Kukula kwa cholangitis

Sclerosing cholangitis amatanthauza kutupa (kutupa), mabala, ndi kuwonongeka kwa ma ducts amkati mkati ndi kunja kwa chiwindi.

Zomwe zimayambitsa vutoli sizidziwika nthawi zambiri.

Matendawa amatha kuwoneka mwa anthu omwe ali ndi:

• Matenda otupa (IBD) monga ulcerative colitis ndi matenda a Crohn
  
• Matenda osokoneza bongo
• Matenda a kapamba (kapamba wotupa)
• Sarcoidosis (matenda omwe amayambitsa kutupa m'malo osiyanasiyana amthupi)

Zomwe zimayambitsa matenda zimakhalanso zoyambitsa. Sclerosing cholangitis amapezeka nthawi zambiri mwa amuna kuposa akazi. Matendawa sapezeka kawirikawiri mwa ana.

Sclerosing cholangitis amathanso kuyambitsidwa ndi:

• Choledocholithiasis (gallstones mu bile bile)
• Matenda m'chiwindi, ndulu, ndi ma ducts

Zizindikiro zoyambirira nthawi zambiri zimakhala:

• Kutopa
• Kuyabwa
• Chikasu cha khungu ndi maso (jaundice)

Komabe, anthu ena alibe zisonyezo.

Zizindikiro zina zitha kuphatikiza:

• Kukulitsa chiwindi
• Kukula kwa nthata
• Kuchepa kwa njala ndi kuonda
• Bwerezani zigawo za cholangitis

Ngakhale anthu ena alibe zizindikilo, kuyezetsa magazi kumawonetsa kuti ali ndi chiwindi chachilendo. Wothandizira zaumoyo wanu adzafuna:

• Matenda omwe amayambitsa mavuto omwewo
• Matenda omwe amapezeka nthawi zambiri ndi matendawa (makamaka IBD)
• Miyala

Mayeso omwe akuwonetsa cholangitis ndi awa:

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

Kuyezetsa magazi kumaphatikizanso michere ya chiwindi (kuyesa chiwindi).

Mankhwala omwe angagwiritsidwe ntchito ndi awa:

• Cholestyramine (monga Prevalite) yothandizira kuyabwa
• Ursodeoxycholic acid (ursodiol) kusintha chiwindi kugwira ntchito
• Mavitamini osungunuka ndi mafuta (D, E, A, K) kuti abwezeretse zomwe zatayika ku matenda omwewo
• Maantibayotiki ochiza matenda m'mitsempha ya bile

Njirazi zitha kuchitidwa:

• Kuyika chubu lalitali, locheperako ndi buluni kumapeto kuti mutsegule (kuchepa kwa zibaluni zosakwanira)
• Kukhazikitsa ngalande kapena chubu pochepetsa pang'ono (zotupa) zaminyewa ya bile
• Proctocolectomy (kuchotsa colon ndi rectum, kwa iwo omwe ali ndi ulcerative colitis ndi sclerosing cholangitis) sikukhudza kukula kwa sclerosing cholangitis (PSC)
• Kuika chiwindi

Momwe anthu amachitira bwino zimasiyanasiyana. Matendawa amawonjezeka pakapita nthawi. Nthawi zina anthu amakula:

• Ascites (kuchuluka kwa madzimadzi pakati pakatikati pamimba ndi ziwalo zam'mimba) ndi minyewa (mitsempha yokulitsidwa)
• Biliary cirrhosis (kutupa kwa ma ducts a bile)
• Kulephera kwa chiwindi
• Jaundice yolimbikira

Anthu ena amatenga matenda am'mabulu am'malewa omwe amabwereranso.

Anthu omwe ali ndi vutoli ali pachiwopsezo chachikulu chotenga khansa yamatope a bile (cholangiocarcinoma). Ayenera kufufuzidwa pafupipafupi ndi kuyesa kulingalira kwa chiwindi komanso kuyezetsa magazi. Anthu omwe ali ndi IBD akhoza kukhala ndi chiopsezo chowonjezeka chokhala ndi khansa ya colon kapena rectum ndipo ayenera kukhala ndi colonoscopy nthawi ndi nthawi.

Zovuta zingaphatikizepo:

• Kutuluka magazi kwamitsempha yamagazi
• Khansa m'mitsempha ya bile (cholangiocarcinoma)
• Matenda a chiwindi ndi kulephera kwa chiwindi
• Matenda a biliary system (cholangitis)
• Kupondereza kwamitsempha ya ndulu
• Kuperewera kwa Vitamini

Pulayimale sclerosing cholangitis; Zamgululi

• Dongosolo m'mimba
• Njira yopanda madzi

Bowlus C, Assis DN, Goldberg D. Pulayimale ndi sekondale sclerosing cholangitis. Mu: Sanyal AJ, Boyer TD, Lindor KD, Terrault NA, olemba. Zakim ndi Boyer's Hepatology. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2018: mutu 43.

Ross AS, Kowdley KV. Pulayimale sclerosing cholangitis komanso mobwerezabwereza pyogenic cholangitis. Mu: Feldman M, Friedman LS, Brandt LJ, olemba. Sleisenger ndi Fordtran's Mimba ndi Matenda a Chiwindi: Pathophysiology / Diagnosis / Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016: chap 68.

Zyromski NJ, Pitt HA. Kuwongolera kwa sclerosing cholangitis. Mu: Cameron JL, Cameron AM, olemba, eds. Chithandizo Chamakono Cha Opaleshoni. Wolemba 12. Philadelphia, PA: Elsevier; 2017: 453-458.