ʻO ke koko i loko o ke aʻa koko o ke ake (Portal Vein Thrombosis): E kamaʻilio kākou e pili ana i kēia!

Aia kekahi mau maʻi e ulu mālie ana i loko o ke kino me ka ʻole o ka hōʻike ʻana i kekahi mau hōʻailona. ʻO kekahi o ia ʻano maʻi he ʻūpā koko i loko o ka aʻa portal o ke akepaʻa, a i ʻole ma ka ʻōlelo lapaʻau, he ʻano i kapa ʻia ʻo "Portal Vein Thrombosis" . Hiki ke lilo i mea koʻikoʻi iki, no laila e kamaʻilio kākou e pili ana i ia mea me nā kikoʻī hou aku, ʻeā?

He aha kēia mea i kapa ʻia ʻo ka portal vein thrombosis (`(Portal Vein Thrombosis)`)?

I ka ʻōlelo maʻalahi, loaʻa i kou ake kahi kīʻaha koko nui e lawe mai i ke koko i kou ake mai nā ʻāpana ʻē aʻe i loko o kou ʻōpū (e like me kou ʻōpū a me nā ʻōpū). Ua kapa ʻia kēia ʻo ka vein portal . Ke hana ʻia kahi clot koko (thrombus) i loko o ka vein portal, i loko o nā lālā e lālā ana i loko o ke ake, a i ʻole ma kekahi o nā vein ʻē aʻe e hoʻolako i ke koko iā ia (e like me ka vein mesenteric superior a me ka vein splenic), hoʻohaiki a ālai loa paha ia i ka vein, i kapa ʻia ʻo portal vein thrombosis, a i ʻole PVT.

He maʻi koʻikoʻi kēia. Akā, ʻaʻole pinepine ia e hōʻike i kekahi mau hōʻailona i ka wā mua. No laila, ʻaʻole paha ʻoe e ʻike he ʻano koko koko kou. Hiki ke loaʻa ma kahi hanana i ka wā o kahi hoʻāʻo no kekahi mea ʻē aʻe, a i ʻole hiki ke ʻike ʻia ma hope o kahi pilikia e like me ka portal hypertension (ka piʻi ʻana o ke kaomi i loko o nā aʻa o ke akepaʻa). Hiki i kēia mau pilikia ke hoʻoweliweli i ke ola inā ʻaʻole mālama pono ʻia. ʻOi loa inā loaʻa iā ʻoe nā hōʻailona e like me ka luaʻi ʻana i ke koko a i ʻole ke kahe ʻana o ke koko i loko o kou ʻōpala, he koʻikoʻi ia a pono ʻoe e ʻimi koke i ke kōkua lapaʻau.

ʻO ka poʻe me ka fibrosis akepaʻa, ʻoi aku ka cirrhosis, ʻoi aku ka nui o ka pilikia o ka loaʻa ʻana o ka thrombosis vein portal. ʻO ka poʻe me nā maʻi olakino ʻē aʻe, e like me nā maʻi clotting koko, ʻoi aku ka nui o ka pilikia. No laila, inā loaʻa iā ʻoe kekahi o kēia mau mea pilikia, he mea nui e kamaʻilio me ke kauka, e hoʻāʻo ʻia, a e ʻike ʻia a mālama ʻia i ka wā hikiwawe loa.

Aia kekahi mau ʻano o ka thrombosis vein portal (PVT)?

ʻAe, ua hoʻokaʻawale nā ​​kauka i kēia "Portal Vein Thrombosis" i ʻelua ʻano nui, ma muli o ke kanaka nāna i hoʻomohala:

• ʻO ka Cirrhotic Portal Vein Thrombosis (PVT) ke ʻano maʻamau o ka thrombosis e kū mai ana me ka cirrhosis . He kūlana kēia e hana ʻia ai nā ʻūpā koko i loko o ka vein portal i nā poʻe me ka cirrhosis.
• ʻO ka Non-cirrhotic Portal Vein Thrombosis (PVT): He ʻūpā koko kēia e hana ʻia i loko o kekahi kanaka ʻaʻohe cirrhosis.

