I-Cholangitis

Ubuwazi ukuthi i-cholangitis ingaba yingozi enkulu empilweni yakho? Lesi simo, esithinta ama-bile ducts, singabangela ukungakhululeki okukhulu futhi kubangele izinkinga ezisongela ukuphila uma zingelashwa. Izimpawu ze-cholangitis ngokuvamile zihlanganisa umkhuhlane, ubuhlungu besisu, Futhi jaundice, ukwenza ukuxilongwa kusenesikhathi nokunakekelwa okufanele kubalulekile ukuze ululame.

Lesi sihloko sihlose ukucacisa izimbangela ze-cholangitis, izimpawu zayo, kanye nezinketho zokwelashwa ezihlukahlukene ze-cholangitis. 

Iyini i-Cholangitis?

I-cholangitis ukuvuvukala noma ukuvuvukala kwe-bile duct system (uhlelo lunesibopho sokuthwala i-bile isuka esibindini ne-gallbladder iye emathunjini amancane). Lesi simo senzeka lapho imigudu yenyongo icasuka, ivuvukele, futhi ingase itheleleke. I-bile, into eyakhiwe ngemfucumfucu evela egazini nama-bile acids, idlala indima ebalulekile ekugayeni ukudla nasekukhipheni imfucuza. I-Cholangitis ingaba yizinhlobo ezimbili:

• I-Acute Cholangitis, noma i-acending Cholangitis, yisimo esibulalayo esibangelwa ukutheleleka kwamagciwane okukhuphuka esihlahleni se-biliary. 
• I-Cholangitis engapheli, ngakolunye uhlangothi, yisimo sesikhathi eside esingapheli. Kungaba umphumela wezifo ezihlukahlukene ezingapheli ezithinta uhlelo lwe-bile duct. 

Izimpawu ze-Cholangitis

Izimpawu ezivame kakhulu zihlanganisa ubuhlungu besisu esingenhla kwesokudla, umkhuhlane, kanye ne-jaundice, eyaziwa ngokuthi i-Charcot's Triad. Lobu buhlungu bungase bube bukhali noma bube buthuntu, ngezinye izikhathi buphume ehlombe elingakwesokudla noma emuva. Ivame ukuza ngeziqephu, ikakhulukazi ngemva kokudla okunzima, isimo esibizwa ngokuthi i-biliary colic.

Ezinye izimpawu zifaka:

• Ukugodola kanye ukulahlekelwa ukudla
• I-nausea nokuhlanza
• Indle enombala wobumba nomchamo omnyama
• Umfutho wegazi ophansi kanye nokukhathala
• Ukudideka nokudideka

Izinkinga ze-Cholangitis

I-Cholangitis ingabangelwa izici ezihlukahlukene, kuhlanganise: 

• Isizathu esivame kakhulu sokuphazamiseka ohlelweni lwe-biliary yi-choledocholithiasis, ehlanganisa ukuba khona kwamatshe enyongo emiseleni ye-bile. 
• Ezinye izimbangela ukuqina okuyingozi noma okulimazayo kwemigudu yokuphefumula, umdlavuza wamanyikwe, nezimila ezihlukahlukene. 
• Ukutheleleka kwe-parasitic, njengalezo ezibangelwa i-Clonorchis sinensis noma i-Fasciola hepatica, nazo zingaholela ku-Cholangitis.
• Amanyikwe avuvukele, inyongo, amahlule egazi, izimo ezivuvukalayo ezithinta isibindi namapayipi enyongo, izifo ezibangelwa yizilokazane, noma ukuhlukumezeka kwesisu nakho kungaholela kuCholangitis.
• I-acute cholangitis ngokuvamile ivela ngenxa yokutheleleka kwebhaktheriya emiseleni ye-bile. Amagciwane ngokuvamile anesibopho ahlanganisa i-Escherichia coli, i-Klebsiella, i-Enterobacter, i-Pseudomonas, ne-Citrobacter. 
• Ukwethulwa kwe-iatrogenic kwamagciwane, okuvamise ukulandelwa yizinqubo ezifana ne-endoscopic retrograde cholangiopancreatography (ERCP), nakho kungabangela i-Cholangitis kubantu abane-biliary obstruction.

Izingozi ze-Cholangitis

Kunezici eziningana ezandisa ingozi yokuthuthukisa i-cholangitis. 

