He paʻa anei kou ʻauwai bile? (Bile Duct Obstruction) - E ʻike kākou e pili ana i kēia!

Ke ʻike nei ʻoe i kekahi manawa i ka ʻeha nui o ka ʻōpū o luna, ka melemele o nā maka, a me ka melemele o ka ʻili? A i ʻole ua lilo kou mau ʻōpala i kala māmā a lilo kou mimi i ʻeleʻele? ʻAʻole kēia he mau hōʻailona e hoʻowahāwahā ʻia. Hiki iā lākou ke lilo i hōʻailona o kahi mea e ālai ana i kou mau ala bile.

He aha ka mea e ālai ai ke ala o ka ʻauwai bile?

I ka ʻōlelo maʻalahi, ʻo ka pale ʻana o ke ala bile kahi kūlana kahi e paʻa ai kekahi mea i loko o kāu mau ala bile, e pale ana i ka bile mai ke kahe ʻana ma o lākou.

I kēia manawa ke noʻonoʻo nei paha ʻoe i ke ʻano o ka bile a me nā ducts bile, ʻeā? ʻAe, e wehewehe pū kākou i kēlā.

He wai ka bile e kōkua iā mākou e hoʻoheheʻe i nā momona i loko o ka meaʻai a mākou e ʻai ai. Hana ʻia ia i loko o ko mākou ake. ʻO kēia bile, i hana ʻia e ke ake, ua mālama ʻia i loko o ka gallbladder. Ke ʻai mākou, hoʻokuʻu ʻia kēia bile mai ka gallbladder a hele i ka ʻōpū liʻiliʻi e kōkua i ka hoʻoheheʻe ʻana i ka meaʻai. Aia kekahi mea ʻē aʻe i loko o kēia bile, a ʻo ia ka huahana ʻōpala i kapa ʻia ʻo bilirubin . Hana ʻia kēia bilirubin i ka wā e haki ai nā hunaola koko ʻulaʻula i loko o ko mākou koko. Hoʻopau ke ake i kēia bilirubin mai ke kino ma o ka bile.

Ua like nā ʻauwai bile me kahi ʻōnaehana o nā paipu liʻiliʻi. E noʻonoʻo iā lākou he mau paipu liʻiliʻi e lawe ana i ka wai. Lawe kēia mau paipu i ka bile, ka mea i hana ʻia i loko o ke akepaʻa, i ka gallbladder a laila i ka ʻōpū liʻiliʻi. Kōkua pū lākou i ka lawe ʻana i ka bilirubin i waho o ke akepaʻa.

No laila, inā paʻa kekahi mea i loko o kēia mau ʻauwai bile, e ālai ʻia nā ʻauwai bile, a hoʻomaka ka bile e hoʻihoʻi i loko o ke ake. Hiki i kēia ke hōʻeha nui a, inā ʻaʻole mālama pono ʻia, hiki ke alakaʻi i nā pilikia olakino koʻikoʻi .

Pehea ka maʻamau o kēia ʻano?

ʻO ka ʻoiaʻiʻo, ʻo ka pilikia maʻamau e hoʻopilikia ana i nā ʻauwai bile, ʻo ia nā mea e ālai ana . E noʻonoʻo wale, ma kahi o 5 o 1,000 poʻe e loaʻa nā pōhaku gall, hiki ke ālai i nā ʻauwai bile. ʻO nā pōhaku gall kahi ʻano pōhaku e hana ʻia i ka wā e hōʻiliʻili ai a paʻakikī nā mea i loko o ka bile. ʻO nā pōhaku gall ke kumu nui o nā ālai ʻana o nā ʻauwai bile.

He aha nā hōʻailona o ke ālai ʻana o ke ala bile?

I ka manawa pinepine, ua like nā hōʻailona me nā pōhaku gallstones a me ka jaundice. ʻO nā hōʻailona jaundice he hōʻailona ia he nui loa ka bilirubin i kou koko.