He mea nui ka hoʻomaopopo ʻana i kēia hoʻokaʻawale ʻana no ka hoʻolālā ʻana i ka mālama ʻana. No ka laʻana, hana nā kauka i nā hoʻoholo lapaʻau ma muli o ka loaʻa ʻana o ka cirrhosis iā ʻoe. ʻO ka loaʻa ʻana o ka cirrhosis e hoʻonui i kou pilikia o nā pilikia, hiki ke hoʻopilikia i kāu prognosis. Eia nō naʻe, ke aʻo mau nei nā kauka e pili ana i nā ʻano ʻelua o ka thrombosis vein portal a pehea e hōʻemi ai i nā pilikia. No laila he mea nui e kamaʻilio me kāu kauka e pili ana i kāu mau koho lapaʻau a me nā mea āu e manaʻo ai.

Pehea ka maʻamau o kēia ʻano?

ʻAʻole maʻamau ka Portal Vein Thrombosis i nā poʻe me ka maʻi ʻole o ke akepaʻa. Eia nō naʻe, ʻoi aku ka nui o ka pilikia o kekahi mau hui, ʻoiai ka poʻe me ka cirrhosis. Ma kahi o hoʻokahi o ka ʻehā o ka poʻe me ka cirrhosis e loaʻa i ka PVT. ʻO kēia no ka mea e lohi ai ke kahe koko i loko o ke akepaʻa. Ke lohi ke kahe koko, ʻoi aku ka nui o ka paʻa ʻana o nā ʻōpū koko.

He aha nā pilikia e hiki mai ana o ka portal vein thrombosis (PVT)?

Hiki ke ʻokoʻa kēia mau pilikia ma muli o nā mea e like me kahi o ke koko a me nā kūlana olakino ʻē aʻe āu e loaʻa nei. ʻO kekahi o nā pilikia e hiki ke hana ʻia:

• ʻO nā varices esophageal (ka pehu ʻana o nā aʻa koko i loko o ka esophagus)
• Ke kahe koko ʻana o ka ʻōpū (GI)
• Ka hōʻino ʻana i nā ʻōpū ma muli o ka emi ʻana o ke kahe koko (`(Mesenteric Ischemia)`)
• Hoʻonui ʻia ke kaomi i loko o nā aa koko o ke akepaʻa (`(Portal Hypertension)`)
• Splenomegaly (spleen i hoʻonui ʻia)

He aha nā hōʻailona o ka portal vein thrombosis (PVT)?

ʻAʻohe hōʻailona o ka nui o ka poʻe. Hoʻomaopopo pinepine nā kauka i ke kūlana ma o nā hoʻokolohua kiʻi i hana ʻia no kekahi kumu ʻē aʻe.

Eia nō naʻe, inā loaʻa nā pilikia, hiki ke ʻike ʻia nā hōʻailona. ʻO ia mau hōʻailona:

• Ke luaʻi ʻana i ke koko.
• Koko i loko o ka ʻōpala (ʻeleʻele a ʻulaʻula paha).
• ʻŌpū pehu, palahēhē.
• Ka pehu ʻana o nā wāwae a me nā kuʻekuʻe wāwae (`(Edema)`).
• ʻEha ka ʻōpū, ʻōʻō.

He aha ke kumu o ke kāpili ʻana o ke koko i loko o kēia aa koko portal?

Ua kapa ʻia kēia e nā kauka he kūlana 'multifactorial' . ʻO ke ʻano kēia, ua hoʻokumu pinepine ʻia e ka hui pū ʻana o ʻelua a ʻoi aku paha mau kumu.

ʻEkolu mau kumu nui e kōkua ai i ke kūkulu ʻia ʻana o kahi ʻūpā koko i loko o kou "Portal Vein":

• Loaʻa i ke kūlana hypercoagulable ("(Hypercoagulable State)`). ʻO ke ʻano kēia, ʻoi aku ka wikiwiki o ke kāpili ʻana o kou koko ma mua o ke kanaka maʻamau.
• Ka holo mālie o ke koko ma o ke akepaʻa.
• Ka hōʻino ʻana i ka paia o loko (endothelium) o ka vein portal.

He aha nā kumu pilikia no kēia maʻi?

