He puʻupuʻu e like me ka pōpō i loko o ke aʻa splenic? E aʻo pono kākou e pili ana i ka Splenic Artery Aneurysm!

Ua lohe paha ʻoe i kahi aneurysm o ke aʻa splenic? He mea weliweli iki paha ke kani ʻana o ka inoa, akā mai hopohopo. E kamaʻilio kākou e pili ana i ia mea ma ke ʻano maʻalahi e hiki ai iā ʻoe ke hoʻomaopopo. ʻO ka hapa nui o ka manawa, hiki ke loaʻa kēia ʻano me ka ʻole o nā hōʻailona, ​​​​akā i kekahi manawa hiki ke hōʻike ʻia me nā mea e like me ka ʻeha ma ka ʻaoʻao hema o luna o ka ʻōpū.

He aha kēia aneurysm o ke aʻa splenic?

I ka ʻōlelo maʻalahi, loaʻa i kou spleen kahi kīʻaha koko nui, kahi aʻa , e hoʻolako ana i ke koko, a i ka wā e nāwaliwali ai kahi ʻāpana o ka paia o kēlā aʻa a puka i waho e like me ka pōpō, kapa mākou ia he aneurysm . E noʻonoʻo iā ia e like me kahi paipu wai e puka i waho ma kahi hoʻokahi i ka wā e ʻelemakule ai. I ka hala ʻana o ka manawa, hiki i kēia puʻupuʻu ke nui aʻe. ʻO ka nui o ka puʻupuʻu, ʻoi aku ka nui o ka pōʻino e hiki ai ke hana. I ka pololei, inā puʻupuʻu ka aʻa splenic ma 1.0 cm a ʻoi aku paha, kapa mākou ia he aneurysm aʻa splenic. I kekahi manawa hiki ke asymptomatic no ka manawa lōʻihi. Akā i kekahi manawa hiki iā ia ke hōʻike i nā hōʻailona e pono ai ka mālama olakino ulia pōpilikia. No laila, he mea nui loa ka ʻike ʻana i kēia, ʻo ia hoʻi, nā hōʻailona a me nā mea pilikia.

Pehea ka maʻamau o kēia maʻi? ʻO wai ka mea i ʻoi aku ka paʻakikī o ka loaʻa ʻana?

ʻO kēia kūlana, i kapa ʻia ʻo ka aneurysm o ke aʻa splenic, hoʻopilikia ia ma waena o hoʻokahi i loko o 1,000 a me hoʻokahi i loko o 2,500 mau kānaka. ʻO ia hoʻi, ʻoiai ʻaʻole paha he mea nui ia, ʻo ia ke ʻano maʻamau o ka aneurysm e ulu ana i loko o nā aʻa i loko o ko kākou ʻōpū (visceral artery aneurysm).

Hiki i kēia ke hoʻopilikia i nā pākeke o nā makahiki āpau. Akā inā he wahine ʻoe, ʻoi aku hoʻi ma luna o 60 mau makahiki , aia ʻoe i kahi pilikia kiʻekiʻe iki. ʻO ka ʻoiaʻiʻo, he mea nui hoʻi e pili ana i ka 80% o kēia mau aneurysms i nā wahine .

Pehea ka hopena o kahi aneurysm i ke kino? He mea weliweli anei ia?

ʻO ka maʻamau, he palupalu loa ko kākou mau aʻa. Hoʻopaʻa lākou a hoʻonui i ke kahe ʻana o ke koko ma o lākou, akā ʻaʻole lākou e nalowale i ko lākou ʻano maʻamau. Akā i ka wā e hana ʻia ai kahi aneurysm, kahi wahi nāwaliwali i loko o ke aʻa e hoʻoulu ai i waho. Ua like ia me kahi kaula laholio e huki ʻia ana ma kahi hoʻokahi. He nāwaliwali loa ka paia o ke aʻa i kēlā manawa. I ka hala ʻana o ka manawa, inā ʻaʻole mālama ʻia, hiki i kēia ke alakaʻi i nā pilikia koʻikoʻi .

