Omanyi embeera eyitibwa Endoleak ebaawo oluvannyuma lw'okujjanjabwa emisuwa?

Wali owuliddeko ku `Aneurysm`, embeera nga bbugwe w'omusuwa oba omusuwa omunene mu mubiri gunafuwa ne gubumbulukuka nga bbaatule? Mpozzi nga obadde nayo, era abasawo bagijjanjabe nga bateekamu akatuba akatono akayitibwa `Stent Graft`, nga eno nkola eyitibwa `Endovascular`, ekitegeeza nga tosalako kinene. Kilowoozeeko ng’okukulukuta mu payipu y’amazzi enkadde. Kale abasawo bateekamu ttanka endala munda mu leak okuginyweza. Wabula oluusi oluvannyuma lw’obujjanjabi obwo, omusaayi omutono gutandika okukulukuta okuva mu `Stent Graft`, mu nsawo awaali `Aneurysm`. Ekyo kye tuyita `Endoleak` mu busawo. Leero, tugenda kwogera mu bujjuvu katono ku kino ddala kye kiri, lwaki kibaawo, kya bulabe, engeri y’okukizuulamu, n’obujjanjabi bwe buli.

Ddala `Endoleak` kye ki?

Mu ngeri ennyangu, `Endoleak` kitegeeza nti oluvannyuma lwa `Aneurysm` okujjanjabwa n'okusibibwa, omusaayi gutandika okuddamu okukulukuta munda mu nsawo enkadde eya `Aneurysm`. Kati, laba, ebiseera ebisinga nga `Aneurysm` ejjanjabwa, omusaayi gwo gukulukuta mu ttanka ya `Stent Graft` eyaakayingizibwa yokka. `Stent Graft` eno eringa ekiwanirizi ky'ekisenge ky'emisuwa ekinafuye. N’olwekyo, omusaayi tegukulukuta kugenda mu kitundu ky’omusuwa ekyonooneddwa, ekibumbujja, kwe kugamba, `Aneurysm Sac`. Olwo `Aneurysm` n'ekoma okukula n'okukutuka. Kibeere kirungi singa tewabaawo musaayi.

Naye singa olw’ensonga ezimu omusaayi gukulukuta ebweru wa `Stent Graft` ne guyingira mu `Aneurysm Sac`, ekyo kiyitibwa `Endoleak`. Waliwo ensonga ez'enjawulo lwaki `Endoleak` eno ebaawo. Ebimu ku byo biva ku buzibu ku `Graft` yennyini, ate ebimu biyinza okuba nga biva ku misuwa emirala emitono egitandikira ku `Aneurysm Sac`. Kiba ng’amazzi agakulukuta okuva mu bifo ebimu oluvannyuma lw’okuggulawo akasolya.

Singa `Endoleak` ebaawo mu nnaku 30 okuva ku bujjanjabi buno obwa `Endovascular`, tugiyita ``early endoleaks`` . Ezo ezikula oluvannyuma lw'ennaku 30 ziyitibwa ``secondary endoleaks`` oba ``late endoleaks`` .

`Endoleak` ya bulijjo etya?

Kati oyinza okuba nga weebuuza oba `Endoleak` eno kintu ekituuka ku buli muntu oba kintu ekitatera kubaawo. Mu butuufu, embeera eno eya `Endoleak` esobola okubaawo mu bantu nga 1 ku buli 4 abakola `Endovascular Aneurysm Repair` (tugiyita `EVAR` mu bufunze - buno bujjanjabi okusinga ku `Aneurysm` mu bbugwe w'olubuto) oba `Thoracic Endovascular Aneurysm Repair` (`TEVAR`) ku `Aneurysm` mu kifuba . Kale, si bwe kityo ekitawuliddwa. Eno y’ensonga lwaki kikulu nnyo okukimanya ku nsonga eno.

`Endoleak` ya bulabe?

