He pilikia paha kāu me kou mau ʻauwai bile? E kamaʻilio kākou e pili ana i ka Cholangitis!

Loaʻa iā ʻoe i kekahi manawa kahi ʻeha ʻē ma ka ʻaoʻao ʻākau o luna o kou ʻōpū? Manaʻo ʻoe e melemele ana kou ʻili? A i ʻole luhi wale ʻoe i ke kuni? ʻOiai ʻaʻole mākou e nānā nui i kēia mau mea i kekahi manawa, hiki iā lākou ke lilo i pilikia me nā ʻauwai bile i loko o ko mākou kino. I kēia lā e kamaʻilio mākou e pili ana i ia ʻano maʻi, i kapa ʻia ʻo `(Cholangitis)` i ka ʻepekema lapaʻau. Mai hopohopo, e kamaʻilio maʻalahi kākou e pili ana i kēia.

He aha ka Cholangitis? I ka ʻōlelo maʻalahi...

E noʻonoʻo he akepaʻa kou i loko o kou kino, kahi e hana ai i kahi wai i kapa ʻia ʻo bile . He mea nui loa kēia bile no ko mākou kino. Kōkua ia iā mākou e hoʻoheheʻe i nā momona a mākou e ʻai ai. No laila, ʻo ka bile i hana ʻia i loko o kēia akepaʻa e hele i ka gallbladder, kahi e mālama ʻia ai no kekahi manawa, a laila hele i ka ʻōpū liʻiliʻi . ʻO ka ʻōnaehana o nā ʻōmole lahilahi e lawe ana i kēia bile ua kapa ʻia ʻo nā ʻāpana bile .

I kēia manawa, ʻo ka cholangitis kahi mumū o nā ʻauwai bile . Ke noʻonoʻo ʻoe i ka mumū, hiki iā ʻoe ke noʻonoʻo, ʻeā? ʻO ia hoʻi, pehu nā ʻauwai, lilo i ʻulaʻula, a i kekahi manawa lilo i maʻi. Ua like ia me nā tonsils i loko o ko mākou puʻu e pehu a lilo i pehu, ʻo ia ka mea e hana ʻia i kēia mau ʻauwai bile.

ʻElua mau ʻano nui o ka cholangitis:

1. ʻO ka Cholangitis ʻākea a i ʻole ka Cholangitis piʻi aʻe: ʻO kēia ke ʻano maʻamau. Hoʻokumu pinepine ʻia e kahi maʻi bacteria. Hiki koke mai ia a hoʻoulu koke i nā hōʻailona.

2. Cholangitis Mau Loa: He kūlana lōʻihi kēia, e holomua mālie ana. Hiki ke hana ʻia e nā mea e like me kekahi mau maʻi autoimmune.

He aha ka mea e hana ʻia ke loaʻa iā ʻoe ka cholangitis? He mea weliweli anei ia?

ʻAe, hiki ke lilo kēia i mea weliweli iki i kekahi manawa. Ke pehu nā ʻauwai bile, hiki ke loaʻa kekahi mau pilikia:

• Ke ālai ʻia ʻana o ke kahe ʻana o ka bile: Ke pehu nā ducts, ʻaʻole holo pono ka bile. A laila hiki i ka bile ke hoʻihoʻi a hōʻiliʻili i loko o nā ʻōpū e like me ke akepaʻa a me ka gallbladder. Ua kapa ʻia hoʻi kēia he `(Cholestasis)`.
• ʻO ka mumū o nā kino: Ke hōʻiliʻili ka bile, hiki ke hana i ka mumū i loko o kēlā mau kino.
• Ka laha ʻana o ka maʻi: Ke kū ka ʻawaʻawa, e like me ka ʻauwai i paʻa a lilo i wahi ʻūlū, lilo ia i wahi kūpono no ka ulu ʻana o ka bacteria. Inā komo kēia maʻi i loko o ke koko, hiki ke hoʻoweliweli i ke ola . Hiki i kēia ke alakaʻi i kahi maʻi koʻikoʻi i kapa ʻia ʻo "Septicemia" a i ʻole "Sepsis." E noʻonoʻo, ua like ia me nā germs e laha ana ma ke kino holoʻokoʻa!
• Ka ʻeha:ʻOi loa aku i ka cholangitis mau loa, hiki i ka mumū lōʻihi ke hana i ka ʻeha o nā ʻauwai bile. A laila lilo nā ʻauwai i ololi a paʻakikī, e like me nā paipu wai kahiko. ʻOi aku ka paʻakikī o ka hoʻokahe ʻana o ka bile.
• Ka hōʻino ʻana o ke akepaʻa: Inā hoʻomau kēia mau pilikia, hiki ke hōʻino ʻia ke akepaʻa a hiki ke hana ʻia ka hāʻule ʻana o ke akepaʻa. He kūlana weliweli loa nō hoʻi kēlā.

