I-Retroperitoneal fibrosis

I-Retroperitoneal fibrosis yisifo esingajwayelekile esivimba amashubhu (ureters) athwala umchamo kusuka ezinso aye esinyeni.

I-Retroperitoneal fibrosis yenzeka lapho izicubu ezengeziwe zemicu endaweni ngemuva kwesisu namathumbu. Izicubu zakha isisindo (noma uquqaba) noma izicubu ezinzima ze-fibrotic. Ingavimba amashubhu athutha umchamo kusuka ezinso aye esinyeni.

Imbangela yale nkinga ayaziwa kakhulu. Kuvame kakhulu kubantu abaneminyaka engama-40 kuya kwengama-60. Abesilisa bangamathuba aphindwe kabili okuhlaselwa yilesi sifo njengabesifazane.

Izimpawu zokuqala:

• Ubuhlungu obuthuntu esiswini obukhula ngokuhamba kwesikhathi
• Ubuhlungu nokushintsha kombala emilenzeni (ngenxa yokwehla kokugeleza kwegazi)
• Ukuvuvukala komlenze owodwa

Izimpawu zakamuva:

• Ukwehla kokukhishwa komchamo
• Akukho okukhipha umchamo (anuria)
• Ukucanuzela kwenhliziyo, ukuhlanza, izinguquko esimweni sengqondo ezibangelwa ukwehluleka kwezinso nokwakhiwa kwamakhemikhali anobuthi egazini
• Ubuhlungu obukhulu besisu negazi esitokisini (ngenxa yokufa kwezicubu zamathumbu)

Ukuskena kwe-Abdominal CT kuyindlela engcono yokuthola isisindo se-retroperitoneal.

Ezinye izivivinyo ezingasiza ukuxilonga lesi simo zifaka:

• I-BUN ne-creatinine ukuhlolwa kwegazi
• I-intravenous pyelogram (IVP), hhayi njengoba isetshenziswa kakhulu
• Izinso ultrasound
• I-MRI yesisu
• Ukuskena kwe-CAT kwesisu ne-retroperitoneum

I-biopsy yesisindo nayo ingenziwa ukukhipha umdlavuza.

AmaCorticosteroids azanywa kuqala. Abanye abahlinzeki bezempilo baphinde banikeze umuthi obizwa nge-tamoxifen.

Uma ukwelashwa kwe-corticosteroid kungasebenzi, kufanele kwenziwe i-biopsy ukuqinisekisa ukuxilongwa. Kungabekwa eminye imithi yokuvimbela amasosha omzimba.

Lapho umuthi ungasebenzi, kudingeka ukuhlinzwa kanye nama-stents (ukukhipha amashubhu).

Umbono uzoncika ebucayini benkinga kanye nenani lomonakalo ezinsweni.

Ukulimala kwezinso kungaba okwesikhashana noma unomphela.

Lesi sifo singaholela ku:

• Ukuvaleka okuqhubekayo kwamashubhu asuka ezinso ohlangothini olulodwa noma zombili
• Ukwehluleka kwezinso okungamahlalakhona

Shayela umhlinzeki wakho uma unesisu esingezansi noma izinhlungu eziseceleni kanye nokukhishwa okuncane komchamo.

Zama ukugwema ukusetshenziswa kwesikhathi eside kwemithi equkethe i-methysergide. Lesi sidakamizwa sikhonjisiwe ukuthi sidala i-retroperitoneal fibrosis. I-Methysergide kwesinye isikhathi isetshenziselwa ukwelapha ukukhanda ikhanda.

Idiopathic retroperitoneal fibrosis; Isifo sika-Ormond

• Uhlelo lwesilisa lomchamo

I-Comperat E, i-Bonsib SM, i-Cheng L. i-renal pelvis kanye ne-ureter. Ku: Cheng L, MacLennan GT, Bostwick DG, ama-eds. I-Urologyic Pathology Yokuhlinzwa. Umhla wesi-4. IPhiladelphia, PA: Elsevier; 2020: isahluko 3.

I-Nakada SY, i-Best SL. Ukuphathwa kokuvinjelwa okuphezulu komgudu womchamo. Ku: Wein AJ, Kavoussi LR, Partin AW, Peters, CA, ama-eds. ICampbell-Walsh Urology. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2016: isahluko 49.

U-O'Connor OJ, uMaher MM. Ipheshana le-urinary: ukubuka konke kwe-anatomy, amasu nezinkinga zemisebe. Ku: Adam A, Dixon AK, Gillard JH, Schaefer-Prokop CM, ama-eds. I-Grainger & Allison's Diagnostic Radiology: Incwadi Yokufunda Ngezithombe. Umhlaka 6. IPhiladelphia, PA: Elsevier Churchill Livingstone; 2015: isahluko 35.

I-Shanmugam VK. I-Vasculitis namanye ama-arteriopathies angavamile. Ku: Sidawy AN, Perler BA, ama-eds. Rutherford’s Vascular Surgery and Endovascular Therapy. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2019: isahluko 137.

I-Turnage RH, iMizell J, iBadgwell B. Udonga lwesisu, umbilicus, i-peritoneum, i-mesenteries, i-omentum ne-retroperitoneum. Ku: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. ISabiston Incwadi Yokuhlinzwa. Umhla ka-20. IPhiladelphia, PA: Elsevier Saunders; I-2017: isahluko 43.