Kino kiyinza okukutiisa katono. "Oo, ntya nti egenda kuddamu okuvaamu omusaayi, si bwe kiri?" Naye si endoleaks zonna nti za bulabe . Endoleaks ezimu tezireeta bulabe bwonna era zitereera ku bwazo. Nga ekiwundu ekitono bwe kiwona ku bwakyo. Mu mbeera ng’ezo, omusawo ayinza okusalawo okulondoola embeera yo yokka. Kino kitegeeza okugenda mu maaso n’okukola ebigezo n’okulaba ekiddako.

Wabula ebika ebimu ebya `Endoleak` biba bya maanyi katono. Okuziyiza okusobola nti `Aneurysm` eyo okuddamu okukula n'okubutuka, yeetaaga okujjanjabibwa mu bwangu. Kubanga singa `Aneurysm` ekutuka, kiyinza okutta obulamu. Kale, oba kino kya bulabe oba nedda kisinziira ku kika kya `Endoleak` n'ekifo we kiri. Abasawo basalawo nga basinziira ku bintu bino byonna.

Bika ki ebya `Endoleak` ebiriwo?

Mu kiseera kino waliwo ebika bya `Endoleak` bitaano ebizuuliddwa. Buli kika kirina ekivaako eky’enjawulo. Nga buli bulwadde bwe bulina ekibuvaako. Olw'okukulaakulanya tekinologiya omupya owa `Stent Graft`, ebika ebimu ebya `Endoleak` kati bikendedde katono, ekintu ekirungi.

Ku bino , `Type 2 Endoleak` y'esinga okubeerawo . Naye , `Type 1` ne `Type 3` endoleaks are a bit more dangerous , nga zongera obulabe bwa `Aneurysm` okukutuka (`okukutuka`). Ka twekenneenye nnyo ebika bino.

`Ekika 1 Endoleak`

Kino kibaawo ng’ekisenge kya stent tekikwatiddwa bulungi ku bbugwe w’omusuwa, ekitegeeza nti tekisibiddwa bulungi. Teebereza, singa wabaawo ekituli ekitono wakati w’ekibikka ne bbugwe, amazzi gajja kukulukuta okuva awo, era omusaayi gujja kukulukuta okuva ku nkomerero eya waggulu (proximal) oba eya wansi (distal) ey’ekisenge kya stent ne gugenda mu nsawo y’emisuwa. Endoleak ey’ekika kya 1 mbeera ya maanyi, n’olwekyo ebiseera ebisinga yeetaaga okujjanjabibwa mu bwangu. Bino bitera okukutuka emisuwa okusinga ebika ebirala. Kino abasawo bwe bakiraba, bajja kubaako ky’akolawo mangu.

`Ekika kya 2 Endoleak`

Kino kye kika kya endoleak ekisinga okubeerawo . Kitera nnyo oluvannyuma lwa EVAR okusinga TEVAR ku misuwa gy’olubuto. Okukulukuta kuno kubaawo ng’omusaayi gukulukuta okuva mu aorta yo oba omusuwa ogussiddwako stent ne guyingira mu nsawo y’emisuwa nga guyita mu misuwa emitono (emisuwa gy’amatabi oba emisuwa egy’omusingo). Teebereza nti omusuwa gwo gulina amatabi amatonotono (amatabi). Kati ne bwe tussaako ekyuma ekipya ekiyitibwa stent graft okuziba ekituli mu aorta, omusaayi ogumu gukyayinza okukulukuta okuva mu matabi ago. Bw’atyo Type 2 endoleak bw’eri.

Ebiseera ebisinga, Endoleaks ez’ekika kya 2 zizuulibwa mu nnaku 30 ng’omaze okujjanjabwa Endovascular. Naye oluusi zisobola okubaawo oluvannyuma, ezimanyiddwa nga "late endoleaks." Ebitundu nga 40% ku Endoleaks ez’ekika kya 2 zizuulibwa oluvannyuma lw’ennaku 30. Ebitundu nga 8% bazuulibwa oluvannyuma lw’omwaka mulamba nga bajjanjabiddwa.