No laila, ua maopopo iā ʻoe, ʻeā? ʻAʻole ia he manaʻo maikaʻi e hoʻokuʻu wale i kēia me he ʻeha ʻōpū wale nō.

He like nā mea like o ka cholangitis a me ka cholecystitis?

ʻAe, ua like iki kēia mau inoa ʻelua, no laila hiki ke huikau.

• ʻO Cholangitis ka mumū o nā ʻauwai bile a mākou e kamaʻilio nei.
• ʻO ka Cholecystitis kahi mumū o ka gallbladder .

Pili kēia mau mea ʻelua i ka bile. ʻOiai ke hele mai nei ka bile mai ka gallbladder ma o nā ʻauwai bile, hiki i kahi pilikia i kekahi ke hoʻopilikia i kekahi. Ua like ia me kahi pahu wai a me nā paipu i pili iā ia. Hiki i kahi pilikia i loko o ka pahu ke hoʻopilikia i nā paipu, a hiki i kahi pilikia i loko o nā paipu ke hoʻopilikia i ka pahu, ʻeā? Pēlā nō ia.

He aha nā kumu o ka cholangitis?

Aia paha kekahi mau kumu no kēia.

Nā kumu o ka Cholangitis ʻākī:

• Nā maʻi: ʻO ka hapa nui i hana ʻia e ka bacteria. I kekahi manawa hiki ke hana ʻia e nā virus a i ʻole nā ​​​​​​parasites.
• Nā ālai ʻana: ʻO kēia ke kumu nui pinepine.
• Nā pōhaku ʻōpū: Hiki i nā pōhaku ʻōpū ke hana ʻia i loko o ka ʻōpū a ālai i nā ala bile. Ua kapa ʻia kēia he choledocholithiasis.
• Nā Kūlana: Hiki ke hoʻololi a paʻa ʻia nā ʻāpana bile no kekahi kumu.
• Nā Tumors: Ke kūkulu ʻia ʻana o nā tumors maʻi kanesa a i ʻole nā ​​​​​​tumors ʻē aʻe i loko o nā ʻauwai bile.
• Cholestasis: Inā pau ke kahe ʻana o ka bile no kekahi kumu.

ʻO ka hapa nui o ka manawa (ma kahi o 90%) he hui pū ʻana o kēia mau kumu ʻekolu e hoʻoulu ai i ka cholangitis acute. E noʻonoʻo, ua paʻa kahi pōhaku i loko o ka gallbladder a ālai i kahi duct. A laila, ʻaʻole kahe ka bile. ʻO ka bile e noho ana ma kahi hoʻokahi hiki ke maʻalahi i ka maʻi bacteria. I kekahi manawa hiki i ka bacteria i loko o ka ʻōpū liʻiliʻi ke hele hou i loko o nā ducts bile.

Eia nō naʻe, i kekahi manawa hiki ke loaʻa ka cholestasis a me ka cholangitis ma muli o ke ālai ʻana o nā ʻauwai bile, me ka ʻole o ka maʻi bacteria. Hiki ke hana ʻia ka Cholestasis e kekahi mau maʻi, nā lāʻau lapaʻau, a i ʻole ka hānai intravenous lōʻihi (hānai IV). Hiki ke loaʻa ka maʻi me ka ʻole o kahi pale, he mea kakaikahi ia, akā hiki nō hoʻi ke loaʻa ma o ke koko a i ʻole ma o nā lako i hoʻohana ʻia i kahi hoʻāʻo lapaʻau.

Nā kumu o ka Cholangitis Mau Loa:

ʻO kēia mau maʻi he mau maʻi autoimmune.ʻO kēia no ka mea ke hoʻouka nei ko kākou ʻōnaehana pale ponoʻī i ko kākou mau hunaola ponoʻī, e mālama ana iā lākou me he mea lā he malihini lākou. Hoʻoulu kēia i ka mumū mau o nā ʻauwai bile.

