Ingaba amatye akho enyongo nawo anamathele kwi-common bile duct? (Choldocholithiasis) Masifunde ngayo!

Ngaba ngamanye amaxesha uziva intlungu ebukhali kwicala eliphezulu lasekunene lesisu sakho emva kokutya? Ngaba uziva unesicaphucaphu okanye ufuna ukuhlanza? Ngaba ngamanye amaxesha uziva ngathi amehlo akho nolusu lwakho lujika lube tyheli? Ezi ayizompawu zilungileyo zokungazinaki nje. Ezi zinokubonisa ukuba kukho ilitye elinamathele kwi -'Common Bile Duct' yakho. Namhlanje, siza kuthetha ngale meko ibizwa ngokuba yi-'Choledocholithiasis'.

Kalula nje, yintoni le (i-choledocholithiasis)?

I-Choledocholithiasis yimeko apho ilitye elinye okanye ngaphezulu linamathele kwi- common bile duct yakho. Igama elithi "Choldocho" ligama lesiLatini le-common bile duct. Igama elithi "Lithiasis" lithetha ilitye. Amatye enyongo ziingceba zenyongo eziqinileyo, ezifana nelitye. La matye anokwakheka naphi na emzimbeni wethu apho inyongo igeleza khona.

Ngoku usenokuba uzibuza ukuba yintoni le nyongo kunye neentlobo zenyongo. Kulula kakhulu. Isibindi sethu sivelisa le nyongo. Le nyongo isinceda sitye ukutya esikutyayo, ingakumbi amafutha. Le nyongo iqokelelana kwinyongo. Ukusuka apho, ihamba ngetyhubhu encinci ukuya kwi-common bile duct, ethi emva koko ijoyine amathumbu amancinci. Ngoko ke, ukuba ilitye lenzeka ndaweni ithile kolu hambo, ingxaki yile.

Ngoko ke ngaba (iCholdocholithiasis) kunye (iCholelithiasis) zizinto ezimbini ezahlukeneyo?

Ewe, kukho umahluko omncinci. Usenokuba ukhe weva igama elithi 'cholelithiasis'. Lithetha ukuba namatye kwinyongo . Amatye enyongo anokwakheka kwinyongo ngokwayo, kwimibhobho yenyongo, okanye kuzo zombini. Kwanelitye elenziwa kwinyongo linokuthi kamva lingene kwimibhobho yenyongo eqhelekileyo.

Ngamafutshane, 'iCholelithiasis' ithetha amatye enyongo. 'iCholdocholithiasis' ithetha amatye (elinye okanye ngaphezulu) aphume kwinyongo aze anamathele kwi-common bile duct. Uyayazi?

Yintoni umahluko phakathi kweCholedocholithiasis kunye neBiliary Colic?

Ukuba une-choledocholithiasis, oko kuthetha ukuba unelitye elinye ubuncinane kumsele wakho wenyongo oqhelekileyo. Ukuba ilitye lincinci kakhulu , usenokungabi nangxaki. Lisenokudlula emathunjini akho liphume emzimbeni wakho. Kodwa ukuba ilitye liyakhula lize livale umsele wenyongo oqhelekileyo, unokufumana iintlungu zesisu ezingapheliyo kunye ne-jaundice.

I-biliary colic yimeko eyenzeka xa ilitye lihlala kwinkqubo yenyongo. Ixhaphake kakhulu kubantu abane-gallstones. Nangona kunjalo, ukuba ilitye elikwi-common bile duct lihlala livale i-duct, umntu one-choledocholithiasis unokufumana i-biliary colic. Cinga ngayo njengelitye elifakwe kumbhobho wamanzi, ngamanye amaxesha amanzi ayageleza, ngamanye amaxesha awahambi.

Ingaba le yingxamiseko? Ngaba ndifuna unyango olukhawulezileyo?

Ukuba nelitye okanye amatye kwi-common bile duct akusoloko kuyinto engxamisekileyo. Nangona kunjalo, kukho umngcipheko . Njengoko bekutshiwo ngaphambili, amatye amancinci anokuphuma emzimbeni. Nangona kunjalo, umngcipheko kukuba amatye anokunamathela apho, akhule abe makhulu ngokuhamba kwexesha, aze avale ngokupheleleyo i-duct.

