Fibrosis Retroperitoneal

ʻO Retroperitoneal fibrosis kahi maʻi laha ʻole e ālai i nā paipu (ureter) e halihali i ka mimi mai nā puʻupaʻa i ka pūpū.

Hana ʻia nā fibrosis retretritoneal ke hana ʻia ke kinona fibrous keu i kahi ma hope o ka ʻōpū a me nā ʻōpū. Hoʻokumu ke kiko i kahi nui (a i ʻole nā ​​lehulehu) a i ʻole nā ​​uaua fibrotic paʻakikī. Hiki iā ia ke pale i nā paipu e halihali i ka mimi mai ka puʻupaʻa i ka pūpū.

ʻAʻole ʻike ʻia ke kumu o kēia pilikia. ʻO ka mea maʻamau i nā makahiki 40 a 60 paha. ʻElua ka nui o nā kāne e hoʻomohala i ke ʻano e like me nā wahine.

Nā ʻōuli mua:

• ʻEha puʻupuʻu i ka ʻōpū e hoʻonui me ka manawa
• Pain a me ka loli o ke kala i nā wāwae (ma muli o ka hōʻemi ʻana o ke kahe o ke koko)
• ʻO ka pehu ʻana o hoʻokahi wāwae

Nā hōʻailona hope:

• Hoʻoemi i ka puka mimi
• ʻAʻohe puka mimi (anuria)
• ʻO Nusea, ka luaʻi, nā loli i ke kūlana noʻonoʻo i hoʻokumu ʻia e ke kōpaʻa ʻole a me ke kūkulu ʻia ʻana o nā mea ʻino i loko o ke koko
• ʻO ka ʻeha o ka ʻōpū koʻikoʻi me ke koko i loko o ka pahu (ma muli o ka make ʻana o ka naʻau o nā ʻōpū)

ʻO Abdominal CT scan ke ala ʻoi loa e loaʻa ai kahi nui retroperitoneal.

Nā hōʻike ʻē aʻe i hiki ke kōkua i ke kuhi ʻana i kēia ʻano me:

• BUN a me nā hoʻokolohua koko creatinine
• ʻO ka pyelogram Intravenous (IVP), ʻaʻole i hoʻohana mau ʻia
• Pākuʻi ultrasound
• MRI o ka ʻōpū
• ʻO ka scan CAT o ka ʻōpū a me ka retroperitoneum

Hiki ke hana ʻia kahi biopsy o ka lehulehu e hōʻoki i ka maʻi ʻaʻai.

Hoʻomaʻo mua ʻia ʻo Corticosteroids. Kauoha pū kekahi poʻe lawelawe olakino i kahi lāʻau i kapa ʻia ʻo tamoxifen.

Inā holo ʻole ka lāʻau corticosteroid, pono e hana i kahi biopsy e hōʻoia i ka ʻike. Hiki ke kuhikuhi ʻia nā lāʻau ʻē aʻe e kāohi i ka ʻōnaehana pale.

Ke holo ʻole ka lāʻau, pono ka ʻoki a me nā stent (draining tubes).

E nānā ka nānā i ka nui o ka pilikia a me ka nui o nā hōʻino i nā puʻupaʻa.

Kūlohelohe a paʻa paha ka ʻino o ka hakuʻala.

Hiki i ka maʻi ke alakaʻi i:

• Ke hoʻomau nei i ka paʻa o nā paipu e alakaʻi ana mai ka puʻupaʻa ma hoʻokahi a i ʻole ʻaoʻao ʻelua
• Ka hōʻeha kīnā ʻole

Kāhea i kāu mea hāʻawi inā loaʻa ʻoe i ka ʻōpū haʻahaʻa a i ʻole ʻeha flank a emi ka puka o ka mimi.

E hoʻāʻo e pale i ka hoʻohana wā lōʻihi o nā lāʻau i loaʻa ka methysergide. Ua hōʻike ʻia kēia lāʻau e kumu i nā fibrosis retroperitoneal. Hoʻohana ʻia ka Methysergide i kekahi manawa e mālama i ka maʻi migraine.

Idiopathic retroperitoneal fibrosis; Maʻi ʻo Ormond

• ʻŌnaehana mimi kāne

ʻO Comperat E, Bonsib SM, pelena Cheng L. Renal a me ureter. I: Cheng L, MacLennan GT, kertwick DG, eds. Pathology ʻoki lāʻau urologic. ʻEhā ed. Piladelapia, PA: Elsevier; 2020: chap 3.

Nakada SY, ʻoi loa SL. Ka hoʻokele o ka luna urinary tract ālai. I: Wein AJ, Kavoussi LR, Partin AW, Peters, CA, eds. Campbell-Walsh Urology. 11th hua. Piladelapia, PA: Elsevier; 2016: chap 49.

O'Connor OJ, Maher MM. ʻO ke ala urinary: nānā ākea o ka anatomy, nā ʻenehana a me nā pilikia radiation. I: Adam A, Dixon AK, Gillard JH, Schaefer-Prokop CM, eds. ʻO Grainger & Allison's Diagnostic Radiology: He puke aʻo ʻike kiʻi. ʻElua huaʻōlelo Piladelapia, PA: Elsevier Churchill Livingstone; 2015: chap 35.

Shanmugam VK. ʻO Vasculitis a me nā arteriopathies ʻē aʻe ʻole. I: Sidawy AN, Perler BA, hua. ʻO Rutherford's Vascular Surgery a me Endotherapy Therapy. 9th ed. Piladelapia, PA: Elsevier; 2019: chap 137.

ʻO Turnage RH, Mizell J, Badgwell B. Paʻu ʻōpū, umbilicus, peritoneum, mesenteries, omentum, a me retroperitoneum. I: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. ʻO Sabiston Textbook of Surgery. 20 ouk. Piladelapia, PA: Elsevier Saunders; 2017: chap 43.