Ake sifunde ngemigudu yakho yenyongo. Lokhu kubaluleke kakhulu!

Sawubona! Wake wacabanga ukuthi ngisho nemigudu emincane kakhulu emizimbeni yethu ibaluleke kangakanani? Enye into ebaluleke kangaka, kodwa mhlawumbe into esingakhulumi kakhulu ngayo, imigudu yenyongo. Ngakho-ke namuhla sizoxoxa ngale migudu yenyongo ngamagama alula, ukuthi iyini, kwenzekani kuyo, yiziphi izifo ezibangelwa yiyo, nokuthi singayinakekela kanjani.

Iyini i-Bile Duct? Yenzani?

Kalula nje, i-bile duct iyisimiso samapayipi amancane axhumanisa ezinye izitho ohlelweni lwethu lokugaya ukudla. Ifana nepayipi elithwala amanzi. Umsebenzi walo oyinhloko ukuthutha into ebizwa ngokuthi 'i-bile' phakathi kwalezi zitho. Isibindi sethu, i-gallbladder, kanye namathumbu amancane, kanye nalezi zimbobo ze-bile, zakha uhlelo lwe-biliary . Ngakho-ke, kungani lawa mapayipi e-bile edingeka? Umzimba wethu udinga i-bile ukuze wenze imisebenzi ehlukahlukene. Amapayipi e-bile asiza ukuthutha ngokuphephile le nyongo isuka endaweni eyodwa iye kwenye. Lolu hlelo lwamapayipi lubalulekile ekuthutheni inyongo emzimbeni nganoma yisiphi isikhathi, noma kuphi, ngaphandle kokuphazamisa noma yini enye, futhi ngaphandle kokulimaza ezinye izitho. Manje bheka, le nyongo iwuketshezi olwenziwe yisibindi sethu. Iqukethe uhlobo lwento ebizwa ngokuthi ama-bile acid . Lokhu yilokho okusisiza ukugaya amafutha namaprotheni ekudleni esikudlayo. Kodwa lawa ma-bile acid aqinile kancane futhi angaba yingozi ezithweni ezingakajwayeli. Futhi, amanye ama-enzyme okugaya ukudla avela kuma-pancreas ethu nawo adlula kula mapayipi e-bile. Ngokufanayo, uma engahambi endaweni efanele, kungavela izinkinga.

Lo msele wenyongo uxhumene kanjani nezitho zethu zomzimba?

Cabanga ngakho njengomuthi onamagatsha. Kuqala ngesibindi sethu. Isibindi sitholakala ohlangothini oluphezulu kwesokudla lwesisu sethu. Ngaphakathi kwesibindi kukhona imibhobho ye-bile emincane kakhulu. Sibiza lokhu ngokuthi imibhobho ye-bile yangaphakathi kwesibindi. Lapho isibindi senza i-bile, siyiqoqa ngale mibhobho. Bese kuthi, le mibhobho emincane ngaphakathi kwesibindi ihlangane ukuze yakhe imibhobho ye-hepatic emikhulu kancane kwesokudla nakwesobunxele. Le mibhobho emibili iphuma esibindini bese ihlangana ukuze yakhe umsele ovamile we-hepatic . Imibhobho engaphandle kwesibindi ibizwa ngokuthi imibhobho ye-extrahepatic . Manje, lo msele ovamile we-hepatic uhlangana nomsele we-cystic ovela enyongweni yethu ukuze wakhe umsele we-bile ovamile.Kudala. Cishe ingxenye yenyongo evela esibindini ingena ngqo kulo msele wenyongo ovamile. Enye ingxenye iya enyongweni. Inyongo itholakala ngaphansi kwesibindi. Kufana nesikhwama esincane esigcina inyongo. Sigcina inyongo engasetshenziswa ngaleso sikhathi. Inyongo iyigcina kuze kube yilapho amathumbu ethu amancane eyidinga. Lapho amathumbu ethu amancane ezwa ukuthi kunamafutha namaprotheni okugaya, ithumela isignali enyongweni. Bese inyongo iyafinyela bese ithumela inyongo ngomsele wenyongo ojwayelekile iye emseleni wenyongo ovamile. Ukusuka lapho, inyongo iya emathunjini amancane. Lo msele wenyongo ovamile uwumsele wenyongo omkhulu kunayo yonke esinayo. Ungamasentimitha ayi-10 ubude. Zonke ezinye inyongo ziyahlukana nalokhu. Umsele wethu wenyongo uxhumeka endaweni efanayo lapho lo msele wenyongo ovamile uvulekela khona emathunjini amancane, kodwa njengomsele ohlukile. Uyaqonda?