E nānā pono i kēia mau hiʻohiʻona:

• ʻEha ʻōpū o luna: Hiki ke manaʻo ʻia kēia he ʻeha mālie, ʻoi, a palupalu. Hoʻonui mālie ia i loko o kekahi mau minuke.
• Melemele o ka ʻili a i ʻole melemele o nā keʻokeʻo o nā maka:ʻO kēia ka mea a mākou e kapa nei he jaundice.
• ʻO ka ʻōpala kala lepo a me ka mimi ʻeleʻele: Ke hoʻokuʻu pono ʻole ʻia ka bile i loko o nā ʻōpū, loli ke kala o ka ʻōpala. Eia kekahi, lilo ka mimi i ʻeleʻele no ka mea ua hoʻokuʻu ʻia ka bilirubin hou aku i loko o ka mimi.
• Kuni a me ke anu.
• Ka luaʻi a me ka luaʻi.
• ʻIli maneʻo (pruritus): Ma muli paha kēia o ka waiho ʻia ʻana o nā paʻakai bile ma ka ʻili.
• ʻAʻohe ʻono o ka meaʻai.
• Ka wiwi ʻana me ke kumu ʻole.
• Manaʻo luhi loa.

He aha ke kumu o ka ālai ʻana o ke ala bile?

Aia kekahi mau kumu kūpono o ke ālai ʻana o ke aʻa bile. E nānā kākou i nā mea nui:

• ʻO nā pōhaku Gallstones e ālai ana i kāu mau kahawai bile: ʻO kēia ke kumu maʻamau.
• Nā cysts Choledochal: He kūlana hānau kakaikahi kēia. Hoʻolohi kēia mau cysts i ke kahe o ka bile.
• ʻO ke koʻikoʻi o ke ala bile: He ʻano ʻokoʻa kēia o ka ʻauwai bile. Hiki ke hana ʻia kēia e kahi maʻi a i ʻole ka ʻeha ma hope o ke ʻoki ʻana.

Hiki i nā ʻūlū o ke ala bile ke loaʻa i nā kumu like ʻole (kane a me nā mea ʻole). No ka laʻana, hiki ke hana ʻia e ka ʻōpala ma hope o ke ʻoki ʻana i ka gallbladder (cholecystectomy).

Eia kekahi mau kumu ʻē aʻe o nā ʻūlū o ke kahawai bile e hiki ai ke alakaʻi i ka ālai ʻana o ke kahawai bile:

• Kanesa: Kanesa pancreatic, kanesa bile duct, kanesa ate, a me ke kanesa metastatic.
• Nā kūlana hānau: ʻO nā hiʻohiʻona e pili ana i nā kūlana e like me `(Biliary atresia)` a me `(Alagille syndrome)`.
• Ka mumū mau loa o nā ʻauwai bile: Nā maʻi e like me `(Primary biliary cholangitis)` a me `(primary sclerosing cholangitis)`.
• ʻO ka pancreatitis Autoimmune a me ka pancreatitis mau loa.
• ʻO ka mumū i hoʻokumu ʻia e kahi ʻeha, maʻi bacteria a parasitic paha.
• He kūlana i kapa ʻia ʻo 'Mirizzi syndrome'.
• ʻO ke ʻoki ʻana i ka ʻōpū gall (Cholecystectomy).
• Hoʻōla radiation.

He aha nā pilikia e hiki mai ana mai ke ālai ʻana o ke ala bile?

E like me kā mākou i ʻōlelo ai ma mua, hiki i kēia ālai ʻana ke hoʻoulu i ka ʻāʻī o ka bile i loko o ke ake. Hiki i kēia ke hoʻoulu i ka mumū nui a, inā ʻaʻole mālama ʻia, nā maʻi e hoʻoweliweli i ke ola.Hiki iā ia ke hana i ka ʻeha mau loa o ke akepaʻa, hiki ke alakaʻi i kahi maʻi i kapa ʻia ʻo `(cirrhosis of the liver)`. ʻO kēia kekahi, inā ʻaʻole mālama pono ʻia, hiki ke alakaʻi i ka hāʻule ʻana o ke akepaʻa.

E noʻonoʻo, inā paʻa ka bile i loko o nā ducts kokoke i kou gallbladder, hiki iā ʻoe ke loaʻa i kahi maʻi gallbladder (cholecystitis).

Eia kekahi, me ka lawa ʻole o ka bile, ʻaʻole hiki i kou ʻōpū liʻiliʻi ke hoʻoheheʻe i nā momona. Hiki i kēia ke alakaʻi i ka nele i ka ʻai .

Pehea e ʻike ai inā ua ālai ʻia ke ala bile?

