Hiki i kekahi poʻe me nā pilikia ate ke hoʻomaka koke i ke kahe koko mai ka waha, a i ʻole e ʻike paha lākou i ke koko i loko o ko lākou mau ʻōpala. Ke hana ʻia kēia, ʻaʻole hiki iā ʻoe ke noʻonoʻo i ka mea e hana nei. ʻO kekahi o nā kumu nui o kēia kūlana, ʻo ia ka pehu ʻana o nā kīʻaha koko i loko o kou esophagus , ka ʻōmole e hele ai ka meaʻai, a pohā, e kahe ana ke koko . Ua like ia me nā aʻa varicose i kou mau wāwae, akā hana kēia i loko o kou kino. I kēia lā e kamaʻilio mākou e pili ana i kēia kūlana, i ʻike ʻia ma ke ʻano lapaʻau ʻo Esophageal Varices. Mai hopohopo, e mālama maʻalahi kākou.
He aha kēia mau mea (Esophageal Varices)? I ka ʻōlelo maʻalahi…
E noʻonoʻo, ʻo kou esophagus kahi paipu e lawe ana i ka meaʻai mai kou waha a i kou ʻōpū. Aia i loko o kēia paipu kahi pūnaewele o nā kīʻaha koko maikaʻi. Inā no kekahi kumu, ua nui loa ke kaomi ʻana o kēia mau kīʻaha koko, e pehu mālie lākou a hoʻomaka e hoʻonui. Ua kapa ʻia kēia he esophageal varices.
ʻO ka mea weliweli loa e pili ana i kēia, ʻo ia ka nāwaliwali loa o nā paia o kēia mau aa koko pehu. E like me ka pōpō pehu nui. No laila, hiki iā lākou ke pahū maʻalahi a kahe ke koko . Hiki i kēia kahe koko i loko o ke kino ke lilo koke, koʻikoʻi, a hiki ke hoʻoweliweli i ke ola.
Pehea ke koʻikoʻi o (Esophageal Varices)?
ʻO ka pilikia nui a koʻikoʻi loa o kēia maʻi, ʻo ia ke kahe ʻana o ke koko . ʻOiai ʻaʻole nā kānaka a pau e kahe ke koko, ma kahi o 50% o ka poʻe me kēia maʻi hiki ke kahe ke koko. E like me ka mea i ʻōlelo ʻia ma mua, piʻi kēia pilikia i ka piʻi ʻana o ke kaomi i loko o ke kīʻaha koko nui e hele ana ma ke akepaʻa, ʻo ia hoʻi, (Portal Hypertension). I ka hapanui o nā hihia, ua hoʻokumu ʻia kēia maʻi (Portal Hypertension) e kahi maʻi mau o ke akepaʻa. No laila, i ka wā e ʻoi aku ka ʻino o ka maʻi akepaʻa, ʻoi aku ka ʻino o kēia maʻi.
ʻO ka poʻe me nā maʻi akepaʻa koʻikoʻi, ʻo ia hoʻi ka cirrhosis, loaʻa paha nā pilikia ʻē aʻe ma waho aʻe o nā varices esophageal.Eia nō naʻe, ʻo ke kumu nui i hoʻokomo ʻia ai ka poʻe me ka cirrhosis i ka haukapila a make no ka mea ua pohā kēia mau aa koko pehu a kahe ke koko. Inā loaʻa kēia ʻano kahe koko, aia ma kahi o 20% ka pilikia o ka make. Eia kekahi, ma hope o ke kahe koko ʻana i hoʻokahi manawa, kiʻekiʻe ka pilikia o ke kahe hou ʻana o ke koko.
He aha nā hōʻailona o (Esophageal Varices)?
ʻAʻole ʻike ʻia kēia mau aʻa koko pehu e like me ko lākou ʻike ʻia ma nā wāwae. Aia lākou i loko o ka umauma, kahi pinepine e pili ai ka esophagus i ka ʻōpū. ʻAʻole ʻoe e ʻike iā lākou ke ale ʻoe. ʻAʻole lākou e hōʻike i kekahi mau hōʻailona a hiki i ko lākou kahe ʻana o ke koko.