• ʻO ka cholangitis sclerosing mua (PSC)
• ʻO ka cholangitis biliary mua (PBC)
• ʻO ka cholangitis e pili ana iā IgG4

I kēia mau hihia, ʻaʻole paha e like ka koʻikoʻi o nā hōʻailona o ka cholangitis acute me nā hōʻailona o ka cholangitis acute. ʻAʻole paha e ʻike ʻia no nā makahiki. Eia nō naʻe, i ka hala ʻana o ka manawa, hiki i nā ʻauwai bile ke lilo i ʻeha, ālai ʻia, a hana i ka "cholestasis", hiki ke alakaʻi i ka cholangitis acute.

Pehea ke ʻano o ka cholangitis? He aha nā hōʻailona?

ʻAʻole paha e ʻike kekahi kanaka me ka cholangitis mau loa i kekahi mau hōʻailona no nā makahiki. ʻIke pinepine ʻia ia ke hoʻopilikia ʻia ke akepaʻa a hoʻomaka e hōʻike i nā hōʻailona o ka maʻi akepaʻa.

Akā ua ʻike maoli ʻia ka cholangitis ʻākea .

I ka manawa pinepine, aia ka ʻeha ma ka ʻaoʻao ʻākau o luna o ka ʻōpū . Hiki i kēia ʻeha ke pālahalaha i ka poʻohiwi ʻākau a i ʻole ke kua. I kekahi manawa he koʻikoʻi ia, i kekahi manawa he akahai, a hele mai a nalo.

Inā ua ālai ʻia ke ala bile, hiki iā ʻoe ke loaʻa i kahi maʻi i kapa ʻia ʻo "biliary colic." Hana ʻia kēia i ka wā e ʻūlū ai ka gallbladder a hoʻāʻo e hoʻokuke i ka bile i waho, ʻoiai ma hope o ka ʻai ʻana i kahi meaʻai momona. Hoʻoulu kēia i ka nui o ke kaomi a me ka ʻeha no ka mea ʻaʻole hiki i ka bile ke hele ma waena o ka mea i ālai ʻia. Hiki iā ʻoe ke manaʻo i ka luaʻi. Hiki ke hele koke mai ka ʻeha a laila e emi mālie i ka hala ʻana o ka manawa.

Nā hōʻailona nui - Charcot's Triad

ʻO nā hōʻailona ʻekolu maʻamau o ka cholangitis acute i kapa ʻia ʻo Charcot's Triad .

1. ʻEha ʻōpū ma ka ʻaoʻao ʻākau o luna: ʻO kēia kahi i loaʻa ai kā mākou ʻōnaehana gallbladder.

2. Kuni: Hiki pinepine ke kuni ke hoʻāla ʻia ka ʻōnaehana pale.

3. Jaundice: Melemele o ka ʻili a me nā keʻokeʻo o nā maka. Hana ʻia kēia ke ālai ʻia nā ala bile a kahe ka bile i loko o ke koko.

Inā loaʻa kēia mau hōʻailona ʻekolu a pau, nui ka manawa kūpono he cholangitis ia.

Nā hōʻailona ʻē aʻe:

Ma muli o ke koʻikoʻi o ke kūlana, hiki i ka bile leakage i loko o ke koko ke hana i nā hōʻailona ʻē aʻe:

• ʻŌhū: Ke komo nā waikawa bile i loko o ka bile i ke koko, e hoʻoheheʻe lākou i ka ʻili.
• Hana lolo hemahema (Hepatic encephalopathy): Ke hōʻiliʻili nā mea ʻawahia i loko o ka bile i loko o ke koko, hiki ke hana ʻia nā pilikia noʻonoʻo liʻiliʻi e like me ka huikau a me ka disorientation.

Inā ua pālahalaha ka maʻi i ke koko, e ʻike ʻia paha nā hōʻailona o ka haʻalulu :

• Ka wikiwiki o ka puʻuwai (Tachycardia)
• Ke koko haʻahaʻa (Hypotension)

Inā, ma waho aʻe o ka triad a Chacko, aia kekahi mau hōʻailona o ka huikau a me ka haʻalulu, ua kapa ʻia ia he pentad a Reynolds . Hōʻike kēia i nā kauka he koʻikoʻi loa ke kūlana a pono e mālama koke ʻia.

