ʻO ka pale ʻana i ka maʻi Hepatic (Bud-Chiari)

ʻO ka pale ākea Hepatic kahi paʻa o ka aa hepatic, e lawe ana i ke koko mai ke ake.

ʻO ka pale ʻana i ke aa koko Hepatic e pale i ke kahe ʻana o ke koko mai ke ake a hoʻi i ka puʻuwai. Hiki i kēia paʻa ʻana ke hoʻopōʻino i ke ake. Hiki ke hoʻopili ʻia kēia aʻa e ka tumo a i ʻole ka ulu ʻana e kaomi ana i ka moku, a i ʻole ke ʻōpala i loko o ka ipu (thrombosis hepatic vein).

ʻO ka hapanui pinepine, kumu ʻia ia e nā ʻano e hana i nā kahe koko, e like me:

• Ka ulu maʻamau o nā hunaola i ka iwi iwi (myeloproliferative disorders)
• Nā maʻi ʻōiwi
• Nā maʻi kūpilikiʻi a autoimmune paha
• Nā maʻi ʻino
• Hoʻoilina (hoʻoilina) a i ʻole loaʻa nā pilikia me ke kāpili ʻana i ke koko
• Nā ʻoki lāʻau waha
• Hapai keiki

ʻO ka Hepatic vein blockage ke kumu maʻamau o ka maʻi ʻo Buddh-Chiari.

ʻO nā hōʻailona me:

• ʻO ka ʻōpū o ka ʻōpū a i ʻole ke kīloi ʻana ma muli o ka wai i loko o ka ʻōpū
• ʻEha ma ka ʻōpū luna pono
• Koko luaʻi
• Melemele o ka ʻili (jaundice)

ʻO kekahi o nā hōʻailona ka pehu ʻana o ka ʻōpū mai ka paʻa ʻana o ka wai (ascites). Pehu pinepine ke akepaʻa a palupalu hoʻi.

Loaʻa i nā hoʻāʻo:

• CT scan a MRI paha o ka ʻōpū
• ʻO Doppler ultrasound o nā ate veins
• ʻO ka biopsy ate
• Nā hoʻāʻo hana ate
• Ultrasound o ke ake

Hoʻololi nā lāʻau lapaʻau, e like me ke kumu o ka paʻa.

Hiki i kāu kauka olakino ke ʻōlelo i nā lāʻau aʻe:

• Nā koko lahilahi (anticoagulants)
• ʻO nā lāʻau lapaʻau (lole thrombolytic)
• Nā lāʻau lapaʻau e mālama i ka maʻi o ke ake, me nā ascites

Paipai ʻia ke ʻoki. Pili paha kēia:

• Hoʻonohonoho Angioplasty a me stent
• Transjugular intrahepatic portosystemic shunt (TIPS)
• ʻOki kino Venous shunt
• Ka hoʻoliʻiliʻi ate

Hiki ke ʻoi aku ka pale ʻana o ka Hepatic vein a alakaʻi i ka cirrhosis a me ke kō ʻole o ke ake. Hiki i kēia ke hoʻoweliweli i ke ola.

Kāhea i kāu mea hāʻawi inā:

• Loaʻa iā ʻoe nā ʻōuli o ka pale o ka maʻi hepatic
• Mālama ʻia ʻoe no kēia maʻi a hoʻomohala ʻoe i nā hōʻailona hou

ʻO ka maʻi ʻo Budd-Chiari; Maʻi ʻo Hepatic veno-occlusive

• ʻŌnaehana Digestive
• Nā ʻōnaehana ʻōnaehana Digestive
• Hoʻomaʻamaʻa koko
• Huʻi koko

Kahi CJ. Nā maʻi Vascular o ka gastrointestinal tract. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 134.

ʻO Nery FG, Valla DC. Nā maʻi vascular o ke ake. I: Feldman M, Friedman LS, Brandt LJ, eds. ʻO Sleisenger a me Fordtran's Gastrointestinal a me ka maʻi ate. 11th hua. Piladelapia, PA: Elsevier; 2021: chap 85.