Sclerosing cholangitis

Sclerosing cholangitis inoreva kuzvimba (kuzvimba), vanga, uye kuparadzwa kwenzara dzemukati mukati nekunze kwechiropa.

Chikonzero cheichi chiitiko hachizivikanwe mune dzakawanda zviitiko.

Chirwere ichi chingaonekwa kune vanhu vane:

• Chirwere chinoputira chirwere (IBD) senge ulcerative colitis uye Crohn chirwere
  
• Autoimmune kusagadzikana
• Chirwere chepancreatitis (inopisa pancreas)
• Sarcoidosis (chirwere chinokonzera kuzvimba munzvimbo dzakasiyana dzemuviri)

Majini anogona kuvewo anokonzeresa. Sclerosing cholangitis inoitika kazhinji muvarume kupfuura vakadzi. Ichi chirwere hachiwanzoitika muvana.

Sclerosing cholangitis inogona zvakare kukonzerwa ne:

• Choledocholithiasis (gallstones mu bile duct)
• Zvirwere muchiropa, nduru, uye bile ducts

Zviratidzo zvekutanga zvinowanzo:

• Kuneta
• Itching
• Kupenya kweganda nemaziso (jaundice)

Zvisinei, vamwe vanhu havana zviratidzo.

Zvimwe zviratidzo zvinogona kusanganisira:

• Yakawedzera chiropa
• Yakawedzera spleen
• Kurasikirwa nechido uye kurasikirwa nekurema
• Dzokorora zvikamu zve cholangitis

Kunyangwe vamwe vanhu vasina zviratidzo, kuongororwa kweropa kunoratidza kuti vane chisina kujairika chiropa chinoshanda. Mutapi wako wezvehutano achatsvaga:

• Zvirwere zvinokonzera matambudziko akafanana
• Zvirwere zvinowanzoitika nemamiriro aya (kunyanya IBD)
• Matombo

Miedzo inoratidza cholangitis inosanganisira:

• Abdominal CT scan
• Abdominal ultrasound
• Endoscopic kudzokorora cholangiopancreatography (ERCP)
• Chiropa biopsy
• Magnetic resonance cholangiopancreatography (MRCP)
• Percutaneous transhepatic cholangiogram (PTC)

Kuongororwa kweropa kunosanganisira enzyme yechiropa (chiropa chinoshanda bvunzo).

Mishonga inogona kushandiswa inosanganisira:

• Cholestyramine (senge Prevalite) kurapa kuchenesa
• Ursodeoxycholic acid (ursodiol) kugadzirisa chiropa mashandiro
• Mavhitaminzi ane mafuta (D, E, A, K) kutsiva chakarasika kubva pachirwere chaicho
• Mishonga inorwisa mabhakitiriya ekurapa hutachiona mu bile ducts

Aya maitiro ekuvhiya anogona kuitwa:

• Kuisa iyo refu, yakatetepa chubhu nebhaluni kumagumo kuvhura kutetepa (endoscopic balloon kudzikiswa kwezvimisikidzo)
• Kuiswa kwedhivha kana chubhu yekudzora kukuru (strictures) yenyuchi ducts
• Proctocolectomy (kubviswa kwekoloni uye rectum, kune avo vane zvese ulcerative colitis uye sclerosing cholangitis) hakukanganisa kufambira mberi kwekutanga sclerosing cholangitis (PSC)
• Chiropa chinotamisa

Vanhu vanoita zvakanaka zvakadii zvakasiyana. Chirwere ichi chinowedzera kuwedzera nekufamba kwenguva. Dzimwe nguva vanhu vanokura:

• Ascites (buildup yemvura munzvimbo iri pakati pechigadziko chedumbu uye nhengo dzemudumbu) uye varices (akawedzera mutsinga)
• Biliary cirrhosis (kuzvimba kweiyo bile ducts)
• Chiropa kutadza
• Kuramba uine jaundice

Vamwe vanhu vanoita hutachiona hwemaburi ducts anoramba achidzoka.

Vanhu vane chirwere ichi vane njodzi huru yekubatwa nekenza yemaburi ducts (cholangiocarcinoma). Vanofanira kuongororwa nguva dzose nechiropa imaging test uye kuongororwa kweropa. Vanhu vanewo IBD vanogona kuva nenjodzi yakawedzera yekuva nekenza yekoloni kana rectum uye vanofanirwa kuve ne periodic colonoscopy.

Zvinetso zvinogona kusanganisira:

• Kubuda ropa esophageal varices
• Kenza mune bile ducts (cholangiocarcinoma)
• Cirrhosis uye kutadza kwechiropa
• Kubatwa kweiyo biliary system (cholangitis)
• Kuderedza kweiyo bile ducts
• Vitamin kushomeka

Primary sclerosing cholangitis; PSC

• Kugaya chirongwa
• Bile nzira

Bowlus C, Assis DN, Goldberg D. Primary uye yechipiri sclerosing cholangitis. Mune: Sanyal AJ, Boyer TD, Lindor KD, Terrault NA, eds. Zakim uye Boyer's Hepatology. 7th ed. Philadelphia, PA: Elsevier; 2018: chits. 43.

Ross AS, Kowdley KV. Primary sclerosing cholangitis uye inowanzoitika pyogenic cholangitis. Muna: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger uye Fordtran's Gastrointestinal uye Chirwere Chirwere: Pathophysiology / Diagnosis / Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016: chits. 68.

Zyromski NJ, Pitt HA. Iwo manejimendi epuraimari sclerosing cholangitis. Mune: Cameron JL, Cameron AM, eds. Parizvino Kuvhiya Therapy. 12th ed. Philadelphia, PA: Elsevier; 2017: 453-458.