Damages of a liver at chronic colitis - Diseases of digestive organs at children
Page 66 of 73 DAMAGES OF THE LIVER AT CHRONIC COLITIS
Disturbance of functions of a liver is often observed at patients with nonspecific ulcer colitis and a granulematozny coloenteritis (an illness Krone). Damages of a liver are various — from fatty dystrophy to a carcinoma of bilious ways, however chronic active hepatitis and a sclerosing cholangitis most often meet. On the other hand, colitis — frequent complication of chronic active hepatitis (lupoid option) at which symptoms of damage of a liver are shown earlier, than intestinal symptoms. Such colitis gives in to corticosteroid therapy and does not recur if it is possible to suppress system autoimmune process. At some patients chronic damage of intestines persistirut many years before symptoms of an illness of a liver appear. Finally cirrhosis forms and its symptoms begin to dominate over displays of colitis.
Sclerosing cholangitis. It is the most accurately outlined damage of a liver which is combined with chronic colitis. 80% of patients have a nonspecific ulcer colitis. The reason of such combination is unknown; opinions on a certain role of a toxaemia in portal system of a channel and a gall bladder were expressed it is captured by the progressing inflammatory process which eventually destroys a biliary tree. In bioptata of a liver it is visible that interlobular bilious ductules are surrounded with inflammatory elements and connecting fabric, as at a hypoplasia of bilious ways at newborns. Over time in cells of a liver copper begins to collect. Inflammatory exudate is the reason or a consequence of a sclerosing cholangitis, remains not clear.
The sclerosing cholangitis strikes mainly males, 20 years are usually more senior, but it can be observed at children and teenagers. In the beginning there are signs of an inflammation of bilious ways (fever, jaundice, pains in right hypochondrium, anorexia, weight loss, a skin itch); further portal hypertensia develops. Cirrhosis can be found accidentally. The increased level of an alkaline phosphatase, IgM and bilirubin is noted. The diagnosis of a sclerosing cholangitis is made on the basis of results of a retrograde pankreatokholangiografiya (inside - and extrahepatic channels look as beads); in some cases it is difficult to exclude a carcinoma of bilious channels.
The forecast depends on prevalence of sclerous process and effects of portal hypertensia. Usually the illness slowly progresses and the patient dies approximately in 10 flyings after its beginning. There are no effective methods of treatment. Corticosteroid therapy does not yield satisfactory results. Attempts to use D-Penicillaminum in hope that removal from a liver of copper will slow down development of pathological changes in a parenchyma are made.