He toto o roto i te puku? (Hemoperitoneum) Me kōrero tātou mō tēnei!

Kua pāngia koe e te mamae o te puku kāore i te mārama te take, te ahua kī tonu, me te ahua pōuri ohorere? He āhuatanga ohorere pea tēnei. I tēnei rā ka kōrero tātou mō te hemoperitoneum, arā, te toto e puta ana i roto i te puku. Ehara tēnei i te mea ngāwari ki te mahi, nō reira he mea nui kia whakarongo pai.

I te whakarapopototanga, ko te Hemoperitoneum te kohikohinga toto i roto i te wāhi takoto kau i roto i tō puku, arā, te kōhao peritoneal. Ko te tikanga o 'Hemo' he toto, ā, ko te tikanga o 'peritoneum' he kiriuhi e whakarārangi ana i tēnei kōhao puku. Nō reira, he tino morearea te toto i roto i te tinana pēnei (e kiia ana hoki ko te toto o roto, ko te toto toto rānei) ā, me tere tonu te kawe ki te hōhipera.

He aha i tino kino ai tēnei?

Whakaarohia, he aha te mea ka tupu mēnā ka turuturu te toto i roto i tō tātou tinana i roto i ngā uaua ka kohia ki tētahi atu wāhi? Ka heke te nui o te toto e tae atu ana ki ō tātou whekau me ngā kiko tino nui. Ina rere te toto i roto i te tinana, kāore tātou e kite i te nui o te toto e rere ana me te tere o tōna nekehanga. Ina koa i roto i tēnei kōhao puku, ka taea te kohi i te nui o te toto. Ki te kore te toto e mutu i tēnei ara, ka tūpono te ngaronga o te toto kia tae ki te wāhi ka tūpono te ora. Koia te take he tino kino tēnei.

He aha ngā tohu?

Ka rerekē ngā tohu o te hemoperitoneum i ia tangata, i runga i te pūtake.

• Tērā pea ka pāngia koe e te mamae nui o te puku , te mamae rānei o te hope.
• Engari mō ētahi take, ka iti haere pea te mamae i a koe e haere mai ana.
• Tērā pea ka pupuhi tō puku, ka mamae hoki ina pā atu .
• Ki te haere tonu te toto, ka tīmata mārire te puta mai o ngā tohu o te anemia kino.
• Tērā pea ka pōuri koe, ka māuiui te mahunga, me te whakapairuaki .
• Tērā pea ka rongo koe i te pikinga o te tere o tō ngakau .

Mena ka pāngia koe e ēnei tohu, me rapu tonu koe i te tohutohu hauora.

He aha ngā take?

He maha ngā take pea o te hemoperitoneum, engari ko ētahi o ngā mea tino noa. Ka wehea e ngā tākuta ēnei take kia toru ngā wāhanga:

1. Ngā mamae

2. Ātaahua

3. Hei pānga taha o te maimoatanga hauora (Iatrogenic)

O ēnei, ko ngā whara nā ngā aituā me ngā hāputanga ectopic ngā tino take o te hemoperitoneum.

1. Hemoperitoneum whara

Ka puta tēnei mēnā ka whara tetahi okana, tetahi oko toto rānei i roto i tō puku. Ko ngā wāhi e pāngia ana ko te ate me te whēkau.Ka nui te toto e puta mai i ēnei whekau e rua. Ka puta pea i te whiunga kaha (te whara tuturu) i te mea rānei e wero ana i roto (te whara uru) i te wā o te aituā.

Whakaarohia ngā mea penei:

• Te hinganga mai i runga.
• Ngā aituā waka.
• Ngā tukinga i te wā e tākaro ana.
• He whiu tika ki te puku.
• He wero ki te maripi.
• He pū.

Ki te pāngia koe e te mamae o te puku, e ētahi atu tohu rānei i muri i tētahi aituā kino pēnei, ko te mea pai ko te haere tonu ki te hōhipera.

2. Hemoperitoneum Tūpono

Ka kiia tēnei ko te Hemoperitoneum Ātaahua, Kore-Tūkino rānei. He toto tēnei e puta noa mai ana, kāore he mōrearea. Ka puta pea i tētahi mate, i tētahi atu tukanga rānei i roto i te tinana. I ētahi wā ka pakaru te okana, te uaua toto rānei i roto, nā te pupuhi mai i roto, nā tētahi whara o mua rānei. Ka puta hoki ngā tipu kiko rerekē (pēnei i ngā pukupuku) i roto i te puku, ā, ka toto.

