I-duodenum (kusuka kwelesiLatini elithi duodenum digitorum, elisho ukuthi “eminwe eyishumi nambili”) iyingxenye yamathumbu amancane, isitho sohlelo lokugaya ukudla.

Isikhundla. I-duodenum itholakala phakathi kwe-pylorus yesisu ne-duodeno-jejunal angle.

Isakhiwo se-duodenum. Ingenye yezingxenye ezintathu zamathumbu amancane (i-duodenum, jejunum ne-ileum). U-5-7 m ubude no-3 cm ububanzi, ithumbu elincane lilandela isisu futhi landiswa amathumbu amakhulu (1). I-C-emise futhi itholakala ngokujulile, i-duodenum yingxenye engaguquki yamathumbu amancane. Amapayipi angaphandle avela kumanyikwe kanye nomgudu wenyongo afika kule ngxenye (1) (2).

Isakhiwo sodonga lwe-duodenal. I-duodenum yakhiwe ngezimvilophu ezi-4 (1):

• Ulwelwesi lwamafinyila ungqimba lwangaphakathi, oluqukethe izindlala eziningi ezifihla ikakhulukazi isikhwehlela esivikelayo.
• I-submucosa ungqimba oluphakathi olwakhiwe ikakhulukazi lwemithambo yegazi nezinzwa.
• I-muscularis ungqimba lwangaphandle olwakhiwe ngemicu yemisipha.
• Ulwelwesi lwe-serous, noma i-peritoneum, imvilophu ehlanganisa udonga olungaphandle lwamathumbu amancane.

Ukugaya. Ukugaya kwenzeka ikakhulukazi emathunjini amancane, futhi ikakhulukazi ku-duodenum ngokusebenzisa ama-enzyme wokugaya kanye ne-bile acid. Ama-enzyme wokugaya avela kuma-pancreas ngokusebenzisa amapayipi angaphandle, kuyilapho i-bile acid ivela esibindini ngemigudu ye-bile (3). Ama-enzyme wokugaya ukudla kanye ne-bile acid kuzoguqula i-chyme, uketshezi oluqukethe ukudla okugaywe ngaphambili ngamajusi wokugaya esiswini, kuya ku-chyle, uketshezi olucacile oluqukethe imicu yokudla, ama-carbohydrate ayinkimbinkimbi, ama-molecule alula, kanye nezakhamzimba (4).

Ukwamukela. Ngomsebenzi wawo, umzimba uzomunca izakhi ezithile ezinjengama-carbohydrate, amafutha, amaprotheni, ama-electrolyte, amavithamini, kanye namanzi (5). Ukumuncwa kwemikhiqizo yokugaya kwenzeka ikakhulukazi emathunjini amancane, futhi ikakhulukazi ku-duodenum nejejunum.

Ukuvikelwa kwamathumbu amancane. I-duodenum iyazivikela ekuhlaselweni ngamakhemikhali nangomshini ngokufihla amafinyila, ivikele i-mucosa (3).

Isifo samathumbu esingapheli. Lezi zifo zihambisana nokuvuvukala kolwelwesi lwengxenye yohlelo lokugaya ukudla, njengesifo sikaCrohn. Izimpawu zifaka phakathi ubuhlungu obukhulu besisu kanye nohudo (6).

I-syndrome e-irritable syndrome. Lesi sifo sibonakaliswa yi-hypersensitivity odongeni lwamathumbu, ikakhulukazi ku-duodenum, kanye nokungajwayelekile kokuphambana kwemisipha. Izibonakalisa ngezimpawu ezahlukahlukene ezihambisana nokuphazamiseka kokugaya ukudla njengohudo, ukuqunjelwa, noma ubuhlungu besisu. Isizathu salesi sifo asikaziwa nanamuhla.

Ukuvinjwa kwamathumbu. Kukhombisa ukumiswa kokusebenza kokuhamba, kubangele ubuhlungu obukhulu nokuhlanza. Ukuvinjelwa emathunjini kungaba yimvelaphi yemishini ngokuba khona kwesithiyo ngesikhathi sokuhamba (amatshe enyongo, izicubu, njll.) Kepha futhi kungaba ngamakhemikhali ngokuxhunyaniswa nokutheleleka kwezicubu eziseduze, ngokwesibonelo ngesikhathi se-peritonitis.

Isilonda se-Peptic. Lesi sifo sihambisana nokwakheka kwesilonda esijulile odongeni lwesisu noma leso se-duodenum. Isifo se-Peptic ulcer sivame ukubangelwa ukukhula kwamagciwane kepha futhi singenzeka ngemithi ethile (7).

Ukwelashwa. Ngokuya nge-pathology etholakele, izidakamizwa ezithile zingabekwa njengezidakamizwa ezilwa nokuvuvukala noma ama-analgesics.

Ukwelapha okuhlinzwa. Ngokuya nge-pathology kanye nokuziphendukela kwayo, ukungenelela kokuhlinzwa kungenziwa.

Ukuhlolwa komzimba. Ukuqala kobuhlungu kuqala ngokuhlolwa komzimba ukuhlola izimpawu nokuthola izimbangela zobuhlungu.

Ukuhlolwa kwezinto eziphilayo. Ukuhlolwa kwegazi kanye nesitulo kungenziwa ukwenza noma ukuqinisekisa ukuxilongwa.

Ukuhlolwa kwe-imaging yezokwelapha. Ngokuya nge-pathology esolwayo noma efakazelwe, kungenziwa izivivinyo ezengeziwe njenge-ultrasound, i-CT scan noma i-MRI.

Ukuhlolwa kwe-Endoscopic. I-Endoscopy ingenziwa ukutadisha izindonga ze-duodenum.

Izazi zokwakheka komzimba zinikeze igama elithi duodenum, elivela esiLatini amasentimitha ayishumi nambili, okusho ukuthi "iminwe eyishumi nambili", kule ngxenye yamathumbu amancane kwazise yayiminwe eyishumi nambili ubude.