So w’akyi berɛmo da asiane mu? Ɛnnɛ yɛbɛka (Ruptured Spleen) ho asɛm!

So woasusuw akwaa ketewaa a ɛwɔ wo yafunu benkum so, a ɛwɔ wo mpampam ase pɛɛ no ​​ho pɛn? Eyi ne nea yɛfrɛ no akyi berɛmo. Ɛyɛ bɛyɛ sɛ wo nsateaa. Nanso ɛyɛ adwuma kɛse. Nanso ɛtɔ mmere bi a, saa ahurututu yi betumi apira na apaapae. Sɛ ɛba saa a, ebetumi ayɛ aniberesɛm kakra.

Dɛn ne akyi berɛmo? Sɛ ɛpae a, ɛkyerɛ dɛn?

Sɛ yɛbɛka no tiawa a, wo dwonku yɛ akwaa ketewaa bi a ɛho hia yiye a ɛwɔ wo yafunu atifi benkum so, na ne kɛse bɛyɛ sɛ nsateaa. Ɛyɛ adwuma te sɛ nea wɔde yiyi mu. Ɛkura mogya a ɛwɔ yɛn nipadua mu no bɛyɛ nkyem anan mu biako bere biara, na ɛho tew, na ɛkora mogya mu nkwammoaa kɔkɔɔ ne mogya mu nkwammoaa kɔkɔɔ so. Ɛboa nso ma wɔyɛ mogya mu nkwammoaa fitaa a ɛko tia nyarewa. Akisikuru yɛ akwaa bi a ɛte sɛ kotoku wɔ mu, na ntini a ɛyɛ tratraa akata so. Mogya ntini nso tu fa mu.

Nanso, esiane baabi a akyi berɛmo no wɔ, titiriw sɛ wɔbɔ no denneennen a, ɛda adi sɛ ebepira. Sɛ akyi kataso a mekaa ho asɛm no mu atetew anaasɛ apaapae a, ɛno ne nea yɛfrɛ no ‘splenic rupture’ . Sɛ akyi berɛmo no mu paapae, sɛ yɛde toto akwaa afoforo a ɛwɔ yɛn yafunu mu ho a, hokwan kɛse wɔ hɔ sɛ mogya bɛtu akɔ nipadua no mu, na ebetumi de nkwa ato asiane mu. Enti, akyi berɛmo mu a ɛpaapae yɛ ade a egye ntɛmpɛ a ehia sɛ wɔkɔ ayaresabea ntɛm ara. Ɛtɔ mmere bi a, ebia ɛho behia sɛ wɔyɛ oprehyɛn.

Dɛn na ɛde akyi berɛmo mu paapae?

Okay, afei momma yɛnhwɛ nea enti a ahurututu no mu paapae saa.

Mpɛn pii no, ade titiriw a ɛma eyi ba ne opira a efi akwanhyia mu. Sɛ nhwɛso no, fa w’adwene bu kar akwanhyia bi. Akwanhyia a ɛte saa no mu bɛyɛ 50% kosi 75% betumi ama akyi berɛmo mu apaapae. Saa ara na ɛte wɔ opira a ɛba bere a wɔredi agumadi no ho. Eyi betumi asi titiriw wɔ agumadi a ɛfa nipadua ne nipadua a ɛne wɔn ho wɔn ho di nkitaho te sɛ rugby mu. Ɛtɔ mmere bi a, akyi berɛmo no tumi paapae fi biribi a emu yɛ den te sɛ ɔhwe a emu yɛ den, sekan a wɔde sekan, anaa tuo a wɔapirapira obi.

Nea ɛho hia ne sɛ ɛtɔ mmere bi a, ahurututu no tumi paapae wɔ akwanhyia no akyi pɛɛ. Nanso ɛtɔ mmere bi a, akwanhyia no akyi bere bi no, kuru no hohoro na ahurututu no betumi apaapae. Wɔfrɛ eyi sɛ ‘Delayed Rupture’.

So akyi berɛmo betumi apaapae a ɛrempira hwee?

Afei ebia wubesusuw sɛ gye sɛ akwanhyia bi si a, biribiara rensi akyi berɛmo no. Nanso, ɛwom sɛ ɛntaa nsi de, nanso akyi berɛmo no tumi paapae wɔ ne ho a akwanhyia biara nni ho. Eyi yɛ nwonwa kakra sɛ wobɛte, ɛnte saa?