Yiziphi izimo ezithinta imigudu ye-bile?

Kulungile, manje ake sibone ukuthi yiziphi izinhlobo zezifo ezingathinta lolu hlelo olubalulekile lwe-bile duct.

1. Ukuvuvukala

Ezinye izifo nezinye izimo zokuvuvukala zingabangela izinkinga ngemigudu ye-bile. Lokhu kungaba isikhathi esifushane noma eside. Esikhathini esifushane, ukuvuvukala okukhulu kungavimba imigudu futhi kumise ukugeleza kwe-bile. Kodwa-ke, esikhathini eside, ukuvuvukala okungapheli kungabangela izibazi zezicubu ngaphakathi kwemigudu ye-bile. Lesi sikhumba sesibazi sibangela ukuthi imigudu ibe mincane - lokhu kubizwa ngokuthi i-stricture . Ekugcineni, ukuhlinzekwa kwegazi kuyanqamuka futhi imigudu ye-bile ingonakala. Lokhu kuvuvukala kwemigudu ye-bile kubizwa ngokuthi i-cholangitis . Ukutheleleka nokuvaleka kungabangela i-acute cholangitis . Futhi, izifo zokuzivikela komzimba zingabangela i-cholangitis engapheli . I-Primary Biliary Cholangitis (PBC) kanye ne -Primary Sclerosing Cholangitis (PSC) yizimo ezimbili ezinjalo ezingapheli.

2. Ukuvimbela

Imbangela evame kakhulu yezinkinga zomgudu wenyongo ukuvaleka . Enye yezinto ezivame kakhulu amatshe enyongo . Lawa matshe angamakristalu akha enyongweni noma emigudwini yenyongo. Akhula kancane eminyakeni eminingi. Ngokuvamile, amatshe enyongo ayaqhekeka futhi angene emgudwini wenyongo ovamile. Lesi simo esithile sibizwa ngokuthi i-choledocholithiasis.Uma la matshe angaphakathi kwemisele yenyongo eba makhulu, angavimba ukugeleza kwenyongo. Futhi, ukuqina kwemisele yenyongo , okuwukuncishiswa kwemisele yenyongo, kungavimba ukugeleza kwenyongo. Ukuvuvukala kwesikhathi eside kungabangela ukwakheka kwezicubu zesilonda emimiseleni yenyongo, kuzinciphise ngale ndlela. Ezinye izifo zokuzalwa - isibonelo , i-biliary atresia kanye ne-Alagille Syndrome - nazo zingabangela lesi simo.

3. Umdlavuza

Umdlavuza we-bile duct ubizwa ngokuthi i-cholangiocarcinoma . Ungakhula emigudwini yangaphandle kwesibindi - okuyiyona evame kakhulu - noma emigudwini engaphakathi kwesibindi (imigudu ye-intrahepatic). Lokhu kuhlukile kumdlavuza wesibindi. Kodwa-ke, uma umdlavuza wesibindi ukhula, ungalimaza nemigudwini ye-bile engaphakathi kwesibindi ngokubangela ukuvuvukala noma ukuvaleka.

Kwenzekani uma i-bile duct ivalekile?