He maʻi koʻikoʻi ka Splenic Artery Aneurysm. I kekahi manawa hiki ke hoʻoweliweli i ke ola, ʻoiai inā hāpai ʻoe. E like me nā aneurysms ʻē aʻe, he mea weliweli kēia no ka mea hiki ke haki a ʻokiʻoki paha . He mau pilikia hoʻoweliweli ola kēia mau haki a me nā ʻokiʻoki e pono ai ke kōkua koke ʻia e ke kauka.

Aia kekahi mea ʻē aʻe, ua kapa ʻia ʻo pseudoaneurysms., i kapa ʻia ʻo 'aneurysm wahaheʻe'. Hiki i kēia ke hoʻopilikia i ke aʻa splenic. I loko o kahi aneurysm maoli, ua hoʻopilikia ʻia nā papa āpau o ka paia o ke aʻa. I loko o kahi pseudoaneurysm, hoʻokahi a ʻelua paha papa i hoʻopilikia ʻia. Eia nō naʻe, he koʻikoʻi loa kēia pseudoaneurysm o ke aʻa splenic a ʻoi aku ka nui o ka pilikia o ka haki ʻana ma mua o kahi aneurysm maoli.

He aha nā hōʻailona o kahi aneurysm o ka splenic artery?

Aia kekahi mau hōʻailona āu e ʻike ai inā loaʻa iā ʻoe kēia aneurysm.

• ʻEha ma ka ʻaoʻao hema o luna o kou ʻōpū . Hiki i kēia ʻeha ke pālahalaha i kou poʻohiwi hema.
• He manaʻo e kuʻi ana ma ka ʻaoʻao hema o luna o ka ʻōpū.

E noʻonoʻo i ka mea e hiki mai ana inā pahū kēia aneurysm. A laila hiki iā ʻoe ke ʻike koke i nā hōʻailona e like me:

• Ka luaʻi a me ka luaʻi .
• He ʻeha nui ma ka ʻōpū o luna , ma lalo pono o kou mau iwi ʻaoʻao.
• ʻEha ma ka poʻohiwi hema .
• Nā hōʻailona o ka haʻalulu hypovolemic (kahi kūlana i hoʻokumu ʻia e ka emi ʻana o ka nui o ke koko i loko o ke kino).

Hiki ke hiki koke mai kēia maʻi ahulau, a i ʻole hiki ke hana ʻia i ʻelua mau pae. Ma kahi o hoʻokahi o ka ʻehā o ka poʻe e ʻike i ka hui pū ʻana o kēia mau pae ʻelua. ʻO ia hoʻi, ʻike koke ʻia nā hōʻailona, ​​a laila emi iki. Akā, he pōkole wale nō kēlā hōʻoluʻolu, a komo koke ke kino i ka haʻalulu.

ʻO ka mea nui loa, inā loaʻa iā ʻoe kekahi o nā hōʻailona o kahi aneurysm a i ʻole ka haki ʻana o ke aʻa splenic, pono ʻoe e kāhea koke i ka 1990 a i ʻole kāu helu ulia pōpilikia kūloko.

ʻAʻohe hōʻailona o ka nui o ka poʻe a hiki i ka wā e haki ai kahi aneurysm a i ʻole ua haki. ʻO ia ke kumu he mea nui e ʻike i kāu mau kumu pilikia a kamaʻilio me kāu kauka e pili ana i kou pae pilikia.

No ke aha i hoʻokumu ʻia ai kēia aneurysm o ke aʻa splenic?

ʻO ka nāwaliwali i loko o ka paia o ke aʻa splenic ke kumu nui o kēia aneurysm. ʻAʻole maopopo mau ke kumu o kēia nāwaliwali. Eia nō naʻe, ua ʻike nā kānaka noiʻi he nui nā kumu pilikia e hiki ke kōkua i ke kūlana.