Me titiro tātou ki ētahi take:

• He uaua toto kua pakaru (Ruptured Aneurysm).
• Te pakaru o te malformation arteriovenous (AVM).
• Pakaru o ngā varicose o te puku.
• Te pakaru o te hematoma.
• Ka pupū ake ngā pukupuku.
• He pakaru o te whēkau ovarian.
• He hapūtanga ectopic pakaru - he mea motuhake tēnei ki ngā wāhine.
• Te Pakaru Āhuakore o te Wāhanga.
• Te poka o te puku, te puku rānei (Gastrointestinal Perforation).
• Puku Auaha Pōkākā.
• Pancreas toto nui.

3. Hei pānga taha o te maimoatanga hauora (Iatrogenic Hemoperitoneum)

Ka puta tēnei hei pānga taha o tētahi maimoatanga hauora. He tino onge tēnei, engari ka taea. Ka puta tēnei mēnā ka pakaru pōrearea tētahi okana, tētahi oko toto rānei i te wā e rongoatia ana.

Ētahi tauira:

• Ngā pokanga puku, pērā i te laparoscopy, ngā pokanga e tango ana i te okana, te whānautanga rānei o te pēpi mā te pokanga cesarean.
• Ngā whakamātautau hei tango tauira kiko (Biopsy), hei tauira, mai i te ate (Liver Biopsy) mai i te tākihi rānei (Kidney Biopsy).
• Ngā tikanga mō te whakauru i tētahi ngongo (catheter) mā roto i te puku, arā, i te wā e mahi ana i te PEG, i te Paracentesis rānei.
• Ko ngā whakamātautau endoscopy, hei tauira, he endoscopy o runga, he colonoscopy rānei.

Ki te pāngia koe e ētahi tohu rerekē i muri i tētahi mea pēnei, he mea nui kia kōrero koe ki te tākuta nāna koe i rongoā.

He aha tōna pānga ki ngā wāhine?

Kei roto hoki i tēnei kōhao puku ngā okana o te pūnaha whakaputa uri wahine. Nō reira, ka taea hoki e rātou te toto ki roto i te puku i tēnei ara. Hei tauira, ka puta pea ngā mea pēnei i te pakaru o ngā ovaries (ngā ovaries kua pakaru) me te haputanga ectopic . He āhuatanga tino tere ēnei.

He maha ngā huarahi ka piki ake ai te mōrearea o te hemoperitoneum i te wā e hapu ana. Ka tere te tipu o ētahi momo pukupuku ate, ka pakū hoki i te wā e hapu ana. Waihoki, ka puta te toto i te wā e whānau ana, nā te mea kāore i te āta whakaarohia, nā te take hauora rānei.

He mōrearea motuhake tēnei i te wā e hapu ana? (Spontaneous Hemoperitoneum in Pregnancy - SHiP)

He mate onge te Hemoperitoneum Tūpono i te Wā Hapūtanga (SHiP) e puta ana i te wā e hapū ana. I te nuinga o te wā ka puta i te toru marama tuarua, tuatoru rānei. Kāore i te mōhiotia te tino take. I te nuinga o te wā, he pakaru o te uaua toto. Engari kāore anō kia tino mārama ngā tākuta he aha i puta ai. E kī ana ētahi taunakitanga he hononga pea ki te endometriosis o mua, ki te whakatōnga in vitro rānei (IVF) .

He ētahi atu āhuatanga mōrearea anō kei reira?

Āe, ka taea e ētahi atu mea te whakanui ake i tēnei mōrearea.

• Mena he mate toto tōu, he ngoikore rānei te toto e totohu ana, he nui ake te tūponotanga ka toto koe. Kei roto i tēnei ko te toto ohorere, te toto nui rānei mai i ngā whara iti. Tērā pea ka nui ake ō toto i ētahi atu.
• Mō te hunga whai mate pūmau, ki te kino haere te mate, ā, ka pahū tetahi okana, ka taea e rātou te totohu noa ki roto i te puku. Heoi, ehara tēnei i te mea tino noa.

He aha ngā raruraru ka pā mai?

He mea kino te toto i roto i te puku nā te mea he mea kei roto i te tinana, ā, ka tino kino rawa atu i te wā e mōhio ai koe. Ka puta ngā raruraru mēnā ka tere te ngaro o te toto. Ko te nui o te toto me te tere o te puta ka whakawhirinaki ki te take tuatahi (whara, mate rānei), te nui o te toto i te nuinga o te wā, me te tere o te whiwhi maimoatanga.

Ki te nui te toto, ka arahi pea ki tētahi āhuatanga e kiia nei ko te Hypovolemic Shock. Haunga tēnā, ka pā mai pea te ngoikore o ngā okana, tae atu ki te mate. Nō reira, he āhuatanga tino tere tēnei, kaua e moumou tetahi hēkona.

