Mogya a ɛtɔ mmerɛbo no mu (Portal Vein Thrombosis): Momma yɛnka eyi ho asɛm!

Nyarewa bi wɔ hɔ a ɛba nipadua no mu komm a yenhu sɛnkyerɛnne biara. Tebea a ɛte saa no mu biako ne mogya a ɛtɔ wɔ mmerɛbo no pon ano, anaasɛ wɔ aduruyɛ mu no, tebea bi a wɔfrɛ no ``Portal Vein Thrombosis`` . Eyi betumi ayɛ aniberesɛm kakra, enti momma yɛnka ho asɛm nkɔ akyiri kakra, ɛnte saa?

Dɛn ne nea wɔfrɛ no portal vein thrombosis (`(Portal Vein Thrombosis)`) yi?

Sɛ yɛbɛka no tiawa a, wo mmerɛbo no wɔ mogya ntini titiriw bi a ɛde mogya fi akwaa afoforo a ɛwɔ wo yafunu mu (te sɛ wo yafunu ne wo dwensɔtwaa) mu ba wo mmerɛbo mu. Wɔfrɛ eyi sɛ portal vein . Sɛ mogya a ɛtwetwe (thrombus) ba ntini a ɛwɔ ɔpon no ano no mu, wɔ nkorabata a ɛpue kɔ mmerɛbo no mu, anaa ntini afoforo a ɛde mogya kɔ hɔ no biako mu (te sɛ ntini a ɛwɔ soro a ɛma mogya tu ne ntini a ɛwɔ akyi berɛmo no mu) a, ɛyɛ ntini no mu teateaa anaasɛ esiw kwan koraa, na wɔfrɛ no portal vein thrombosis, anaa PVT.

Eyi yɛ tebea a emu yɛ den ankasa. Nanso mpɛn pii no ɛnna sɛnkyerɛnne biara adi mfiase no. Enti, ebia wunnim sɛ wowɔ mogya a ɛtɔ kɔ yi. Ebia wobehu no wɔ akwanhyia mu bere a wɔreyɛ biribi foforo ho nhwehwɛmu, anaasɛ wobetumi ahu bere a ɔhaw bi te sɛ portal hypertension (nhyɛso a ɛkɔ soro wɔ mmerɛbo no ntini mu) akyi nkutoo. Saa nsɛnnennen yi betumi de nkwa ato asiane mu sɛ wɔansa no yiye a. Titiriw sɛ wowɔ sɛnkyerɛnne ahorow te sɛ mogya a wobɛfe anaa mogya a ɛbɛfa wo nsu mu a, ɛyɛ aniberesɛm na ɛsɛ sɛ wohwehwɛ aduruyɛfo afotu ntɛm ara.

Nnipa a wɔwɔ mmerɛbo mu ntini a ɛyɛ mmerɛw, titiriw mmerɛbo mu yare no wɔ asiane kɛse mu sɛ wobenya portal vein thrombosis. Nnipa a wɔwɔ ayaresa mu tebea afoforo te sɛ mogya a ɛtwetwe no nso wɔ asiane kɛse mu. Enti, sɛ wowɔ asiane ahorow yi mu bi a, ɛho hia sɛ wo ne oduruyɛfo kasa, yɛ nhwehwɛmu, na wohu yare no na wɔsa wo yare ntɛm ara.

So portal vein thrombosis (PVT) ahorow bi wɔ hɔ?

Yiw, nnuruyɛfo kyekyɛ saa ``Portal Vein Thrombosis'' yi mu abien titiriw, a egyina onipa a onya bi no so:

• Cirrhotic Portal Vein Thrombosis (PVT) ne mogya mu nkwammoaa a ɛma mogya tu a ɛtaa ba bere a obi anya akisikuru . Eyi yɛ tebea a mogya a ɛtɔ gu ntini a ɛwɔ ɔpon ano no mu wɔ nnipa a wɔwɔ cirrhosis mu.
• Non-cirrhotic Portal Vein Thrombosis (PVT): Eyi yɛ mogya a ɛtɔ gu obi a onni cirrhosis mu.