Njengomsele ovalekile, uma inyongo ingakwazi ukugeleza ngemibhobho yenyongo, iyabuya futhi iqale ukunqwabelana ezithweni zomzimba. Lokhu kungabangela ukuvuvukala kanye nomonakalo kulezo zitho zomzimba. Isibonelo, ukuvuvukala kwenyongo ( i-cholecystitis ), ukuvuvukala kwe-pancreas ( i-gallstone pancreatitis ), kanye nokuvuvukala kwesibindi kanye nemibhobho yenyongo ngokwayo. Lapho ukugeleza kwenyongo kuyeka ( i-cholestasis ), ukutheleleka kungenzeka kakhulu. Ukutheleleka ohlelweni lwenyongo kubuhlungu kakhulu futhi kuyingozi. Uma kusakazekela esibindini, kungangena egazini futhi kubangele i-septicemia emzimbeni wonke, okuholela esimweni esiyingozi esibizwa ngokuthi i-sepsis .

Okubalulekile: I-Sepsis iyisimo esiphuthumayo esisongela ukuphila.

Futhi, lapho inyongo ebuyayo iqala ukuvuza egazini, ingabangela izifo ezahlukahlukene. Ungaba ne -jaundice - ukuphuzi kwesikhumba namehlo - isicanucanu, ukulunywa, kanye nokukhubazeka okuncane kwengqondo (i-hepatic encephalopathy) . Amapayipi enyongo avinjiwe awakwazi ukuthulula inyongo kahle emathunjini amancane. Lokhu kungabangela izinkinga zokugaya ukudla. Uhlelo lwakho lokugaya ukudla lunenkinga yokugaya amafutha kanye nokumunca amavithamini ancibilikayo. Lokhu kungayimunci kungaholela nasekungondlekini kahle .

Wazi kanjani ukuthi unenkinga ye-bile duct?

Izimo ezingamahlalakhona zivame ukukhula kancane eminyakeni eminingi. Ngakho-ke ungase ungabi nazo izimpawu kuze kube yilapho imisele yakho yenyongo yonakele kakhulu. Kodwa-ke, uma unesifo esibi kakhulu , njengokuvaleka noma ukutheleleka, uzovame ukuzwa izimpawu ezibizwa ngokuthi i-biliary colic . Kuyini i-biliary colic?

• Lokhu ubuhlungu besisu.
• Kuvame ukuza nesicanucanu , futhi ngezinye izikhathi nokuhlanza .
• Lokhu kuvame ukwenzeka ngemva kokudla ukudla okunamafutha .
• Ubuhlungu buqala kancane kancane, bukhula kancane kancane phakathi nehora, bese buphinde buphele phakathi nehora noma amabili.

Lolu hlobo lwe-biliary colic lwenzeka lapho uhlelo lwakho lwe-biliary luzama ukuthumela i-bile emathunjini akho amancane ukusiza ekugayeni ukudla. I-gallbladder bese iyafinyela, okwandisa ingcindezi ngaphakathi kwe-bile ducts. Uma i-bile ducts yakho inegciwane noma ivinjiwe, leyo ngcindezi yiyo ebangela ubuhlungu.

Khumbula: Uma unezimpawu ze-biliary colic, noma ngabe ayinzima kakhulu, iya esibhedlela ngokushesha . Ukuhlolwa kwezokwelapha kungasheshe kunqume ukuthi inkinga iyini. Uma ungenabo ubuhlungu obukhulu, kodwa unezinye izimpawu ezihlobene nohlelo lwe-biliary, njenge -jaundice , kungaba uphawu lwesifo esingamahlalakhona.

Ungayelapha kanjani i-bile duct evalekile?

Kunezindlela eziningana odokotela abazisebenzisayo ukuthola nokususa ukuvaleka kwemisele yenyongo. Indlela enconyelwe wena izoncika esimweni sakho, kungakhathaliseki ukuthi singesingapheli noma sibi kakhulu, nokuthi siphuthuma kangakanani.