Eia nō naʻe, inā ʻike kāu kauka i nā hōʻailona ʻē aʻe e hōʻike ana i ka hypertension portal a i ʻole ka maʻi akepaʻa mau, hiki iā ia ke kānalua i nā varices esophageal. ʻO ia mau hōʻailona:
- Jaundice : Melemele o ka ʻili a me nā maka.
- Ascites : Ka hōʻiliʻili ʻana o ka wai i loko o ka ʻōpū.
- Edema : Ka pehu ʻana o nā wāwae a me nā kuʻekuʻe wāwae.
- ʻEha ʻōpū o luna : Hiki ke hana ʻia ka ʻeha e ka pehu ʻana o ke akepaʻa a i ʻole ka spleen .
- ʻŪhū : Ka maneʻo o ka ʻili me ka ʻole o ka hōʻeha.
- Huikau (Hepatic Encephalopathy) : Hiki ʻole ke noʻonoʻo pono, nalowale ka ʻike.
Nā hōʻailona o ke kahe ʻana o ke koko
Inā pohā koke kahi aʻa koko pehu a hoʻomaka ke kahe ʻana o ke koko, ʻaʻole paha ʻoe e ʻike koke i ka ʻeha. Eia nō naʻe, pono ʻoe e makaʻala i nā hōʻailona o ke kahe ʻana o ke koko mai ka ʻōpū ʻai a i ʻole mai ke kino :
| Nā hōʻailona o ke kahe ʻana o ke koko | Penei ka hana ʻana… |
|---|---|
| Ka luaʻi ʻana i ke koko mai ka waha | Ke luaʻi ʻoe i ke koko, e luaʻi paha ʻoe i ke koko i paʻa a like me ke ʻano o ka ʻōpala kope. Akā inā pohā koke kahi aʻa koko, e luaʻi paha ʻoe i ke koko hou a ʻulaʻula. |
| Koko i loko o ka ʻōpala | Ke hoʻoheheʻe ʻia ke koko mai ka waha a puka pū me ka ʻōpala, lilo ia i melemele ʻeleʻele a ʻeleʻele paha (melena). Eia nō naʻe, inā wikiwiki loa ke kahe ʻana o ke koko, hiki ke puka mai ke koko ʻulaʻula hou me ka ʻōpala. |
| Nā hiʻohiʻona kino ʻē aʻe | Ke nalowale ka nui o ke koko mai ke kino aku, e mae paha ke alo, a e luhi loa paha ʻoe a make ke ola. Hiki i ke koko haʻahaʻa ke hoʻoulu i ka poniuniu. |
Mea nui: Nā Hōʻailona o kahi Pōpilikia (Hypovolemic Shock)
Inā loaʻa koke iā ʻoe nā hōʻailona o kahi maʻi weliweli i kapa ʻia ʻo hypovolemic shock, e hele koke i ka ETU! ʻO kēia mau hōʻailona:
- Nā palpitations o ka puʻuwai
- Hoʻonui ʻia ka hanu ʻana
- Ke anu nei a me ka hou ʻana
- Ka hoʻomaha ʻole a me ka huikau
- Nalowale o ka ʻike
He aha nā kumu o nā varices esophageal?
ʻO ke kumu nui o kēia ʻano he ʻano i kapa ʻia ʻo Portal Hypertension , ʻo ia hoʻi ke koko kiʻekiʻe i loko o ke kīʻaha koko nui e hele ana ma o ke akepaʻa (portal vein) a me nā aa koko ʻē aʻe e lālā ana mai ia mea.
Hoʻāʻo ko mākou kino e hoʻomaʻamaʻa i kēia kaomi i hoʻonui ʻia ma ke kuhikuhi ʻana i ke koko keu i loko o nā aa liʻiliʻi i hiki ʻole ke lawelawe iā ia. ʻO kēia mau mea, ʻo nā aa palupalu i loko o ka anus nā mea e pehu nui loa.