Eyi ba bere a akyi berɛmo no fi ase hohoro esiane aduruyɛ tebea foforo a ɛda adi wɔ nipadua no mu nti. Bere a ɛrehuru no, saa akyi kataso a madi kan aka ho asɛm no yɛ mmerɛw nkakrankakra, na awiei koraa no ebetumi apaapae.

Tebea horow bi a ebetumi ama akyi berɛmo mu ahonhon a ɛte sɛɛ ne:

• Kokoram ahorow, sɛ nhwɛso no `(Lymphoma)`.
• Nyarewa a wɔde nyarewa ba, .Te sɛ `(Mononucleosis)` anaa `(Asramma)`.
• Nyarewa a ɛma obi ho hyehye no a enni sabea , te sɛ mmerɛbo mu yare, mmerɛbo mu yare bi, anaa dwensɔtwaa mu yare.

Sɛ wo dwonku mu paapae a, wote nka dɛn?

Okay, afei ma yɛnhwɛ sɛnea sɛ wo dwonku mu paapae a, ɛte sɛ nea ɛte.

Sɛnea mekae no, akyi berɛmo no wɔ wo yafunu no benkum atifi, wɔ wo benkum mpampam ne wo akyi berɛmo no ase pɛɛ. Sɛ akyi berɛmo no mu paapae a, ebia wobɛte ɛyaw a ano yɛ den wɔ saa beae no.

Nanso biribi foforo wɔ ha. Akwanhyia koro no ara a ɛma akyi berɛmo mu paapae no nso betumi ama obi apirapira afoforo, ɛnte saa? Sɛ nhwɛso no, wubetumi abubu mparow bi. Afei, ebia worentumi nhu nsonsonoe a ɛda ɛyaw a ɛwɔ akyi berɛmo a apaapae mu ne ɛyaw a efi apirakuru afoforo mu ntam.

Bere a wo akyi berɛmo mu apaapae akyi no, ebia wobɛte ɛyaw a ɛrehyerɛn akɔ wo koko benkum anaa wo mmati so. Wɔfrɛ eyi Kehr sɛnkyerɛnne . Eyi ba efisɛ sɛ mogya tu wɔ akyi berɛmo no mu a, mogya no mia ntini bi a efi wo kɔn mu kɔ fam fa wo moma benkum (benkum phrenic ntini) so. Ebia wobɛte nka sɛ ɛyaw no mu reyɛ den bere a wohome no.

So sɛnkyerɛnne afoforo wɔ hɔ a ɛkyerɛ sɛ akyi berɛmo apaapae?

Ɛyaw akyi no, wubetumi anya sɛnkyerɛnne afoforo esiane mogya a ɛbɛtɔ wo mu ne mogya mmoroso a ɛkɔ fam mpofirim nti. Hwɛ sɛ eyinom te sɛ nea wunim no yiye anaa:

• Adwene a ɛyɛ basaa anaasɛ ne ti a ɛyɛ hare
• Adwene mu basaayɛ anaasɛ adwene a ɛyɛ basaa
• Anisoadehu a ɛyɛ kusuu
• Paleness ne nea ɛyɛ mmerɛw
• Ahomegye a wonni anaa dadwen
• Abofono

Sɛ akyi berɛmo no mu paapae a, dɛn na ɛba? Dɛn na ɛsɛ sɛ wɔyɛ?

Fa no sɛ wowɔ ɛyaw kɛse wɔ wo yafunu benkum atifi, anaasɛ wowɔ saa Kehr sɛnkyerɛnne a mekaa ho asɛm no. Sɛ saa sɛnkyerɛnne ahorow yi ba wɔ akwanhyia no akyi bere tiaa bi mpo a, ɛsɛ sɛ wokɔ Emergency Room (ER) tẽẽ. Sɛ ɛho hia a, frɛ ambulance.

Ɛhɔ no, ɛho behia sɛ woka wo yare no ho sɛnkyerɛnne, akwanhyia biara a woahyia nnansa yi, ɔyare mmoawa biara a woanya, anaa nyarewa biara a enni sabea a wowɔ ho asɛm kyerɛ nnuruyɛfo. Aduruyɛ kuw no bɛhwɛ wo tebea no na wɔayɛ adwuma de ama wo ho agyina, na sɛ ɛho hia a, wɔbɛma wo mogya.

Wobɛyɛ dɛn ahu sɛ wo dwonku apaapae?

Okay, afei momma yɛnhwɛ sɛnea nnuruyɛfo hu eyi.

