Sclerosing cholangitis

ʻO Sclerosing cholangitis e pili ana i ka pehu (mumū), scarring, a me ka luku ʻana o nā aʻa aʻa i loko a ma waho o ke ake.

ʻAʻole ʻike ʻia ke kumu o kēia ʻano i ka hapanui o nā hihia.

ʻIke ʻia ka maʻi i ka poʻe i loaʻa iā:

• ʻO ka maʻi ʻōpū ʻōlapa (IBD) e like me ka ulcerative colitis a me ka maʻi Crohn
  
• Nā maʻi Autoimmune
• Maʻamau pancreatitis (inflamed pancreas)
• Sarcoidosis (kahi maʻi e kumu i ka wela ma nā wahi like ʻole o ke kino)

ʻO nā kumu genetic paha ke kuleana. Kū pinepine ʻo Sclerose cholangitis i nā kāne ma mua o nā wahine. Kākaʻikahi kēia maʻi i nā keiki.

Hoʻokumu pū ʻia ʻo Sclerose cholangitis e:

• Choledocholithiasis (nā pōhaku i ke kaila bile)
• Nā maʻi i ke akepaʻa, ka pehu, a me nā aʻa o ka bile

ʻO nā ʻōuli mua ka maʻa mau:

• Ka luhi
• Kāwili
• Yellowing o ka ʻili a me nā maka (jaundice)

Eia naʻe, ʻaʻohe hōʻailona o kekahi poʻe.

Hiki i nā ʻōuli ʻē aʻe ke:

• Ake akea
• ʻLepala hoʻonui
• Ka nele o ka makemake a me ka pohō kaumaha
• E hana hou i nā ʻāpana o cholangitis

ʻOiai ʻaʻohe o kekahi poʻe i hōʻailona, ​​hōʻike ʻia nā hōʻike koko e loaʻa iā lākou ka hana ate ʻole. E nānā kāu mea mālama ola:

• Nā maʻi e kū ai nā pilikia like
• Nā maʻi e hana pinepine ʻia me kēia ʻano (ʻoi loa ʻo IBD)
• Nā Pohaku

ʻO nā hoʻāʻo e hōʻike nei i ka cholangitis me:

• Scanner CT ʻōpū
• ʻO ke ultrasound ʻōpū
• Endoscopic retrograde cholangiopancreatography (ERCP)
• ʻO ka biopsy ate
• Mākēneki resonance cholangiopancreatography (MRCP)
• ʻO cholangiogram transhepatic transutanputan (PTC)

Hoʻopili nā hoʻokolohua koko i nā enzymes ate (nā hoʻāʻo hana ate)

ʻO nā lāʻau e hiki ke hoʻohana ʻia:

• ʻO Cholestyramine (e like me Prevalite) e mālama i ka makaʻu
• Ursodeoxycholic acid (ursodiol) e hoʻomaikaʻi i ka hana ate
• ʻO nā wikamina momona-momona (D, E, A, K) e pani i nā mea i nalowale mai ka maʻi ponoʻī
• Nā Antibiotics e mālama i nā maʻi i nā aʻa o ka bile

Hana ʻia paha kēia mau kaʻina hana:

• Hoʻokomo i kahi paipu lōʻihi, lahilahi me kahi baluna i ka hopena e wehe i ka hoʻopili ʻana (endoscopic balloon dilation of strikities)
• Ke kau ʻana i kahi ʻauwaha a i ʻole ka paipu no ka hoʻopili nui ʻana (nā koʻikoʻi) o nā aʻa o ka bile
• ʻO Proctocolectomy (ka hemo ʻana o ke kolona a me ke kiko, no ka poʻe i loaʻa i ka colitis ulcerative a me ka sclerosing cholangitis) ʻaʻole e hoʻopili i ka holomua o ka cholangitis sclerosing mua (PSC)
• Ka hoʻoliʻiliʻi ate

Pehea ka loli ʻana o ka poʻe. Maʻa mau ka maʻi i ka holo ʻana o ka manawa. I kekahi manawa hoʻomohala ka poʻe:

• Ascites (buildup o ka loli i ka hakahaka ma waena o ka uhi o ka ʻōpū a me nā ʻōpū o nā ʻōpū) a me nā varises (hoʻonui ʻia nā uaua)
• ʻO cirrhosis Biliary (ka hoʻā o nā lāʻau bile)
• Hoka kōpaʻa
• Jaundice hoʻomau mau

Hoʻomohala kekahi poʻe i nā maʻi o nā aʻa aʻa i hoʻi mau.

He pilikia nui ka poʻe me kēia ʻano i ka hoʻomohala ʻana i ka maʻi ʻaʻai o nā aʻa aʻa (cholangiocarcinoma). Pono lākou e nānā pinepine ʻia me kahi hōʻike kiʻi kiʻi ate a me nā hoʻokolohua koko. Hiki i ka poʻe i loaʻa iā IBD ke hoʻonui i ka makaʻu i ka hoʻomohala ʻana i ka maʻi ʻaʻai o ke kolona a i ʻole ke kolopa.

Komo pū nā pilikia:

• ʻO nā varises esophageal kahe
• Ka maʻi ʻaʻai i loko o nā aʻa oʻa (cholangiocarcinoma)
• Cirrhosis a me ke kō ʻole o ke ake
• ʻO ka maʻi o ka ʻōnaehana biliary (cholangitis)
• Pahu o nā aʻa oʻa
• Nā hemahema o ka wikamina

ʻO cholangitis sclerosing mua; PSC

• ʻŌnaehana Digestive
• Ala hele bile

Bowlus C, Assis DN, Goldberg D. ʻO ke kolamu a me ka lua sclerosing cholangitis. I: Sanyal AJ, Boyer TD, Lindor KD, Terrault NA, eds. ʻO Zakim lāua ʻo Boyer's Hepatology. ʻEpekema 7 Piladelapia, PA: Elsevier; 2018: chap 43.

Ross AS, Kowdley KV. ʻO cholangitis sclerosing mua a me cholangitis pyogenic hou. I: Feldman M, Friedman LS, Brandt LJ, eds. ʻO Sleisenger a me Fordtran's Gastrointestinal a me ka maʻi Liver: Pathophysiology / Diagnosis / Management. 10 o ka lā. Piladelapia, PA: Elsevier Saunders; 2016: chap 68.

Zyromski NJ, Pitt HA. ʻO ka mālama ʻana i ka cholangitis sclerosing mua. I: Cameron JL, Cameron AM, eds. ʻO ke kaʻoki lāʻau lapaʻau o kēia manawa. 12th ed. Piladelapia, PA: Elsevier; 2017: 453-458.