Cirrhosis ea mantlha ea biliary

Methapo ea bile ke methapo e tsamaisang bile ho tloha sebeteng ho ea mala a manyane. Bile ke ntho e thusang ka tšilo ea lijo. Litsela tsohle tsa bile hammoho li bitsoa pampitšana ea biliary.

Ha methapo ea bile e ruruha kapa e ruruha, sena se thibela phallo ea bile. Liphetoho tsena li ka lebisa ho hlasetsoeng ke sebete se bitsoang cirrhosis. Sena se bitsoa biliary cirrhosis. Cirrhosis e tsoetseng pele e ka lebisa ho senyeheng ha sebete.

Ha ho tsejoe sesosa sa likotopo tsa bile tse ruruhileng sebeteng. Leha ho le joalo, lefu la pele la biliary cirrhosis ke boloetse bo ikemetseng. Seo se bolela hore boits'ireletso ba mmele oa hau ka phoso bo hlasela lisele tse phetseng hantle. Lefu lena le ka amahanngoa le mathata a ikemetseng a kang:

• Lefu la Celiac
• Ketsahalo ea Raynaud
• Sicca syndrome (mahlo a omileng kapa molomo)
• Boloetse ba qoqotho

Hangata lefu lena le ama basali ba lilemong tse bohareng.

Batho ba fetang halofo ea batho ha ba na matšoao nakong ea tlhahlobo. Matšoao hangata a qala butle. Matšoao a pele a ka kenyelletsa:

• Ho nyekeloa ke pelo le bohloko ba mpeng
• Mokhathala le ho felloa ke matla
• Mafura a beha ka tlasa letlalo
• Litulo tse mafura
• Ho hlohlona
• Takatso e mpe ea lijo le ho theola boima ba 'mele

Ha ts'ebetso ea sebete e ntse e mpefala, matšoao a ka kenyelletsa:

• Mokelikeli o mokelikeli maotong (edema) le ka mpeng (ascites)
• 'Mala o mosehla letlalong, lera la mahlo, kapa mahlo (jaundice)
• Bokhubelu liatleng tsa matsoho
• Ho banna, ho hloka matla, ho honyela hoa makoala le ho ruruha ha matsoele
• Ho loma habonolo le ho tsoa mali ka mokhoa o sa tloaelehang, hangata ho tsoa methapong e ruruhileng ea tšilo ea lijo
• Pherekano kapa mathata a ho nahana
• Litulo tse pente kapa tse 'mala oa letsopa

Mofani oa tlhokomelo ea bophelo o tla etsa tlhahlobo ea 'mele.

Liteko tse latelang li ka hlahloba ho bona hore na sebete sa hau se sebetsa hantle:

• Teko ea mali ea albin
• Liteko tsa ts'ebetso ea sebete (serum alkaline phosphatase e bohlokoa ka ho fetisisa)
• Nako ea Prothrombin (PT)
• Liteko tsa mali tsa k'holeseterole le lipoprotein

Liteko tse ling tse ka thusang ho lekanya hore na lefu la sebete le matla le ka ba joang:

• Boemo bo phahameng ba immunoglobulin M maling
• Biopsy ea sebete
• Li-antibodies tsa anti-mitochondrial (liphetho li ntle ho linyeoe tse ka bang 95%)
• Mefuta e ikhethileng ea ultrasound kapa MRI e lekanyang boholo ba lisele tse bohale (e ka bitsoa elastography)
• Magnetic resonance cholangiopancreatography (MRCP)

Morero oa kalafo ke ho fokotsa matšoao le ho thibela mathata.

Cholestyramine (kapa colestipol) e ka fokotsa ho hlohlona. Ursodeoxycholic acid e ka ntlafatsa ho tlosoa ha bile maling a mali. Sena se ka ntlafatsa bophelo ba batho ba bang. Lithethefatsi tse ncha tse bitsoang obeticholic acid (Ocaliva) le tsona lia fumaneha.

Phekolo ea vithamine e khutlisetsa livithamini A, K, E le D, tse lahlehileng ka litulo tse mafura. Tlatsetso ea calcium kapa meriana e meng ea masapo e ka eketsoa ho thibela kapa ho phekola masapo a fokolang kapa a bonolo.

Tlhokomelo ea nako e telele le kalafo ea ho hloleha ha sebete ea hlokahala.

Ho kenyelletsa sebete ho ka atleha haeba ho etsoa pele ho hloleha ha sebete ho etsahala.

Phello e ka fapana. Haeba boemo bona bo sa phekoloe, batho ba bangata ba tla shoa ba sa kenyetsoa sebete. Hoo e ka bang kotara ea batho ba nang le lefu lena ka lilemo tse 10 ba tla ba le bofokoli ba sebete. Hona joale lingaka li se li ka sebelisa mokhoa oa lipalo-palo ho bolela esale pele nako e nepahetseng ea ho kenya setala. Maloetse a mang a kang hypothyroidism le khaello ea mali le ona a ka hlaha.

Ho thatafala ha lefu la ho thatafala ha sebete ho ka lebisa ho senyeheng ha sebete. Mathata a ka kenyelletsa:

• Ho tsoa mali
• Tšenyo ho boko (encephalopathy)
• Ho se leka-lekane ha mokelikeli le elektrolyte
• Ho hloleha ha liphio
• Malabsorption
• Khaello ea phepo e nepahetseng
• Masapo a bonolo kapa a fokolang (osteomalacia kapa osteoporosis)
• Ascites (mokelikeli o hahellang ka mpeng)
• Kotsi e eketsehileng ea mofetše oa sebete

Bitsa mofani oa hau haeba u na le:

• Ho ruruha ha mpa
• Mali malulong
• Pherekano
• Jaundice
• Ho hlohlona ha letlalo le sa tloheng ebile ho sa amane le lisosa tse ling
• Ho hlatsa madi

Biliary cholangitis ea mantlha; PBC

• Cirrhosis - ho tsoa

• Tsamaiso ea ho sila lijo
• Tsela ea Bile

Eaton JE, Lindor KD. Motsoako oa mantlha oa biliary cholangitis. 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 91.

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.

Mabone LW. Sebete: maloetse a sa buleheng. Ka: Goldblum JR, Lamp LW, McKenney JK, Myers JL, bahlophisi. Rosai le Ackerman's Pathology ea ho Buoa. 11th ed. Philadelphia, PA: Elsevier; 2018: khaolo ea 19.

Smith A, Baumgartner K, Bositis C. Cirrhosis: tlhahlobo le taolo. Ke ngaka ea malapa. 2019; 100 (12): 759-770 (Khatisitsoeng) PMID: 31845776 phatlalalitsoe.ncbi.nlm.nih.gov/31845776/.