According to publicly available data, the number of diseases of the biliary system has now increased. This is explained by the conduct of an unhealthy lifestyle, malnutrition, as well as a hereditary predisposition of a person. Every year there is an increase in diseases accompanied by the development of biliary hypertension. This serious pathology will be discussed in our article.
Features of the disease
Biliary hypertension is the most common manifestation of a malignant neoplasm that occurs in the liver and gall bladder. Very often, this pathology is accompanied by obstructive jaundice. A tumor on the head of the pancreas begins to press on the bile ducts, and the stones or polyps located there contribute to the occurrence of pressure, which prevents bile from flowing normally. Such hypertension is treated, if it is benign, with surgical endoscopic intervention.
Development reasons
Biliary hypertension can develop in the following pathological conditions:
- Benign and malignant tumors that occur in one of the bile ducts, leading to impaired outflow. In addition, the compression of one of the ducts by a neoplasm developed in a nearby organ leads to the appearance of such a pathology.
- Gallstone disease and calculous cholecystitis. Such diseases are characterized by the formation of insoluble stones in various parts of the hepatobiliary system and the occurrence of obstructive jaundice.
- The presence of parasites in the ducts - helminths.
Also, this ailment can develop due to congenital malformations of the biliary tract, which have an altered shape and diameter of the lumen. In this case, the signs of the disease appear already in childhood.
Symptoms
Signs of biliary hypertension at the initial stage of their development do not manifest themselves in any way, which is why many patients start this disease. However, you should be wary of the following symptoms:
- weakness;
- flatulence;
- diarrhea;
- pain in the right hypochondrium.
The main symptom that clearly indicates biliary hypertension syndrome is an increase in spleen volume associated with pressure in the portal system. At a later stage, anemia, thrombocytopenia, leukopenia occurs.
In this case, jaundice appears as a result of mechanical pressure on the gallbladder. In the abdominal cavity, fluid (ascites) may accumulate, a feature of which is its resistance to ongoing therapy. It usually takes a long time to get rid of it. The patient begins to increase the volume of the abdomen, legs swell, on the abdominal wall there is an expansion of the anterior vein.
The most severe manifestation of the disease is hemorrhage in the stomach, rectum or esophagus. All this is accompanied by blood vomiting. And if bleeding occurs in the esophagus, then there will be blood impurities in the stool.
Diagnostics
Instrumental research methods are carried out in the following cases:
- to confirm the presence of biliary hypertension;
- in order to establish the disease that caused the occurrence of such a pathology.
The following methods are considered the most informative.
Ultrasound scan
One of the important points in choosing a treatment plan for biliary hypertension is to determine the level of the block of bile ducts. In this case, the main non-invasive method is ultrasound examination of the abdominal cavity and retroperitoneal space. Thanks to this diagnosis, the expansion of the extra- and intrahepatic bile ducts is detected, which is a symptom of such a pathology.
Biliary hypertension with a distal level of the block is characterized by the expansion of hepatic choledochus, and after some time the intrahepatic ducts expand, and an increase in the size of the gallbladder occurs . A duct with a diameter of more than 10 mm occurs in the event of a neoplasm. With a high block, the presence of a collapsed gallbladder and the expansion of the intrahepatic ducts are revealed. The tumor is observed in 51.3% of cases.
CT scan
CT of the organs of the abdominal cavity and retroperitoneal space helps to visualize the structural features of many organs. Such a study makes it possible to obtain fairly accurate results in relation to large formations and assesses how much their germination into adjacent structures occurred.
X-ray contrast research methods
If there is a suspicion of such a pathology as biliary hypertension, then specialists most often carry out endoscopic retrocholangiopancreatography or cholangiography. The introduction of radiopaque substances with such methods is carried out in different ways, but has a similar result. Thanks to such a substance, the degree of patency of the duct system can be assessed in an x-ray.
Biopsy
Such a study is considered an invasive method, and they resort to it only in a difficult case, namely when a malignant tumor is suspected. Usually carry out targeted trepanobiopsy of the liver under the supervision of ultrasound. A small amount of tissue is taken from the focus of the pathology, which is subjected to histological examination. The obtained result makes it possible to judge the nature of the neoplasm.
Diagnostic laparoscopy
If the above diagnostic methods could not identify the cause of biliary hypertension, then an operation is performed. It can be performed laparoscopically or laparotomically, while it becomes possible to carry out both diagnostic and therapeutic surgical procedures at a time. With the help of diagnostics, direct visualization and intraoperative biopsy are carried out. Surgical manipulations are carried out depending on the nature of the detected pathology.
Treatment
If biliary hypertension has been diagnosed, treatment is carried out conservatively or surgically.
Conservative treatment is usually carried out with functional disorders, the elimination of which is carried out by such drugs as Atenolol, Nitroglycerin, Monopril, Anaprilin, Nitrosorbid, Sulodexide, Ednit.
Surgical treatment is carried out only if the listed drugs did not bring any result. The operation is performed when ascites, bleeding of the intestines, stomach and esophagus are detected, as well as with the development of hypersplenic syndrome. Modern methods of surgical intervention involve the use of laparoscopy, which is a low-invasive gentle operation with the introduction of small tubes with a camera, micromanipulators and lighting through small incisions. An image appears on the monitor, focusing on which the doctor removes the obstacle.
In no case should you self-medicate and take medications, as well as chemicals to remove the tumor, reduce the volume of the abdomen and remove stones without a doctor's prescription. In addition, if biliary hypertension of the liver and gall bladder is detected, the following therapeutic actions are performed:
- put droppers to maintain an optimal level of fluid and electrolytes;
- use medicines that improve blood circulation and nutrition of liver cells;
- carry out antibacterial therapy;
- decompression of the biliary tract.
Output
Thus, biliary hypertension is considered a very serious pathology. Basically, the diseases leading to this ailment are treated surgically. But do not be afraid of this, since timely access to a doctor allows you to eliminate the root cause of such hypertension and the pathology itself.