• Umlando wamatshe enyongo uphezulu ohlwini
• Impilo yokunganyakazi
• Ukwanda kwe-triglyceride yokudla
• Inkomba yesisindo somzimba (BMI) ngaphezu kwama-30 
• Abantu abane-HIV 
• Izinqubo zakamuva ezibandakanya indawo ye-bile duct 
• Ukuchayeka ezibungwini noma izimuncagazi kwezinye izifunda kungaholela kuCholangitis. 

Ukuxilongwa kwe-Cholangitis

Odokotela baxilonga i-cholangitis ngenhlanganisela yokwethulwa komtholampilo, ukuhlolwa kwaselabhorethri, nezifundo zokuthwebula izithombe. 

• Uphenyo lwegazi ludlala indima ebalulekile ekuhlonzeni izifo kanye nokungalungi kokusebenza kwesibindi. Lokhu kufaka phakathi inani legazi eliphelele, elivame ukubonisa ngaphezu kwebanga elivamile lesibalo samangqamuzana amhlophe egazi, nokuhlolwa kokusebenza kwesibindi okuveza amazinga anyukile e-bilirubin, i-alkaline phosphatase, ne-gamma-glutamyl transferase.
• I-ultrasound yesisu ngokuvamile iyindlela yokucabanga yomugqa wokuqala ngenxa yokufinyeleleka kwayo kanye nekhono lokubona ukuvuleka kwemigudu ye-bile kanye namatshe enyongo. 
• I-Magnetic resonance cholangiopancreatography (MRCP) isiphenduke indlela ethandwayo yokucabanga engahlaseli. 
• I-Endoscopic retrograde cholangiopancreatography (ERCP) isalokhu iyindinganiso eyigolide yokuxilongwa nokwelashwa. Ivumela ukubonwa okuqondile kwemigudu ye-bile futhi ingasetshenziswa ukususa izithiyo noma ukuthatha amasampula e-biopsy.
• Kwezinye izimo, odokotela bangase bacele i-biopsy yesibindi ukuze bahlaziye izinga lomonakalo owenzekile esibindini. 
• I-Endoscopic ultrasound (EUS) ivela njengethuluzi elibalulekile lokuxilonga, elinikeza izithombe zokucaca okuphezulu zesistimu ye-biliary futhi engase imiselele i-ERCP kwezinye izimo.

Ukwelashwa kweCholangitis

Odokotela benza ukwelashwa kwe-cholangitis engapheli kanye ne-acute ngokubhekana nokutheleleka kanye nokuvinjelwa kwe-bile duct. Baqala ngokunikeza ama-antibiotics ukulwa nokutheleleka. 
Ukusula i-bile duct evinjiwe kubalulekile. Odokotela bavame ukusebenzisa inqubo ebizwa nge-ERCP (Endoscopic Retrograde Cholangiopancreatography) ukwenza lokhu. Ihlasela kancane kunokuhlinzwa futhi ibavumela ukuthi babeke i-stent noma i-drain emgodini we-bile. Uma i-ERCP ingenzeki, bangasebenzisa indlela ebizwa nge-PTC (Percutaneous Transhepatic Cholangiography).

Izinkinga ze-Cholangitis

I-Cholangitis ingaholela emiphumeleni emibi uma ingelashwa noma uma ukwelashwa kubambezelekile. 

Ezimweni ezinzima, iziguli zingase zithole ukuphuka kwe-gallbladder noma i-necrosis, ukungena kwe-bile ku-peritoneum, nokopha emgudwini we-biliary. Lezi zinkinga zingakhula ngokushesha zibe ukushaqeka kwe-biliary kanye ne-sepsis, kube usongo olukhulu empilweni.

Izinkinga ezingapheli zihlanganisa ukwakheka kwamathumba ku-biliary tract kanye isibindi. Iziguli zingase zibe namathumba esibindi, okungamaphakethe obomvu esibindini. I-Portal vein thrombosis, ukuthuthukiswa kwehlule legazi emthanjeni we-portal, kungenye inkinga enkulu. I-cholecystitis eyingozi kanye nokuvuvukala kwe-gallbladder nakho kungenzeka.

