Biliary atresia

ʻO Biliary atresia kahi paʻa i nā paipu (ducts) e halihali i kahi wai i kapa ʻia he bile mai ke akepaʻa a i ka lāʻau hānai.

Hana ʻia nā biliary atresia ke hoʻopili ʻia nā aʻa aʻa o loko a i waho paha o ke akepaʻa, ālai ʻia, a hele ʻole paha. Lawe nā kī ʻoi i kahi wai digestive mai ke ake a i ka ʻōpū liʻiliʻi e wāwahi i nā momona a kānana i nā ʻōpala mai ke kino.

ʻAʻole maopopo ke kumu o ka maʻi. Pili paha ia i:

• ʻO ka maʻi Viral ma hope o ka hānau ʻana
• Hōʻike i nā mea ʻona
• Nā kumu kūlohelohe
• ʻEha Perinatal
• ʻO kekahi mau lāʻau e like me carbamazepine

Hoʻololi pinepine ia i ka poʻe o ko East Asia a me ko ʻApelika-ʻAmelika moʻokūʻauhau.

Kōkua nā aʻa o ka bile i ka lawe ʻana i ka ʻōpala mai ke ake a lawe i nā paʻakai e kōkua i ka ʻōpū liʻiliʻi e haki (hoʻowali) i ka momona.

I nā pēpē me nā atresia biliary, ālai ʻia ke kahe o ka bile mai ke akepaʻa a i ka ʻāpā. Hiki i kēia ke alakaʻi i ka hōʻino o ke ake a me ka cirrhosis o ke ake, i hiki ke make.

Hoʻomaka ka hoʻomaka ʻana o nā ʻōuli ma waena o 2 a 8 mau pule. Hoʻolālā mālie ʻo Jaundice (kahi melemele i ka ʻili a me nā membrane mucus) 2 a 3 mau pule ma hope o ka hānau ʻana. Loaʻa paha i ka pēpē ke kaupaona maʻamau no ka mahina mua. Ma hope o kēlā kiko, e lilo ka pēpē i ke kaumaha a lilo i mea huhū, a e loaʻa i ka jaundice e ʻoi aku ana.

Hiki i nā ʻōuli ʻē aʻe ke:

• Mimi ʻeleʻele
• ʻŌpū ʻōhū
• Nā noho hohono a hohono hoʻi
• Nā noho Pale a i ʻole nā ​​pālolo kele
• Hoʻonui lohi

E lawe kāu mea mālama ola i ka mōʻaukala olakino o kāu keiki a hana i kahi hoʻokolohua kino e nānā ai no ka hoʻonui ʻia o ke ake.

ʻO nā hoʻokolohua e kuhikuhi ai i ka biliary atresia me:

• ʻO ka x-ray ʻōpū e nānā i ka ake a me ka lihi ākea
• ʻO ke ultrasound ʻōpū e nānā i nā mea kūloko
• Nā ho'āʻo koko e nānā i nā pae bilirubin āpau a kuhikuhi
• Hepatobiliary scintigraphy a i ʻole HIDA scan e nānā ai inā e hana pono nā aʻa aʻa a me ka gallbladder
• ʻO ke biopsy ake e nānā i ke koʻikoʻi o ka cirrhosis a i ʻole e kāpae ʻia i nā kumu ʻē aʻe o ka jaundice
• X-ray o nā aʻa aʻa (cholangiogram) e nānā ai inā wehe ʻia a pani ʻia paha nā aʻa aʻa

Hana ʻia kahi hana i kapa ʻia ʻo ka hana ʻo Kasai e hoʻohui i ke ake i ka ʻōpū liʻiliʻi. Hōʻalo ʻia nā aʻa ʻewaʻewa. ʻOi ke kūleʻa o ke kaha inā hana ma mua o ka piha ʻana o ka pēpē i 8 mau pule.

Pono pono ke kanu ʻana i ka ake ma mua o 20 mau makahiki i ka hapanui o nā hihia.

E hoʻomaikaʻi ke ʻōpala mua i ke ola o ka hapakolu o nā pēpē me kēia ʻano. ʻO ka pōmaikaʻi manawa lōʻihi o kahi neʻe ʻana o ka ate ʻaʻole i ʻike ʻia, akā manaʻo ʻia e hoʻomaikaʻi i ke ola.

Komo pū nā pilikia:

• Maʻi kīnā
• Cirrhosis hiki ʻole ke hoʻololi
• Hoka kōpaʻa
• Nā pilikia ʻoki, me ka hoʻokō ʻole o ke kaʻina hana Kasai

Kāhea i kāu mea hāʻawi inā ʻikea he keiki keʻokeʻo kāu keiki, a i ʻole inā ulu kekahi mau ʻōuli ʻē aʻe o ka biliary atresia.

Jaundice hānau hou - biliary atresia; Jaundice hānau hou - biliary atresia; Ductopenia keu; ʻO cholangiopathy holomua holomua

• Jaundice hānau hou - hoʻokuʻu
• Jaundice hānau hou - he aha e nīnau aku ai i kāu kauka

• Hana ʻia ka paila i ke akepaʻa

Berlin SC. ʻO ke kiʻi diagnostical o ka neonate. I: Martin RJ, Fanaroff AA, Walsh MC, hua. ʻO Fanaroff lāua ʻo Martin's Neonatal-Perinatal Medicine. 11th hua. Piladelapia, PA: Elsevier; 2020: chap 38.

ʻO Cazares J, Ure B, Yamataka A. Biliary atresia. I: Holcomb GW, Murphy JP, St. Peter SD, eds. ʻO Holcomb a me Ashcraft's Pediatric Surgery. ʻEpekema 7 Piladelapia, PA: Elsevier; 2020: chap 43.

ʻO Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC. ʻO Cholestasis. I: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. ʻO Puka Textbook of Pediatrics ʻo Nelson. 21st ed. Piladelapia, PA: Elsevier; 2020: chap 383.

O'Hara SM. ʻO ke ake pediatric a me ka pelupelu. I: Rumack CM, Levine D, eds. ʻIkioma ultrasound. 5th lā. Piladelapia, PA: Elsevier; 2018: chap 51.