ʻO kēia mau mea , he mea koʻikoʻi loa ka hāpai ʻana . Eia kekahi, ʻoi aku ka kiʻekiʻe o kēia pilikia no nā wahine i hāpai mua. I ka wā hāpai, hoʻopilikia nā loli hormonal i kou kahe koko, e hoʻonui ana i ke kaomi i loko o ke aʻa splenic. Hiki i kēia ke hoʻonāwaliwali i nā paia o ke aʻa a hana i kahi aneurysm.

Hiki i nā ʻano maʻi like ʻole ke hoʻonui i ka pilikia o ka hoʻomohala ʻana i kahi aneurysm artery splenic. Eia kekahi mau laʻana:

• Ke koko kiʻekiʻe (ʻO ke koko kiʻekiʻe)
• Atherosclerosis
• ʻO ka aneurysm o ka lolo
• ʻO ka Cirrhosis o ke akepaʻa
• Nā maʻi pili pili, no ka laʻanaʻO ka maʻi Marfan
• Maʻi diabetes (Diabetes Mellitus)
• Ka maʻi o ka ʻili o loko o ka puʻuwai (Endocarditis)
• ʻO ka dysplasia fibromuscular (FMD)
• ʻO ka Granulomatosis me ka polyangiitis (GPA) (i ʻike mua ʻia ʻo Wegener's)
• Hoʻoili ʻana i ke akepaʻa
• ʻO ka Polyarteritis nodosa (PAN)
• ʻO ke koko kiʻekiʻe o ka puka (ke kaomi kiʻekiʻe i loko o nā aʻa e alakaʻi ana i ke akepaʻa)
• ʻO ka maʻi ʻaʻai

Aia kekahi mau mea pilikia e kōkua ai i ka ulu ʻana o nā pseudoaneurysms i ʻōlelo ʻia ma mua:

• ʻO ka pancreatitis mau loa
• Nā pilikia ma hope o ke ʻoki kino.
• Nā ulia pōpilikia, nā ʻeha e like me kahi ulia kaʻa a i ʻole kahi hou ʻana o ka pahi.

He aha nā kumu o ka pahū ʻana o ka aneurysm?

Aia kekahi mau kumu pilikia nui no ka haki ʻana o kahi aneurysm o ke aʻa splenic:

• ʻO ke koko kiʻekiʻe portal: ʻO ka hoʻonui ʻana i ke kahe koko i kahi o ka aneurysm e hoʻonui ai i ka pilikia o ka haki ʻana.
• Hāpai: Ma kahi o 50% o nā aneurysms i nā wahine hāpai e haki i ka wā hāpai. ʻO ka hapa pinepine, hana ʻia kēia haki i ka trimester hope o ka hāpai ʻana.
• Ka ʻike ʻana i nā hōʻailona: ʻO ka poʻe me nā hōʻailona he 80% ka pilikia o ka loaʻa ʻana o kahi maʻi ahulau. ʻOi aku ke kiʻekiʻe o kēia ma mua o ka poʻe me ka ʻole o nā hōʻailona (he 10% ka pilikia).

Pehea e ʻike ai nā kauka i kēia maʻi?

ʻO kaʻoiaʻiʻo, hiki ke paʻakikī iki ka ʻike ʻana i nā aneurysms o ke aʻa splenic. ʻO kēia no ka mea ʻaʻole maopopo loa nā hōʻailona, ​​a hiki iā lākou ke hoʻohālike i nā kūlana ʻē aʻe he nui. I kekahi manawa, ʻike nā kauka i kēia kūlana i ka wā e hana ana i nā hoʻokolohua no kekahi kumu ʻē aʻe.

ʻO nā hoʻokolohua kiʻi kūikawā ke ala maikaʻi loa e ʻike ai i kēia mau aneurysms, ʻoiai inā ʻaʻohe ou hōʻailona.