Hiki i nā ʻano maʻi like ʻole ke hoʻonui i kou pilikia o ke koko ʻana a lohi ke kahe ʻana o ke koko ma o ke akepaʻa. ʻO kekahi o kēia mau mea pilikia:

• Nā Puʻupuʻu ʻōpū.
• ʻO ka maʻi Antiphospholipid (`(Antiphospholipid Syndrome)`).
• Ka hemahema o ka antithrombin (`(Ka hemahema o ka antithrombin)`).
• ʻO ka fibrosis o ke akepaʻa (`(Cirrhosis)`).
• Factor V Leiden (`(Factor V Leiden)`) - He ʻano maʻi hoʻoilina kēia e hoʻopilikia ai i ke kāpili ʻana o ke koko.
• Nā maʻi ʻōpū (e.g. pancreatitis).
• Nā neoplasms Myeloproliferative (`(Myeloproliferative Neoplasms)`) - ʻO kēia nā maʻi e pili ana i ka iwi ʻiʻo.
• He hihia koʻikoʻi o ka hypertension portal.
• Ka hāpai ʻana.
• Ka hemahema o ka protein C (`(Ka hemahema o ka protein C)`).
• Ka nele o ka protein S (`(Ka nele o ka protein S)`).
• Ka hoʻololi ʻana o ka gene prothrombin (`(Prothrombin Gene Mutation)`).

Eia kekahi, hiki i kekahi mau ʻoki ʻōpū (e.g., splenectomy) ke hōʻino i ka paia o loko o ke kīʻaha koko, e hoʻonui ana i kēia pilikia.

Pehea e ʻike ʻia ai ka thrombosis vein portal (PVT)?

Hoʻoponopono nā kauka i kēia maʻi ma o ka hoʻokolokolo kino piha a me nā hoʻokolohua like ʻole. E nīnau pū lākou e pili ana i kou mōʻaukala olakino e ʻike inā he mau kumu pilikia kou no ka hoʻomohala ʻana i ka "Portal Vein Thrombosis".

He aha nā hoʻokolohua e hana ʻia e ʻike ai i kēia?

Hiki i kāu kauka ke kauoha i nā hoʻokolohua e like me kēia e ʻike ai i ka "Portal Vein Thrombosis" a nānā i nā pilikia:

• CT scan (`(Computed Tomography (CT) Scan)`).
• ʻO ka hoʻāʻo ultrasound Doppler ("(Doppler Ultrasound)`). Hiki ke hoʻohana ʻia kēia e ʻike i ke kahe ʻana o ke koko i loko o nā kīʻaha koko a inā he mau ʻūpā koko.
• Nā hoʻāʻo hana ate (`(Nā Hoʻāʻo Hana Ate)`).
• ʻO ke kiʻi MRI ("(Ima Resonance Magnetic (MRI))`.)

E hoʻoholo ʻia kāu hoʻolālā lapaʻau ma muli o nā hopena o kēia mau hoʻokolohua.

Pehea e mālama ai nā kauka i ka thrombosis vein portal (PVT)?

Hoʻoholo nā kauka i ka lāʻau lapaʻau no kēlā me kēia maʻi pākahi. ʻO ia hoʻi, hoʻopilikino lākou i ka lāʻau lapaʻau i kāu mau pono. Aia kekahi mau kumu e hoʻopilikia i kēia:

• Ma hea kahi o ke koko e paʻa ai.
• Ke kumu o ka hoʻokumu ʻia ʻana o ke koko koko.
• Nā pilikia olakino ʻē aʻe āu e loaʻa nei (e like me ka cirrhosis).
• Inā paha he mau pilikia.
• Kou mōʻaukala lapaʻau holoʻokoʻa.

