻe faʻailoga
• Ua tupu aʻe ni faʻailoga fou

Totogi lipodystrophy

Maiwald M, von Herbay A, Relman DA. Faamaʻi Whipple. I totonu: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger ma le Fordtran's Gastrointestinal ma le Maʻi o le ate. 11th lomiga. Filatelefia, PA: Elsevier; 2021: mata 109.

Marth T, Schneider T. Whipple faʻamaʻi. I totonu: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, ma Bennett's Mataupu Faavae ma Faʻataʻitaʻiga o Faamaʻi pipisi. 9th ed. Filatelefia, PA: Elsevier; 2020: chap 210

SG Sisifo. Faʻamaʻi sisitema o loʻo vaʻaia ai le gugu. I totonu: Goldman L, Schafer AI, eds. Faʻafomaʻi Goldman-Cecil. 26th lomiga. Filatelefia, PA: Elsevier; 2020: chap 259.