Ngenxa yale ngozi, oogqirha badla ngokunyanga amatye e-bile duct aqhelekileyo ngokukhawuleza nje ukuba afunyenwe. Badla ngokucebisa ukuba kusetyenziswe i-endoscopy ukuhlola nokususa amatye. Oku kuthetha ukuba ugqirha we-gastroenterologist usebenzisa ityhubhu encinci (i-catheter) efakwa emqaleni wakho ukuze ifikelele kwi-bile ducts ize isuse amatye. Ungakhathazeki, oku kwenziwa phantsi kwe-anesthesia, ukuze ungaziva ungonwabanga kangako.

Kuza kwenzeka ntoni ukuba le meko (i-choledocholithiasis) iba mandundu?

Ukuba ilitye libhajwe kumjelo wenyongo oqhelekileyo lize limise ukuhamba kwenyongo, oko kuchaphazela yonke inkqubo yenyongo. Oko kukuthi, zonke ezinye izitho kunye nemijelo ehamba ngayo inyongo. Oku kunokubangela ukudumba, usulelo , kwaneengxaki ezisongela ubomi.

Eyona nto ibalulekileyo kukufuna ingcebiso kagqirha ngokukhawuleza ukuba uneempawu ezinje, ngaphandle kokuzityeshela.

Ixhaphake kangakanani le meko?

Ngokomyinge, malunga ne-10 kubantu abali-100 banama-gallstones. Nangona kunjalo, uninzi lwala matye luvela kwi-gallstones. Malunga ne-15% yabantu abanama-gallstones bavelisa amatye kwi-common bile duct. Uninzi lwabantu alunangxaki ngala matye. Kuphela malunga ne-20% yabantu abanama-gallstones bavelisa iingxaki ezifuna unyango.

Ziziphi iimpawu zeCholedocholithiasis?

Usenokungabi nazo naziphi na iimpawu. Ukuba inyongo yakho ayivalwanga ngamatye enyongo, usenokungazi nokuba unazo. Nangona kunjalo, ukuba uneempawu, oko kuthetha ukuba inyongo yakho eqhelekileyo ivalwe lilitye. Iimpawu zokuqala ezenzeka xa inyongo ivalwe zibizwa ngokuba yi-biliary colic. Ziquka:

• Intlungu yesisu: Le ntlungu yenzeka emva kokutya. Ingathatha iyure enye ukuya kweziliqela. Intlungu iba qatha kwimizuzu engama-20 yokuqala, ize iphele kancinci kancinci. Uninzi lwabantu luyiva kwinxalenye ephezulu ngasekunene yesisu. Kodwa ngamanye amaxesha intlungu ingasasazeka iye kwicala lasekunene okanye egxalabeni.
• Isicaphucaphu nokuhlanza: Kuqhelekile ukuba nesicaphucaphu nokuhlanza xa une-biliary colic. Nangona kunjalo, uya kuqaphela ukuba, ngokungafaniyo nezinye iintloko ezibuhlungu, intlungu ayipheli emva kokuhlanza. Ukuba i-biliary colic ayinzima kangako, unokuziva ungenamdla wokutya.
• I-Jaundice:Xa inyongo ingahambi kakuhle ize ibuyele egazini, ulusu lwakho kunye namehlo amhlophe anokuba tyheli. Umchamo wakho nawo unokuba mnyama. I-jaundice, njenge-biliary colic, iyafika ize ihambe. Kodwa inokufika ize ihambe de kususwe ukuvaleka kombhobho.
• Umkhuhlane: Ukuba unokuvuvukala okukhulu kwinkqubo yenyongo, usenokuba nomkhuhlane. Umkhuhlane unokuba luphawu losulelo. Xa imibhobho yenyongo ivaliwe, iintsholongwane azikwazi ukuphuma emzimbeni ngokufanelekileyo, nto leyo eyenza kube lula ukuba usulelo luvele.

Zeziphi ezinye iingxaki ezinokubangela oku?

Ilitye elivala umbhobho wenyongo oqhelekileyo libangela ukuba inyongo ibuyele umva. Oku kunokuchaphazela eminye imibhobho edibene nayo, kunye namalungu anjengenyongo, ipancreas, nesibindi. Oku kunokubangela ukudumba, usulelo, kunye nomonakalo wezicubu ixesha elide. Iingxaki ezinokubakho ziquka:

• Usulelo: Umbhobho wenyongo ovalekileyo yindawo elula yokungena kosulelo lweentsholongwane. Usulelo olukwinkqubo yenyongo luyingozi kakhulu . Lunokusasazeka esibindini nasegazini. Ukuba usulelo lusasazeka luye egazini (septicemia), lunokukhokelela kwimeko embi nesongela ubomi (sepsis).
• I-Cholangitis: Eyona nto ibangela ukudumba kunye nosulelo lwe-common bile duct yi-'Choledocholithiasis'. I-bile duct iyadumba ngenxa yokuqokelelwa kwe-bile ngasemva, kwaye ukuhamba kwe-bile kuhamba kancinci. Oku kudumba kunye nosulelo kunokusasazeka ukusuka kwi-common bile duct ukuya kwamanye amasebe, oko kukuthi, ukuya kwi-ducts ezidlula esibindini. Oku kunokubangela ukuba isibindi sidumbe.
• I-Cholecystitis: Oku kukudumba kwenyongo. Xa inyongo ibuyela kwinyongo, iyadumba. Oku kubuhlungu. Kunokuphazamisa ukusebenza kwenyongo, kwaye ekuhambeni kwexesha, kuyonakalise. Le yeyona nto ibangela isifo senyongo.
• I-Gallstone Pancreatitis: Umsele wakho wenyongo kunye nepancreas zombini zivulekela emathunjini amancinci (amathumbu amancinci). Ukuba le ndlela iqhelekileyo ivalwe ngamatye enyongo, ukukhutshwa kwepancreas kunokuyeka ukuhamba. Ezi mveliso ziqulathe ii-enzymes ezinamandla kakhulu, ezinokubuyela kwipancreas, zibangele ukudumba okukhulu kunye nomonakalo wamalungu omzimba. Oku kubizwa ngokuba yi-pancreatitis. Amatye enyongo zezona zinto ziphambili kwi-pancreatitis engeyotywala.

Kutheni le nto (i-choledocholithiasis) isenzeka?

Isibindi sethu senza inyongo ngezinto esizihluza egazini lethu. Ezi zinto ziquka i-cholesterol, i-bilirubin, i-bile salts, kunye ne-lecithin. Amatye enyongo ayenzeka xa enye yezi zinto - ngokuqhelekileyo i-cholesterol, ngamanye amaxesha i-bilirubin - iba yininzi kakhulu. Emva koko, ezi zinto zigqithisileyo ziyaqokelelana njengodaka.

Le nto ifana nodaka iqokelelana ezantsi kwenyongo okanye kwi-common bile duct ize iqine kancinci kancinci. Njengoko udaka oluninzi luhamba phezu kwayo, la matye akhula kancinci kancinci. Oku kungathatha iminyaka. Uninzi lwamatye enyongo luvela kwi-gallbladder. Emva koko ahamba nge-bile duct aze aphele kwi-common bile duct.

Ziziphi izinto ezibangela umngcipheko ezichaphazela oku?

Usenokuba namathuba amaninzi okuphuhlisa amatye e-bile duct aqhelekileyo ngenxa yezi zizathu zilandelayo:

• Ukuba ne-cholangitis engapheliyo: I-Choledocholithiasis yeyona nto ibangela i-cholangitis. Kodwa inokwenzeka nangayiphi na indlela. Ukuba imibhobho yenyongo yakho ivuvukele ngesinye isizathu, ukuhamba kwenyongo kunokucotha, okubangela ukuba amatye avele kwimibhobho yenyongo.
• Amatye enyongo angaphambili: Uninzi lwabantu abaneenyongo ababi neengxaki. Nangona kunjalo, abantu ababenawo ngaphambili banamathuba amaninzi okuphinda bawafumane. Nokuba inyongo yakho isusiwe njengonyango lwamatye enyongo, kwiimeko ezingaqhelekanga, amatye amatsha anokwakheka kwimibhobho yakho yenyongo.

Ezinye izinto ezibangela umngcipheko ezidla ngokubangela ukwakheka kwamatye enyongo ziquka:

• Amanqanaba aphezulu eCholesterol: Uninzi lwamatye enyongo (malunga ne-75%) lwenziwa yi-cholesterol engaphezulu egazini. Ezinye izinto zenyongo (ityuwa yenyongo kunye ne-lecithin) kuthiwa ziyayinyibilikisa le cholesterol. Kodwa ukuba kukho ukungalingani phakathi kwezi zinto, ayizukusebenza kakuhle.
• Iihomoni zabasetyhini: I-estrogen inyusa i-cholesterol. I-progesterone inciphisa ukushwabana kwenyongo kwaye inyusa ukuhamba kwenyongo. Zombini ezi homoni ngamanye amaxesha ziphakama ngexesha lokuzala kwabasetyhini. Unyango lokutshintshwa kweehomoni lunokunyusa amanqanaba e-cholesterol.