Ke hele ʻoe e ʻike i ke kauka, e nīnau ʻo ia e pili ana i kou mōʻaukala olakino, me kāu mau hōʻailona a me nā lāʻau lapaʻau āu e lawe ai. A laila, e hana lākou i kahi hoʻokolokolo kino e nānā i nā hōʻailona o ke ālai ʻana, e like me ka ʻeha o ka ʻōpū a i ʻole ka pehu ʻana.

E hoʻomanaʻo, inā loaʻa iā ʻoe nā hōʻailona e like me kēia, he mea nui loa e ʻike koke i ke kauka.

A laila, pono ʻoe e hana i nā hoʻokolohua koko a me nā hoʻokolohua kiʻi kūikawā e hōʻoia i ka pale ʻana a ʻike pono i ke kumu.

Nā hoʻāʻo koko

Hiki i nā hoʻokolohua koko ke hōʻike i nā hōʻailona o kahi ālai. Hiki i kāu kauka ke kauoha i nā hoʻokolohua e like me kēia:

• Helu koko piha (CBC): Hiki i ka helu koko piha (CBC) ke hāʻawi iā ʻoe i kahi manaʻo o kou olakino holoʻokoʻa.
• Nā hoʻāʻo hana ate: Inā kiʻekiʻe kou pae bilirubin koko, he hōʻailona paha ia o kahi ālai ʻia. Eia kekahi, inā ʻoi aku ke kiʻekiʻe o nā enzymes ate e like me ka alkaline phosphatase (ALP) a me ka gamma-glutamyltransferase (GGT) ma mua o ka maʻamau, ʻo ia hoʻi ke ʻano ʻaʻole hana pono ke akepaʻa ma muli o kahi ālai ʻia.
• Nā hoʻāʻo koko pancreas: Inā kiʻekiʻe nā enzyme pancreatic e like me ``(Amylase)`` a me ``(lipase)``, he hōʻailona paha ia o kahi pilikia pancreatic e pili ana i ka poloka ʻana o ka ʻaʻa bile.

Nā hoʻokolohua kiʻi

Inā hōʻike nā hopena o nā hoʻāʻo koko i kahi paʻa, pono paha ʻoe i nā hoʻokolohua kiʻi. Hiki ke hana ʻia kekahi a ʻoi aku paha o kēia mau hoʻokolohua:

• Ultrasound: Hoʻohana ka ultrasound i nā nalu kani e hana i nā kiʻi o loko o kou kino. Hiki i kēia ke kōkua i ka ʻike ʻana i nā ʻano ʻē e hōʻike ana i kahi ālai ʻana. Pono paha ʻoe i kahi ultrasound endoscopic, ultrasound ʻōpū, a i ʻole ultrasound akepaʻa.
• ʻO ka tomography computed ʻōpū (CT scan): Hoʻohana ka CT scan i nā kukuna X a me ke kamepiula e hana i nā kiʻi kikoʻī. Hiki iā ia ke kāpae i nā kumu ʻē aʻe o kāu mau hōʻailona i ʻike ʻole ʻia ma ka ultrasound.
• ʻO ka Endoscopic retrograde cholangiopancreatography (ERCP): Hiki i kahi hoʻāʻo i kapa ʻia ʻo ERCP ke kōkua i ka ʻike ʻana i ke kumu o kahi ālai a mālama iā ia. Ma kēia hoʻāʻo, hoʻokomo kāu kauka i kahi paipu palupalu (endoscope) me ke kukui a me ke kāmela i hoʻopili ʻia iā ia i loko o kāu mau ʻauwai bile. Hiki ke hoʻohana ʻia nā mea hana e lawe i kahi laʻana ʻiʻo (biopsy) a i ʻole e hoʻoponopono i ka ālai. E hoʻomaha ʻia ʻoe i ka wā o kēia hoʻāʻo.
• ʻO ka cholangiopancreatography resonance magnetic (MRCP): He hoʻāʻo MRI holomua kēia. Hoʻokomo ʻia kahi kala kūikawā i loko o kāu mau ʻauwai bile i kona hele ʻana ma o lākou. E like me ka ERCP, hiki iā ia ke hōʻike i ke kumu o ka paʻa ʻana, e like me nā gallstones a i ʻole nā ​​strictures. Eia nō naʻe, ʻaʻole ia he invasive ma mua o ka ERCP.
• ʻO ka nānā ʻana o ka waikawa iminodiacetic Hepatobiliary (HIDA): Ma kahi scan HIDA, hoʻohana ʻia kahi tracer radioactive e hana i nā kiʻi i kona hele ʻana ma o kāu mau ʻauwai bile. Hiki i kēia ke hōʻike i ke kumu o ka paʻa ʻana, e like me nā pilikia gallbladder a i ʻole nā ​​​​maʻi hānau e hoʻoulu ai i ka haiki o nā ʻauwai.
• ʻO ka cholangiography transhepatic Percutaneous (PTC): Ma kahi hoʻāʻo "PTC", hoʻohana ʻia ka ultrasound a i ʻole nā ​​​​X-ray e kiʻi i nā kiʻi o kahi dye kūikawā i hoʻouna ʻia ma o kou mau ducts bile a hiki i kou ʻōpū liʻiliʻi. Hōʻike ka dye i nā mea āpau i pale ʻia i loko o nā ducts.