Uzoyibona Nini Udokotela

Umuntu ngamunye kufanele ayofuna usizo lwezokwelapha uma eba nanoma yiziphi izimpawu ezibakhathazayo, ikakhulukazi lezo ezihambisana neCholangitis. Izimpawu ezivame kakhulu zihlanganisa ubuhlungu besisu obungaphezulu kwesokudla, umkhuhlane, kanye ne-jaundice, eyaziwa ngokuthi i-Charcot's Triad. 

Ezinye izimpawu ezingase zibe yimbangela yokukhathazeka zihlanganisa:

• Izinguquko ekugayeni ukudla kanye nokuphuma kwamathumbu
• I-biliary colic (ubuhlungu be-episodic besisu, ngokuvamile ngemva kokudla okunzima)
• Ukuphuzi kwamehlo nesikhumba

Prevention

Nakuba kungenzeki ngaso sonke isikhathi ukuvimbela i-cholangitis, umuntu angathatha izinyathelo zokunciphisa ubungozi futhi athuthukise imiphumela. 

• A Ukudla okunazo zonke nge-fiber eningi namafutha aphansi kungadambisa izimpawu futhi kuvimbele izinkinga. Odokotela batusa ukukhetha ukudla okuncishisiwe kwe-sodium ukuze kuncishiswe ukuvuvukala kwezicubu nokunqwabelana koketshezi esiswini.
• Kulabo abanomlando we-gallstones noma izifo ze-biliary ductal, imfundo ibalulekile. Kufanele bazijwayeze nezimpawu zeCholangitis futhi bafune usizo lwezokwelapha ngokushesha uma kuvela izimpawu. Ukuhlonzwa kusenesikhathi kanye nokwelashwa kwe-cholelithiasis eyizimpawu ezigulini ezisengozini kunganciphisa kakhulu ingozi ye-cholangitis.
• Ukuvivinya umzimba njalo, izinsuku eziningi zesonto, kungasiza ekunciphiseni ingozi yokulahlekelwa amathambo. Kubalulekile ukugwema ukubhema nokuphuzwa kotshwala, njengoba le mikhuba ingabangela ukucindezeleka okwengeziwe esibindini. Abantu abane-cholangitis eyinhloko ye-biliary kufanele bagweme ukuphuza utshwala ngokuphelele.
• Abantu abathola izinqubo ze-ERCP bangazuza kuma-antibiotics e-prophylactic ukunciphisa ingozi ye-Cholangitis. Kulabo abane-cholangitis eyingozi ephindaphindayo, ukwelashwa okuqhubekayo kwama-antibiotic kungasiza ekunciphiseni ukwenzeka kanye nokuqina kwesifo.
• Iziguli kufanele zithintane nodokotela wazo ngaphambi kokuqala imithi emisha noma izithasiselo zokudla, njengoba ukonakala kwesibindi kuzo kungase kwandise ukuzwela kulezi zinto.

Isiphetho

I-Cholangitis iveza inselele enkulu yezempilo edinga ukunakwa ngokushesha nokunakekelwa okufanele. Ukuqonda izimpawu zaso, izimbangela, kanye nezindlela zokwelapha kubalulekile ekulawuleni lesi simo ngempumelelo. Ukuxilongwa kusenesikhathi kanye nokungenelela kudlala indima ebalulekile ekuvimbeleni izinkinga ezinkulu kanye nokwenza ngcono imiphumela yalabo abathintekile.

FAQ sika

1. Kwenzekani uma une-Cholangitis?

I-Cholangitis ibangela ukuvuvukala emiseleni yenyongo, ethwala i-bile isuke esibindini iye kwezinye izitho zokugaya ukudla. Lokhu kuvuvukala kungaholela ezinkingeni ezinkulu eziningana. Ukuvuvukala kungase kuvimbele ukugeleza kwe-bile, kubangele ukuthi ibuyele ezithweni futhi izale amagciwane. 

2. Uyini umehluko phakathi kweCholangitis vs. cholecystitis?

Nakuba zombili izimo zithinta uhlelo lwe-biliary, zibandakanya izingxenye ezahlukene:

• I-Cholangitis ukuvuvukala kwe-bile ducts
• I-Cholecystitis ukuvuvukala kwe-gallbladder

3. Ingabe i-Cholangitis yisifo sesibindi?

I-Cholangitis ngokuyinhloko isifo se-biliary tract kunokuba isifo sesibindi. Nokho, kungaba nomthelela omkhulu empilweni yesibindi ngokuhamba kwesikhathi. 

CARE Medical Team

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