Ukuphazamiseka kwendlela yokubila

Ukuthintelwa kwe-Bile duct is a blockage in the tubes that car bile from the liver to the gallbladder and small intestine.

Ibile lulwelo olukhutshwa sisibindi. Iqukethe i-cholesterol, i-bile salts, kunye nemveliso yenkunkuma efana ne-bilirubin. Iityuwa zebile zinceda umzimba wakho ukuba uchithe (ugaye) amafutha. Ibile iphuma ngaphandle kwesibindi ngemibhobho yenyongo kwaye igcinwe kwinyongo. Emva kwesidlo, ikhutshwa iye emathunjini amancinci.

Xa imibhobho yenyongo ivalekile, inyongo iyakha esibindini, kunye ne-jaundice (umbala omthubi wolusu) ikhula ngenxa yenqanaba elonyukayo le-bilirubin egazini.

Unobangela onokubakho we-bile duct evaliweyo kubandakanya:

• Iingqungquthela zendlela eqhelekileyo ye-bile
• Ukwandiswa kwee-lymph node kwi-porta hepatis
• Amatye egall
• Ukudumba kwemibhobho yenyongo
• Ukunciphisa i-bile ducts ukusuka ekutyeni
• Ukwenzakala kuqhaqho lwe-gallbladder
• Ukudumba kwamadangatye enyongo okanye injeke
• Amathumba athe saa kwinkqubo yonyango
• Iintshulube zesibindi kunye ne-bile duct (i-flukes)

Izinto ezinobungozi zibandakanya:

• Imbali yeenyongo, i-pancreatitis engapheliyo, okanye umhlaza wepancreatic
• Ukwenzakala kwindawo esiswini
• Utyando lwamva nje
• Umhlaza we-biliary wamva nje (onje ngomhlaza wenyongo)

Ukuvaleka kunokubangelwa zizifo. Oku kuqheleke kakhulu kubantu abanamajoni omzimba abuthathaka.

Iimpawu zingabandakanya:

• Iintlungu zesisu kwicala lasekunene
• Umchamo omnyama
• Ifiva
• Ukurhawuzelela
• IJaundice (umbala wesikhumba omthubi)
• Isicaphucaphu nokugabha
• Izitulo ezimibala-bala

Umboneleli wakho wezempilo uya kukuvavanya kwaye usiva isisu sakho.

Ezi ziphumo zovavanyo lwegazi zilandelayo zinokubangelwa luvavanyo olunokwenzeka:

• Ukunyusa inqanaba le-bilirubin
• Ukunyuka kwenqanaba le-alkaline phosphatase
• Ukwanda kwee-enzymes zesibindi

Olu vavanyo lulandelayo lunokusetyenziselwa ukuphanda i-bile duct evaliweyo:

• I-ultrasound yesisu
• Ukuskena kwe-CT esiswini
• I-Endoscopic retrograde cholangiopancreatography (ERCP)
• Ipolututaticatichephepatic cholangiogram (PTCA)
• Imagnetic resonance cholangiopancreatography (MRCP)
• I-endoscopic ultrasound (i-EUS)

I-bile duct evaliweyo inokutshintsha iziphumo zolu vavanyo lulandelayo:

• Uvavanyo lwegazi lwe-Amylase
• Ukususwa kwe-gallbladder radionuclide scan
• Uvavanyo lwegazi lweLipase
• Ixesha leprothrombin (PT)
• Umchamo bilirubin

Injongo yonyango kukhulula ukubhloka. Amatye anokususwa kusetyenziswa i-endoscope ngexesha le-ERCP.

Kwezinye iimeko, utyando luyafuneka ukudlula ukucinywa. I-gallbladder iya kuhlala isuswa ngotyando ukuba ukubhloka kubangelwa ngamatye enyongo. Umboneleli wakho unokumisela amayeza okubulala iintsholongwane ukuba ukrokrela usulelo.

Ukuba ukukhutshwa kubangelwa ngumhlaza, i-duct ingadinga ukwandiswa. Le nkqubo ibizwa ngokuba yi-endoscopic okanye i-percutaneous (ngesikhumba ecaleni kwesibindi). Umbhobho unokufuna ukubekwa ukuvumela umsele.

Ukuba ukuvalwa kungalungiswa, kunokukhokelela kusulelo olusongela ubomi kunye nokwakha okuyingozi kwe-bilirubin.

Ukuba ukuvalelwa kuhlala ixesha elide, isifo sesibindi esinganyangekiyo sinokubangela. Uninzi lwezithintelo lunokunyangwa nge-endoscopy okanye ngoqhaqho. Izithintelo ezibangelwa ngumhlaza zihlala zineziphumo ezibi.

Ukushiya kunganyangwa, iingxaki ezinokubakho zibandakanya usulelo, isifo se-sepsis, kunye nesifo sesibindi, njenge-cirrhosis ye-biliary.

Fowunela umnikezeli wakho ukuba:

• Qaphela utshintsho kumbala womchamo wakho kunye nezihlalo
• Ukuphuhlisa i-jaundice
• Yiba nentlungu esiswini engahambiyo okanye eqhubeka iphindaphindeka

Yazi nayiphi na imingcipheko onayo, ukuze ufumane ukuxilongwa ngokukhawuleza kunye nonyango ukuba i-bile duct iyavalwa. Ukuvaleka ngokwakho akunakuthinteleka.

Uthintelo lweBiliary

• Inkqubo yokwetyisa
• Amadlala endocrine
• Indlela yendlela
• Uthintelo lweBiliary - uthotho

UFogel EL, uSherman S. Izifo ze-gallbladder kunye ne-bile ducts. Ku: IGoldman L, iSchafer AI, ii-eds. Amayeza eGoldman-Cecil. Ngomhla wama-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 146.

ILidofsky SD. I-jaundice. Ku: UFeldman M, uFriedman LS, uBrandt LJ, ii-eds. Sleisenger kunye neFordtran's Gastrointestinal and Liver Disease. Ngomhla we-11. IPhiladelphia, PA: Elsevier; 2021: Isahluko 21.