Eia kekahi mau hoʻokolohua i hoʻohana ʻia no kēia:

• ʻO ka CT Angiography (Computed tomography angiography - CTA)
• ʻO ka angiography unuhi kikohoʻe (DSA)
• Nā hoʻokolohua ultrasound (Ultrasonography) , me nā hoʻokolohua ultrasound endoscopic .
• ʻO M.R. Angiography (Magnetic resonance angiography - MRA)

Loaʻa i kēlā me kēia o kēia mau hoʻokolohua nā pono kūikawā no ka ʻike ʻana i nā aneurysms a me ka hoʻolālā ʻana i ka mālama ʻana. E wehewehe kāu kauka iā ʻoe i nā hoʻokolohua āu e pono ai a no ke aha.

Pehea e ʻike ai au inā pono iaʻu ka lāʻau lapaʻau?

Pono e mālama koke ʻia nā aneurysms o ke aʻa splenic, kahi e pilikia ai ka pahū a haki paha. Inā loaʻa iā ʻoe kekahi o kēia mau kūlana, hiki i kāu kauka ke ʻōlelo i ka lāʻau lapaʻau:

• Inā ʻoi aku ka nui o ka aneurysm ma mua o 3 kenimika (30 millimeters) ke anawaena.
• Inā e nui aʻe ka aneurysm i ka hala ʻana o ka manawa .
• Inā he mau hōʻailona kou.
• Inā ʻoe e pono ai i kahi hoʻoili ate .
• Inā hāpai ʻoe, a inā paha he hiki ke hāpai .

Inā ʻaʻole pilikia kou aneurysm i ka haki ʻana, e paipai paha kāu kauka i ka nānā ʻana , ʻo ia hoʻi nā hoʻokolohua kiʻi hahai ma nā manawa maʻamau. Inā piʻi kou pilikia o ka haki ʻana i kēlā me kēia manawa, e paipai kāu kauka i ka lāʻau lapaʻau.

He aha nā lāʻau lapaʻau no ka aneurysm o ka splenic artery?

Aia kekahi mau koho lapaʻau no kēia.

• Kaʻina hana Endovascular: ʻO kēia ka mea maʻamau ke koho maikaʻi loa no ka mālama ʻana i kahi aneurysm ma mua o ka pahū ʻana (lāʻau koho). Maanei, ke ālai nei ke kauka i ke kahe koko ma o ka aneurysm. Aia nā ʻano hana like ʻole no kēia. No ka laʻana, ma ke ʻano i kapa ʻia ʻo 'coiling', hoʻohana ʻia nā ʻōwili metala e hoʻopiha i ka aneurysm. Ma kekahi ʻano hana ʻē aʻe, ua hoʻokomo ʻia kahi wai kūikawā, kahi e hoʻomānoanoa a hoʻōki i ke kahe koko ma o ka aneurysm. Koho ke kauka i ke ʻano hana kūpono loa ma muli o ke ʻano a me kahi o ka aneurysm.
• ʻO ke ʻoki kino hāmama: Manaʻo ʻia kēia no ka poʻe hiki ʻole ke loaʻa ka lāʻau endovascular a i ʻole ʻaʻole i kūleʻa me ia. Maanei, wehe ke kauka i ka ʻāpana i hōʻino ʻia o ke aʻa. Pono paha ʻoe e wehe i kou spleen (splenectomy) .
• Kaʻina hana Laparoscopic: He hana invasive ʻole kēia ma mua o ke ʻoki hāmama, a ʻoi aku ka pōkole o ka manawa hoʻōla. ʻO kēia pinepine ke koho maikaʻi loa no ka mālama ʻana i ka wā hāpai.

E kamaʻilio me kāu kauka e pili ana i ka hoʻolālā lapaʻau kūpono loa iā ʻoe.