Saa nkyekyɛmu yi ntease ho hia ma ayaresa ho nhyehyɛe. Sɛ nhwɛso no, nnuruyɛfo gyina sɛ ebia wowɔ akisikuru so na wosi ayaresa ho gyinae. Sɛ wowɔ cirrhosis a, ɛma asiane a ɛwɔ hɔ sɛ wubenya nsɛnnennen no yɛ kɛse, na ebetumi aka wo nkɔmhyɛ. Nanso, nnuruyɛfo resua pii afa portal vein thrombosis ahorow abien no nyinaa ho ne sɛnea wɔbɛtew nsɛnnennen so bere nyinaa. Enti ɛho hia sɛ wo ne wo duruyɛfo kasa fa ayaresa a wubetumi apaw ne nea wubetumi ahwɛ kwan ho.

Saa tebea yi abu so dɛn?

Portal Vein Thrombosis ntaa mma wɔ nnipa a wonni mmerɛbo mu yare mu. Nanso, akuw bi, titiriw wɔn a wɔwɔ akisikuru no, wɔ asiane kɛse mu. Bɛyɛ nnipa baanan biara a wɔwɔ cirrhosis no mu biako benya PVT. Nea enti a ɛte saa ne sɛ akuru a ɛwɔ mmerɛbo no mu no ma mogya no nkɔ brɛoo. Sɛ mogya no kɔ brɛoo a, ɛda adi sɛ mogya a ɛbɛtɔ.

Dɛn ne nsɛnnennen a ebetumi afi portal vein thrombosis (PVT) mu aba?

Saa nsɛnnennen yi betumi ayɛ soronko a egyina nneɛma te sɛ baabi a mogya no wɔ ne aduruyɛ mu tebea afoforo a ɛhyɛ ase a wowɔ so. Nsɛnnennen a ebetumi aba no bi ne:

• Esophageal varices (ntini a ɛwɔ aduan mu a ɛho ahonhon) .
• Yafunu mu (GI) Mogya a ɛtɔ
• Ɔsɛe a ɛba dwensɔtwaa mu esiane mogya a ɛso tew nti (`(Mesenteric Ischemia)`) .
• Nhyɛso a ɛkɔ soro wɔ mmerɛbo no ntini mu (`(Portal Hypertension)`) .
• Splenomegaly (akisikuru a ɛyɛ kɛse) .

Dɛn ne sɛnkyerɛnne ahorow a ɛkyerɛ sɛ obi anya portal vein thrombosis (PVT)?

Nnipa pii nni yare no ho sɛnkyerɛnne biara. Mpɛn pii no, nnuruyɛfo nam mfoninitwa nhwehwɛmu a wɔyɛ esiane biribi foforo nti so hu tebea no.

Nanso, sɛ nsɛnnennen ba a, yare no ho sɛnkyerɛnne betumi ada adi. Nsɛnkyerɛnne a ɛtete saa no bi ne:

• Mogya a wɔfe.
• Mogya a ɛwɔ nsu mu (a ɛyɛ tuntum anaa kɔkɔɔ).
• Yafunu a ɛho ayɛ kurukuruwa, yafunu a ɛyɛ mmerɛw.
• Nan ne nansoaa a ɛho ahonhon (`(Edema)`).
• Yafunu mu yaw, a ɛyɛ mmerɛw.

Dɛn na ɛma mogya tu wɔ saa portal vein yi mu?

Nnuruyɛfo frɛ eyi tebea a ‘ɛyɛ nneɛma pii’ . Eyi kyerɛ sɛ mpɛn pii no, nneɛma abien anaa nea ɛboro saa a wɔaka abom na ɛde ba.

Nneɛma atitiriw abiɛsa na ɛma mogya a ɛkɔ wo ``Portal Vein'' mu no yɛ kɛse:

• Sɛ wowɔ tebea a ɛma mogya tu boro so (`(Hypercoagulable State)`). Eyi kyerɛ sɛ wo mogya tu ntɛmntɛm sen obi a ɔte ase.
• Mogya fa mmerɛbo no mu brɛoo.
• Ɔsɛe a ɛba ɔfasu a ɛwɔ mu (endothelium) a ɛwɔ portal vein no mu.

Dɛn ne asiane ahorow a ɛde tebea yi ba?

