Ukubola kwe-cholangitis

I-Sclerosing cholangitis ibhekisa kukudumba (ukudumba), ukunqatyulwa, kunye nokutshatyalaliswa kwemibhobho yenyongo ngaphakathi nangaphandle kwesibindi.

Unobangela wale meko awaziwa kwiimeko ezininzi.

Esi sifo sinokubonakala kubantu abane:

• Isifo sesibindi sokuvuvukala (IBD) njengesifo se-ulcerative colitis kunye nesifo sikaCrohn
  
• Ukuphazamiseka ngokuzenzekelayo
• I-pancreatitis engapheliyo (i-pancreas evuthayo)
• I-Sarcoidosis (isifo esibangela ukuvuvukala kwiindawo ezahlukeneyo zomzimba)

Izinto zemfuza zinokuba noxanduva. I-Sclerosing cholangitis yenzeka rhoqo emadodeni kunabafazi. Esi sifo sinqabile ebantwaneni.

Ukubumba i-cholangitis kunokubangelwa ngu:

• I-Choledocholithiasis (i-gallstones kwi-bile duct)
• Usulelo kwisibindi, i-gallbladder, kunye ne-bile ducts

Iimpawu zokuqala zihlala:

• Ukudinwa
• Ukurhawuzelela
• Ubumthubi besikhumba namehlo (i-jaundice)

Nangona kunjalo, abanye abantu abanazimpawu.

Ezinye iimpawu zingabandakanya:

• Ukwandiswa kwesibindi
• Ipeni eyandisiweyo
• Ukuphelelwa ngumdla wokutya kunye nokwehla kobunzima
• Phinda iziqendu ze-cholangitis

Nangona abanye abantu bengenazo iimpawu, uvavanyo lwegazi lubonisa ukuba banesibindi esingaqhelekanga. Umboneleli wakho wezempilo uya kukhangela:

• Izifo ezibangela iingxaki ezifanayo
• Izifo ezidla ngokwenzeka ngale meko (ngakumbi i-IBD)
• Amatye egall

Uvavanyo olubonisa i-cholangitis lubandakanya:

• Ukuskena kwe-CT esiswini
• I-ultrasound yesisu
• I-Endoscopic retrograde cholangiopancreatography (ERCP)
• Isibindi se-biopsy
• Imagnetic resonance cholangiopancreatography (MRCP)
• Ipolututaticatichephepatic cholangiogram (PTC)

Uvavanyo lwegazi lubandakanya ii-enzyme zesibindi (uvavanyo lwesibindi).

Amayeza anokusetyenziswa abandakanya:

• I-Cholestyramine (njenge-Prevalite) yokunyanga ukurhawuzelela
• Ursodeoxycholic acid (ursodiol) ukuphucula ukusebenza kwesibindi
• Iivithamini ezinyibilika ngamafutha (D, E, A, K) ukubuyisela into elahlekileyo kwesi sifo
• Antibiotic ukunyanga usulelo kwimibhobho yenyongo

Ezi nkqubo zotyando zinokwenziwa:

• Ukufaka ityhubhu ende, ebhityileyo ngebhaluni ekugqibeleni ukuvula ukucuthwa (ibhaluni ye-endoscopic ukunciphisa ukungqinelana)
• Ukubekwa koxinzelelo okanye ityhubhu yokunciphisa kakhulu (ukubetheka) kwemibhobho yenyongo
• Iproctocolectomy (ukususwa kwe-colon kunye ne-rectum, kwabo bane-ulcerative colitis kunye ne-sclerosing cholangitis) akuchaphazeli ukuqhubela phambili kwe-sclerosing cholangitis (PSC)
• Ukufakelwa kwesibindi

Benza kakuhle kangakanani abantu eyahlukileyo. Esi sifo siba mandundu ngokuhamba kwexesha. Ngamanye amaxesha abantu bayaphuhlisa:

• I-Ascites (i-fluid yokwakha kwindawo phakathi komtya wesisu kunye nezitho zesisu) kunye ne-varices (i-veins eyandisiweyo)
• Isibindi sokudumba (ukudumba kwemibhobho yenyongo)
• Ukungaphumeleli kwesibindi
• I-jaundice eqhubekayo

Abanye abantu bahlakulela ukusuleleka kwimibhobho ye-bile eqhubeka ibuya.

Abantu abanale meko banomngcipheko ophezulu wokufumana umhlaza kwimibhobho ye-bile (cholangiocarcinoma). Kuya kufuneka zihlolwe rhoqo kuvavanyo lwe-imaging yesibindi kunye novavanyo lwegazi. Abantu abane-IBD banokuba nomngcipheko okhulayo wokuba nomhlaza kwi-colon okanye kwi-rectum kwaye kufuneka babe ne-colonoscopy yexesha elide.

Iingxaki zinokubandakanya:

• Ukopha kwe-varices esophageal varices
• Umhlaza kwii-bile ducts (cholangiocarcinoma)
• I-Cirrhosis kunye nokusilela kwesibindi
• Usulelo lwenkqubo ye-biliary (cholangitis)
• Ukunciphisa imijelo yenyongo
• Ukusilela kweVitamin

Isikali sclerosing cholangitis; I-PSC

• Inkqubo yokwetyisa
• Indlela yendlela

I-Bowlus C, i-Assis DN, i-Goldberg D. Isiseko kunye nesekondari sclerosing cholangitis. Ku: Sanyal AJ, Boyer TD, Lindor KD, Terrault NA, ii-eds. I-Zakim kunye neBoyer's Hepatology. Umhla wesi-7. IPhiladelphia, PA: Elsevier; I-2018: isahluko 43.

Ross AS, uKowdley KV. I-primary sclerosing cholangitis kunye ne-pyogenic cholangitis ephindaphindiweyo. Ku: UFeldman M, uFriedman LS, uBrandt LJ, ii-eds. Sleisenger kunye neFordtran's Gastrointestinal and Liver Disease: IPathophysiology / Diagnosis / Management. Ngomhla we-10. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 68.

IZyromski NJ, iPitt HA. Ulawulo lwe-primary sclerosing cholangitis. Ku: UCameron JL, uCameron AM, ii-eds. Unyango lwangoku lonyango. Umhla we-12. IPhiladelphia, PA: Elsevier; Ngo-2017: 453-458.