Sclerosing cholangitis

Sclerosing cholangitis e bolela ho ruruha (ho ruruha), ho senya, le ho senya methapo ea bile kahare le kantle ho sebete.

Lebaka la boemo bona ha le tsejoe maemong a mangata.

Lefu lena le ka bonoa ho batho ba nang le:

• Lefu la ho ruruha la mala (IBD) joalo ka lefu la ulcerative colitis le lefu la Crohn
  
• Mathata a ho itšireletsa mafung
• Pherekano e sa foleng (manyeme a chesang)
• Sarcoidosis (lefu le bakang ho ruruha likarolong tse fapaneng tsa 'mele)

Lisosa tsa lefutso le tsona e ka ba tsona tse ikarabellang. Sclerosing cholangitis e etsahala khafetsa ho banna ho feta basali. Boloetse bona ha bo fumanehe hangata baneng.

Sclerosing cholangitis le eona e ka bakoa ke:

• Choledocholithiasis (li-gallstones ka mokokotlong oa bile)
• Tšoaetso sebeteng, gallbladder le methapo ea bile

Matšoao a pele hangata ke ana:

• Mokhathala
• Ho hlohlona
• Ho soeufala ha letlalo le mahlo (jaundice)

Leha ho le joalo, batho ba bang ha ba na matšoao.

Matšoao a mang a kenyeletsa:

• Sebete se atolositsoeng
• Spleen e atolositsoeng
• Ho felloa ke takatso ea lijo le ho theola boima ba 'mele
• Pheta linako tsa cholangitis

Le ha batho ba bang ba sena matšoao, liteko tsa mali li bontša hore ba na le ts'ebetso e sa tloaelehang ea sebete. Mofani oa hao oa tlhokomelo ea bophelo o tla batla:

• Maloetse a bakang mathata a tšoanang
• Maloetse a atisang ho hlaha ka boemo bona (haholo-holo IBD)
• Majoe a majoe

Liteko tse bontšang cholangitis li kenyelletsa:

• Tlhaloso ea mpa ea mpa
• Mpa ea ka mpeng
• Endoscopic retrograde cholangiopancreatography (ERCP)
• Biopsy ea sebete
• Magnetic resonance cholangiopancreatography (MRCP)
• Percutaneous transhepatic cholangiogram (PTC)

Liteko tsa mali li kenyelletsa li-enzyme tsa sebete (liteko tsa ts'ebetso ea sebete).

Meriana e ka sebelisoang e kenyelletsa:

• Cholestyramine (joalo ka Prevalite) ho phekola ho hlohlona
• Ursodeoxycholic acid (ursodiol) ho ntlafatsa ts'ebetso ea sebete
• Li-vithamine tse nang le mafura a mangata (D, E, A, K) ho nkela se lahlehileng lefu lena ka bolona
• Lithibela-mafu ho phekola tšoaetso methapong ea bile

Ts'ebetso ena ea ho buoa e ka etsoa:

• Ho kenya tube e telele, e tšesaane e nang le balune qetellong ho bula ho fokotseha (balloon ea endoscopic
• Ho beoa ha drain kapa tube bakeng sa ho theola haholo (litepisi) tsa methapo ea bile
• Proctocolectomy (ho tlosoa ha colon le rectum, bakeng sa ba nang le ulcerative colitis le sclerosing cholangitis) ha e ame tšwelopele ea sclerosing cholangitis (PSC)
• Ho kenyelletsa sebete

Batho ba sebetsa hantle hakae. Lefu lena le atisa ho mpefala ha nako e ntse e tsamaea. Ka linako tse ling batho ba nts'etsapele:

• Li-ascites (mokelikeli o mongata o pakeng tsa lesela la mpa le litho tsa mpa) le li-varices (methapo e atolositsoeng)
• Biliary cirrhosis (ho ruruha ha methapo ea bile)
• Ho hloleha ha sebete
• Pherekano e phehellang

Batho ba bang ba ba le tšoaetso ea methapo ea bile e lulang e khutla.

Batho ba nang le boemo bona ba na le kotsi e kholo ea ho tšoaroa ke mofetše oa methapo ea bile (cholangiocarcinoma). Li lokela ho hlahlojoa khafetsa ka tlhahlobo ea litšoantšo tsa sebete le liteko tsa mali. Batho ba nang le IBD ba ka ba le kotsing e kholo ea ho ba le mofetše oa colon kapa rectum mme ba lokela ho ba le colonoscopy ea nako le nako.

Mathata a ka kenyelletsa:

• Ho tsoa mali a li-esophageal varices
• Kankere ka har'a methapo ea bile (cholangiocarcinoma)
• Ho thatafala ha sebete le sebete
• Tšoaetso ea tsamaiso ea biliary (cholangitis)
• Ho khutsufatsa methapo ea bile
• Ho haella ha vithamine

Matšoao a mantlha a sclerosing cholangitis; PSC

• Tsamaiso ea ho sila lijo
• Tsela ea Bile

Bowlus C, Assis DN, Goldberg D. Sekolo sa mathomo le sa bobeli sa sclerosing cholangitis. Ka: Sanyal AJ, Boyer TD, Lindor KD, Terrault NA, bahlophisi. Hepatology ea Zakim le Boyer. La 7th. Philadelphia, PA: Elsevier; 2018: khaolo ea 43.

Ross JOALOKAHA, Kowdley KV. Primary sclerosing cholangitis le pyogenic cholangitis e iphetang. Ka: Feldman M, Friedman LS, Brandt LJ, bahlophisi. Sleisenger le Fordtran's Mpeng le Mafu a Sebete: Pathophysiology / Diagnosis / Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016: khaolo ea 68.

Zyromski NJ, Pitt HA. Tsamaiso ea sclerosing cholangitis ea mantlha. Ka: Cameron JL, Cameron AM, bahlophisi. Phekolo ea Hajoale ea Ts'ebetso. 12th ed. Philadelphia, PA: Elsevier; Ka 2017: 453-458.