ʻO nā kumu nui o ka hypertension portal
ʻO ke kumu nui o kēia, ʻo ia ka cirrhosis, ʻo ia hoʻi ka paʻakikī o ke akepaʻa . Hoʻokumu ʻia kēia e ka hōʻino lōʻihi o ke akepaʻa. Hoʻopōʻino mau ʻia nā hunaola akepaʻa ( hepatitis ), a i ka hopena lilo lākou i ʻiʻo ʻeha. Ke ālai nei kēia ʻeha i ke kahe o ke koko ma o ke akepaʻa. ʻAʻole hana ʻia kēia i ka manawa hoʻokahi, akā hana ʻia i nā makahiki he nui.
ʻO Cirrhosis ke kahua hope loa o kekahi maʻi akepaʻa mau loa. Eia kekahi laʻana:
- ʻO ka maʻi hepatitis i hoʻoulu ʻia e ka waiʻona
- ʻO ka steatohepatitis ʻaʻohe waiʻona (NASH)
- ka maʻi hepatitis viral mau loa (e like me B, C)
- ʻO ka maʻi hepatitis autoimmune
Aia kekahi mau kumu ʻē aʻe o ka Portal Hypertension:
- Nā Granulomas i loko o ke akepaʻa : ʻO kēia nā hōʻiliʻili o nā hunaola mumū e kū mai ana me nā maʻi like ʻole a me nā kūlana mumū. ʻO ke kumu nui o kēia he maʻi parasitic i kapa ʻia ʻo Schistosomiasis, ka mea e hoʻopilikia ana i kahi 230 miliona mau kānaka ma ka honua holoʻokoʻa.
- Thrombosis: Inā hana ʻia kahi ʻaʻa koko i loko o ka ʻōnaehana venous i pili i ke akepaʻa, hiki ke ālai ʻia ke kahe o ke koko (e.g. Budd-Chiari syndrome).
- Ka hoʻonui ʻia ʻana o ka spleen .
- Maʻi puʻuwai : e like me ka hāʻule ʻana o ka puʻuwai ʻākau.
(Nā Varices Esophageal) Ka ʻike a me ka mālama ʻana
ʻAʻole ʻoe e ʻike e pili ana i kēia a hiki i ka wā e nānā ai ke kauka iā ʻoe. Inā ua ʻike mua ʻia ʻoe me ka cirrhosis, e ʻōlelo pinepine kāu kauka e nānā i kēia pehu ʻana o nā aʻa. ʻO ka hoʻāʻo nui i hoʻohana ʻia no kēia he endoscopy luna .
He aha ka (Endoscopy Kiʻekiʻe)?
ʻO ka Endoscopy Kiʻekiʻe , i ʻike ʻia hoʻi he hoʻāʻo EGD, he nānā ʻana i kou ʻāpana ʻai o luna, e komo pū ana me kou esophagus, ʻōpū, a me ka hoʻomaka ʻana o kou ʻōpū liʻiliʻi (duodenum). Hana ʻia kēia e kahi gastroenterologist, he kauka loea i nā maʻi o ka ʻōnaehana ʻai a me nā kaʻina hana endoscopy. ʻO ka endoscope kahi paipu lōʻihi a lahilahi me kahi kāmela liʻiliʻi ma ka hopena. Hoʻokomo ʻia ka paipu ma kou waha a hoʻouna ʻia i lalo i kou esophagus e nānā pololei i kekahi pehu. Inā loaʻa kekahi mau pilikia, hiki ke hoʻokomo ʻia nā mea hana liʻiliʻi ma o ka endoscope e mālama iā lākou.
He aha nā lāʻau lapaʻau no (Esophageal Varices)?
ʻO nā pahuhopu nui o ka mālama ʻana, ʻo ia ke kāohi ʻana i ke kahe ʻana o ke koko i kēia manawa, pale i ke kahe ʻana o ke koko i ka wā e hiki mai ana, a inā hiki, e hoʻēmi i ka hypertension portal.
