Utachiona mu bile ducts hunogona kunge hwakakomba asi vanhu vakawanda vanopora zvakanaka
Cholangitis chirwere che bile bile ducts. Acute cholangitis inogona kuita zviratidzo zvefivha, jaundice, uye kurwadziwa mumimba. Mamiriro acho ezvinhu dzimwe nguva anonzi kukwira cholangitis.
Acute cholangitis chirwere chakakomba chinoda kurapwa. Zvakakosha kuti vanhu vane rudzi urwu hwehutachiwana vaone uye vanobatwa nokukurumidza kuitira kuti vasadzike matambudziko makuru.
Izvo zvinonzi chilangitis zvakavandudzwa mumakore achangobva kupfuura uye vanhu vakawanda vanorapwa.
Bhuku Rakavhara Blockages
Bhiri chinhu chinobatsira kuputsa mafuta muzvokudya kuitira kuti inogona kudyiwa. Bhiri inogadzirwa mukati mechiropa uye inofamba nenzira dzinonzi bile ducts kusvika ku gallbladder , iyo inochengeterwa kusvikira ichidikanwa. Mushure mokudya, kunyanya imwe inosanganisira mafuta, bile inosunungurwa kuburikidza neharayi uye kusvika muchikamu chekutanga chemukati mudumbu (the duodenum).
Dzimwe nguva iyo ducts inogona kudzivirirwa kana, kazhinji, inonyanya kuderera. Izvi zvinogona kuitika kana mapurisa akaumbwa kana apo pane chimwe chikonzero icho madhara acho akaomeswa, zvakadai sekukura kwechirwere pedyo nedhara kana kuti bile duct stricture. Zvipfeko zvinowanzoonekwa kune vakadzi, vanhu vane chirwere chinoputira chirwere (IBD, kunyanya Crohn's disease), sclerosing cholangitis , uye HIV / AIDS. Tumhondi kana zvipfeko sechikonzero chebii ducts zvishoma nezvishoma hazvisi zvishoma.
Kana bhodhoro rebii rakavharwa kubva kune gorova kana chimwe chikonzero, kune mikana yokuti itapukirwe nemaabhakitiriya. Utachiona hunogona kuitika zvakare mushure mekuvhiyiwa uko stent inowanikwa mu bile duct. Urwu hutachiona hwehutachiona hunonzi cholangitis.
Risk Factors
Dambudziko rekugadzira cholangitis rinotarisa pane zvimwe zvinhu asi kune mamiriro mashomanana anogona kuita kuti utachiona uwedzere.
Vanhu vari pangozi yakakura yokuva nehutachiwana muBate duct vanosanganisira chero ani ane:
- Nhoroondo yezvinyenyeri
- Kuongororwa kwe sclerosing cholangitis
- Munguva pfupi yapfuura akaenda kune dzimwe nzvimbo apo zvirwere zvepasita kana bhakitiriya zvinogona kuitika
- Ichangobva kugadziriswa inonzi retrograde cholangiopancreatography (ERCP) ine stent kuiswa (mune imwe yongororo, njodzi yaiva 13.2 muzana)
Zviratidzo nezviratidzo
Zviratidzo nezviratidzo zve acute cholangitis zvinowanzowanana neyedzigoni uye zvinogona kusanganisira:
- Kutambudzika shure
- Chills
- Mifananidzo yakatsvuka
- Urine yakasviba
- Fever
- Jaundice (kuchena kweganda nemeso)
- Nausea
- Pain pasi pemapfudzi emafudzi
- Kumusoro kwepamusoro pemakumbo kana mukati-kati marwadzo omumakumbo akajeka, akaoma kana kuti akaoma
- Kudzora
Kuziva
Kuita kuti kuongororwa kwecholangitis nokukurumidza sezvinobvira kuti utange kurapwa kunokosha. Chimwechete kana kupfuura mimwe miedzo yakasiyana-siyana yakatarisa gallbladder uye bile ducts ingashandiswa.
Kuyera ropa
Nepo kuongororwa kweropa hakuzoshandiswa chete kuti uongorore utachiona mu bile ducts, zvinoshandiswa kubatsira kuwana mufananidzo wezvose zvinogona kuisa zviratidzo. Ropa rekuongorora rinogona kuitwa rinosanganisira:
- Bilirubin level
- Liver enzyme levels
- Chiropa basa test
- White cell cell (WBC) yakaverengwa
Abdominal ultrasound
An ultrasound muedzo unoshandisa mazaya ezwi kuitira kuti uone zvivako mukati memuviri. Izvo zvinogona kuitwa pamimba kana gorosi kana bhile chibvumirano chikafungidzirwa.
ERCP
Pakati pomuedzo uyu, tube inodarika mumuromo uye ichidzika kuburikidza nehutano hwekudya kusvika kuB bile ducts. Izvi zvingaitwa kwete kungoona zviri kuitika mumakumbo asi zvakare zvinogona kushandiswa mune dzimwe mamiriro ezvinhu kubvisa matombo. Pakati pekuedzwa imwe bile inogona kubviswa kuitira kuti iongorore mabhakitiriya. Iyo bile ichagadzirwa mubazi kuti ione kuti mabhakitiriya anokonzera utachiona.