Nā pilikia o ka mālama ʻana

E wehewehe kāu kauka iā ʻoe i nā pilikia a me nā pilikia o ka mālama ʻana. ʻO ka mea maʻamau o kēia mau mea he kūlana i kapa ʻia ʻo post-embolization syndrome (PES) . ʻO nā hōʻailona o ka PES:

• Kuni.
• Ka luaʻi a me ka luaʻi.
• ʻEha ʻōpū.

Inā loaʻa iā ʻoe kēia mau hōʻailona ma hope o ka mālama ʻana, e kamaʻilio me kāu kauka. Hiki i kāu kauka ke kuhikuhi i nā mea hōʻeha ʻeha a i ʻole ka saline (nā wai IV) e kōkua i ka hōʻoluʻolu ʻana i kāu mau hōʻailona a hiki i kou hoʻōla ʻana.

He aha kaʻu e hana ai e hōʻemi i kēia pilikia?

He mea nui e mālama pono i nā kūlana olakino ʻē aʻe āu e loaʻa nei, ʻoiai nā mea e hoʻonui ai i kou pilikia o ka aneurysm aʻa splenic. E kamaʻilio me kāu kauka e pili ana i nā mea e pono ai ʻoe e hana no kou kūlana.

Eia kekahi mau mea maʻamau hiki iā ʻoe ke hana:

• E lawe i nā lāʻau lapaʻau a pau i kauoha ʻia iā ʻoe i ka manawa kūpono .
• Inā loaʻa iā ʻoe kekahi mau hōʻailona hou a inā loli paha kāu mau hōʻailona, ​​e haʻi koke aku i kāu kauka .
• E hele i nā hoʻokolohua lapaʻau makahiki , a e hele i kēlā me kēia manawa i hoʻonohonoho ʻia me ke kauka.

Eia kekahi, ʻo ka hana ʻana i kekahi mau loli o ke ʻano o ka nohona e hiki ke kōkua i ka mālama ʻana i ke olakino o kou mau kīʻaha koko āpau , me kou aʻa splenic.

• E hoʻōki loa i ka puhipaka a me ka hoʻohana ʻana i ka paka .
• E ʻai i ka meaʻai olakino no ka puʻuwai .
• E hoʻoikaika kino mau e like me ka ʻōlelo a kāu kauka.
• E kaupalena i ka inu ʻana i ka waiʻona .

Inā loaʻa iaʻu kēia maʻi, he aha kaʻu e manaʻo ai? He aha ka manaʻo?

Inā loaʻa iā ʻoe kahi aneurysm o ke aʻa splenic, e hahai pono i nā ʻōlelo a kāu kauka. ʻAʻole paha ʻoe e pono koke i ka lāʻau lapaʻau. Akā, hiki i kāu kauka ke ʻōlelo aku i ka mea a lākou e kapa nei he "kali makaʻala." ʻO ke ʻano kēia e loaʻa iā ʻoe nā hoʻokolohua kiʻi maʻamau (ʻo ia hoʻi i kēlā me kēia makahiki) e ʻike ai inā e nui ana ka aneurysm. He mea nui ka lāʻau lapaʻau kūpono e pale ai i ka pahū ʻana a i ʻole ka haki ʻana o kahi aneurysm.

ʻO ke kūlana no kekahi me kēia maʻi e pili ana i kekahi mau kumu:

• Ka nui a me kahi o ka aneurysm.
• Pehea ka wikiwiki o ka ulu ʻana o ka aneurysm .
• Inā paha e pahū ka aneurysm a i ʻole .
• Nā kūlana olakino ʻē aʻe a me nā kumu pilikia i loaʻa iā ʻoe.

He mea make pinepine ka haki ʻana o ka aneurysm o ke aʻa splenic. Ua hōʻike ʻia e ka noiʻi hiki i ka haki ʻana ke make i ka poʻe:

* Ma waena o 25% a me 40% o nā wahine hāpai ʻole.

* Ma waena o 65% a me 75% o nā wahine hāpai (ka nui o ka make ʻana o ka pēpē ma waena o 90% a me 95%).