Hiki i nā koho lapaʻau ke komo pū me:

• Nā Anticoagulants: Kōkua kēia mau lāʻau lapaʻau i ka pale ʻana i nā ʻōpū koko mai ka nui ʻana a pale i nā ʻōpū hou mai ke kūkulu ʻana. Eia nō naʻe, no ka mea, ʻoi aku ka nui o ka pilikia o ka poʻe me ka cirrhosis i ke kahe koko i loko, hoʻohana nā kauka i kēia mau lāʻau lapaʻau me ke akahele nui.
• Ka Lapaʻau Thrombolytic:Inā ʻaʻole lawa nā anticoagulants wale nō, hiki ke hāʻawi ʻia kēia lāʻau lapaʻau ma ke ʻano he wai i hāʻawi ʻia i loko o kahi aʻa (IV) a i ʻole ma o kahi paipu liʻiliʻi (catheter) e hoʻoheheʻe i ke koko. Hiki i nā kauka ke hoʻohana i kēia ʻano hana inā ʻaʻole lawa ka lako koko o kou mau ʻōpū.
• ʻO Transjugular Intrahepatic Portosystemic Shunt (TIPS): He kaʻina hana kēia e hoʻohana ana i kahi catheter liʻiliʻi. Hoʻohana ʻia ia e kāohi i nā pilikia o ka thrombosis vein portal, ʻoi aku hoʻi ke kahe koko GI. Pili ia i ka hana ʻana i kahi tunnel ma o kou ake a me ka hoʻopili ʻana i kou vein portal i kahi vein nui i loko o kou ake. ʻAe kēia ala hou i ke koko mai kou mau ʻōpū e kāpae i ke ake. Hoʻemi kēia i ke kaomi i loko o nā veins i loko o kou ake, e hōʻemi ana i ka pilikia o ke kahe ʻana. Eia naʻe, ʻoiai ke kānana maʻamau nei kou ake i nā mea ʻawaʻawa mai kou koko, ke kahe nei ke koko i kānana ʻole ʻia i loko o kou kino. No laila, ʻo kekahi pilikia o kēia lāʻau lapaʻau, ʻo ia ka hiki i nā mea ʻawaʻawa ke hele i ka lolo a hoʻopilikia i ka hana o ka lolo (`(Hepatic Encephalopathy)`).

He mea nui loa e kūkākūkā i nā pono a me nā pōʻino o kēia mau lāʻau lapaʻau me kāu kauka e hoʻomaopopo i kā lākou mau pono a me nā hemahema ma muli o kou kūlana.

He aha ka wānana no kēia kūlana?

ʻO kāu kauka ke kanaka kūpono loa e nīnau e pili ana i ka wānana o kou kūlana. E haʻi aku ʻo ia iā ʻoe i ka mea e manaʻo ai ma muli o kou kūlana. Hiki ke ʻokoʻa nā manawa e ola ai a me ke ola mai ka thrombosis vein portal ma muli o:

• Ke kumu o ka hoʻokumu ʻia ʻana o ke koko koko.
• Inā paha he `(Cirrhosis)` kou a ʻaʻole paha.
• Nā pilikia olakino ʻē aʻe āu e loaʻa nei.
• Nā pilikia e kū mai ana.
• Ke kūlana o kou akepaʻa.

Ma keʻano laulā, hiki i ka ʻike mua ʻana a me ka mālama ʻana ke hoʻonui i kou manawa e hoʻōla ai.

Hiki ke pale ʻia ka portal vein thrombosis (PVT)?

ʻAʻole hiki ke pale ʻia nā ʻūpā koko, me nā mea i loko o ke aʻa portal. Eia nō naʻe, aia kekahi mau mea hiki iā ʻoe ke hana e hōʻemi i kou pilikia:

• E hele i nā hoʻokolohua lapaʻau makahiki, a hele i nā hoʻokolohua hahai a pau a kāu kauka e kauoha ai. No ka laʻana, inā loaʻa iā ʻoe ka cirrhosis i kona mau wā mua, hiki i ka ʻike mua ʻana ke kōkua i ka pale ʻana i ka PVT.
• E hana pū me kāu kauka e hoʻokele i kekahi mau kūlana olakino maʻi āu e loaʻa nei. Eia kekahi laʻana, inā he maʻi kou e like me ka maʻi diabetes (`(Diabetes Mellitus)`), e mālama pono iā ia.
• E lawe i kāu mau lāʻau lapaʻau a pau e like me ke kauoha, i nā manawa kūpono.
• Inā loaʻa iā ʻoe kekahi mau hōʻailona hou, a inā loli kāu mau hōʻailona, ​​e haʻi koke aku i kāu kauka.

