Ukusuleleka kwi-ducts ye-bile ingaba yinto enzulu kodwa abaninzi abantu baphila kakuhle
I-Cholangitis yintsholongwane ye-bile ducts. I-cholangitis enobuchule ingabangela iimpawu zomkhuhlane, i-jaundice, nesisu esiswini. Ngezinye iinkalo imeko ibizwa ngokuba yenyuka i-cholangitis.
I-cholangitis enobuchule yingozi enkulu efuna unyango. Kubalulekile ukuba abantu abanolu hlobo lwesifo bafumane unyango kwaye baphathwe ngokukhawuleza ukwenzela ukuphepha iingxaki ezinzulu.
I-prognosis ye-cholangitis iye yaphucula kwiminyaka yamuva kwaye abaninzi abantu bafumana unyango.
I-Bile Duct Blockages
Ibhili yinto eyanceda ukuphula amanqatha ekudleni ukuze igalelwe. Ibhili yenziwa kwisibindi kwaye ihamba ngeendlela ezibizwa ngokuba yi-bile ducts kwi- gallbladder , apho igcinwa khona kuyafuneka. Emva kokutya, ngokukodwa okubandakanya amafutha, i-bile ikhutshwa nge-duct kwaye ibe yintlahlela yokuqala yamathumbu amancinci (i-duodenum).
Ngamanye amaxesha i-bile ducts iyakhutshwa okanye, ngokungafanekiyo, ibe mncinci kakhulu. Oku kuya kwenzeka xa i-gallstones yakha okanye xa kukho esinye isizathu sokuba amathanga ancitshisiwe, afana nokukhula kwe-tumor kufuphi ne-conduit okanye i-bile conduit stricture. I-Gallstones ixhaphake kakhulu kubasetyhini, abantu abanezifo zesibindi esivuthayo (IBD, kunye nesifo se-Crohn), i- sclerosing cholangitis , kunye ne-HIV / AIDS. Izidumbu okanye izithintelo njengesizathu se-ducts binyane zincinci azincinci.
Xa i-buct ye-bile ivinjiwe kwi-gallstone okanye esinye isizathu, kunokukwazi ukusuleleka kwi-bacteria. Usulelo luyakwenzeka kwakhona emva kokuhlinzwa apho i-stent ifakwa kwi-bile duct. Olu hlobo lwesifo se-bhakteria lubizwa ngokuba yi-cholangitis.
Izinto zobungozi
Umngcipheko wokwakha i-cholangitis iya kuxhomekeka kwizinto eziliqela kodwa kukho iimeko ezimbalwa ezenza ukuba le ntsholongwane ibe lula.
Abantu abasengozini enkulu yokuphulela isifo kwi-buct buct kubandakanya nabani na:
- Imbali ye-gallstones
- Ukuxilongwa kwe-sclerosing cholangitis
- Kutshanje uye waya kwiindawo apho izifo zonyango okanye izifo ezinobungozi zingenzeka
- I- endoscopic retrograde ye-retlgraphic cholangiopancreatographyography (ERCP) nge-stent placement (kwelinye uphando, umngcipheko wawuyi-13.2 ekhulwini)
Izimpawu kunye neMpawu
Iimpawu neempawu ze-cholangitis eziqhelekileyo zivame ukufana nezo-gallstones kwaye zingaquka:
- Umqolo obuhlungu
- IChills
- Izigqoko ezinemibala
- Umchamo omnyama
- Fever
- I-jaundice (ukuphuka kwesikhumba kunye namehlo)
- I sizathu
- Ubunzima ngaphantsi kwegxala
- I-right quadrant ephezulu okanye ubuhlungu besisu esiswini bubukhali, buqhekeza okanye bubuhlungu
- Ukuvutha
Ukuxilongwa
Ukwenza ukuxilongwa kwe-cholangitis ngokukhawuleza kunokwenzeka ukuze uqale unyango kubalulekile. Enye okanye ngaphezulu kweemvavanyo ezahlukeneyo ezijongene ne-gallbladder kunye ne-bile ducts zingasetyenziswa.
Ukuhlolwa kwegazi
Ngoxa iimvavanyo zegazi zingasetyenziswanga zodwa ukuba zifumanise intsholongwane kwi-ducts ye-bile, zisetyenziselwa ukukunceda ukufumana umfanekiso wezinto ezinokubangela iimpawu. Iimvavanyo zegazi ezinokwenziwa ziquka:
- KwiBilirubin
- Amanqanaba enzyme
- Izilingo zomsebenzi wesibindi
- Inani le-White White (WBC)
Isisu se-abdominal
I-ultrasound ngumvavanyo osebenzisa amaza omsindo ukuze ubone izakhiwo ngaphakathi komzimba. Kungenziwa kwisisu xa kukhankanywa i-gallstone okanye i-buct b obstruction.
ERCP
Ngethuba lokuvavanya, ityhubhu idluliselwa emlonyeni nasezantsi ngephepha lokutya ukuze ifikelele kwi-bin ducts. Oku kunokwenziwa kuphela ukubona oko kwenzekayo kumadada kodwa kungasetyenziselwa kwezinye iimeko ukususa ama-gallstones. Ngethuba lo vavanyo i-bile ibinki ingasuswa ukuze ivivinye iibhaktheriya. I-bile iya kuhlonywa kwibhuyibhile ukuze ifumene ukuba yiyiphi ibhaktheriya ebangela ukusuleleka.