* ʻOi aku ma mua o 50% o ka poʻe me ka portal hypertension .

ʻO ka haki ʻana o nā pseudoaneurysms o ke aʻa splenic he mea make pinepine ia .

E kamaʻilio me kāu kauka e pili ana i ka nānā ʻana no kou kūlana pilikino.

Pehea e hiki ai iaʻu ke mālama iaʻu iho? Āhea wau e ʻike ai i ke kauka?

ʻO ka noho ʻana me kahi Splenic Artery Aneurysm he mea paʻakikī iki ia...Hiki ke kaumaha . E noʻonoʻo paha ʻoe i ka mea e hana nei i loko o kou kino, a i ʻole e makaʻu paha ʻoe e pahū ka aneurysm.

He mea maʻamau ka hopohopo. E haʻi i kou mau manaʻo me kāu kauka. Hiki i kāu kauka ke ʻōlelo aku i ka mālama mua ʻana no kahi aneurysm i pilikia i ka haki ʻana. E noi i kāu kauka e hōʻike iā ʻoe i kāu mau hopena kiʻi a wehewehe i ko lākou manaʻo. ʻO ka nui o kou komo ʻana i kāu mālama ola kino, ʻo ka nui o kou manaʻo e kāohi i kou kūlana.

E haʻi aku kāu kauka iā ʻoe i ka pinepine o kou pono e hele mai no nā nānā kino a me nā hoʻokolohua kiʻi. Inā he mau nīnau kāu, hopohopo, a i ʻole nā ​​hōʻailona hou a loli paha, e kāhea koke i kāu kauka .

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

E noi i kāu kauka e wehewehe i kāu hōʻailona a me kāu hoʻolālā lapaʻau. Eia kekahi mau nīnau hiki iā ʻoe ke nīnau:

• Pehea ka nui o koʻu aneurysm?
• Aia i hea pololei ia?
• He aha ka manawa kūpono e pahū ai ?
• He aha nā hōʻailona e pono iaʻu e makaʻala ?
• Āhea wau e kamaʻilio ai me 1990 ?
• ʻEhia mau manawa e pono ai iaʻu e hele mai no nā hoʻokolohua lapaʻau ?
• He aha nā hoʻokolohua e pono ai iaʻu e hana? Pehea wau e hoʻomākaukau ai no lākou?

Eia kekahi, e nīnau i kāu kauka e pili ana i nā kumu ʻike hou aʻe e hiki ke kōkua iā ʻoe e hoʻomaopopo i kāu hoʻolālā hōʻoia a me ka mālama ʻana.

Leka Hoʻihoʻi Hope Loa

E like me nā aneurysms ʻē aʻe, ʻoi aku ka weliweli o nā aneurysms o ke aʻa splenic inā ʻaʻole mālama ʻia . Inā ʻike kāu kauka he loaʻa iā ʻoe kēia ʻano maʻi, ua hala mua ʻoe i hoʻokahi ʻanuʻu i mua. E nānā ke kauka i ke ʻano a haʻi iā ʻoe i ka wā e pono ai ʻoe i ka lāʻau lapaʻau.

Inā ʻoe e mālama ʻia ana no ka aneurysm a i ʻole ka haki ʻana, he mea nui e makaʻala i ka wā lōʻihi . Mai poina i nā manawa a kāu kauka, a kamaʻilio me kāu kauka e pili ana i nā hōʻailona hou a loli paha. E lilo i hoa hana i kāu mālama olakino a aʻo i nā mea hiki iā ʻoe e pili ana i kou kūlana. Me ka ʻike a me ka ʻike, hiki iā ʻoe ke hana pū me kāu hui lapaʻau e kōkua i ka hōʻemi ʻana i nā pilikia e hiki mai ana.

ʻAneurysm o ke aʻa Splenic, Spleen, Aʻa, ʻEha ʻōpū, Hāpai keiki, Nā kīʻaha koko