Āhea wau e ʻike ai i ke kauka?

E hōʻoia e hele i kāu mau hoʻokolohua lapaʻau makahiki. Inā loaʻa iā ʻoe kekahi mau hōʻailona hou i wehewehe ʻole ʻia, e ʻike mua i kāu kauka.

Inā he hoʻokahi a ʻoi aku paha mau kumu pilikia no ka hoʻomohala ʻana i ka `(Portal Vein Thrombosis)`, he manaʻo maikaʻi e kamaʻilio me kāu kauka e pili ana i ia mea. E nīnau ʻo ia iā ʻoe e pili ana i kou pae pilikia pilikino a me nā mea hiki iā ʻoe ke hana e hōʻemi ai.

Āhea wau e hele ai i kahi Emergency Treatment Unit (ETU) ?

ʻO kahi pilikia o ka thrombosis vein portal ka kahe koko gastrointestinal (GI). Hiki koke mai nā hōʻailona a hiki ke koʻikoʻi. Inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona, ​​​​e hele koke i ka haukapila a kāhea aku paha i 911:

• Inā manaʻo ʻoe ua poniuniu a nāwaliwali paha (syncope).
• Inā he ʻeleʻele a ʻulaʻula paha kou mau ʻōpala, a inā ʻoe e luaʻi i ke koko.
• Inā wikiwiki ka puʻuwai.

He aha nā nīnau e pono iaʻu e nīnau aku i kaʻu kauka?

Eia kekahi mau nīnau e kōkua iā ʻoe e aʻo hou e pili ana i kou kūlana:

• No ke aha i loaʻa ai iaʻu kēia ʻūpā koko?
• He aha ka hoʻolālā lapaʻau maikaʻi loa noʻu?
• Pono anei au e lawe i kekahi lāʻau lapaʻau? Inā pēlā, pehea ka lōʻihi?
• He aha nā pōmaikaʻi a me nā pōʻino o nā lāʻau lapaʻau?
• He aha kaʻu e manaʻo ai i koʻu ho'ōla ʻana?
• He aha kaʻu wānana lōʻihi (`(Prognosis)`)?

Hiki ke hopohopo ka ʻike ʻana he ʻūpā koko kou. I ke kūlana e like me ka "Portal Vein Thrombosis", e noʻonoʻo paha ʻoe i nā pilikia e hiki mai ana a pehea ke koʻikoʻi o ia mau mea. E kākau i kāu mau nīnau a kaʻana like me kāu kauka. E aʻo i nā mea āpau e pono ai ʻoe e ʻike e pili ana i kou kūlana a me nā koho lapaʻau. Me kāu kauka, hiki iā ʻoe ke loaʻa i kahi ala e hoʻōla ai.

Nā mea nui e hoʻomanaʻo (Leka Lawe-Home)

ʻAe, no laila, e hōʻuluʻulu i ka mea a mākou i kamaʻilio ai, ʻo ka Portal Vein Thrombosis, he ʻaʻa koko e ālai ana i ke aʻa nui e lawe i ke koko i ke akepaʻa.

ʻOiai ʻaʻole ia e hōʻike pinepine i nā hōʻailona i ka wā mua, hiki i kēia ke lilo i maʻi koʻikoʻi, ʻoiai hoʻi i nā poʻe me ka cirrhosis.

Inā loaʻa iā ʻoe ka luaʻi ʻana i ke koko a i ʻole ke koko i loko o kou ʻōpala, e ʻimi koke i ke kōkua lapaʻau.

Inā he mau kumu pilikia kou, he mea nui e kamaʻilio me kāu kauka e pili ana iā lākou a loaʻa nā hoʻokolohua e pono ai. ʻO ka ʻike mua a me ka mālama ʻana ka mea maikaʻi loa. E hahai pono i nā ʻōlelo a kāu kauka, a mai makaʻu e nīnau inā he mau nīnau kāu. E noho olakino!

ʻO ka thrombosis vein portal, nā ʻūpā koko i loko o ke akepaʻa, cirrhosis, hematemesis, maʻi akepaʻa, ke ālai ʻana o nā kīʻaha koko, PVT