Tšitiso ea mokokotlo oa metsi

Tšitiso ea li-bile ke thibelo ea li-tubes tse tsamaisang bile ho tloha sebeteng ho ea ho gallbladder le mala a manyane.

Bile ke metsi a tsoang sebeteng. E na le k'holeseterole, matsoai a bile le lihlahisoa tsa litšila tse kang bilirubin. Letsoai le phehang le thusa 'mele oa hau ho senya mafura. Bile e feta sebeteng ka methapo ea bile ebe e bolokoa ka har'a gallbladder. Kamora 'lijo, e ntšetsoa ka maleng a manyane.

Ha methapo ea bile e koalehile, bile e ea bokellana sebeteng, 'me manonyeletso (' mala o mosehla oa letlalo) a hlaha ka lebaka la boemo bo ntseng bo eketseha ba bilirubin maling.

Lisosa tse ka bang teng tsa "bile" e koetsoeng li kenyelletsa:

• Li-cyst tsa mokoti o tloaelehileng oa bile
• Lymph nodes tse atolositsoeng porta hepatis
• Majoe a majoe
• Ho ruruha ha methapo ea bile
• Ho khutsufatsa methapo ea bile ho tsoa ho mabali
• Kotsi ea ho buuoa ka gallbladder
• Lihlahala tsa methapo ea bile kapa manyeme
• Lihlahala tse hasaneng tsamaisong ea biliary
• Liboko tsa sebete le bile (flukes)

Mabaka a kotsi a kenyelletsa:

• Nalane ea li-gallstones, pancreatitis e sa foleng kapa mofetše oa pancreatic
• Kotsi sebakeng sa mpa
• Ho buuoa ka biliary haufinyane
• Kankere ea morao-rao ea biliary (joalo ka mofetše oa bile duct)

Thibelo e ka boela ea bakoa ke tšoaetso. Sena se tloaelehile haholo ho batho ba nang le boits'ireletso ba mmele bo fokolang.

Matšoao a ka kenyelletsa:

• Mahlaba a mpeng ka lehlakoreng le ka holimo le letona
• Moroto o lefifi
• Feberu
• Ho hlohlona
• Jaundice ('mala oa' mala o mosehla)
• Ho nyekeloa le ho hlatsa
• Litulo tse mebala-bala

Mofani oa hao oa tlhokomelo ea bophelo o tla u hlahloba le ho utloa mpa ea hau.

Liphetho tse latelang tsa liteko tsa mali li ka bakoa ke thibelo e ka bang teng:

• Boemo ba bilirubin bo eketsehileng
• Ho eketsa boemo ba alkaline phosphatase
• Keketseho ea li-enzyme tsa sebete

Liteko tse latelang li ka sebelisoa ho batlisisa tsela e ka 'nang ea koaloa ea bile:

• Mpa ea ka mpeng
• Tlhaloso ea mpa ea mpa
• Endoscopic retrograde cholangiopancreatography (ERCP)
• Percutaneous transhepatic cholangiogram (PTCA)
• Magnetic resonance cholangiopancreatography (MRCP)
• Endoscopic ultrasound (EUS)

Tsela e koetsoeng ea bile e kanna ea fetola sephetho sa liteko tse latelang:

• Teko ea mali ea Amylase
• Sesebelisoa sa `` gallbladder radionuclide ''
• Teko ea mali ea Lipase
• Nako ea Prothrombin (PT)
• Moroto bilirubin

Morero oa kalafo ke ho imolla thibelo. Majoe a ka tlosoa ka "endoscope" nakong ea ERCP.

Maemong a mang, ho hlokahala opereishene ho feta thibelo eo. Hangata gallbladder e tla tlosoa opereishene haeba thibelo e bakoa ke majoe a gallstones. Mofani oa hau a ka fana ka lithibela-mafu haeba ho belaelloa tšoaetso.

Haeba ho thiba ho bakoa ke mofetše, tsela e kanna ea hloka ho holisoa. Ts'ebetso ena e bitsoa phallo ea endoscopic kapa percutaneous (ka letlalo le haufi le sebete). Ho ka hlokahala hore ho beoe tube hore ho tsoe metsi.

Haeba blockage e sa lokisoe, e ka lebisa ts'oaetsong e sokelang bophelo le sehahong se kotsi sa bilirubin.

Haeba ho thiba ho nka nako e telele, ho ka hlaha lefu le sa foleng la sebete. Lithibelo tse ngata li ka phekoloa ka endoscopy kapa ka ho buuoa. Litšitiso tse bakoang ke mofetše hangata li ba le litlamorao tse mpe.

Ha e sa alafatsoe, mathata a ka bang teng a kenyelletsa tšoaetso, sepsis le lefu la sebete, joalo ka lefu la ho thatafala ha methapo.

Bitsa mofani oa hau haeba u:

• Hlokomela phetoho mmala oa moroto oa hau le litulo
• Hlaolela jaundice
• E-ba le bohloko ba mpeng bo sa foleng kapa bo lulang bo ipheta

Hlokomela mabaka afe kapa afe a kotsi ao u nang le 'ona, e le hore u tsebe ho fumana tšoaetso le kalafo ka potlako haeba tsela ea bile e koaloa. Thibelo ka boeona e kanna ea se thibeloe.

Tšitiso ea biliary

• Tsamaiso ea ho sila lijo
• Litšoelesa tsa endocrine
• Tsela ea Bile
• Tšitiso ea biliary - letoto la lihlooho tse

Fogel EL, Sherman S. Maloetse a gallbladder le bile ducts. Ka: Goldman L, Schafer AI, li-eds. Phekolo ea Goldman-Cecil. La 26th. Philadelphia, PA: Elsevier; 2020: khaolo ea 146.

Lidofsky SD. Jaundice. Ka: Feldman M, Friedman LS, Brandt LJ, bahlophisi. Sleisenger le Fordtran's Mpeng le Mafu a Sebete. 11th ed. Philadelphia, PA: Elsevier; 2021: khaolo ea 21.