I-magnetic resonance cholangiopancreatographyography (MRCP)
Olu vavanyo luvavanyo lwengqondo olungenayo intsha kwaye lisetyenziselwa ukujonga ngepascreas, gallbladder kunye ne-bile ducts. Naliphi na i-blockages kwi-bin ducts ibonakala kwimifanekiso ethathwe.
I-cholangiogram ye-Percutaneous transhepatic (PTCA)
I-PTCA yimihlobo ye-ray-ray esetyenziselwa ukubona i-ducts ye-bile. Nangona isigulane sitsalwa, inaliti ifakwa kwisisu kunye nesibindi ukulawula umlinganiselo ohlukileyo kummandla. Emva koko uchungechunge lwe-x-ray lugqithiselwa ukujonga ngokucacileyo iidonki kunye nomoya ohlukileyo owela kuwo.
Unyango
Emva kokuxilongwa, unyango kufuneka luqale ngokukhawuleza. Ngenxa yokuba i-cholangitis ibangelwa yintsholongwane, unyango luya kubandakanya i-antibiotics ukubulala ibhaktheriya. Okwesibini, ingcambu ibangela ukuphathwa. Kwimeko ye-gallstones, amatye angaphathwa ngokubakhupha nge-ERCP, ukuwachitha, okanye ukuwaphula ngamaza okutshatyalaliswa. Kwamanye amaxesha, ukuhlinzwa ngokugqithiswa kwe-gallbladder kungenziwa.
Ukuze kubekho izithintelo kwi-buct ye-bile, inkqubo inokwenziwa ukuba ibeke i-stent kwaye igcine ivule. Kwimeko apho kuncitshiswe khona i-bile ducts ngenxa yesisu (esingaqhelekanga), esinokufuna ukuhlinzwa okanye ezinye iindlela zokwelapha ukuba zifunyanwe zibi.
Iingxaki
I-Sepsis yinto enokubangela inkxalabo ye-cholangitis, kwaye yimeko esongela ubomi. I-Sepsis iyenzeka xa isifo singagqirwanga kwaye sibangela ukungaphumeleli komzimba, umonakalo wesisu kunye nokufa. I-Sepsis iphathwa nge antibiotics kwaye ngamanye amaxesha amanye amanyathelo adingekayo ukunceda ukususa izicubu ezinesifo. I-Sepsis inokungabonakali kwaye isongela ubomi, yingakho kubalulekile ukuqaphela ootitshala bezonyango ngokukhawuleza ukuba kukho ukukhankanywa ukuba usulelo luye lwaba yile mqathango.
Thintelo
Kwezinye iimeko, ukuthintela i-cholangitis kungenzeka ukuba akunakwenzeka. Nangona kunjalo, njengoko amaninzi amatyala abangelwa ngama-gallstones avimbela i-bile ducts, ukuthintela i-gallstones kunokunceda. Ukukhusela i-gallstones kunokubandakanya ukutya ukutya okunempilo kunye nemilinganiselo efanelekileyo yefayibhile engahlanjululwayo kunye neyokuzilolonga rhoqo. Ukuyeka ukutshaya kunokunceda ukunqanda ukuphuhliswa kweendlela ezininzi ezikhethileyo ze-cholangitis. I-cholangitis ehambelana ne-ERCP kunye nokubekwa kwe-stent, i-antibiotics inokunikwa ngexesha leenkqubo okanye emva kokukhusela intsholongwane.
ILizwi
I-cholangitis enobuchule yimeko embi kuba yintsholongwane eyenza umntu agule kwaye akholele kwiinkathazo. Ukufumana uvavanyo ngokukhawuleza kunye nokufumana unyango kubalulekile, ngoko iimpawu zesisu esiswini, i-jaundice, kunye nomkhuhlane kubangelwa ukubona ugqirha ngokukhawuleza. Xa ukuxilongwa kukukhawuleza kwaye unyango lwe-antibiotics luqalisiwe, iindaba ezilungileyo kukuba abantu abaninzi baphuma kwi-cholangitis.
> Imithombo:
> Afdhal, NH. "I-cholangitis enobuchule." Isemgangathweno. 18 uMatshi 2016.
> Amacandelo okuLawula nokuLawula izifo. "Sepsis." CDC.gov. 23 uJuni 2018.
> Tierney J, Bhutiani N, Isitampu B, et al. "Iziganeko zobungozi ezibandakanya i-cholangitis elandelayo ERCP . 2018: 32; 799. i-doi: 10.1007 / s00464-017-5746-z
> Yeom DH, Oh HJ, Nyana YW, Kim TH. "Ziziphi izinto ezibeka umngcipheko kwi-cholangitis ekhuselekileyo ebangelwa ngamatye aqhelekileyo?" I- Gut Liver . 2010; 4: 363. INGXELO: 10.5009 / gnl.2010.4.3.363