Ʋu ƒe sisi le aklã ƒe ʋuka me (Portal Vein Thrombosis): Mina míaƒo nu tso esia ŋu!

Dɔléle aɖewo li siwo dona le ametia me le ɖoɖoezizi me evɔ míeɖea dzesi aɖeke fiana o. Nɔnɔme mawo dometɔ ɖekae nye ʋu ƒe sisi le aklã ƒe ʋuka si le agbo nu, alo le atikewɔwɔ me la, nɔnɔme si woyɔna be ``Portal Vein Thrombosis`` . Esia ate ŋu anye nya vevi aɖe vie, eyata mina míaƒo nu tso eŋu tsitotsito vie, alo?

Nukae nye nusi woyɔna be portal vein thrombosis (`(Portal Vein Thrombosis)`) sia?

Kpuie ko la, ʋuka vevi aɖe le wò aklã me si tsɔa ʋu tso ŋutinu bubu siwo le wò ƒodo me (abe wò dɔgbo kple dɔgbowo ene) vaa wò aklã me. Woyɔa esia be ʋuka si woyɔna be portal vein . Ne ʋu ƒe sisi (thrombus) va le ʋuka si le agbo nu, alɔ siwo alɔ ɖe aklãa me, alo le ʋuka bubu siwo naa ʋu yia aklãa me (abe ʋuka si le ŋgɔgbe kple ʋuka si me ʋu sina tona ene) me la, etsia ʋukaa me alo xea mɔ nɛ keŋkeŋ, si woyɔna be ʋuka si me ʋu sina tona, alo PVT.

Le nyateƒe me la, esia nye nɔnɔme sesẽ aɖe. Gake zi geɖe la, meɖea dzesi aɖeke fiana le gɔmedzedzea me o. Eyata, ɖewohĩ mànya be ʋu ƒe sisi sia ƒomevi le ye ŋu o. Woate ŋu akpɔe le vo me ne wole nu bubu aɖe dodokpɔ wɔm, alo ne kuxi aɖe abe ʋusɔgbɔdɔ si le agbo nu (aklã ƒe ʋukawo ƒe nyaƒoɖeamenu ƒe dzidziɖedzi) ene megbe hafi woate ŋu ake ɖe eŋu. Kuxi siawo ate ŋu ade ame ƒe agbe afɔku me ne womeda wo nyuie o. Vevietɔ ne dzesiwo abe ʋu si le dodom alo ʋu si le dodom le wò aɖuɖɔ me ene le ŋuwò la, esesẽ ŋutɔ eye ele be nàdi atikewɔlawo ƒe aɖaŋuɖoɖo enumake.

Amesiwo ŋu aklã me fibrosis le, vevietɔ cirrhosis, le afɔku gã aɖe me be woaxɔ portal vein thrombosis. Ame siwo ŋu atikewɔwɔ me dɔléle bubuwo le abe ʋu ƒe sisi ƒe kuxiwo ene hã le afɔku gã aɖe me. Eyata ne afɔku siawo dometɔ aɖe le ŋuwò la, ele vevie be nàƒo nu kple ɖɔkta, adoe kpɔ, eye woakpɔ dɔlélea ahada dɔ na wò kaba ale si nàte ŋui.

Ðe ʋuka me ʋu ƒe sisi (PVT) ƒomevi aɖewo lia?

Ẽ, ɖɔktawo ma ``Portal Vein Thrombosis'' sia ɖe ƒomevi vevi eve me, le amesi xɔe nu:

• Cirrhotic Portal Vein Thrombosis (PVT) ye nye ʋumenugbagbeviɣidɔ ƒomevi si bɔ wu si dzɔna le ʋumenugbagbeviɣidɔ me . Esia nye nɔnɔme si me ʋu ƒe sisi le ʋuka si me ʋu sina tona me le amesiwo ŋu ʋumenugbagbeviɣidɔ le me.
• Non-cirrhotic Portal Vein Thrombosis (PVT): Esia nye ʋu ƒe sisi si dzɔna le amesi si ʋumenugbagbeviɣidɔ mele o me.