Naye `Type 2 Endoleaks` ezisinga si za bulabe bwe zityo . Zitereera ku bwazo oluvannyuma lw’emyezi nga mukaaga nga tebalina bujjanjabi bwonna. Kubanga obusuwa obwo obutono buggalawo ku bwabwo. Ne bwe batatereera, singa `Aneurysm Sac` ebeera nnywevu ate nga tegenda kukula, omusawo asobola okugitunuulira. Naye oluusi n'oluusi, okumala ekiseera, `Type 2 Endoleak` eno esobola okuleeta enkyukakyuka mu `Aneurysm Sac` n'efuuka `Endoleak` ey'obulabe ennyo nga `Type 1` oba `Type 3`. Ekyo bwe kibaawo, kyetaagisa obujjanjabi. Singa `Aneurysm` eba nnene okusinga milimita 5 (`5mm`), oyinza okwetaaga obujjanjabi. Singa `Aneurysm` erekebwa nga tejjanjabiddwa, waliwo omukisa nti `Aneurysm` ejja kukutuka.

`Ekika kya 3 Endoleak`

Endoleak ey’ekika kya 3 ebaawo ng’ebitundu bya modulo ebikwatagana eby’ekisenge kyo ekya stent byawukana, oba singa olugoye lw’ekisenge kyennyini lukutuka oba lwe lukutuka. Kino kifaananako ne payipu eyawukana ku kiyungo, oba ekituli ne kikolebwa mu payipu yennyini. Okufaananako ne Type 1 Endoleak, waliwo akabi k’okubutuka kw’omusuwa kubanga omusaayi gukulukuta butereevu mu nsawo y’emisuwa nga puleesa. N’olwekyo, kyetaagisa nnyo okufuna obujjanjabi obw’amangu. Wabula olw’enkulaakulana mu dizayini y’ebyuma, Type 3 Endoleaks tezitera kubaawo.

`Ekika 4 Endoleak`

Kino kibaawo ng’omusaayi gukulukuta okuyita mu butuli obutonotono obuli mu stent graft (obutuli bw’ekintu ekissiddwa). Kino kitera okulabibwa nga bukyali mu bujjanjabi, naye emirundi mingi kiwona ku bwakyo. Kino kizibu ekitali kya bulijjo nnyo eky’okusimbuliza, era tekitera kubaawo nnyo ku nsengekera ezikozesebwa ennaku zino.

`Ekika kya 5 Endoleak`

`Endoleak ey'ekika kya 5` era eyitibwa ``Endotension``. Kino kyewuunyisa katono. Ekibaawo mu mbeera eno kiri nti, newankubadde nga tewali kabonero ka ``Endoleak`` ku kugezesebwa kwa ``Imaging``, ``Aneurysm Sac`` yeeyongera okukula. Wadde nga ekituufu ekivaako kino tekitegeerekeka bulungi, kirowoozebwa nti wayinza okubaawo ``okutambuza puleesa`` okuyita mu ``Stent Graft``, wadde nga tewali kukulukuta kwa musaayi kulabika. Eno nayo mbeera eyeetaaga okulondoolebwa.

Bubonero ki obw'obulwadde bwa `Endoleak`?

Kino kye kizibu abantu bangi kye balina. Ebiseera ebisinga tewabaawo bubonero bwe wandisuubidde okulaba oba olina endoleak. Oyinza obutalaba njawulo yonna. Endoleak ezuulibwa okusinziira ku kukebera ebifaananyi okukolebwa ku lunaku lw’obujjanjabi bwo n’okukeberebwa okugoberera okukolebwa oluvannyuma.Y’ensonga lwaki kikulu nnyo, nnyo okugenda ku bigezo ebyo eby’okugoberera. Okugenda okwekebeza ku nnaku zennyini omusawo z’agamba nti y’engeri yokka ey’okuzuula amangu ekintu nga kino.