Nā hōʻailona ʻē aʻe i ka cholangitis mau loa:

ʻIke wale ʻia kēia mau mea ke holomua loa ka maʻi.

• Luhi
• ʻŌpū pehu
• Nā wāwae a me nā wāwae pehu
• Nā waihona momona ma lalo o kou ʻili
• Nā aa koko nui i ʻike ʻia ma kou ʻōpū
• Nā aʻa koko
• Mimi ʻeleʻele a me ka ʻōpala māmā
• Ka maʻi pākī

Pehea e ʻike ʻia ai ka cholangitis?

Ke hele ʻoe e ʻike i ke kauka, e nīnau mua ʻo ia iā ʻoe e pili ana i kāu mau hōʻailona a nānā iā ʻoe. A laila, e kauoha lākou i nā hoʻokolohua koko a me kekahi mau hoʻokolohua kiʻi o kāu ʻōnaehana biliary .

• Nā hoʻāʻo koko:
• Helu koko piha (CBC): Nānā i ka maʻi a me ka helu o nā cell koko.
• Nā hoʻāʻo hana o ke akepaʻa: E nānā i ka nui o ka bile i loko o ke koko, nā pae o nā enzyme a me nā protein o ke akepaʻa, a inā e hana maikaʻi ana ke akepaʻa.
• Nā hoʻāʻo kiʻi:
• ʻO ka cholangiopancreatography resonance magnetic (MRCP): Ua like kēia me kahi scan MRI, a hiki ke ʻike maopopo i nā ʻāpana bile a me nā ʻāpana pancreatic.
• ʻO ka ultrasound ʻōpū: Hiki i kēia ke nānā no nā poloka i nā ʻāpana bile a me nā pōhaku.

Hiki i kēia mau hoʻokolohua ke ʻike maopopo inā he poloka i loko o nā ʻauwai bile, kahi o ia mea, a inā he maʻi.

He aha nā lāʻau lapaʻau no ka cholangitis?

ʻO ka lāʻau lapaʻau nui no ka cholangitis ʻoi a me ka maʻi mau ka endoscopic biliary drainage . Ke ʻike ke kauka i ke kumu o ka pilikia, ʻo ka hana mua, ʻo ia ka hoʻomaha ʻana i ke kaomi i loko o nā ʻauwai bile a ʻae i ka bile e kahe.

Hiki ke hana pinepine ʻia kēia i ka wā o ka endoscopy , ʻo ia hoʻi ke hoʻokomo ʻana i kahi ʻōmole liʻiliʻi i lako me ke kāmela ma o ka waha a hoʻokomo iā ia i loko o nā ʻāpana bile.

• Ma o kēlā ʻōmole, hiki ke hoʻoneʻe ʻia ka bile keu a hiki ke hoʻemi ʻia ke kaomi.
• Inā he mea ālai, hiki ke wehe ʻia (e.g. he pōhaku).
• I kekahi manawa, hiki ke hoʻokomo ʻia nā ʻōmole mesh liʻiliʻi i kapa ʻia ʻo stents e wehe i nā ducts.

E noʻonoʻo, inā ʻoe e hana i kahi endoscopy e ʻike ai i ka cholangitis, hiki iā ʻoe ke mālama koke iā ia. Inā loaʻa iā ʻoe ka cholangitis mau loa, pono paha ʻoe e loaʻa i kēia ʻano endoscopy i kēlā me kēia manawa e kāohi i kāu mau hōʻailona.

Nā lāʻau lapaʻau ʻē aʻe no ka cholangitis mau loa:

• Nā antihistamines no ka ʻeha.
• Nā mea hoʻohui huaora no ka nele o nā huaora .
• ʻO ka Ursodeoxycholic acid (UDCA) kahi lāʻau lapaʻau i hoʻohana ʻia e kāohi i ka holomua o ka cholangitis biliary mua (PBC).

Nā lāʻau lapaʻau ʻē aʻe no ka cholangitis ʻākika:

• Nā wai intravenous (nā wai IV): Kāohi i ka maloʻo ʻana o ka wai a hāʻawi i ke kino i ka ikehu.
• Hoʻopau ʻeha .
• Nā lāʻau lapaʻau: Kāohi i ka maʻi. Hāʻawi pinepine ʻia kēia mau mea ma o ka intravenous.