Ayaresa mu tebea horow betumi ama asiane a ɛwɔ hɔ sɛ mogya bɛtɔ na ama mogya afa mmerɛbo no mu ayɛ brɛoo no ayɛ kɛse. Nneɛma a ɛde asiane ba yi bi ne:

• Yafunu mu Akisikuru.
• Antiphospholipid yare (`(Antiphospholipid Yare)`).
• Antithrombin a enni nipadua mu (`(Antithrombin a enni nipadua mu)`).
• Fibrosis a ɛwɔ mmerɛbo mu (`(Cirrhosis)`).
• Factor V Leiden (`(Factor V Leiden)`) - Eyi yɛ awosu mu tebea a ɛka mogya a ɛtwetwe.
• Yafunu mu yare (e.g. pancreatitis).
• Myeloproliferative neoplasms (`(Myeloproliferative Neoplasms)`) - Eyinom yɛ nyarewa a ɛfa nnompe mu ntini ho.
• Asɛm a emu yɛ den a ɛfa portal hypertension ho.
• Nyinsɛn a wɔde di dwuma.
• Protein C a Ɛho Nni Mu (`(Protein C a Ɛnyɛ Den)`).
• Protein S a enni nipadua mu (`(Protein S a enni nipadua mu)`).
• Prothrombin awosu mu nkwaadɔm mu nsakrae (`(Prothrombin Awosu mu Nsakrae)`).

Nea ɛka ho no, yafunu mu oprehyɛn ahorow bi (e.g., splenectomy) nso betumi asɛe mogya ntini no mu ɔfasu no, na ama asiane yi ayɛ kɛse.

Ɔkwan bɛn so na wohu sɛ obi anya portal vein thrombosis (PVT)?

Nnuruyɛfo nam nipadua mu nhwehwɛmu a edi mũ ne nhwehwɛmu ahorow a wɔyɛ so hu saa tebea yi. Wɔbɛbisa wo aduruyɛ ho abakɔsɛm nso ahwɛ sɛ wowɔ asiane bi a ɛbɛma woanya ``Portal Vein Thrombosis'' anaa.

Nhwehwɛmu bɛn na wɔyɛ de hu eyi?

Wo duruyɛfoɔ bɛtumi ahyɛ sɛ wɔnyɛ nhwehwɛmu te sɛ yeinom mfa nhunu ``Portal Vein Thrombosis'' na wɔahwehwɛ nsɛnnennen:

• CT scan (`(Kɔmputa so Tomography (CT) Scan)`).
• Doppler ultrasound sɔhwɛ (`(Doppler Ultrasound)`). Yebetumi de eyi adi dwuma de ahu sɛnea mogya sen fa mogya ntini no mu ne sɛ ebia mogya atɔw bi wɔ hɔ anaa.
• Mmerɛbo dwumadi ho sɔhwɛ (`(Mmerɛbo Dwumadi Sɔhwɛ)`).
• MRI scan (`(Magnetic Resonance Imaging (MRI))`.) Nsɛm a Wɔka Kyerɛ (MRI))`.)

Wɔbɛgyina nea ebefi nhwehwɛmu ahorow yi mu aba so akyerɛ w’ayaresa nhyehyɛe.

Ɔkwan bɛn so na nnuruyɛfo sa portal vein thrombosis (PVT)?

Nnuruyɛfo na wosi ayaresa a wɔde bɛma ɔyarefo biara ho gyinae mmiako mmiako. Ɛne sɛ, wɔyɛ ayaresa no ma ɛne w’ahiade hyia. Nneɛma pii wɔ hɔ a ɛka eyi:

• Baabi a mogya a ɛretu no wɔ.
• Nea ɛde mogya a ɛyɛ mmerɛw ba.
• Ayaresa mu tebea afoforo a ɛhyɛ ase a wowɔ (e.g., cirrhosis).
• Sɛ́ ebia nsɛnnennen bi wɔ hɔ anaa.
• Wo aduruyɛ ho abakɔsɛm nyinaa.

Ebia ayaresa a wobetumi apaw bi ne:

