Ukutheleleka emadayini we-bile kungabi sína kodwa abantu abaningi baphuluke kahle
I-Cholangitis isifo se-bile ducts. I-cholangitis enamandla ingabangela izimpawu ze-fever, i-jaundice, nobuhlungu besisu. Isimo ngezinye izikhathi sibizwa ngokuthi ukunyuka kwe-cholangitis.
I-cholangitis enamandla yisifo esibi esidinga ukwelashwa. Kubalulekile ukuthi abantu abanalo hlobo lokutheleleka bahlolwe futhi baphathwe ngokushesha ukuze bagweme izinkinga ezinkulu.
Isibikezelo se-cholangitis siye sathuthuka eminyakeni yamuva futhi abantu abaningi baphinde baphilise.
Ama-blockages we-Bile
I-bile yinto esiza ukudiliza amanoni ekudleni ukuze igazwe. I-bile idalwe esibindi futhi ihamba ngezinyathelo ezibizwa ngokuthi i-bile ducts kuya enkanyeni ye- gallbladder , lapho igcinwa kuze kudingeke khona. Ngemuva kokudla, ikakhulukazi okufaka amafutha, i-bile ikhishwa nge-duct futhi ingena engxenyeni yokuqala yamathumbu amancane (i-duodenum).
Ngezinye izikhathi i-bile ducts ingavinjelwa noma, ngokungajwayelekile, ibe mncane kakhulu. Lokhu kungenzeka uma ama-gallstones enza noma uma kukhona esinye isizathu sokuthi amathanga anciphise, njengokukhula kwesimila esiseduze nomgwaqo noma ukuqina kwe-bile. Ama-gallstones ajwayelekile kubantu besifazane, abantu abanesifo sofuba (IBD, ikakhulukazi isifo se-Crohn), i- sclerosing cholangitis , ne-HIV / AIDS. Ama-tumor noma izigxobo ezinjengezimbangela zamadaysi we-bile azincane azivamile.
Lapho i-bile duct ivinjiwe ku-gallstone noma esinye isizathu, kukhona okungenzeka ukuthi igciwane le-bacteria. Ukutheleleka kungase kwenzeke ngemuva kokuhlinzwa lapho i-stent efakwa khona ku-bile duct. Lolu hlobo lokutheleleka kwebhaktheriya lubizwa nge-cholangitis.
Izingozi Zezingozi
Ingozi yokuthuthukisa i-cholangitis izoxhomeka eziningana ezimbalwa kodwa kunezimo ezimbalwa ezingenza lokhu kutheleleka kube khona.
Abantu abasengozini enkulu yokuthola isifo kwi-bile duct kubandakanya noma ubani onokuthi:
- Umlando wama-gallstones
- Ukuxilongwa kwe-sclerosing cholangitis
- Usanda kuhambela ezindaweni lapho izifo ezithathelwanayo noma izifo zengculaza zingenzeka
- I- endoscopic retrograde i-cholangiopancreatography (ERCP) yamuva yokubeka (ngesinye isifundo, ingozi yayiyi-13.2%)
Izimpawu Nezibonakaliso
Izibonakaliso nezimpawu ze-cholangitis eziyingozi ngokuvamile zifana nezama-gallstones futhi zingabandakanya:
- Ukuhlungu obusemhlane
- Ama-Chills
- Izitembu ezimibalabala
- Umchamo omnyama
- Fever
- I-jaundice (i-yellowing yesikhumba namehlo)
- I-nausea
- Ubuhlungu ngezansi kwehlombe lehlombe
- I-quadrant ephezulu kwesokudla noma ubuhlungu besisu esisemkhatsini obukhali, obunzima noma obuthakathaka
- Ukuvota
Ukuxilongwa
Ukwenza ukuxilongwa kwe-cholangitis ngokushesha ngangokunokwenzeka ukuze uqale ukwelashwa kubalulekile. Ukuhlolwa okukodwa noma okuningi okungafani okubukeka ku-gallbladder ne-bile ducts kungasetshenziswa.
Ukuhlolwa kwegazi
Ngenkathi ukuhlolwa kwegazi kungasetshenziswanga yedwa ukuxilonga ukutheleleka emidayeni ye-bile, basetshenziselwa ukusiza ukuthola isithombe esiphezulu sezinto ezingabangela izimpawu. Ukuhlolwa kwegazi okungenziwa kwenziwe kuhlanganisa:
- Izinga le-Bilirubin
- Amazinga enzyme yesibindi
- Ukuvivinya kokusebenza kwesibindi
- I-white cell cell (WBC) ibalwa
I-ultrasound yesisu
I-ultrasound wuhlolo olusebenzisa amagagasi omsindo ukuze ubone izakhiwo ngaphakathi komzimba. Kungenzeka kwenziwe esiswini lapho kutholakala khona isikhubekiso se-gallstone noma i-bile duct.
ERCP
Phakathi nalesi sivivinyo, ithubhu idluliselwa emlonyeni futhi phansi ngokusebenzisa umzila wokugaya ukuze ufinyelele emidayeni ye-bile. Lokhu kungenziwa kuphela ukuze ubone ukuthi kwenzekani emidayini kodwa futhi ingasetshenziswa kwezinye izimo ukususa ama-gallstones. Phakathi nalesi sivivinyo i-bile ingase isuswe ukuze ihlolwe ngamabhaktheriya. I-bile izokwakhiwa ebhodini ukuthola ukuthi yiziphi amagciwane ezibangela ukutheleleka.