Sifunyaniswa njani esi sifo (i-choledocholithiasis)?

Amatye e-bile duct adla ngokufunyanwa emva kokuba iimpawu zivele. Ukuba ufuna uncedo lwezonyango ngeempawu ezifana ne-biliary colic okanye i-jaundice, ugqirha wakho uya kwenza uvavanyo lwegazi kunye novavanyo lwemifanekiso . Uvavanyo lwegazi lunokubonisa ukuba ingakanani i-bile eqokeleleneyo. Uvavanyo lwemifanekiso lunokunceda ekumiseleni apho ukuvaleka kukhoyo.

Zeziphi iimvavanyo ezenziwayo koku?

Uvavanyo lwegazi:

• Ubalo lwegazi olupheleleyo (i-CBC)
• Uvavanyo lweBilirubin
• Uvavanyo lomsebenzi wePancreas
• Uvavanyo lokusebenza kwesibindi

Njengovavanyo lomfanekiso:

• I-ultrasound yesisu:Olu luvavanyo olulula nolungabuhlungu. Lungakunika umbono wokuqala wemeko yakho. Lungabonisa ukuba kukho amatye kwinyongo yakho. Nangona lungayibonisi ngokucacileyo indlela eqhelekileyo yokukhupha inyongo, lunokubonisa ukuba indlela yokukhupha inyongo ivulekile. Oku kubonisa ukuba kukho indawo evalekileyo. Ukuvalwa kungabonakala njengesithunzi.
• I-ultrasound ye-Endoscopic: Olu vavanyo ludibanisa iteknoloji ye-ultrasound kunye ne-endoscopy ephezulu ukuvelisa imifanekiso ecacileyo yemibhobho yenyongo. Oku kubandakanya ukufaka ityhubhu encinci exhotyiswe ngekhamera (i-endoscope) ezantsi emqaleni wakho nakwisisu sakho nasemathunjini amancinci aphezulu. Isixhobo se-ultrasound esisekupheleni kwe-endoscope sisebenzisa amaza esandi ukwenza imifanekiso yenkqubo yenyongo.
• I-MRCP (iMagnetic Resonance Cholangiopancreatography): Olu luhlobo lwe-MRI (iMagnetic Resonance Imaging). Ithatha imifanekiso yemibhobho yenyongo ngokukodwa. Ayinabungozi emzimbeni. Ingathatha imifanekiso ecacileyo yenkqubo yonke yenyongo, kuquka ne-common bile duct. Ugqirha angenza olu vavanyo kuqala ukuba ukrokrela ukuba kukho ilitye kwi-common bile duct. Nangona kunjalo, ukuba kukho amathuba aphezulu okuba kukho ilitye, unokuya ngqo kwi-ERCP.
• I-ERCP (Endoscopic Retrograde Cholangiopancreatography): Olu vavanyo luhlasela kancinci kunezinye. Kodwa luluncedo kakhulu ekufumaneni amatye enyongo. Lunokususa amatye. Lusebenzisa zombini ii-X-reyi kunye ne-endoscopy. Nje ukuba i-endoscope iphume emathunjini amancinci, ingcali ifaka enye ityhubhu encinci kuyo ize iyikhokelele kwimibhobho yenyongo. Emva koko, kufakwa ulwelo olukhethekileyo (idayi) ngetyhubhu, kwaye kuthathwa ii-X-reyi zevidiyo (i-fluoroscopy) njengoko idayi ihamba ngemibhobho. Ukuba kufunyenwe amatye, anokunyangwa.

Oogqirha bawasusa njani amatye kwi-common bile duct?

La matye adla ngokususwa ngexesha lenkqubo ye-ERCP. Oogqirha banokusebenzisa izixhobo ezikhethekileyo ezinamathele kwisiphelo se-endoscope ukuqhekeza nokususa amatye xa efunyenwe. Ngamanye amaxesha, kwenziwa isilonda esincinci kwisihlunu se-duct (sphincterotomy) ukuze kwandiswe i-duct kwaye kuvunyelwe ilitye ukuba lidlule.

Ngaba utyando luyimfuneko kwi-Choledocholithiasis?

I-Endoscopic retrograde cholangiopancreatography (ERCP) ayifuni kususwa isisu ukuze ifikelele kwimibhobho yenyongo. Nangona kunjalo, emva kokususa amatye kwimibhobho yenyongo, oogqirha badla ngokucebisa utyando lokususa inyongo . Isizathu soku kukuthintela amatye ukuba angaphindi aphume kwinyongo aze abangele i-choledocholithiasis.

