I-Biliary atresia

I-biliary atresia kukuvaleka kwimibhobho (imibhobho) ehambisa ulwelo olubizwa ngokuba yinyongo ukusuka kwisibindi ukuya kwi-gallbladder.

I-biliary atresia yenzeka xa i-bile ducts ngaphakathi okanye ngaphandle kwesibindi imxinwa ngokungaqhelekanga, ivaliwe, okanye ingekhoyo. Imijelo yenyongo ithwala ulwelo lokugaya olusuka esibindini luye emathunjini amancinci ukuphula amafutha kunye nokucoca inkunkuma emzimbeni.

Unobangela wesi sifo akucaci. Isenokuba ngenxa:

• Usulelo lwentsholongwane emva kokuzalwa
• Ukubonakaliswa kwezinto ezinobuthi
• Izinto ezininzi zofuzo
• Ukulimala komzimba
• Amanye amayeza afana ne-carbamazepine

Ichaphazela ngakumbi abantu baseMpuma Asia nabaseAfrika nabaseMelika.

Imijelo yenyongo inceda ekususeni inkunkuma esibindini kwaye ihambisa iityiwa ezinceda amathumbu amancinci ukuba aphule (acole) amanqatha.

Kwiintsana ezine-biliary atresia, ukuphuma kwenyongo ukusuka kwisibindi ukuya kwi-gallbladder kuthintelwe. Oku kunokukhokelela kumonakalo wesibindi kunye nokuqina kwesibindi, okunokubulala.

Iimpawu zihlala ziqala ukwenzeka phakathi kweeveki ezi-2 ukuya kwezi-8. IJaundice (umbala omthubi kwesikhumba kunye neembonakalo zencindi) ikhula kancinci kwiiveki ezi-2 ukuya kwezi-3 emva kokuzalwa. Usana lunokuba nobunzima ngesiqhelo kwinyanga yokuqala. Emva kwelo nqanaba, umntwana uya kuncipha kwaye abe nomsindo, kwaye uya kuba ne-jaundice eyandayo.

Ezinye iimpawu zingabandakanya:

• Umchamo omnyama
• Isisu esidumbileyo
• Iphunga elinuka kakubi nelindlayo
• Ipeyinti okanye izitulo ezinombala wodongwe
• Ukukhula kancinci

Umboneleli wakho wezempilo uya kuthatha imbali yezonyango yomntwana wakho kwaye enze uvavanyo lomzimba ukukhangela isibindi esandisiweyo.

Uvavanyo lokufumanisa i-biliary atresia ibandakanya:

• I-x-ray esiswini ukukhangela isibindi esandisiweyo kunye ne-spleen
• I-ultrasound yesisu ukujonga amalungu angaphakathi
• Uvavanyo lwegazi ukujonga amanqaku apheleleyo kunye nathe ngqo kwiibilirubin
• I-Hepatobiliary scintigraphy okanye i-HIDA ukuskena ukujonga ukuba ingaba i-bile ducts kunye ne-gallbladder zisebenza ngokufanelekileyo
• I-biopsy yesibindi ukujonga ubunzima be-cirrhosis okanye ukukhupha ezinye izizathu ze-jaundice
• IX-reyi yemibhobho yenyongo (cholangiogram) ukujonga ukuba ngaba imibhobho yenyongo ivuliwe okanye ivaliwe

Utyando olubizwa ngokuba yinkqubo yeKasai lwenziwa ukudibanisa isibindi kunye namathumbu amancinci. Imijelo engaqhelekanga idlulile. Olu tyando luphumelela ngakumbi ukuba lwenziwe ngaphambi kokuba umntwana abe neeveki ezisi-8 ubudala.

Ukufakelwa kwesibindi kusenokufuneka ngaphambi kweminyaka engama-20 ubudala kwiimeko ezininzi.

Ukuhlinzwa kwangoko kuyakuphucula ukuhlala ngaphezulu kwesinye kwisithathu seentsana ezikule meko. Isibonelelo sexesha elide sokufakelwa kwesibindi asikaziwa, kodwa kulindeleke ukuba siphucule ukusinda.

Iingxaki zinokubandakanya:

• Usulelo
• Isirrhosis engalungisekiyo
• Ukungaphumeleli kwesibindi
• Iingxaki zotyando, kubandakanya nokusilela kwenkqubo yeKasai

Biza umnikezeli wakho ukuba umntwana wakho ubonakala ngathi une-jaundiced, okanye ukuba ezinye iimpawu ze-biliary atresia zikhula.

Iintsana ezisanda kuzalwa - atresia biliary; Isifo senyongo esisanda kuzalwa - biliary atresia; I-ductopenia eyongezelelweyo; Ukuqhubela phambili kokuchithwa kwe-cholangiopathy

• Isifo senyongo esanda kuzalwa - ukubhobhoza
• Isifo senyongo esisandul 'ukuzalwa - yintoni ongayibuza ugqirha wakho

• Ibhokhwe iveliswe esibindini

IBerlin SC. Ukuqonda isifo kwi-neonate. Ku: UMartin RJ, uFanaroff AA, uWalsh MC, ii-eds. UFanaroff kunye noMartin's Neonatal-Perinatal Medicine. Ngomhla we-11. IPhiladelphia, PA: Elsevier; 2020: isahluko 38.

IiCazares J, iUre B, iYamataka A. I-Biliary atresia. Ku: Holcomb GW, Murphy JP, St Peter SD, ii-eds. Uqhaqho lwabantwana lweHolcomb kunye neAshcraft. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2020: isahluko 43.

IKliegman RM, iSt. Geme JW, iBlum NJ, i-Shah SS, iTasker RC. ICholestasis. Ku: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, ii-eds. Incwadi kaNelson yeNcwadi yePediatrics. Umhla wama-21. IPhiladelphia, PA: Elsevier; 2020: isahluko 383.

O'Hara SM. Isibindi sabantwana kunye ne-spleen. Ku: iRumack CM, uLeviine D, ii-eds. Uxilongo lwe-Ultrasound. Umhla we-5. IPhiladelphia, PA: Elsevier; I-2018: isahluko 51.