| ʻAno lapaʻau | He aha ka mea e hana ʻia ai? |
|---|---|
| Nā lāʻau lapaʻau | Hāʻawi nā kauka i nā lāʻau lapaʻau intravenous e like me Octreotide e hoʻohaʻahaʻa i ke koko. Aia kekahi mau lāʻau lapaʻau e like me Beta-blockers hiki iā ʻoe ke lawe e hoʻōki i ke kahe ʻana o ke koko. |
| Hoʻopaʻa ʻana i ke kāʻei Varicose | I ka hoʻokomo koke ʻia ʻana o ka endoscope, e kau ʻia kahi kaula laholio liʻiliʻi a puni ke aʻa koko, a i ʻole ke aʻa koko i manaʻo ʻia e kahe ana ke koko, a hoʻopaʻa ʻia. Hoʻōki kēia i ke kahe ʻana o ke koko. |
| Nā Kaʻina Hana Shunt | He mea paʻakikī iki kēia. Aia ʻelua mau ʻano hana, ʻo TIPS a me DSRS. Pili kēia i ka hana ʻana i kahi ala hou no ke koko e kāpae i ke akepaʻa. Ma o ke ʻoki kino a i ʻole nā kukui X, ua hoʻopili ʻia kahi aʻa koko i loko o ke akepaʻa i kekahi aʻa koko ʻē aʻe e hōʻoluʻolu i ke kaomi. |
| Ke mālama nei i ke kumu kumu | ʻO ka mea nui loa, ʻo ia ka mālama ʻana i ke kumu kumu. ʻO ia hoʻi ka hoʻōki ʻana i ka inu ʻona, ka hoʻēmi ʻana i ke kaumaha, a i ʻole ka lawe ʻana i nā lāʻau lapaʻau no kahi maʻi kumu e like me ka maʻi hepatitis C. |
Ke noho nei me kēia kūlana
Aia kou manaʻo i ka loaʻa ʻana o ke koko mai kou mau aa koko a me ke koʻikoʻi o kou maʻi akepaʻa. ʻO ka nui o ke ola no hoʻokahi makahiki no ka poʻe me ka cirrhosis a me ke koko ma kahi o 50%. ʻO ka pilikia o ka make mai ke koko mua he 20%, a ʻo ka pilikia o ke koko ʻelua, ʻoiai me ka mālama ʻana, he kiʻekiʻe a hiki i ka 60%.
He maʻi koʻikoʻi nā varices esophageal. Eia nō naʻe, inā ʻike mua ʻia ka maʻi akepaʻa, hiki ke hoʻololi i ke ʻano o ka nohona e pale aku ai i ka maʻi mai ka ʻino ʻana, a hiki nō hoʻi ke pale ʻia kēia mau aa koko mai ka pehu ʻana.
Leka Lawe-Home
- ʻO nā varices esophageal ka hopena pinepine o ka hypertension portal, kahi maʻi i hoʻokumu ʻia e ka cirrhosis ate .
- ʻO ka pōʻino nui o kēia, ʻo ia ka hiki ke pohā a kahe ke koko o ke kīʻaha koko . Hiki i kēia ke hoʻoweliweli i ke ola.
- ʻOiai inā ʻaʻole ʻoe e hōʻike i kekahi mau hōʻailona nui i ka wā mua, inā ʻike ʻoe i nā hōʻailona e like me ke kahe ʻana o ke koko mai ka waha, nā ʻōpala ʻeleʻele, ka melemele o ka ʻili, a me ka ʻōpū pehu, e ʻike koke i kāu kauka .
- Ua ʻike pololei ʻia kēia a hana ʻia kekahi mau lāʻau lapaʻau ma o kahi hoʻokolokolo i kapa ʻia ʻo endoscopy.
- Aia nā lāʻau lapaʻau, akā ʻo ka mea nui loa, ʻo ia ka pale ʻana i nā mea e hōʻino ai i ke ake (ka waiʻona, kekahi mau meaʻai maikaʻi ʻole) a e hahai pono i nā ʻōlelo aʻoaʻo lapaʻau .
- Inā loaʻa iā ʻoe ka maʻi akepaʻa, he mea nui loa ia e hana i nā hoʻokolohua lapaʻau maʻamau e nānā i nā pilikia e like me kēia .
💬 Comments (0)
ʻAʻohe manaʻo i kau ʻia. Hoʻohui i kāu manaʻo ma ʻaneʻi no ka manawa mua.
Hoʻohui i kāu manaʻo