Naye singa omusuwa gweyongera obunene ne gukutuka (omusuwa ne gukutuka) olw’okukulukuta kw’omubiri (naddala ekika eky’obulabe), kiba kya mangu mu by’obujjanjabi . Singa kino kibaawo, obubonero buno wammanga buyinza okulabika. Kino bwe kibaawo olina okukuba ku ssimu 911 oba okugenda mu ddwaaliro erikuli okumpi mu bwangu :

• Omubiri gunnyogoga era gutuuyana (`Clammy, sweaty skin`).
• Okuziyira, okuwulira nga weekulukuunya mu mutwe.
• Okuzirika, okubulwa amagezi.
• Omutima gukuba mangu (`Fast heartbeat`).
• Okuziyira n’okusiiyibwa.
• Okukaluubirirwa okussa, okuwulira ng’oziyira (okussa obubi).
• Obulumi obw’amangu, obw’amaanyi mu lubuto, wansi w’omugongo oba amagulu.
• Obulumi obw’amangu obw’amaanyi era obukutuse mu kifuba oba mu mugongo.

Obubonero buno bwe bulabika, tolwawo.

Osanga otya `Endoleak`?

Nga bwe kyayogeddwako emabegako, endoleak ezuulibwa nga bayita mu kukebera ebifaananyi. Okukebera kuno kukolebwa mu kiseera ky’okuddaabiriza emisuwa gyo egy’omu misuwa n’oluvannyuma lw’okuddaabiriza. Ebiseera ebisinga, kizuulibwa ku lunaku lwe lumu oba mu nnaku 30 oluvannyuma lw’okulongoosebwa. Kyokka oluusi kiyinza okumala emyezi 12 oba n’okusingawo. Eno y’ensonga lwaki kikulu nnyo okukuuma enteekateeka zo zonna ez’okugoberera. Okufaananako n’okukola saaviisi y’emmotoka, kino kyetaaga okufaayo obutasalako.

Ebigezo okuzuula `Endoleak`

Ebigezo ebikulu ebikozesebwa okuzuula `Endoleak` nga bajjanjabwa n'oluvannyuma lw'okujjanjabwa bye bino:

• `Computed Tomography (CT) scans`: Kino kikwata ebifaananyi ebisalasala eby'omunda mu mubiri. `Stent Graft`, `Aneurysm Sac`, n'okukulukuta kw'omusaayi bisobola okulabibwa obulungi.
• Doppler Ultrasound: Eno ekozesa amaloboozi okutunuulira engeri omusaayi gye gutambulamu. Kisobola okuzuula oba waliwo endoleak n’engeri omusaayi gye gutambulamu.
• Angiogram: Mu kino, amazzi ag’enjawulo (contrast dye) gafukibwa mu misuwa ne bakwatibwa ebifaananyi bya X-ray. Okutambula kw’omusaayi n’okukulukuta bisobola okulabibwa obulungi.

Ebigezo bino bisobola okuyamba okuzuula oba obujjanjabi bwo bufunye buwanguzi, oba ekisenge kya stent kiri mu kifo kyayo, era oba waliwo okukulukuta kwonna okwetooloola stent.

Ojja kwetaaga okukola ebigezo bino ebya `imaging` okumala emyezi oba emyaka oluvannyuma lw'okujjanjabwa. Omusawo ajja kukubuulira ku kukeberebwa kuno n’emirundi gy’osaanidde okukeberebwa. Naye ebigezo bino byetaagisa okukwata `endoleak` yonna eyinza okukula oluvannyuma (`secondary endoleaks`) mu bwangu n'okugijjanjaba bwe kiba kyetaagisa.

Bujjanjabi ki obwa `Endoleak`?