He aha ka wānana no ka poʻe me ka cholangitis? (Prognosis)

Inā he cholangitis koʻikoʻi a he cholangitis mau paha kou, he mea hopohopo iki ia. Hiki i nā mea ʻelua, ma hope a ma hope paha, ke lilo i mea hoʻoweliweli i ke ola.

Eia nō naʻe, he pōkole ka manawa o ka cholangitis koʻikoʻi . Inā mālama koke ʻia, hoʻōla piha ka hapa nui o ka poʻe . Inā waiho ʻole ʻia, kiʻekiʻe ka nui o ka make.

Inā loaʻa iā ʻoe ka cholangitis mau loa , hiki iā ʻoe ke ola no nā makahiki me ka ʻole o nā pilikia. Hiki i nā lāʻau lapaʻau ke kāohi i nā hōʻailona. Pono paha ʻoe e hana i nā kaʻina hana hoʻokahe biliary i kēlā me kēia manawa. I kekahi poʻe, hiki i ka maʻi akepaʻa ke holomua i ka hāʻule ʻana o ke akepaʻa. I kēlā hihia, pono paha ʻoe i kahi hoʻoili akepaʻa .

Pehea e mālama ai iaʻu iho i koʻu wā e noho ana me ka cholangitis mau loa?

Inā loaʻa iā ʻoe ka maʻi ʻaʻai bile mau loa, he mea nui loa ia e mālama i kou akepaʻa ma nā ʻano āpau hiki iā ʻoe.

• ʻO ka hahai ʻana i ka ʻai maikaʻi a me ke ʻano o ka nohona hiki ke hōʻemi i ka hōʻino ʻia o ke akepaʻa a hoʻolōʻihi i kona ola.
• E pale i nā mea e hoʻokaumaha hou aku i ke akepaʻa. Eia kekahi laʻana, e noho mamao aku mai ka waiʻona, nā lāʻau lapaʻau, ka puhipaka, a me nā kemika kaiapuni ʻē aʻe i ka hiki.
• E ho'āʻo e hōʻemi i nā momona momona a me ke kō i kāu meaʻai.
• E hoʻoikaika kino , e hōʻemi i ke kaumaha i ka hiki.

E hoʻomanaʻo, he mea nui loa ka bile no ko kākou kino, akā hana pono ia inā hiki ke kahe manuahi. Inā ʻaʻole hiki, e kahe ana i loko o ke koko, e hōʻiliʻili i loko o nā ʻōpū, a e hoʻoulu ai i ka ʻawaʻawa a me ka mumū. ʻO ia ke kumu he mea nui loa nā ducts bile olakino.

Leka Lawe-Home

ʻO ka Cholangitis kahi mumū o nā ʻauwai bile. ʻO ke kumu nui o kēia, ʻo ia ka pale ʻia ʻana o nā ʻauwai bile e nā mea e like me nā pōhaku gall a me nā maʻi i loaʻa mai. Inā ʻike ʻoe i ka ʻeha ma ka ʻaoʻao ʻākau o luna o kou ʻōpū, ke kuni, a me ka jaundice, he cholangitis paha ia, no laila he mea nui e ʻimi koke i ke kōkua lapaʻau.

ʻOkoʻa ka lāʻau lapaʻau ma muli o ka maʻi ʻoi a i ʻole ka maʻi mau. Akā, me ka nānā ʻole i ke ʻano, ʻo ka wikiwiki o kou ʻike ʻana a hoʻomaka i ka lāʻau lapaʻau, ʻoi aku ka maikaʻi o ka hopena. No laila, inā loaʻa iā ʻoe kēia mau hōʻailona, ​​​​mai hoʻowahāwahā wale iā lākou, me ka manaʻo, "He ʻeha ʻōpū wale nō ia." ʻOi aku ka maikaʻi o ke kipa ʻana i ke kauka a ʻike pono i ka mea i pilikia. Aia i kou mau lima ka mālama ʻana i kou akepaʻa a me ka ʻōnaehana biliary olakino!

ʻO ke kōkō, kōkō, ʻAke, ʻAila, Jaundice, ʻEha ʻōpū, Kuni