Ke ʻike nei ʻoe i nā aa koko e pehu ana ma kou ʻōpū? E kamaʻilio kākou e pili ana iā 'Caput Medusae'

Ua nānā anei ʻoe i loko o ke aniani a ʻike ʻoe ua ʻike maopopo ʻia kou mau aa koko ma kou ʻōpū, ʻoiai a puni kou pihi ʻōpū? I kekahi manawa he mea hopohopo iki kēia ke ʻike. He aha kēia? He mea anei kēia e makaʻu ai? I kēia lā, ke kamaʻilio nei mākou e pili ana i kēia kūlana, i ʻike ʻia ma ka ʻepekema lapaʻau ʻo 'Caput Medusae'. ʻAʻole kēia he maʻi, akā he ʻōlelo aʻo koʻikoʻi loa e hāʻawi mai iā mākou e pili ana i kahi pilikia koʻikoʻi i loko o ke kino.

He aha kēia 'Caput Medusae'?

I ka ʻōlelo maʻalahi, ʻo Caput Medusae ka wā e pehu ai nā kīʻaha koko ma lalo o ka ʻili o kou ʻōpū, hoʻonui ʻia, a puʻupuʻu. I ka manawa pinepine, ʻike ʻia kēia mau aa koko e puʻupuʻu ana i nā ʻaoʻao a pau, e like me ka kukuna o ka lā e pālahalaha ana mai waenakonu o kou ʻōpū.

Mai ka moʻolelo Helene mai kēia inoa ʻē. Hōʻike ia i kahi wahine i kapa ʻia ʻo 'Medusa', nona ke poʻo he mau nahesa ma kahi o ka lauoho. ʻO ke ʻano o ka hohola ʻana o nā aʻa koko a puni kona ʻāʻī e like me nā nahesa e puka mai ana mai ke poʻo o Medusa, ʻo ia ke kumu i kapa ai nā kauka iā ia ʻo 'Caput Medusae', ʻo ia hoʻi 'ke poʻo o Medusa'. Kapa pū kekahi iā ia ʻo 'hōʻailona lāʻau pama'.

No ke aha mai kēia? E hoʻomaopopo kākou i kēia me kahi laʻana.

E noʻonoʻo ʻoe ua ālai ʻia kekahi alanui nui e hele ana i Colombo e ke kaʻa nui. He aha ka hana a nā kaʻa? Hoʻāʻo lākou e hōʻea i ko lākou wahi i ka wikiwiki ma o ka lawe ʻana i nā alanui ʻaoʻao, nā alanui ʻiliʻili liʻiliʻi. Akā, ʻaʻole i kūkulu ʻia kēia mau alanui ʻaoʻao e kū i ke kaʻa nui. No laila, ua pani koke ʻia kēlā mau alanui a piha.

Ua like ke ʻano o ka ʻōnaehana koko i loko o ko kākou kino. Ke ālai ʻia kekahi kīʻaha koko nui i loko o ka ʻōpū (portal vein a i ʻole inferior vena cava) no kekahi kumu, ʻaʻole hiki i ke koko ke kahe ma loko. Ua kapa ʻia kēia he ālai .

A laila hoʻāʻo ke kino e hoʻouna i kēia koko i ālai ʻia ma o nā aʻa liʻiliʻi ʻē aʻe e like me nā 'alanui ʻaoʻao'. ʻO kēia mau aʻa liʻiliʻi nā mea ma lalo o ka ʻili o ko kākou ʻōpū. Ke hele koke mai kahi nui o ke koko ma o kēia mau aʻa liʻiliʻi a lahilahi, ʻaʻole hiki iā lākou ke lawelawe a pehu lākou, puʻupuʻu, a ʻike ʻia e ko kākou mau maka. ʻO ia ka mea a mākou e kapa nei ʻo Caput Medusae. I ka lāʻau lapaʻau, ua kapa ʻia kēia ala keu he collateral circulation .

He aha nā kumu nui o Caput Medusae?

ʻElua kumu nui no kēia kūlana. He koʻikoʻi nā mea ʻelua, no laila he mea nui e makaʻala i kēia.

He aha nā hōʻailona ʻē aʻe e hele pū me kēia?

ʻO Caput Medusae kekahi hōʻailona wale nō o kahi maʻi nui aʻe. No laila, hiki iā ʻoe ke ʻike i nā hōʻailona ʻē aʻe i ka manawa like.

