Cudurka 'sclarosing cholangitis'

Cudurka 'sclerosing cholangitis' waxaa loola jeedaa barar (barar), nabarro, iyo baabi'inta dheecaanka xiidmaha gudaha iyo dibedda beerka.

Sababta xaaladan lama yaqaan inta badan kiisaska.

Cudurka waxaa laga arki karaa dadka qaba:

• Cudurka mindhicirka ee caabuqa (IBD) sida ulcerative colitis iyo Crohn disease
  
• Ciladaha iswada
• Cudurka loo yaqaan 'pancreatitis' ee joogtada ah (xammeetida bararsan)
• Sarcoidosis (cudur sababa caabuq ku dhaca qaybaha kala duwan ee jirka)

Sababaha hidaha ayaa sidoo kale mas'uul ka noqon kara. Cudurka 'sclerosing cholangitis' wuxuu badanaa ku dhacaa ragga marka loo eego dumarka. Ciladan ayaa dhif ku ah carruurta.

Sclerosing cholangitis sidoo kale waxaa sababi kara:

• Choledocholithiasis (xammeetida ku jirta xiidmaha xiidmaha)
• Cudurrada ku dhaca beerka, xameetida, iyo dheecaanka xiidmaha

Calaamadaha ugu horreeya badanaa waa:

• Daal
• Cuncun
• Jaalaha maqaarka iyo indhaha (cagaarshow)

Si kastaba ha noqotee, dadka qaarkood ma laha wax calaamado ah.

Calaamadaha kale waxaa ka mid noqon kara:

• Beerka oo weynaaday
• Beerka oo weynaaday
• Rabitaanka cuntada oo yaraada iyo miisaan lumis
• Ku celi dhacdooyinka cholangitis

In kasta oo dadka qaarkiis aysan lahayn astaamo, baaritaannada dhiigga waxay muujinayaan inay leeyihiin shaqo beerka oo aan caadi ahayn. Bixiyaha xanaanada caafimaadkaaga ayaa raadin doona:

• Cudurada sababa dhibaatooyin lamid ah
• Cudurada badanaa ku dhaca xaaladan (gaar ahaan IBD)
• Dhagxaanta

Tijaabooyinka muujinaya cholangitis waxaa ka mid ah:

• Sawirka CT-ga ee caloosha
• Ultrasound caloosha
• Endoscopic retrograde cholangiopancreatography (ERCP)
• Cad ka-qaadista beerka
• Magnetic resonance cholangiopancreatography (MRCP)
• Qalliinka 'cholangiogram' ee 'pheutatic cholangiogram' (PTC)

Tijaabooyinka dhiigga waxaa ka mid ah enzymes beerka (beerka shaqada baaritaan).

Daawooyinka la isticmaali karo waxaa ka mid ah:

• Cholestyramine (sida Prevalite) si loo daaweeyo cuncunka
• Ursodeoxycholic acid (ursodiol) si loo hagaajiyo shaqada beerka
• Faytamiinnada milmaan-baruurta (D, E, A, K) si loogu beddelo waxa ka lumay cudurka laftiisa
• Antibiyootikada si loogu daaweeyo infekshannada ku jira xiidmaha xiidmaha

Nidaamyadan qalliinka ah waa la samayn karaa:

• Gelinta tuubbo dhuuban oo dhuuban oo leh buufin dhamaadka si loo furo cidhiidhiga (ballaadhinta buufin ee endoscopic ee adkaynta)
• Meeleynta bullaacad ama tuubbo si loo adkeeyo (adkeynta) marinnada xiidmaha
• Proctocolectomy (ka saarista xiidanka iyo malawadka, ee loogu talagalay dadka qaba labada ulcerative colitis iyo sclerosing cholangitis) ma saameynayso horumarka cudurka sclerosing cholangitis (PSC)
• Beerka beerka

Sida wanaagsan ee dadku wax u qabtaan way kala duwan yihiin. Cudurku wuxuu u muuqdaa inuu ka sii darayo waqtiga. Mararka qaarkood dadku waxay horumariyaan:

• Ascites (dheecaan ka soo baxa inta u dhexeysa dahaarka caloosha iyo xubnaha caloosha) iyo kala duwanaanta (xididdada weynaaday)
• Cudurka 'Biliary cirrhosis' (caabuq ku dhaca xiidmaha xiidmaha)
• Beerka oo xumaada
• Cagaarshow joogto ah

Dadka qaarkiis waxaa ku dhaca infekshannada dheecaanka xiidmaha oo soo noqnoqda.

Dadka xaaladan leh waxay halis sare ugu jiraan inuu ku dhaco kansarka xiidmaha xiidmaha (cholangiocarcinoma). Waa in si joogto ah looga hubiyaa baaritaanka sawirka beerka iyo dhiig baarista. Dadka sidoo kale qaba IBD waxay yeelan karaan halista sii kordheysa ee kansarka mindhicirka weyn ama malawadka waana inay yeeshaan baarista baarista jirka ee xilliyeed.

Dhibaatooyinka waxaa ka mid noqon kara:

• Noocyada hunguriga ee dhiig baxa
• Kansarka ku jira xiidmaha xiidmaha (cholangiocarcinoma)
• Cirrhosis iyo beerka oo shaqeynaya
• Caabuqa nidaamka biliary (cholangitis)
• Cidhiidhiga marinnada xiidmaha
• Fitamiin la’aanta

Cudurka 'sclerosing cholangitis'; PSC

• Nidaamka dheefshiidka
• Jidka Bile

Bowlus C, Assis DN, Goldberg D. Cudurka 'sclerosing cholangitis' aasaasiga ah iyo kan labaad. Gudaha: Sanyal AJ, Boyer TD, Lindor KD, Terrault NA, eds. Zakim iyo Boyer's Hepatology. 7aad ed. Philadelphia, PA: Elsevier; 2018: cutubka 43.

Ross AS, Kowdley KV. Cudurka 'sclarosing cholangitis' ee caadiga ah iyo cholangitis-ka pyogenic-ka ee soo noqnoqda. Gudaha: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger iyo Cudurka Mindhicirka iyo Beerka ee Fordtran: Pathophysiology / Diagnosis / Management. 10aad ed. Philadelphia, PA: Elsevier Saunders; 2016: cutubka 68.

Zyromski NJ, Pitt HA. Maamulka cudurka 'sclerosing cholangitis' aasaasiga ah. Gudaha: Cameron JL, Cameron AM, eds. Daaweynta Qalliinka ee Hadda. 12aad ed. Philadelphia, PA: Elsevier; 2017: 453-458.