Ngaba ndiza kufuna olunye unyango?

Ngokuxhomekeke kwimeko yakho, ungadinga olunye unyango ngaphambi kokuba ususwe amatye enyongo. Umzekelo:

• Ukuba kukho usulelo , amayeza okubulala iintsholongwane ayanikwa.
• Iindlela zokukhupha inyongo ukususa inyongo eqokeleleneyo.

Ziziphi iingxaki ezinokwenzeka emva konyango?

Ezi ngxaki zilandelayo zinokwenzeka kwixesha elifutshane emva kokususwa kwamatye e-endoscopic:

• Ukopha
• Usulelo
• I-Pancreatitis

Ezi zinto zilandelayo zinokwenzeka kwixesha elide emva konyango:

• Ukuphinda kwamatye enyongo: Nokuba onke amatye akwimibhobho yenyongo asusiwe, amatye amatsha anokwakheka kamva. Abantu ababenamatye ngaphambili banamathuba amaninzi okuphinda bawavelise.
• I-Bile duct fibrosis: Izicubu ezikrwada zinokwenzeka xa i-bile duct isikiwe. Ngamanye amaxesha ezi zicubu zinokubangela ukuba i-duct ibe mxinwa (i-biliary stricture). Oku kunokubangela uhlobo olwahlukileyo lokuvaleka kwi-common bile duct. Kusenokufuneka unyango olwahlukileyo.

Ngaba uphuhliso lwe-choledocholithiasis lungathintelwa?

Uninzi lwamatye enyongo lubangelwa yi-cholesterol, kwaye ungawanciphisa amanqanaba e-cholesterol egazini lakho ngokwenza utshintsho kwindlela otya ngayo nendlela ophila ngayo. Oku kunokunceda ukunciphisa umngcipheko wakho. Oogqirha bathi kuphephe ukutya okubizwa ngokuba yi-"yo-yo", oku kuthetha ukunciphisa ubunzima ngaxeshanye uze uphinde ubufumane. Ukuba unciphisa ubunzima, kwenze kancinci kancinci . Ukunciphisa ubunzima ngaxeshanye kwandisa umngcipheko wakho wokuba namatye enyongo.

Injani imeko emva konyango?

Kubantu abaninzi, unyango lulula kwaye luphumelela. Kwimeko engaqhelekanga yokuba umntu abe neengxaki emva konyango, ezo ngxaki zinokunyangwa. Kwiminyaka eli-10 ukuya kwengama-20, phakathi kwabantu aba-5 nama-25 kwi-100 baya kuvelisa amatye amatsha kwimibhobho yenyongo. Lo mngcipheko uphantsi ukuba inyongo isusiwe.

Uhlaselo lwenyongo lunokuba ngamava abuhlungu kakhulu kwaye othusayo, ingakumbi ukuba ubungazi ukuba unamatye ngaphambili. Okukhona ufumana unyango ngokukhawuleza, kokukhona uza kuziva ungcono ngokukhawuleza. I-biliary colic, nokuba iyafika ize iphele, kwaye ayibi mandundu kakhulu, ayifanele ingananzwa. Iya kuba mandundu kuphela de kususwe ukuvaleka kombhobho wenyongo.

Izinto ezibalulekileyo ekufuneka uzikhumbule (Umyalezo Wokuya Ekhaya)

Kulungile, ngoko ke ndiyathemba ukuba ngoku uyiqonda ngcono i-'choledocholithiasis' esithethe ngayo namhlanje.

Eyona nto ibalulekileyo kukuba ukuba uneempawu ezifana nentlungu eqatha kwicala eliphezulu lasekunene lesisu sakho, isicaphucaphu, ukuhlanza, kunye nokutyheli kwamehlo, musa ukuyityeshela nje uze ubone ugqirha ngoko nangoko.

Kukho unyango olufanelekileyo lwesi sifo. Ukuba sifunyenwe kwangethuba, sinokunyangwa ngaphambi kokuba kubekho iingxaki ezinkulu. Musa ukoyika, landela icebiso likagqirha wakho. Kwakhona nyamekela ukutya kwakho nendlela ophila ngayo. Emva koko ungakhuseleka kakhulu kwiingxaki ezinjalo.

Amatye enyongo , umbhobho wenyongo oqhelekileyo, i-choledocholithiasis, i-jaundice, iintlungu zesisu, i-endoscopy, i-ERCP