Ttiimu yo ey’abasawo ejja kujjanjaba Endoleak yo okusinziira ku byetaago byo ssekinnoomu. Engeri Endoleak gy’eddukanyizibwamu ya njawulo eri buli muntu. Kino kijja kusinziira ku kika ky’omubiri gwo (okugeza, obuwanvu bw’ensingo y’omusuwa gwo, ekifo emisuwa we gibeera n’ebirala), ekika kya Endoleak, n’ekifo we kiri. Okutwaliza awamu, waliwo enkola ssatu enkulu ez’okujjanjaba Endoleak: okwetegereza, okujjanjaba emisuwa, ne/oba okulongoosa mu lwatu.

Okwetegereza

Bw'oba olina ekika ky'endoleak ekitali kya maanyi nnyo, gamba nga Type 2 endoleak, omusawo ayinza okukuwa amagezi okukozesa enkola ya "watchful waiting" okulaba oba ejja kuwona ku bwayo. Kino kiyinza okubaawo singa emisuwa egigatta gizimba (clot off), ne kiyimiriza omusaayi okugenda mu nsawo y’emisuwa. Naye singa endoleak ereetera ensawo y’emisuwa okunene (i.e., ennene okusinga mm 5), ojja kwetaaga obujjanjabi okugiziyiza okukutuka.

Obujjanjabi bw’emisuwa

Buno bwe bujjanjabi obusinga okukozesebwa ku bulwadde bwa endovascular aneurysm. Omusawo wo alongoosa emisuwa gy’omubiri asobola okuddaabiriza emisuwa gy’omubiri ng’akozesa obukodyo obutayingira mu mubiri. Mu bino biyinza okuli:

• Okuziba emisuwa gy’omusaayi egy’amatabi egigabira omusaayi mu misuwa. Kwe kugamba, ekintu eky’enjawulo (embolizing agent) kifukibwa mu misuwa emitono egireeta Type 2 Endoleak ne giggalwa.
• `Stent Graft` nkola erimu okuteeka ebitundu bya `Stent` ebirala (`cuffs oba extenders`) okusukka ekifo ekikulukuta, okugaziya ekitundu ky'omusuwa gwo omunene (`Aorta`) `Stent` mwe yateekebwa. Kino kitera okukolebwa ku `Type 1 Endoleak`.
• Okugenda butereevu mu nsawo y’emisuwa n’okusiba ensawo y’emisuwa ng’okozesa ebintu ebiringa kalaamu.

Enkola zino zisobozesa obujjanjabi okukolebwa awatali kutema kinene, nga bayita mu kinnya ekitono.

Okulongoosa (`Okulongoosa mu lwatu`)

Singa obujjanjabi bw’emisuwa tebusoboka oba ne bulemererwa, okulongoosa mu lwatu ebiseera ebisinga kye kisembayo. Kino kizingiramu okusala ekitundu ekinene, okugenda mu misuwa, n’okuddaabiriza stent graft oba okuyingizaamu empya. Kino tekitera kubaawo nnyo, kubanga obukodyo bw’emisuwa gy’omubiri kati busingako nnyo.

Kiki ky'osuubira singa oba olina `endoleak`?

Ebiseera ebisinga, Endoleak tekyetaagisa bujjanjabi naddala Type 2. Ne bwe kiba nti obujjanjabi bwetaagibwa, waliwo enkola nnyingi ezitayingirira nnyo nga zeetaaga okusalako okutono. Obujjanjabi buno obw’emisuwa (Endovascular treatments) bulaze nti buwanguzi bwa waggulu nnyo. Okugatta ku ekyo, tekinologiya omupya akyagenda mu maaso n’okulongoosa enkozesa y’ebintu ebiteekebwamu stent ebikendeeza ku bulabe bw’okulwala Endoleak.

