Cirrhosis biliary muamua

O totoga o le ponaivi o paipa ia e feʻaveaʻi le ate mai le ate i le tamaʻi manava. Bile o se vailaʻau e fesoasoani i le faʻasoesa. O totoga uma o le ponaivi e taua o le biliary tract.

A faʻafefeteina pe faʻafefeteina ala o le puta, e poloka ai le tafe o le puta. O nei suiga e mafai ona taitai atu ai i maʻila o le ate e taʻu o le cirrhosis. E taʻua lea ole biliary cirrhosis. Advanced cirrhosis mafai ona taitai atu ai i le ate toilalo.

Le mafuaʻaga o afaina o le ate i le ate e le o iloa. Ae ui i lea, muamua biliary cirrhosis o se autoimmune faʻaletonu. O lona uiga o lou tino o le faʻataʻitaʻiga puipuia o le tino osofaʻia sese vaega maloloina. O le faʻamaʻi ono fesoʻotaʻi ma faʻafitauli o le autoimmune pei o:

• Faamaʻi Celiac
• Raynaud mea ofoofogia
• Sicca syndrome (mata matala po o le gutu)
• Faʻamaʻi thyroid

O le faʻamaʻi e masani ona aʻafia ai fafine feololo tausaga.

Sili atu ma le tasi afa o tagata e leai ni faʻailoga i le taimi o faʻamaoniga. Faʻailoga e masani ona amata lemu. O auga vave e ono aofia ai:

• Ua tiga le manava ma manava
• Ua lelava ma leai se malosi
• Puta gaʻo i lalo o le paʻu
• Ova susu
• Mageso
• Le lelei le manaʻo ma le paʻu mamafa

A o faʻatupulaia le gaioiga o le ate, auga e mafai ona aofia ai:

• Faʻaputuga sua i vae (edema) ma i le manava (ascites)
• Lanu samasama i le paʻu, mucous membrane, poʻo mata (jaundice)
• Mumu i luga o alofilima
• I aliʻi, le lava le malosi, faʻamamaina ole toto, ma le fula ole susu
• Faigofie gagau ma le masani ai le palapala toto, masani ona mai fulafula uaua i le digestive tract
• Le mautonu poʻo ni faʻafitauli e mafaufau ai
• Putu poʻo ni kelei-lanu o faʻataʻavalevale

O le fomaʻi soifua maloloina o le a faia se faʻataʻitaʻiga tino.

O suʻesuʻega nei e mafai ona siakiina pe o galue lelei lou ate:

• Suʻega toto ole albumin
• Suʻe galuega tauave tofotofoga (serum alkaline phosphatase e sili ona taua)
• Prothrombin taimi (PT)
• Cholesterol ma lipoprotein toto suʻega

O isi suʻega e mafai ona fesoasoani e fua pe o le a le faigata e aofia ai maʻi ole ate:

• Maualuga immunoglobulin M tulaga i le toto
• Biopsy o le ate
• Aneti-mitochondrial antibodies (o iʻuga e lelei ile 95% o mataupu)
• Faʻapitoa ituaiga o ultrasound poʻo MRI e fuaina le aofaʻi o maʻila sela (e ono valaʻauina elastography)
• Maneta resonance cholangiopancreatography (MRCP)

O le faʻamoemoe o togafitiga o le faʻamamaina o faʻailoga ma puipuia faʻalavelave.

Cholestyramine (poʻo colestipol) ono faʻaititia le mageso. Ursodeoxycholic acid mafai faʻaleleia le aveʻesea o gaʻo mai le toto. Lenei ono faʻaleleia le ola i nisi tagata. O loʻo avanoa foi se vailaʻau fou ua taʻua ole obeticholic acid (Ocaliva).

Vitamini sui togafitiga faʻafouina vitamini A, K, E ma D, lea ua leiloa i fatty nofoa. E mafai ona faʻaopopo se faʻaopoopoga ole kalasi poʻo ni vailaʻau i ponaivi e puipuia pe togafitia ai ponaivi vaivai pe vaivai.

O se taimi umi le vaʻavaʻaia ma togafitiga o le ate toilalo e manaʻomia.

E mafai ona alualu i luma le fesuiaiga o le ate pe a fai ae leʻi tupu le ate.

E mafai ona eseese le iʻuga. Afai e le togafitia le tulaga, o le tele o tagata o le a feoti e aunoa ma le tuiina o le ate. E tusa ma le tasi kuata o tagata na maua i lenei faʻamaʻi mo le 10 tausaga o le a afaina le ate. Fomaʻi ua mafai nei ona faʻaaogaina se fuainumera faʻataʻitaʻiga e valoia le sili taimi e faia ai le taotoga. O isi faʻamaʻi, pei o le hypothyroidism ma le anemia, mafai foi ona tupu.

O le alualu i luma cirrhosis mafai ona taitai atu i le ate toilalo. Faʻafitauli mafai ona aofia ai:

• Toto
• Faʻaleagaina i le faiʻai (encephalopathy)
• Lē paleni o le suavai ma le eletise
• Le manuia fatugaʻo
• Malabsorption
• Paleni meaai
• Ponaivi vaivai pe vaivai (osteomalacia or osteoporosis)
• Ascites (suavai faʻaputuga i totonu o le manava pu)
• Faateleina le ono maua ile kanesa ole ate

Valaʻau lau tautua peʻa iai sau:

• Fula fulafula
• Toto i totonu o faʻataʻavalega
• Le mautonu
• Jaundice
• Paʻu o le paʻu e le alu ese ma e le fesoʻotaʻi ma isi mafuaʻaga
• Toto toto

Cholangitis biliary Peraimeri; PBC

• Cirrhosis - faʻateʻaina

• Polokalama Digestive
• Ala Bile

Eaton JE, Lindor KD. Cholangitis biliary Peraimeri. I totonu: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger ma Fordtran's Gastrointestinal ma le Maʻi o le ate. 11th lomiga. Filatelefia, PA: Elsevier; 2021: mata 91.

Fogel EL, Sherman S. Faʻamaʻi o le gallbladder ma bile ducts. I totonu: Goldman L, Schafer AI, eds. Faʻafomaʻi Goldman-Cecil. 26th lomiga. Filatelefia, PA: Elsevier; 2020: mata 146

Lamepa LW. Ate: faʻamaʻi e le neoplastic. I: Goldblum JR, Lamepa LW, McKenney JK, Myers JL, eds. Rosai ma Ackerman's Surgical Pathology. 11th lomiga. Filatelefia, PA: Elsevier; 2018: mata 19.

Smith A, Baumgartner K, Bositis C. Cirrhosis: faʻamaoniga ma pulega. Am Fomai Fomaʻi. 2019; 100 (12): 759-770. PMID: 31845776 pubmed.ncbi.nlm.nih.gov/31845776/.