Pehea ʻoe e hoʻōla ai i kēia paʻa ʻana o ke aʻa bile?

ʻO ka mālama ʻana no ka poloka ʻana o ka bile duct e pili ana i ka wikiwiki o kou pono ʻana i ka mālama ʻana a me ke kumu o ka poloka ʻana.

Aia kekahi mau ʻano lapaʻau:

• ERCP (Endoscopic retrograde cholangiopancreatography): I ka wā o ka ERCP, hiki i ke kauka ke wehe i nā pōhaku gall mai nā ʻauwai bile. Hiki ke kuʻi ʻia a wehe ʻia nā pōhaku me ka hoʻohana ʻana i nā mea hana i loko o ka ʻōmole i ʻōlelo ʻia ma luna (endoscope).
• ʻO ke ʻoki ʻana i ka ʻōpū gall: Inā loaʻa pinepine iā ʻoe nā pōhaku gall e ālai ana i kou mau ala bile, pono paha ʻoe e wehe i kou gallbladder. Hana pinepine ʻia kēia ma o kahi ʻoki ʻoki minimally invasive i kapa ʻia ʻo laparoscopy. Hiki iā ʻoe ke ola olakino me ka ʻole o ka gallbladder.
• Nā Stents: Hiki i kāu kauka ke hoʻokomo i kahi ʻōmole liʻiliʻi i hana ʻia me ka metala a i ʻole ka plastic, i kapa ʻia he "stent," i loko o kāu ʻauwai bile e hoʻonui iā ia a i ʻole e mālama iā ia i ka wehe. Inā ua hoʻokumu ʻia ka paʻa ʻana e nā strictures, pono paha ʻoe e hoʻokomo i kahi "stent."
• Nā lāʻau lapaʻau no ka maʻi kanesa:Inā hana ʻia ke ālai ʻana e kahi puʻupuʻu, pono paha ʻoe i ke ʻoki ʻana a i ʻole nā ​​​​lāʻau lapaʻau ʻē aʻe e like me ka chemotherapy a me ka radiation.

He aha nā manawa kūpono e ho'ōla ai ma hope o kēia kūlana?

Aia kou wānana ma ke kumu o ke ālai ʻana. No ka laʻana, inā he mau pōhaku gall ke kumu, hiki i ka ʻike mua ʻana a me ka mālama ʻana ke kōkua i ka pale ʻana i nā pilikia. Me ka mālama ʻana, hoʻōla piha ka hapa nui o ka poʻe.

Eia nō naʻe, ʻoi aku ka paʻakikī o ka mālama ʻana i nā ālai ʻana o ke aʻa bile i hoʻokumu ʻia e ka maʻi kanesa a i ʻole ka maʻi akepaʻa mau.

ʻAʻole like ke kūlana o kēlā me kēia kanaka. E wehewehe kāu kauka iā ʻoe i ka mea hiki iā ʻoe ke manaʻo mai ka lāʻau lapaʻau ma muli o ke kumu o ka paʻa ʻana a pehea e pili ai i kou olakino.

Hiki ke pale ʻia ke ālai ʻana o ke aʻa bile?

ʻAʻole hiki ke pale ʻia i nā manawa a pau ke ālai ʻia ʻana o ke aʻa bile.