Nea edi kan no, sɛ wo tebea no gyina (a ɛkyerɛ sɛ nneɛma te sɛ mogya mmoroso ne koma a ɛbɔ bɛn sɛnea ɛte daa) a, nnuruyɛfo kuw no bɛhwehwɛ wo mu anammɔn biara.Nea edi kan no, wɔyɛ nipadua mu nhwehwɛmu. Afei , wɔyɛ mfoninitwa nhwehwɛmu te sɛ scan.

Nanso sɛ wopira wɔ akwanhyia mu na woba baabi a wɔhwɛ wɔn a wɔwɔ ayaresa a egye ntɛmpɛ mu a, nnuruyɛfo kuw no bedi kan ayɛ mpa ho ultrasound titiriw bi. Wɔfrɛ eyi ``FAST ultrasound.'' Eyi hwɛ sɛ mogya bi retu wo yafunu mu anaa.

Sɛ FAST ultrasound no si so dua sɛ mogya retu, na wo sɛnkyerɛnne a ɛho hia no ntumi nnyina a, nnuruyɛfo kuw no nim sɛ w’akyi berɛmo mu apaapae na ɛsɛ sɛ wɔsa wo yare ntɛm ara.

Sɛ mpo wo tebea no gyina hɔ pintinn a, sɛ adwenem naayɛ bi wɔ hɔ sɛ woapira wɔ wo akyi berɛmo mu a, wɔbɛtaa ayɛ ``CT scan`` . Eyi betumi ahwɛ ahurututu no ne baabi a opira no akodu no yiye. Afei wɔkyekyɛ opira no mu fi I kosi V, a egyina sɛnea opira no mu yɛ den so.

Ɔkwan bɛn so na wɔsa akyi berɛmo a apaapae?

Ayaresa a wɔde sa akyi berɛmo a apaapae no gyina sɛnea opira no mu yɛ den so. Ebia mpaapaemu nketenkete bi ankasa begyae mogya a ɛretu. Nanso, ebia afoforo nso behia ayaresa ntɛm ara. Atetew a emu yɛ den yiye (Grade V) no hwehwɛ sɛ wotwa ahurututu no na ama wɔayi akyi berɛmo no afi hɔ. Nanso, ebia akyi berɛmo mu opira a emu yɛ den renhu ntɛm ara. Ɛtɔ mmere bi a, ɔyarefo a ne ho yɛ den betumi ayɛ nea ontumi nnyina wɔ nnɔnhwerew kakraa bi akyi esiane mogya a ɛretu no kɛse nti.

Akwan atitiriw a wɔfa so sa akyi berɛmo a apaapae no bi ni:

• Embolization: Saa adeyɛ yi betumi aboa ma wɔadi mogya a ɛba wɔ Grade III ne IV splenic opira mu, ansa na wɔreyɛ oprehyɛn anaasɛ mmom sen sɛ wɔbɛyɛ oprehyɛn no so. Embolization yɛ adeyɛ a ɛnyɛ oprehyɛn. Oduruyɛfo a ɔde ne ho hyɛ mframa mu a ɔde ne ho hyɛ mu na ɔyɛ. Wɔde radiology imaging akwan di dwuma de afiri ketewaa bi (catheter) hyɛ mogya ntini bi mu na wɔde ahama ketewaa bi a ɛte sɛ sponge hyɛ mu na ama mogya no agyae.
• Splenorrhaphy: Wɔ Grade III anaa IV opira ho no, wobetumi ayɛ eyi de aka embolization ho. Splenorrhaphy yɛ oprehyɛn a wɔyɛ de siesie ahurututu no. Ebia eyi bɛhwehwɛ sɛ wɔde nhama bɛpam kuru no, wɔde anyinam ahoɔden a wɔde hyew nneɛma bedi dwuma, anaasɛ wɔde nnuru a wɔde gu nipadua no so bɛpete so na ama mogya no agyae. Sɛ eyi yɛ yiye a, ebetumi akwati sɛ ɛho nhia sɛ woyi akyi berɛmo no fã bi anaa ne nyinaa fi hɔ.
• Splenectomy: Sɛ wontumi mfa ɔkwan foforo biara so nni mogya a emu yɛ den so, na ɔkwan biara nni hɔ a wɔbɛfa so agye akyi berɛmo no a, ebia ɛho behia sɛ woyi akyi berɛmo no fã bi anaa ne nyinaa.Bɛyɛ 20% a ɛyɛ splenic a ɛpaapae no ba awiei saa kwan yi so. Esiane sɛ eyi yɛ oprehyɛn a wɔyɛ no ntɛm nti, ɛda adi kɛse sɛ wɔnam yafunu a wɔabue mu so na ɛyɛ. Eyi ma ɛyɛ mmerɛw ma oduruyɛfo a ɔyɛ oprehyɛn no sɛ obedi wo tebea a egye ntɛmpɛ no ho dwuma.