Bw’oba ​​olina endoleak, tosattira. Omusawo ajja kukunnyonnyola engeri gy’oyinza okukozesaamu obujjanjabi. Ekisinga obukulu nti ojja kusigala ng’okola okukeberebwa okugoberera ne bwe kiba nti endoleak ewonye.Kikulu nnyo okuzuula n’okujjanjaba ebizibu byonna ebiyinza okubaawo mu biseera eby’omu maaso n’ekintu kyo eky’okusimba stent amangu ddala nga bwe kisoboka, okufaananako n’okuddaabiriza mmotoka.

Ddi lwe nnina okulaba omusawo wange?

Kakasa nti okuuma essaawa zonna ez’okugoberera oluvannyuma lw’obujjanjabi bwo obwa EVAR oba TEVAR. Omusawo ajja kukubuulira emirundi gy’olina okukeberebwa ebifaananyi. Ebiseera ebisinga, zijja kuba zisembereragana mu kusooka, naye ziyinza okweyongera okubeera ez’enjawulo oluvannyuma lw’ekiseera. Goberera ddala ebiragiro ebyo.

Ate era bw’ofuna obubonero obw’amangu obujja n’omusuwa ogukutuse, nga bwe kyayogeddwako emabegako, genda mu ddwaaliro mangu nga tolinze.

Ebibuuzo by’olina okubuuza omusawo wo

Oluvannyuma lw’okukola EVAR oba TEVAR, buuza omusawo wo ku bulabe obuyinza okuva mu bizibu. Era, yogera ku bigezo ebigoberera n‟ebigezo by‟okukuba ebifaananyi by‟osuubira. Osobola okubuuza ebibuuzo nga:

• Biki ebiyinza okuva mu bujjanjabi buno? Obulabe ki obw’okufuna endoleak?
• Mirundi emeka gye nneetaaga okujja okugoberera? Kika ki eky’okukebera (nga CT, ultrasound) kye nja okwetaaga okukola?
• Bujjanjabi ki bwe nnina singa nfuna `endoleak`?
• Nkyukakyuka ki mu bulamu bwe nsobola okukola okuyamba omutima gwange obulamu n’okukuuma ekyuma kyange ekya stent nga kiri mu mbeera nnungi? (e.g., okulekera awo okunywa sigala, okukola dduyiro, endya)

Kikulu nnyo okubuuza ebibuuzo nga bino okusobola okutegeera obulungi embeera gy’olimu.

Bubaka ki bwe tuyinza okutwala awaka okuva mu mboozi eno?

Endoleak kizibu ekiyinza okuddukanyizibwa ekiyinza okubaawo oluvannyuma lw’okuddaabiriza endovascular aneurysm. Oyinza obuteetaaga bujjanjabi bwonna. Kyokka bw’okola bw’otyo, omusawo ajja kwogera naawe ku bujjanjabi obukusaanira.

Kitera okubaawo ebizibu nga bino oluvannyuma lw’okukola enkola etaasa obulamu, gamba ng’okujjanjaba obulwadde bw’emisuwa. Kyokka, emigaso gy’enkola eno gisinga wala akabi akali mu nkola eno . Kale tosattira singa ozuula ku endoleak.

Ekisinga obukulu kwe kugenda mu ssaawa z’okugoberera omusawo z’akuwa n’ofuna okukeberebwa kw’akuteesa. Mu ngeri eyo, ebizibu byonna bisobola okuzuulibwa n’okujjanjabibwa mu bwangu.

Bw’owulira ng’okooye era ng’ozitoowereddwa, kiba kya bulijjo. Abantu bangi bayita mu kintu kye kimu nga ggwe. Yogerako n’omusawo wo n’ab’omu maka go ku ngeri y’okuddukanyaamu situleesi ejja n’okuwona. Toli wekka.

` Endoleak, Aneurysm, Stent Graft, EVAR, TEVAR, Okuvaamu omusaayi, Okuzimba emisuwa, Stent Graft, Obulwadde bw’omutima