Magnetic resonance cholangiopancreatography (MRCP)
Iyi miedzo iyi ndiyo kuedza kwekufungidzira iyo isingasviki uye inoshandiswa kufungidzira pancreas, gallbladder, uye bile ducts. Zvose zvinokonzerwa neB bile ducts zvinogona kuonekwa pamifananidzo yakatorwa.
Percutaneous transhepatic cholangiogram (PTCA)
Iko PTCA inoratidziro ye x-ray iyo inoshandiswa kuona bile ducts. Kunyange zvazvo murwere ari kunyengedzwa, sora inowanikwa kuburikidza nemudumbu uye muchiropa kuti ipe mutsauko wokusiyanisa kunzvimbo. Zvadaro mutsara we x-rays anotorwa kuti aone sekuti mahara ane simiro yakasiyana-siyana inoyerera kuburikidza navo.
Kurapa
Kana chiitiko ichi chikaitwa, chirwere chinofanira kutanga nokukurumidza. Nokuti cholangitis inokonzerwa nehutachiona, kurapwa kunosanganisira mishonga inorwisa mabhakitiriya. Chechipiri, chikonzero chinokonzera kurapwa. Muzvinyorwa zvemaronda, mabwe acho angangobatwa nekuvabvisa ne ERCP, kuapedza, kana kuvhuna nekudengenyeka. Mune zvimwe zviitiko, chirwere chekurwadza chinogona kuita.
Nokuda kwezvinyorwa mu bile duct, nzira inogona kuitwa kuti iise stent uye kuchengeta duct yakazaruka. Mumamiriro ezvinhu apo pane kuderedza b bile ducts nekuda kwechirwere (izvo zvisingawanzoitiki), izvo zvingada kuvhiyiwa kana dzimwe mishonga kana zvichionekwa sechinokuvadza.
Matambudziko
Sepsis ndiyo imwe nzira inogona kukonzera kusangana kwecholangitis, uye ihwo hupenyu hunotyisa. Sepsis inoitika kana utachiona husingatariswi uye hunokonzera kukanganisa kwechimiro, kukuvadza kwemaviri, uye zvichida kufa. Sepsis inorapwa nemishonga inorwisa mabhakitiriya uye dzimwe nguva dzimwe nzira dzinodiwa kubatsira kubvisa mishonga ine utachiona. Sepsis inogona kuva inonyengedza uye kutyisidzira upenyu, ndicho chikonzero zvakakosha kuongorore vashandi vezvokurapa pakarepo kana zvichifungidzirwa kuti hutachiwana hwakashanduka kuva mamiriro ezvinhu aya.
Kudzivirira
Mune zvimwe zviitiko, kudzivirira cholangitis kunogona kusabvira. Zvisinei, sezvakawanda zviitiko zvinokonzerwa nemaronda emhepo anovhara ducts, kuchengetedza mabhesi angabatsira. Kuchengetedza gorostones kunogona kusanganisira kudya kudya kwakanaka nemari yakakodzera ye-soluble uye insoluble fiber uye kugara uchiita muviri. Kusiya kusvuta kunogonawo kubatsira kudzivirira kusimba kwemaitiro akaoma echolangitis. Nokuda kwecholangitis inobatanidza ne ERCP uye stent placement, antibiotics inogona kupiwa panguva yekufamba kana shure kwekudzivirira utachiona.
Shoko Rinobva
Acute cholangitis chirwere chakakomba nekuti ihutachiona hunogona kuita kuti munhu arwara zvikuru uye kutungamirira kumatambudziko. Kuwana zvinoonekwa nekukurumidza uye kugamuchira kurapwa kunokosha, saka zviratidzo zvemarwadzo emimba, jaundice, uye fevha zvinokonzera kuona chiremba pakarepo. Apo kuongororwa kunokurumidza uye kurapwa nemishonga inorwisa mabhakitiriya inotanga, mashoko akanaka ndeokuti vanhu vazhinji vanopora kubva kucholangitis.
> Sources:
> Afdhal, NH. "Acute cholangitis." Kusvika pari zvino. 18 Mar 2016.
> Centres for Disease Control and Prevention. "Sepsis." CDC.gov. 23 Jan 2018.
> Tierney J, Bhutiani N, Stamp B, et al. "Zvimwe zvinokonzera njodzi zvinokonzerwa necholangitis inotevera ERCP." Surgos Endosc. 2018: 32; 799. doi: 10.1007 / s00464-017-5746-z
> Yeom DH, Oh HJ, Mwanakomana YW, Kim TH. "Ndezvipi zvinokonzera ngozi kune acute suppurative cholangitis inokonzerwa nevakawanda bile duct stone?" Gut Liver . 2010; 4: 363. DOI: 10.5009 / gnl.2010.4.3.363