• I-Endoscopic Retrograde Cholangiopancreatography (ERCP): Lena inqubo engeyona eyokuhlinzwa. Ipayipi elide elinekhamera enamathiselwe (i-endoscope) lifakwa ngomlomo bese lidluliselwa emgudwini wokugaya ukudla. Udokotela angenza izinto ezidingekayo ngale endoscope.
• Ukuhlolwa kwe-bile duct: Lena inqubo yokuhlinzwa. Ivame ukwenziwa kusetshenziswa izindlela ezingangenisi kakhulu . Okusho ukuthi , ukuhlinzwa kwe -laparoscopic, okuhilela ukwenza ukusikwa okukodwa noma ngaphezulu okuncane esiswini. Ngezinye izikhathi kwenziwa ngesikhathi sokuhlinzwa ukuze kususwe i-gallbladder ukuze kutholakale amatshe e-gallbladder.

Udokotela angasika umsele wenyongo ukuze asuse ukuvaleka noma afake i -stent ukuze ihlale ivulekile. Ngezinye izikhathi kokubili kwenziwa. Uma imisele yenyongo ibanzi kakhulu (ivulekile) ngenxa yezibazi kanye ne-stenosis, bangase basuse nezingxenye zemisele.

Ngingawanakekela kanjani amapayipi ami enyongo?

Ingozi enkulu emigudwini yakho yenyongo amatshe enyongo . Imbangela eyinhloko yamatshe enyongo i-cholesterol ephezulu egazini. I-cholesterol eyengeziwe egazini ingagcina inqwabelene emigudwini yenyongo, ibangele ukuthi iqine futhi yakhe amatshe e-cholesterol. Unganciphisa le ngozi ngokunciphisa i-cholesterol ekudleni kwakho . Ingozi yesibili enkulu yisifo sesibindi . Uma unesifo sesibindi esingamahlalakhona, unganciphisa umonakalo esibindini sakho kanye nasesimisweni senyongo ngokwamukela indlela yokuphila enempilo.

• Zivocavoce .
• Nciphisa amafutha ekudleni kwakho.
• Gwema utshwala nezidakamizwa.

Lokhu kuzosiza kakhulu.

Amapayipi e-bile mancane kakhulu, kodwa asebenzela imizimba yethu kahle kakhulu. Nsuku zonke, izitho zethu eziningana kanye nezinqubo zomzimba zincike kula mapayipi e-bile. Uma i-bile ingakwazi ukufika lapho idinga ukuya khona, ingagcina ivuza egazini futhi ithinte umzimba wonke.

Ukuphazamiseka kwemigudu yenyongo kungathinta ezinye izitho ohlelweni lwenyongo. Ngakolunye uhlangothi, izinkinga kulezo zitho zingathinta imigudu yenyongo. Ngakho-ke, uma unezimpawu ezihlobene nohlelo lwenyongo, njenge-biliary colic noma i-jaundice, funa iseluleko sezokwelapha ngokushesha . Lokhu kungasiza ekuvikeleni uhlelo lwakho lwenyongo olubucayi, okuhlanganisa nemigudu yenyongo.

Ngakho-ke, yiziphi izinto ezibaluleke kakhulu okufanele sizikhumbule kulokho esikhulume ngakho namuhla?

• Umsele wenyongo uwuhlelo oluncane kodwa olubaluleke kakhulu lwamapayipi athwala inyongo phakathi kwesibindi sethu, inyongo kanye namathumbu amancane.
• Amatshe enyongo kanye nokuvuvukala yizinkinga eziyinhloko ezithinta imigudu yenyongo.
• Qaphela uma uzwa izimpawu ezifana nobuhlungu besisu (i-biliary colic) kanye ne-jaundice ngemva kokudla ukudla okunamafutha.
• Ukugcina ukudla okunempilo kanye nendlela yokuphila enempilo kubaluleke kakhulu empilweni yemigudu yenyongo.
• Uma unezimpawu, ukubona udokotela ngokushesha nokufuna iseluleko kungakusiza ugweme izinkinga ezinkulu.