Nā hōʻailona i ʻike pinepine ʻia

• Ka pehu ʻana o nā wāwae a me nā wāwae (Edema)
• ʻO ka pehu nui o ka ʻōpū, ka wai e hoʻopiha ana i ka ʻōpū (ascites)
• ʻeha ka ʻōpū
• ʻO ke akepaʻa i hoʻonui ʻia, hiki ke paʻi ʻia ma lalo o nā iwi ʻaoʻao ma ka ʻaoʻao ʻākau

Nā hōʻailona kikoʻī e ʻokoʻa ana ma muli o ke kumu

E kōkua kēia mau hōʻailona i kāu kauka e loaʻa kahi manaʻo o ke kumu.

• Inā ma muli o ka cirrhosis o ke akepaʻa:
• Melemele o ka ʻili a me nā maka (Jaundice)
• Ka ʻili nui loa
• ʻO ka mimi ʻeleʻele (e like me ke kī)
• Nā noho palupalu (ʻano lepo)
• ʻO nā angiomas spider (nā kīʻaha koko ʻulaʻula e like me nā ʻupena spider) ma ka umauma a me ke kino o luna

• Inā ma muli o ke koko ʻūlū (Deep Vein Thrombosis - DVT):
• ka pehu koke ʻana ma kekahi wahi o ke kino (e.g., he wāwae)
• Lilo ka wahi i ʻulaʻula a ʻeleʻele paha a mehana ke pā aku

Pehea e ʻike ai ke kauka i ke kumu kūpono?

He mea nui e ʻike koke i ke kauka ke ʻike ʻoe i kēia hōʻailona. E nānā mua ke kauka iā ʻoe a hoʻolohe pono i kāu mau hōʻailona. A laila, e kauoha lākou i kekahi mau hoʻokolohua e hoʻoholo ai i ke kumu pololei.

ʻO ka hoʻāʻo nui i hoʻohana ʻia no kēia he scan ultrasound o ka ʻōpū . Hiki iā ʻoe ke ʻike i nā ʻōkana a me nā kīʻaha koko i loko o ka ʻōpū.

ʻO ke kikoʻī, nānā kēia scan i ke kuhikuhi o ke kahe o ke koko i loko o nā aa koko tortuous.

• Inā e kahe ana ke koko i lalo i nā wāwae , ʻo ia paha kahi maʻi i kapa ʻia ʻo Portal Hypertension, i hoʻokumu ʻia e ka cirrhosis o ke ake .
• Inā holo ke koko i luna i ka puʻuwai , ma muli paha ia o kahi ālai ʻana i ka vena cava haʻahaʻa .

ʻO kēia mea maʻalahi e hiki ai i ke kauka ke loaʻa kahi manaʻo maikaʻi o ke kumu o ka maʻi.

He aha nā lāʻau lapaʻau no kēia?

ʻO ka mea nui, ʻaʻole wale ka mālama ʻana i ka hiʻohiʻona ʻili i ʻike ʻia o Caput Medusae, akā , ʻo ke kūlana kumu . Ke mālama ʻia ke kumu kumu, hiki i kēia mau aa varicose ke emi iho i ka hala ʻana o ka manawa.

• Inā hiki ke wehe ʻia ke kumu: No ka laʻana, inā he mea ālai ia e hiki ke wehe ʻia, e like me ke koko ʻūlū, ʻo ka pahuhopu mua a nā kauka ka wehe ʻana i kēlā mea ālai.
• Inā he maʻi mau loa ke kumu: Inā he maʻi mau loa e like me ka cirrhosis o ke akepaʻa, hāʻawi ʻia nā lāʻau lapaʻau kūikawā e mālama i ka maʻi a kāohi i kona mau pilikia.

I kekahi mau hihia, inā hoʻoulu ka hypertension portal i nā veins i loko o ke ala ʻai e pehu a kahe ke koko, hoʻohana ʻia nā ʻano kūikawā e hoʻohaʻahaʻa i ke koko.

• TIPS (Transjugular Intrahepatic Portosystemic Shunt): ʻO kēia ke komo ʻana i kahi ʻōmole liʻiliʻi ma o ke akepaʻa ma lalo o ke alakaʻi ʻana o X-ray e hana i kahi shunt ma waena o ke aʻa portal a me kekahi aʻa ʻē aʻe i loko o ke akepaʻa. Hoʻokumu kēia i kahi ala hou no ke kahe ʻana o ke koko i ālai ʻia, e hoʻēmi ana i ke kaomi.
• DSRS (Distal Splenorenal Shunt): He hana ʻoki kino kēia kahi e wehe ʻia ai ke aʻa splenic mai ke akepaʻa a hoʻopili ʻia i ke aʻa o ka puʻupaʻa hema. Hoʻemi pū kēia i ke kaomi.