Ƒomedodo sia gɔmesese le vevie na ɖoɖowɔwɔ ɖe atikewɔwɔ ŋu. Le kpɔɖeŋu me, ɖɔktawo nɔa te ɖe nenye be ʋumenugbagbeviɣidɔ le ŋuwò dzi wɔa atikewɔwɔ ŋuti nyametsotsowo. Ne ʋumenugbagbeviɣidɔ le ŋuwò la, edzia kuxiwo xɔxɔ ƒe afɔkua ɖe edzi, si ate ŋu akpɔ ŋusẽ ɖe wò ŋgɔdonya dzi. Gake ɖɔktawo le nu geɖe srɔ̃m tso ʋuka me ʋu ƒe sisi ƒomevi evea siaa kple alesi woaɖe kuxiwo dzi akpɔtɔ ŋu ɣesiaɣi. Eyata ele vevie be nàƒo nu kple wò ɖɔkta tso atikewɔmɔnu siwo nàte ŋu awɔ kple nusiwo nàte ŋu akpɔ mɔ na ŋu.

Aleke gbegbee nɔnɔme sia bɔe?

Portal Vein Thrombosis mebɔ ɖe amesiwo ŋu aklãdɔléle mele o me o. Gake ƒuƒoƒo aɖewo, vevietɔ amesiwo ŋu ʋumenugbagbeviɣidɔ le, le afɔku me wu. Anɔ abe ame ɖeka le ene ɖesiaɖe si ŋu ʋumenugbagbeviɣidɔ le la axɔ PVT. Esia le alea elabena abi siwo le aklãa me nana ʋu ƒe sisi dzi ɖena kpɔtɔna. Ne ʋu le sisim blewu la, ʋu ƒe sisi ate ŋu adzɔ.

Nukawoe nye kuxi siwo ate ŋu ado tso ʋuka me ʋu ƒe sisi (PVT) me?

Kuxi siawo ate ŋu ato vovo le nuwo abe afisi ʋu si le dodom le kple atikewɔwɔ me nɔnɔme bubu siwo le ŋuwò ene nu. Kuxi siwo ate ŋu ado mo ɖa dometɔ aɖewoe nye:

• Esophageal varices (ʋuka siwo le nuɖuɖutome ƒe vuvu) .
• Ʋu si dona le dɔgboa me (GI).
• Nusiwo gblẽ le dɔgboa ŋu le ʋu ƒe agbɔsɔsɔ si dzi ɖe kpɔtɔ ta (`(Mesenteric Ischemia)`)
• Nyaƒoɖeamenu si dzi ɖe edzi le aklã ƒe ʋukawo me (`(Portal Hypertension)`) .
• Splenomegaly (aɖuɖɔtoe si lolo) .

Nukae nye portal vein thrombosis (PVT) ƒe dzesiwo?

Dzesi aɖeke menɔa ame geɖe ŋu o. Zi geɖe la, ɖɔktawo toa nɔnɔmetatawo dodokpɔ siwo wowɔna le susu bubu aɖe ta dzi dea dzesi dɔlélea.

Gake ne kuxiwo do mo ɖa la, dzesiwo ate ŋu adze. Dzesi mawo dometɔ aɖewoe nye:

• Ʋu ƒe ʋuʋu.
• Ʋu le aɖuɖɔ me (eɖanye yevu alo dzĩ).
• Dɔgbo ƒe ʋuʋu, ʋuʋudedi.
• Afɔwo kple afɔkpodziwo ƒe vuvu (`(Edema)`).
• Dɔgbo ƒe vevesese, lãmetutudɔ.

Nukae nana ʋu ƒoa xlã ʋuka sia si me ʋu sina tona?

Ðɔktawo yɔa esia be ‘nu geɖe’ ƒe nɔnɔme. Esia fia be zi geɖe la, nu eve alo esi wu nenema ƒe ƒuƒoƒo gbɔe wòtsona.

Nu vevi etɔ̃ li siwo nana ʋu ƒe sisi le wò ``Portal Vein'' me:

• Nɔnɔme si me ʋu sina sɔ gbɔ ɖo ƒe amesinɔnɔ (`(Hypercoagulable State)`). Esia fia be wò ʋu tsina kabakaba wu ame dzɔdzɔe.
• Ʋu sina toa aklãa me blewu.
• Nusiwo gblẽ le ʋuka si le agbo nu ƒe gli ememetɔ (endothelium) ŋu.

Nukawoe nye nusiwo ate ŋu ahe nɔnɔme sia vɛ?