• Nnuru a ɛko tia mogya a ɛtwetwe: Saa nnuru yi boa ma mogya a ɛtwetwe no nnyɛ kɛse na ɛmma mogya a ɛtwetwe foforo no ntumi nkɔ. Nanso, esiane sɛ nnipa a wɔwɔ akisikuru no wɔ asiane kɛse mu sɛ mogya bɛtu wɔn mu nti, nnuruyɛfo de ahwɛyiye kɛse de nnuru yi di dwuma.
• Thrombolytic Ayaresa a Wɔde Ma:Sɛ nnuru a ekum mogya a ɛtwetwe mogya nkutoo nnɔɔso a, wobetumi de saa ayaresa yi ama sɛ nsu a wɔde ahyɛ ntini (IV) mu anaasɛ wɔde fa afiri ketewaa bi mu (catheter) de apete mogya a ɛretu no. Nnuruyɛfo nso betumi de saa kwan yi adi dwuma sɛ wo dwensɔtwaa nnya mogya a ɛdɔɔso a.
• Transjugular Intrahepatic Portosystemic Shunt (TIPS): Eyi nso yɛ adeyɛ a wɔde catheter ketewaa bi di dwuma. Wɔde di dwuma de siw nsɛnnennen a ɛba wɔ portal vein thrombosis mu, titiriw GI mogya a ɛba no so. Nea ɛka ho ne sɛ wobɛbɔ ɔkwan bi afa wo mmerɛbo mu na wode wo portal vein no abɔ ntini kɛse bi a ɛwɔ wo mmerɛbo mu no ho. Saa kwan foforo yi ma mogya a efi wo dwensɔtwaa mu no twa mmerɛbo no ho. Eyi ma nhyɛso a ɛwɔ ntini a ɛwɔ wo mmerɛbo mu no so tew, na ɛtew asiane a ɛwɔ hɔ sɛ mogya bɛtɔ wo no so. Nanso, esiane sɛ wo mmerɛbo no taa yi awuduru fi wo mogya mu nti, mprempren mogya a wɔannyigye no di akɔneaba wɔ wo nipadua mu. Enti, asiane biako a ɛwɔ saa ayaresa yi mu ne sɛ awuduru no betumi akɔ amemene no mu na aka amemene no dwumadi (`(Hepatic Encephalopathy)`).

Ɛho hia yiye sɛ wo ne wo duruyɛfo susuw mfaso ne ɔhaw ahorow a ɛwɔ saa ayaresa ahorow yi so ho na ama woate mfaso ne sintɔ ahorow a ebetumi aba a egyina wo tebea no so no ase.

Dɛn ne nkɔmhyɛ a ɛfa tebea yi ho?

Wo duruyɛfo ne onipa a oye sen biara a obebisa wo tebea no ho nkɔmhyɛ ho asɛm. Ɔbɛgyina wo tebea so akyerɛ wo nea ɛsɛ sɛ wohwɛ kwan. Hokwan a ɛwɔ hɔ sɛ obi benya nkwa ne nkwa nna a ɛbɛba afi portal vein thrombosis mu no betumi ayɛ soronko a egyina:

• Nea ɛde mogya a ɛyɛ mmerɛw ba.
• Sɛ ebia wowɔ `(Cirrhosis)` anaasɛ wonni bi.
• Ayaresa mu tebea afoforo a ɛhyɛ ase a wowɔ.
• Nsɛnnennen a ɛsɔre.
• Tebea a wo mmerɛbo te.

Mpɛn pii no, sɛ wuhu yare no ntɛm na wosa yare a, ebetumi ama hokwan a wowɔ sɛ wo ho bɛtɔ wo no ayɛ kɛse.

So wobetumi asiw portal vein thrombosis (PVT) ano?

Wontumi nsiw mogya a ɛtɔ, a nea ɛwɔ portal vein no mu ka ho no ano bere nyinaa. Nanso, nneɛma bi wɔ hɔ a wubetumi ayɛ de atew asiane a ɛwɔ hɔ no so:

• Kɔ afe afe aduruyɛ mu nhwehwɛmu, na kɔ nhwehwɛmu a edi akyi a wo duruyɛfo hyɛ nyinaa ase. Sɛ nhwɛso no, sɛ wowɔ cirrhosis wɔ ne mfiase a, sɛ wuhu ntɛm a, ebetumi aboa ma woasiw PVT ano.
• Wo ne wo duruyɛfo nyɛ adwuma mfa nni aduruyɛ mu tebea biara a ɛhyɛ wo ase a ebia wowɔ no ho dwuma. Sɛ nhwɛso no, sɛ wowɔ tebea bi te sɛ asikreyare (`(Diabetes Mellitus)`) a, di so yiye.
• Nom wo nnuru nyinaa sɛnea wɔakyerɛw ama wo, wɔ mmere a ɛfata mu.
• Sɛ wunya sɛnkyerɛnne foforo biara, anaasɛ wo sɛnkyerɛnne no sesa a, ka kyerɛ wo duruyɛfo ntɛm ara.

Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn?

