Kutsekeka kwa ma buleki

Kutsekeka kwa ma bile ndikutseka kwamachubu omwe amanyamula ndulu kuchokera pachiwindi kupita ku ndulu ndi matumbo ang'onoang'ono.

Bile ndi madzi otulutsidwa ndi chiwindi. Muli cholesterol, bile salt, ndi zinyalala monga bilirubin. Mchere wambiri umathandizira thupi lanu kuwononga (kugaya) mafuta. Bile amatuluka m'chiwindi kudzera mumadontho a bile ndipo amasungidwa mu ndulu. Pambuyo pa kudya, amatulutsidwa m'matumbo ang'onoang'ono.

Mitsempha ya bile itatsekedwa, bile imakhazikika m'chiwindi, ndipo jaundice (mtundu wachikaso) imayamba chifukwa cha kuchuluka kwa bilirubin m'magazi.

Zomwe zimayambitsa kutsekeka kwa bile yotsekedwa ndi monga:

• Ziphuphu zamatope wamba
• Zowonjezera ma lymph nodes mu porta hepatis
• Miyala
• Kutupa kwa ma ducts
• Kupendeketsa kwa ma ducts kuchokera pamabala
• Kuvulala chifukwa cha opaleshoni ya ndulu
• Zotupa zaminyewa zam'mimba kapena kapamba
• Zotupa zomwe zafalikira ku biliary system
• Mphutsi za chiwindi ndi bile (zotuluka)

Zowopsa zake ndi izi:

• Mbiri ya ma gallstones, kapamba kapaka, kapena khansa ya kapamba
• Kuvulala kumimba
• Opaleshoni yaposachedwa ya biliary
• Khansa yaposachedwa ya biliary (monga khansa ya bile duct)

Kutsekeka kungayambitsenso matenda. Izi ndizofala kwambiri kwa anthu omwe ali ndi chitetezo chamthupi chofooka.

Zizindikiro zimaphatikizapo:

• Kupweteka m'mimba kumtunda chakumanja
• Mkodzo wakuda
• Malungo
• Kuyabwa
• Jaundice (mtundu wachikaso wachikaso)
• Nseru ndi kusanza
• Zojambula zofiirira

Wothandizira zaumoyo wanu adzakuyesani ndikumva m'mimba mwanu.

Zotsatira zotsatirazi zamagazi zitha kukhala chifukwa chotseka komwe kungachitike:

• Kuchuluka kwa bilirubin level
• Kuchuluka kwa alkaline phosphatase mulingo
• Kuchulukitsa michere ya chiwindi

Mayeso otsatirawa atha kugwiritsidwa ntchito kuti afufuze zotsekeka zotulutsa bile:

• M'mimba ultrasound
• M'mimba mwa CT scan
• Endoscopic retrograde cholangiopancreatography (ERCP)
• Percutaneous transhepatic cholangiogram (PTCA)
• Magnetic resonance cholangiopancreatography (MRCP)
• Endoscopic ultrasound (EUS)

Njira yotchinga ya bile ingasinthenso zotsatira za mayeso otsatirawa:

• Kuyezetsa magazi kwa Amylase
• Gallbladder radionuclide scan
• Kuyesa magazi kwa Lipase
• Nthawi ya Prothrombin (PT)
• Mkodzo bilirubin

Cholinga cha chithandizo ndikuthetsa kutsekeka. Miyala imatha kuchotsedwa pogwiritsa ntchito endoscope nthawi ya ERCP.

Nthawi zina, opaleshoni imafunika kuti ichoke pamitsempha. Ndulu nthawi zambiri imachotsedwa opaleshoni ngati kutsekeka kumayambitsidwa ndi ma gallstones. Wothandizira anu akhoza kukupatsani maantibayotiki ngati matenda akuganiziridwa.

Ngati kutseka kumayambitsidwa ndi khansa, njirayo imatha kukulitsidwa. Njirayi imatchedwa endoscopic kapena percutaneous (kudzera pakhungu pafupi ndi chiwindi). Payipi ingafunikire kuyikidwa kuti izitha kulowa ngalande.

Ngati kutsekako sikunakonzedwe, kumatha kubweretsa matenda owopsa komanso kuchuluka kwa bilirubin.

Ngati kutsekeka kumatenga nthawi yayitali, kumatha kudwala matenda a chiwindi. Zovuta zambiri zimatha kuchiritsidwa ndi endoscopy kapena opaleshoni. Zovuta zomwe zimayambitsidwa ndi khansa nthawi zambiri zimakhala ndi zoyipa zoyipa.

Ngati sanalandire chithandizo, zovuta zomwe zingachitike zimaphatikizapo matenda, sepsis, ndi matenda a chiwindi, monga biliary cirrhosis.

Itanani omwe akukuthandizani ngati:

• Tawonani kusintha kwamtundu wa mkodzo wanu ndi chimbudzi
• Pangani jaundice
• Khalani ndi kupweteka m'mimba komwe sikumatha kapena kumangobwerezabwereza

Dziwani za zoopsa zilizonse zomwe muli nazo, kuti muthe kupeza chithandizo chamankhwala mwachangu ngati njira yotulutsira bile itatsekedwa. Kutsekeka komweko sikungalephereke.

Kuletsa kwa biliary

• Dongosolo m'mimba
• Matenda a Endocrine
• Njira yopanda madzi
• Biliary kutsekeka - mndandanda

Fogel EL, Sherman S. Matenda a ndulu ndi ma ducts. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier; 2020: chap 146.

Lidofsky Sd. Jaundice. Mu: Feldman M, Friedman LS, Brandt LJ, olemba. Sleisenger ndi Matenda a Mimba ndi a Fordtran Amatenda a Chiwindi. 11th ed. Philadelphia, PA: Elsevier; 2021: mutu 21.