Atikewɔwɔ ƒe nɔnɔme vovovowo ate ŋu ana ʋu ƒe sisi ƒe afɔku nadzi ɖe edzi eye ʋu nayi blewu to aklã me. Afɔku siawo dometɔ aɖewoe nye:

• Ƒodo me Dɔdzẽwo.
• Antiphospholipid ƒe dɔléle (`(Antiphospholipid ƒe dɔléle)`).
• Antithrombin ƒe anyimanɔmanɔ (`(Antithrombin ƒe anyimanɔmanɔ)`).
• Fibrosis le aklã me (`(Cirrhosis)`).
• Factor V Leiden (`(Factor V Leiden)`) - Esia nye domenyiŋusẽfianu ƒe nɔnɔme si gblẽa nu le ʋu ƒe sisi ŋu.
• Dɔgbo me dɔlékuiwo (e.g. dɔgbo ƒe dɔléle).
• Myeloproliferative neoplasms (`(Myeloproliferative Neoplasms)`) - Esiawo nye dɔléle siwo do ƒome kple ƒumeŋuɖui.
• Ʋusɔgbɔdɔ si le agbo nu ƒe nya sesẽ aɖe.
• Fufɔfɔ.
• Protein C ƒe Gbɔdzɔgbɔdzɔ (`(Protein C ƒe Gbɔdzɔgbɔdzɔ)`).
• Protein S ƒe anyimanɔmanɔ (`(Protein S ƒe anyimanɔmanɔ)`).
• Prothrombin domenyiŋusẽfianu ƒe tɔtrɔ (`(Prothrombin domenyiŋusẽfianu ƒe tɔtrɔ)`).

Tsɔ kpe ɖe eŋu la, ƒodo ƒe dɔwɔwɔ aɖewo (e.g., splenectomy) hã ate ŋu agblẽ nu le ʋukaa ƒe gli ememetɔ ŋu, si ana afɔku sia nadzi ɖe edzi.

Aleke wokpɔa ʋuka siwo me ʋu sina tona le ʋukawo me (PVT) dzea sii?

Ðɔktawo toa ŋutilãmedodokpɔ blibo kple dodokpɔ vovovowo dzi dea dzesi nɔnɔme sia. Woabia wò atikewɔwɔ ŋutinya hã be woakpɔe ɖa be afɔku aɖewo le ŋuwò be nàxɔ ``Portal Vein Thrombosis'' hã.

Dodokpɔ kawoe wowɔna tsɔ dea dzesi esia?

Wò ɖɔkta ateŋu aɖe gbe be woawɔ dodokpɔwo abe esiawo ene be woakpɔ ``Portal Vein Thrombosis'' eye woadi kuxi siwo le eme:

• CT scan (`(Kɔmpiuta ƒe Tomography (CT) Scan)`).
• Doppler ultrasound dodokpɔ (`(Doppler Ultrasound)`). Woate ŋu azã esia atsɔ akpɔ alesi ʋu sina le ʋukawo me kple nenye be ʋuka aɖewo le ƒoƒom.
• Aklã ƒe dɔwɔwɔ dodokpɔwo (`(Aklã ƒe dɔwɔwɔ dodokpɔwo)`).
• MRI ƒe fotoɖeɖe (`(Magnetic Resonance Imaging (MRI))`.)

Woanɔ te ɖe dodokpɔ siawo me tsonu dzi atso nya me le wò atikewɔwɔ ƒe ɖoɖoa ŋu.

Aleke ɖɔktawo daa ʋuka siwo me ʋu sina tona le ʋukawo me (PVT) lae?

Ðɔktawo tsoa nya me le atikewɔwɔ na dɔnɔ ɖesiaɖe ŋu ɖekaɖeka. Eyae nye be wotrɔa asi le atikewɔwɔa ŋu wòsɔna ɖe wò hiahiãwo nu. Nu geɖe li siwo kpɔa ŋusẽ ɖe esia dzi:

• Afisi ʋu ƒe sisi le.
• Nusi gbɔ ʋu ƒe sisi tsona.
• Atikewɔwɔ me nɔnɔme bubu siwo le ŋuwò (e.g., cirrhosis).
• Ne kuxiwo li hã.
• Wò atikewɔwɔ ŋutinya bliboa.

Atikewɔwɔ ƒe tiatia ate ŋu anye:

• Atike siwo tsia ʋumenugbagbeviɣidɔ nu: Atike siawo kpena ɖe ame ŋu be ʋu ƒe sisi nu megadzina ɖe edzi o eye womexea mɔ na ʋu ƒe sisi yeyewo o. Gake esi wònye be ʋu si dona le ememe ate ŋu ado le amesiwo ŋu ʋumenugbagbeviɣidɔ le ta la, ɖɔktawo zãa atike siawo kple ŋuɖɔɖɔɖo gã aɖe.
• Ʋumenugbagbeviɣidɔ ƒe Atikewɔwɔ:Ne ʋumenugbagbeviɣitikewo ɖeɖe mesɔ gbɔ o la, woate ŋu ana atike sia abe tsi si wotsɔ de ʋuka me (IV) alo to mɔ̃ sue aɖe me (catheter) be wòatsɔ alɔ ʋu si le dodom la me. Ðɔktawo ate ŋu azã mɔnu sia hã ne wò dɔgbowo mele ʋu si sɔ gbɔ kpɔm o.
• Transjugular Intrahepatic Portosystemic Shunt (TIPS): Esia hã nye dɔdamɔnu si me wozãa ka sue aɖe. Wozãnɛ tsɔ léa ʋuka siwo me ʋu sina tona le ʋuka me ƒe kuxiwo nu, vevietɔ ʋu si dona le ʋuka me. Ebia be nàwɔ mɔ aɖe to wò aklã me eye nàtsɔ wò ʋuka si le agbo nu la aƒo ƒu kple ʋuka gã aɖe si le wò aklã me. Mɔ yeye sia nana ʋu si tso wò dɔgbowo me toa aklãa ŋu. Esia ɖea ʋuka siwo le wò aklã me ƒe nyaƒoɖeamenu dzi kpɔtɔna, si wɔnɛ be ʋudodo ƒe afɔkua dzi ɖena kpɔtɔna. Gake esi wònye be zi geɖe la, wò aklã ɖea aɖinuwo ɖa le wò ʋu me ta la, ʋu si womeɖe o la le tsatsam le wò ŋutilã me fifia. Eyata, afɔku ɖeka si le atikewɔwɔ sia me enye be aɖiawo ateŋu azɔ mɔ ayi ahɔhɔ̃a me eye woakpɔ ŋusẽ ɖe ahɔhɔ̃a ƒe dɔwɔwɔ dzi (`(Hepatic Encephalopathy)`).

Ele vevie ŋutɔ be nàdzro atikewɔwɔ siawo ƒe viɖe kple kuxiwo me kple wò ɖɔkta be nàse woƒe viɖe kple kuxi siwo ate ŋu ado tso eme le wò nɔnɔmea nu gɔme.

Nukae nye nɔnɔme sia ƒe ŋgɔdonya?

Wò ɖɔktae nye ame nyuitɔ kekeake si abia nya tso wò dɔlélea ƒe ŋgɔdonya ŋu. Anɔ te ɖe wò nɔnɔmea dzi agblɔ nusi nàkpɔ mɔ na na wò. Mɔnukpɔkpɔ si li be woatsi agbe kple agbenɔƒe didi tso portal vein thrombosis me ate ŋu ato vovo le:

• Nusi gbɔ ʋu ƒe sisi tsona.
• Eɖanye `(Cirrhosis)` le ŋuwò alo mèxɔe o.
• Atikewɔwɔ me nɔnɔme bubu siwo le ŋuwò.
• Kuxi siwo doa mo ɖa.
• Wò aklã ƒe nɔnɔme.

Le goawo katã me la, ne èkpɔ dɔlélea kaba eye nèdae la, ate ŋu ana mɔnukpɔkpɔ si li be nàhaya nadzi ɖe edzi.

Ðe woate ŋu axe mɔ ɖe ʋuka siwo me ʋu sina tona (PVT) nua?

Womate ŋu axe mɔ ɖe ʋu ƒe sisi, siwo dome ʋuka si le agbo nu hã le, nu ɣesiaɣi o. Gake nu aɖewo li nàte ŋu awɔ atsɔ aɖe wò afɔkua dzi akpɔtɔ:

• Yi ɖado wo kpɔ ƒe sia ƒe le atikewɔƒe, eye nàde dodokpɔ siwo katã wò ɖɔkta de se be woatsɔ akplɔe ɖo. Le kpɔɖeŋu me, ne ʋumenugbagbeviɣidɔ le ŋuwò le eƒe gɔmedzedze la, ekpɔkpɔ kaba ate ŋu akpe ɖe ŋuwò nàxe mɔ ɖe PVT nu.
• Wɔ dɔ kple wò ɖɔkta be nàkpɔ atikewɔwɔ me nɔnɔme ɖesiaɖe si ate ŋu anɔ ŋuwò gbɔ. Le kpɔɖeŋu me, ne dɔléle aɖe abe suklidɔ (`(Diabetes Mellitus)`) le ŋuwò la, na nàɖu edzi nyuie.
• No wò atikewo katã abe alesi wogblɔe ene, le ɣeyiɣi nyuitɔ dzi.
• Ne dzesi yeye aɖewo dze le ŋuwò, alo ne wò dzesiwo trɔ la, gblɔe na wò ɖɔkta enumake.