I-magnétic resonance cholangiopancreatography (MRCP)
Lokhu kuvivinywa ukuhlolwa kwe-imaging okungenasidalwa futhi kusetshenziselwa ukubona ngeso lengqondo ama-pancreas, gallbladder, ne-bile ducts. Noma yikuphi ukuvimbela emidayeni ye-bile kungabonakala ezithombeni ezithathwe.
I-percutaneous cholangiogram ye-transhepatic (PTCA)
I-PTCA wuhlobo lwe-ray ray olusetshenziselwa ukubona amadoksi we-bile. Ngenkathi isiguli siguqulwa, inaliti ifakwa ngaphakathi kwesisu nangesibindi ukuze ihlinzeke isikhala esiphambene endaweni. Khona-ke uchungechunge lwe-x-ray lithathwa ukubona ngeso lengqondo amadoksi ane-medium ehlukile egeleza kuwo.
Ukwelapha
Lapho isifo sitholwa, ukwelashwa kufanele kuqale ngokushesha. Ngenxa yokuthi i-cholangitis ibangelwa ukutheleleka, ukwelashwa kuzobandakanya ama-antibiotics ukubulala amabhaktheriya. Okwesibili, imbangela yezimpande idinga ukuphathwa. Endabeni yama-gallstones, amatshe angase aphathwe ngokuwasusa nge-ERCP, ukuwahlakaza, noma ukuwaphula ngamagagasi okwethuka. Kwezinye izimo, ukuhlinzeka nge-gallbladder ukususwa kungenziwa.
Ukuze kube nemigomo ebhodini le-bile, inqubo ingenziwa ukwenza i-stent futhi igcine ivuliwe. Endabeni lapho kunciphisa ama-bucts ngenxa ye-tumor (okungavamile), okungadinga ukuhlinzwa noma ezinye izifo uma kutholakala ukuthi kuyingozi.
Izinkinga
I-Sepsis iyinkinga eyodwa yokwenza i-cholangitis, futhi yisimo esisongela ukuphila. I-Sepsis iyenzeka uma ukutheleleka kungaphathwa futhi kubangele ukuhluleka komzimba, ukulimala kwezicubu, kanye nokufa okungenzeka. I-Sepsis iphathwa ngama-antibiotic futhi ngezinye izikhathi ezinye izinyathelo zidinga ukusiza ukususa izicubu ezinesifo. I-Sepsis ingaba yinkinga futhi isongela ukuphila, yingakho kubalulekile ukuxwayisa ochwepheshe bezokwelapha ngokushesha uma kunolwa ukuthi isifo siphendule lesi simo.
Ukuvimbela
Kwezinye izimo, ukuvimbela i-cholangitis angeke kwenzeke. Kodwa-ke, njengoba amacala amaningi abangelwa ama-gallstones avimbela amathanga we-bile, ukuvimbela izigulane kungasiza. Ukuvimbela ama-gallstones kungabandakanya ukudla ukudla okunempilo ngamanani afanelekile we-fiber e-soluble ne-insoluble futhi usebenzise umzimba njalo. Ukuyeka ukubhema kungasiza ekuvimbeleni ukuthuthukiswa kwezinhlobo ezimbi kakhulu ze-cholangitis. Ukuze i-cholangitis ehlotshaniswe ne-ERCP nokubekwa kwe-stent, ama-antibiotic anganikezwa ngesikhathi senqubo noma ngemuva kokuvimbela ukutheleleka.
Izwi elivela
I-cholangitis enamandla yisimo esibi ngoba yisifo esingenza umuntu agule kakhulu futhi aholele ezinkingeni. Ukuthola ukutholakala ngokushesha nokuthola ukwelashwa kubalulekile, ngakho-ke izimpawu zesisu esiswini, i-jaundice, nomkhuhlane zibangelwa ukubona udokotela ngokushesha. Uma ukuxilongwa kuyashesha futhi ukwelashwa ngama-antibiotics kuqalwa, izindaba ezinhle ukuthi abantu abaningi baphulukana ne-cholangitis.
> Imithombo:
> Afdhal, NH. "I-cholangitis enamandla." Kusesikhathini. 18 Mashi 2016.
> Amasevisi Okulawula Nokuvimbela Izifo. "Sepsis." CDC.gov. 23 Jan 2018.
> Tierney J, uBhutiani N, Stamp B, et al. "Izingozi zokubikezela ezihlobene ne-cholangitis elandela i-ERCP." I- Surg Endosc. 2018: 32; 799. i-doi: 10.1007 / s00464-017-5746-z
> Yeom DH, Oh HJ, iNdodana YW, Kim TH. "Yiziphi izici eziyingozi zokukhipha i-cholangitis ekhushulwa kakhulu ngenxa yamatshe ajwayelekile we-bile duct?" Gut Liver . 2010; 4: 363. I-DOI: 10.5009 / gnl.2010.4.3.363