Hwɛ hu sɛ wobɛkɔ akɔyɛ w’aduruyɛ mu nhwehwɛmu afe biara. Sɛ wunya sɛnkyerɛnne foforo bi a wontumi nkyerɛkyerɛ mu a, di kan kɔ wo duruyɛfo nkyɛn.

Sɛ wowɔ asiane baako anaa nea ɛboro saa a ɛbɛma woanya `(Portal Vein Thrombosis)` a, ɛyɛ papa sɛ wo ne wo duruyɛfoɔ bɛkasa afa ho. Obebisa wo w’ankasa asiane dodow ne nea wubetumi ayɛ de atew so ho asɛm.

Bere bɛn na ɛsɛ sɛ mekɔ Emergency Treatment Unit (ETU) ?

Ɔhaw a ɛwɔ portal vein thrombosis mu ne mogya a ɛba yafunu mu (GI) a emu yɛ den. Mpɛn pii no, sɛnkyerɛnne ahorow no ba mpofirim na ebetumi ayɛ den. Sɛ wowɔ saa sɛnkyerɛnne yi bi a, kɔ ayaresabea anaa frɛ 911 ntɛm ara:

• Sɛ wote nka sɛ wo ho ayɛ wo hyew anaasɛ woatɔ piti (syncope).
• Sɛ wowɔ nsu tuntum anaa kɔkɔɔ, anaasɛ wofe mogya a.
• Sɛ koma no bɔ ntɛmntɛm a.

Nsɛm bɛn na ɛsɛ sɛ mibisa me duruyɛfo?

Nsɛmmisa bi a ɛbɛboa wo ma woasua wo tebea no ho nsɛm pii ni:

• Dɛn nti na me nsa kaa mogya a ɛtɔe yi?
• Dɛn ne ayaresa nhyehyɛe a eye sen biara ma me?
• So ɛsɛ sɛ menom nnuru biara? Sɛ saa a, bere tenten ahe?
• Dɛn ne mfaso ne ɔhaw ahorow a ɛwɔ ayaresa ahorow no so?
• Dɛn na ɛsɛ sɛ mehwɛ kwan bere a me ho retɔ me no?
• Dɛn ne me nkɔmhyɛ a ɛbɛkyɛ (`(Prognosis)`)?

Sɛ wuhu sɛ wo mogya atɔ wo a, ebetumi ayɛ hu. Wɔ tebea te sɛ ``Portal Vein Thrombosis'' mu no, ebia wobɛdwene sɛ nsɛnnennen bɛn na ɛbɛba ne sɛnea ɛbɛyɛ aniberesɛm. Kyerɛw wo nsɛmmisa no to hɔ na ka kyerɛ wo duruyɛfo. Sua nea ɛsɛ sɛ wuhu fa wo tebea no ne ayaresa a wubetumi apaw ho nyinaa. Wo ne wo duruyɛfo no bom betumi anya ɔkwan a wobɛfa so anya ahoɔden.

Nneɛma a ɛho hia sen biara a ɛsɛ sɛ wokae (Take-Home Message) .

Okay, enti, sɛ yɛbɛbɔ nea yɛaka ho asɛm no mua a, Portal Vein Thrombosis yɛ mogya a ɛtwetwe a esiw ntini titiriw a ɛde mogya kɔ mmerɛbo no mu no kwan.

Ɛwom sɛ mpɛn pii no ɛnkyerɛ yare no ho sɛnkyerɛnne mfiase de, nanso eyi betumi ayɛ tebea a emu yɛ den, titiriw wɔ nnipa a wɔwɔ akisikuru mu.

Sɛ wuhu sɛ mogya anaa mogya refe wɔ wo nsu mu a, hwehwɛ aduruyɛfo afotu ntɛm ara.

Sɛ wowɔ asiane ahorow a, ɛho hia sɛ wo ne wo duruyɛfo kasa fa ho na woyɛ nhwehwɛmu a ɛho hia. Sɛ wohu ntɛm na wɔsa yare a, eye sen biara. Di wo duruyɛfo akwankyerɛ akyi yiye, na sɛ wowɔ bi a, nsuro sɛ wubebisa nsɛm. Kɔ so nya apɔwmuden!

` Portal vein thrombosis, mogya a ɛtɔ wɔ mmerɛbo mu, cirrhosis, hematemesis, mmerɛbo mu yare, mogya ntini a ɛsiw, PVT