Me pēhea te kimi i tēnei? (Tauātanga)

Mena he toto o roto tōu, he mea nui kia tere te tātaritanga. Ina hiahia ngā tākuta ki te kite wawe i ngā mea e tupu ana i roto i tō tinana, ka tīmata rātou me te whakamātautau whakaahua tere.

• Ko te tikanga he ultrasound.He mea pērā i te matawai CT.
• He whakamātautau taha moenga te FAST Ultrasound i hangaia mō te tirotiro i te toto i roto i tō puku. Ko te FAST he kupu whakarāpopoto mō te Focused Assessment with Sonography for Trauma.

I te nuinga o te wā, ka taea e ngā tākuta te whakamahi i ēnei whakamātautau whakaahua hei tirotiro mēnā kei a koe te hemoperitoneum me te wāhi e puta mai ai te toto. Engari i ētahi wā, kāore e mārama ngā whakaahua. Me tango pea e rātou he tauira wai mai i tō puku mā te whakamahi i te ngira, i te ngongo rānei (paracentesis). Mēnā kei te tino mate koe, me kawe pea koe ki tētahi pokanga tirotiro, arā, he pokanga hei kimi i te raruraru me te whakatika tonu.

He aha ngā maimoatanga?

Kia kitea te take o te toto i roto i te puku, ka tirohia e te tākuta te pūtake mai o te toto, me te kite mēnā kei te puta tonu mai. Mēnā kei te puta te toto, me mutu tonu. Ka whakawhirinaki te āhua o tēnei mahi ki tō āhua.

• Mēnā he āhuatanga ohorere, me mahi pea koe i tētahi pokanga ohorere hei whakatika i tētahi patunga, hei kati rānei i tētahi oko toto.
• Mena kei te pumau tō āhua, kāore pea e taea e koe te mahi i tētahi mea nui, ka taea noa e koe te whakahaere i te mate me te āta whakaaro.

Kei roto pea i ngā maimoatanga:

• Te Whakahaere Mamae.
• Te whakawhiti toto.
• Te Whakarerenga/Te Waipuke.
• Te rongoā i te mate taketake.
• Ko te embolization he maimoatanga e aukati ana i te oko toto.
• Ngā tikanga endoskopi hei kati i te patunga.
• He tikanga pokanga te Laparoscopy hei tātaritanga i te raruraru me/ranei hei whakatika i te patunga mā te whakamahi i taua tikanga anō.
• Te pokanga puku mā te pokanga laparotomy tūhura hei kimi i te raruraru, hei whakatika rānei i te patunga.

Kei te pēhea te tumanako mō te whakaoranga?

Ko tō whakaoranga ka whakawhirinaki ki te tere o te whiwhi maimoatanga me te pai o te rere o tō toto. Mena he mate toto toto tōu, he mate pūmau rānei e pā ana ki tō hauora whānui, tera pea ka kino ake tō āhua. Mā te whiwhi maimoatanga i te wā e taea ai ka āwhina i te ārai i ngā raruraru mai i te ngaronga toto nui. Mena ka taea e koe te ārai i aua raruraru, he nui ake te tūponotanga ka ora katoa koe.

He āhuatanga ohorere te hemoperitoneum e puta ohorere ana, kāore i te tūmanakohia. Mēnā kua pāngia koe e te aituā, tērā pea kei te whiwhi āwhina hauora koe. Engari ki te kore, tērā pea kāore koe e mōhio ki te aha e tupu ana ina puta mai ngā tohu.Ko te mea nui kia kaua e warewarehia ō tohumate, me rapu tohutohu hauora i mua i te kino haere. Ki te pā wawe te mate ki a koe, ā, ka whiwhi maimoatanga koe, he pai te tūponotanga ka ora koe.

Hei whakamutunga, ngā mea me maumahara koe

He āhuatanga ohorere morearea te hemoperitoneum, ka puta te toto i roto i te puku.

• Ki te pāngia koe e ngā tohu pēnei i te mamae ohorere o te puku, te pupuhi, te whanoke, te ngoikore rānei , kaua e whakahawea.
• Ka puta pea tēnei hei pānga taha o ngā aituā, o ētahi mate, o ngā raruraru e pā ana ki te hāputanga, me ngā maimoatanga hauora.
• Ko te mea nui ko te tautuhi me te rongoā i te mate i te wā wawe. Ki te pērā koe, ka taea e koe te ārai i ngā raruraru nui me te ora katoa.
• Ki te pā mai ēnei tohu ki a koe, me toro atu ki te tākuta tonu , me haere rānei ki te hōhipera tata. He mea nui te wā ki konei. Kaua e manukanuka, engari kia tere.

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