Ɣekaɣie wòle be makpɔ ɖɔkta?

Kpɔ egbɔ be yeyi ɖado yeƒe ƒe sia ƒe atikewɔlawo kpɔ. Ne dzesi yeye aɖewo siwo womate ŋu aɖe o va dze ŋuwò la, yi ɖɔkta gbɔ gbã.

Ne afɔku ɖeka alo esi wu nenema le asiwò be nàxɔ `(Portal Vein Thrombosis)` la, anyo be nàƒo nu tso eŋu na wò ɖɔkta. Abia nya wò tso wò ŋutɔ wò afɔku ƒe agbɔsɔsɔ kple nusi nàte ŋu awɔ atsɔ aɖe edzi akpɔtɔ ŋu.

Ɣekaɣie wòle be mayi Atikewɔwɔ Kpata ƒe Dɔwɔƒe (ETU) ?

Kuxi aɖe si dona tso ʋuka si me ʋu sina tona le ʋukawo me gbɔe nye ʋu si dona le dɔgboa me (GI). Zi geɖe la, dzesiawo dzena kpata eye woate ŋu asẽ. Ne dzesi siawo dometɔ aɖe le ŋuwò la, yi kɔdzi alo ƒo ka na 911 enumake:

• Ne èse le ɖokuiwò me be yeƒe ta le ƒoƒom alo yeƒe tagbɔ gblẽ (syncope).
• Ne aɖuɖɔ yibɔ alo dzĩ le ŋuwò, alo ne èɖe ʋu.
• Ne dzi ƒe tsotso le kabakaba.

Nya kawoe wòle be mabia nye ɖɔkta?

Nyabiase aɖewo siwo akpe ɖe ŋuwò nànya nu geɖe tso wò nɔnɔmea ŋue nye esi:

• Nukatae ʋu ƒe sisi sia va le ŋunye?
• Nukae nye atikewɔwɔ ƒe ɖoɖo nyuitɔ kekeake nam?
• Ðe wòhiã be mano atike aɖea? Ne nenemae la, ke ɣeyiɣi didi kae?
• Viɖe kple kuxi kawoe le atikewɔwɔawo ŋu?
• Nukae wòle be makpɔ mɔ na ne mele hayahayam?
• Nukae nye nye ɣeyiɣi didi ƒe nyagblɔɖi (`(Nyagblɔɖi)`)?

Ne èva nya be ʋu le dodom le ye ŋu la, ate ŋu ado vɔvɔ̃ na ame. Le nɔnɔme abe ``Portal Vein Thrombosis'' ene me la, àte ŋu abia ɖokuiwò be kuxi kawoe ado mo ɖa kple alesi gbegbe woasesẽe hã. Ŋlɔ wò biabiawo ɖi eye nàgblɔ wo na wò ɖɔkta. Srɔ̃ nu siwo katã wòle be nànya tso wò nɔnɔmea kple atikewɔmɔnu siwo nàte ŋu azã ŋu. Mia kple wò ɖɔkta miate ŋu akpɔ mɔ si dzi miato ahaya.

Nu vevitɔ kekeake siwo dzi wòle be woaɖo ŋkui (Take-Home Message) .

Enyo, eyata, ne míaƒo nu tso nusi ŋu míeƒo nu tsoe ŋu kpuie la, Portal Vein Thrombosis, nye ʋu ƒe sisi si xea mɔ na ʋuka vevi si tsɔa ʋu yia aklã me.

Togbɔ be zi geɖe la, meɖea dzesi aɖeke fiana le gɔmedzedzea me o hã la, esia ate ŋu anye nɔnɔme sesẽ aɖe, vevietɔ le amesiwo ŋu ʋumenugbagbeviɣidɔ le gome.

Ne ʋu alo ʋu le dodom le wò aɖuɖɔ me la, di atikewɔlawo ƒe aɖaŋuɖoɖo enumake.

Ne afɔku aɖewo le ŋuwò la, ele vevie be nàƒo nu tso wo ŋu na wò ɖɔkta eye nàwɔ dodokpɔ siwo hiã. De dzesii kaba kple edadae nye nyuitɔ kekeake. Wɔ ɖe wò ɖɔkta ƒe mɔfiamewo dzi nyuie, eye mègavɔ̃ be yeabia nya ne ɖe le asiwò o. Nɔ lãmesẽ me!

` Portal vein thrombosis, ʋu ƒe sisi le aklã me, cirrhosis, hematemesis, aklãdɔ, ʋukawo ƒe xexe, PVT