Hokwan ahorow bɛn na ɛwɔ hɔ sɛ obi benya nkwa wɔ akyi berɛmo a apaapae mu?

Eyi gyina sɛnea wo pira no nye ne sɛnea wuhu no ntɛmntɛm na wosa no so ankasa. Ntwitwiridii ketewaa bi bɛma mogya atu nkakrankakra, nkakrankakra. Enti wowɔ bere kakra, nanso ɛnyɛ den sɛ wobɛpa. Sɛ mogya retu no kɛse a, sɛnkyerɛnne ahorow no bɛda adi, nanso asiane wom kɛse. Sɛ mogya retu kɛse wɔ nipadua no mu a, sɛ wɔansa no ntɛm ara a, owu betumi aba wɔ nnɔnhwerew kakraa bi mu. Enti eyi nyɛ biribi a ɛsɛ sɛ wobu no adewa.

Bere tenten ahe na egye ansa na obi anya yare afi akyi berɛmo a apaapae mu?

Ɛgyina sɛnea wo pira no kɛse ne ayaresa a wɔde maa wo so no, ebetumi agye adapɛn abiɛsa kosi dumien ansa na ayɛ yiye. Sɛ wɔyɛɛ wo oprehyɛn a, ɛda adi sɛ ɛho behia sɛ wotra ayaresabea hɔ nna kakraa bi wɔ ɛno akyi. Bere a wɔayɛ oprehyɛn a wɔabue ano akyi no, wɔatwa no kɛse bi a ɛbɛma wɔasa. Ebia wɔbɛma wo nnuru a wɔde sa ɛyaw bere a worekɔ fie no. Ɔkwan foforo so no, akisikuru nketenkete no sa ntɛmntɛm.

Ɔkwan bɛn so na ɛsɛ sɛ mehwɛ me ho bere a mete ase a minni akyi berɛmo no?

Yiw, wubetumi atra ase a wo srade nka ho. Nanso ɛka wo nipadua mu tumi a ɛko tia nyarewa no. Esiane sɛ akyi berɛmo yɛ akwaa a ɛho hia a ɛbɔ wo ho ban fi nyarewa ho nti, ebia wo ho bɛtɔ wo kakra sɛ wobɛyare bere a wɔayi wo akyi berɛmo no (splenectomy).

Wo oprehyɛn ho ɔyaresafo bɛkamfo nnuru titiriw pii a wɔde bɔ wo ho ban afi ɔyare mmoawa ho wɔ ayaresabea ne bere a woakɔ fie akyi nyinaa. Ɔbɛtu wo fo nso sɛ sɛ wunya ɔyare mmoawa a, fa nnuru a ekum ɔyare mmoawa ntɛm ara.

Sɛ yɛbɛbɔ no mua a, nea ɛsɛ sɛ yɛkae (Take-Home Message) .

Okay, enti eyi ne nkrasɛm a ɛho hia sen biara a ɛsɛ sɛ yɛde kɔ fie fi ɔkasa yi nyinaa mu.

Sɛ́ ebia akyi berɛmo a apaapae no yɛ ketewaa anaasɛ ɛyɛ kɛse no, ɛyɛ nea egye ntɛmpɛ. Mogya a ɛtɔ wɔ nipadua no mu no betumi de nkwa ato asiane mu sɛ wɔanni ho dwuma yiye a.

Nanso, asɛmpa no ne sɛ , sɛ wohu akyi berɛmo a ɛpaapae dodow no ara, na wɔsa no ntɛm a, wobetumi de nneɛma a ɛnyɛ den a ebetumi agye akyi berɛmo no adi ho dwuma. Nanso eyi gyina sɛnea wuhu wo pira no ntɛmntɛm na wosa no so.

Sɛ wowɔ adwenem naayɛ ketewaa bi mpo sɛ woapira w’akyi a, ade a eye sen biara a ɛsɛ sɛ woyɛ ne sɛ wobɛhwehwɛ aduruyɛfo afotu ntɛm ara na woahwɛ sɛ mogya retu anaa.

` Akisikuru, Akisikuru a ɛpaapae, Akisikuru a ɛpaapae, Mogya a ɛtɔ wɔ nipadua no mu, Yafunu mu yaw, Ayaresa a egye ntɛmpɛ, Kehr sɛnkyerɛnne