Eia nō naʻe, hiki iā ʻoe ke hōʻemi i kou pilikia o ka loaʻa ʻana o nā pōhaku gallstones, ʻo ia ke kumu nui , ma ka hōʻemi ʻana i ka nui o ka cholesterol i kāu meaʻai. Hiki iā ʻoe ke hōʻemi i kou pilikia o kekahi mau maʻi ate e hiki ai ke hoʻoulu i nā strictures:

• Ka lawa ʻana o ka hoʻoikaika kino.
• ʻAi ʻana i nā meaʻai momona haʻahaʻa i ka momona paʻa.
• Ka mālama ʻana i kahi kaumaha olakino e kūpono iā ʻoe.
• Ke hōʻalo nei i ka inu ʻana i ka waiʻona, a i ʻole ka inu ʻana i ka waiʻona ma nā ʻāpana liʻiliʻi loa.

Āhea wau e ʻike ai i ke kauka?

Inā loaʻa iā ʻoe nā hōʻailona o ka pale ʻana o ke ala bile, e ʻike pono i ke kauka . Hiki ke hana ʻia kekahi mau hōʻailona maʻamau, e like me ka ʻeha o ka ʻōpū, ka nausea, a me ka luaʻi ʻana, e nā ʻano maʻi like ʻole. No laila, he mea nui e hoʻoholo koke inā he pale maoli ka pilikia - ma mua o ka puka ʻana o nā pilikia ma muli o ka hōʻiliʻili ʻana o ka bile.

He pilikia anei kahi ʻauwai bile i paʻa?

ʻAe, hiki ke lilo i pilikia. ʻOi loa aku inā ʻo ka reflux bile ke kumu o ka mumū nui a me ka maʻi. ʻO ka mea maikaʻi loa e hana ai, ʻo ia ke ʻike i ke kauka i ka wā e ʻike mua ai ʻoe i nā hōʻailona e pale aku ai i kēia mai ka hana ʻana.

He mea nui ka bile no ke kahe mālie ʻana o nā ʻauwai bile, e kōkua ana i ko mākou kino e hoʻoheheʻe i ka meaʻai a me ka wehe ʻana i ka bilirubin (kahi huahana ʻōpala). ʻO ia ke kumu he mea nui loa ka hana ʻana i kēia mau mea e ālai ai. Pono ka bile e kahe i loko o kou ʻōpū liʻiliʻi e wāwahi i nā momona. Pono pū ʻo Bilirubin e haʻalele i kou akepaʻa e pale aku i nā pilikia e like me ka maʻi akepaʻa a i ʻole ka maʻi. Inā loaʻa iā ʻoe kahi mea e ālai ai, hiki i kāu kauka ke haʻi iā ʻoe i nā koho maikaʻi loa e wehe ai.

ʻO ka mea hope loa, nā mea nui e hoʻomanaʻo

ʻAe, ua kamaʻilio nui mākou e pili ana i ka Bile Duct Obstruction. Eia nā mea nui e pono ai ʻoe e hoʻomanaʻo mai kēia moʻolelo:

• ʻO ke ālai ʻana o ke aʻa bile kahi kūlana e pono ai ka nānā ʻana . Inā loaʻa iā ʻoe nā hōʻailona e like me ka ʻeha o ka ʻōpū o luna, ka melemele o nā maka, a i ʻole ka loli ʻana o ke kala o ka ʻōpala , e ʻike i ke kauka me ka hoʻonele ʻole i ka manawa.
• ʻO ka hapa pinepine, hoʻokumu ʻia kēia e nā pōhaku gallstones , akā hiki ke loaʻa nā kumu koʻikoʻi ʻē aʻe, e like me ke kanesa.
• Inā ʻike mua ʻia ka maʻi a mālama pono ʻia, hiki ke hoʻōla piha ʻia.
• ʻO ka mālama ʻana i kahi nohona olakino (ʻai olakino, hoʻoikaika kino, kaohi ʻana i ka waiʻona) hiki ke hōʻemi i kekahi mau mea pilikia.
• Inā he kānalua a nīnau paha kāu, mai hilahila e nīnau i kāu kauka. Aia lākou ma laila e kōkua iā ʻoe.

He mea nui loa kou olakino iā ʻoe. No laila e mālama pono. Mai hopohopo, aia kahi hopena no kēlā me kēia pilikia!

ʻO ke ālai ʻana o ka ʻauwai bile, nā pōhaku Gall, ka ʻāʻī, ke akepaʻa, ka ʻōpū Gall, ke ālai ʻana o ka ʻauwai bile, ka ʻāʻī