ʻO ka ischemia ʻōpū liʻiliʻi a me ka infarction

Hiki i ka ischemia Intestinal a me ka infarction ke hiki i kahi ākea a blockage paha o hoʻokahi a ʻoi paha o nā aʻa e hoʻolako i ka ʻōpū liʻiliʻi.

Aia kekahi mau kumu kūpono o ka ischemia ʻōpū a me ka infarction.

• Hernia - Inā neʻe ka ʻōpū i kahi hewa a i ʻole huehue ʻia, hiki iā ia keʻoki i ke kahe o ke koko.
• Adhesions - hiki i ka ʻōpū ke paʻa i loko o nāʻiʻo scar (adhesions) mai nā ʻoki i hala. Hiki i kēia ke alakaʻi i ka nalo o ke kahe o ke koko inā haʻalele ʻole ʻia.
• Embolus - Hiki i nā kahe koko ke ālai i kekahi o nā aʻa e hāʻawi ana i ka ʻōpū. ʻO ka poʻe i loaʻa i ka puʻuwai puʻuwai a i ʻole i loaʻa nā arrhythmia, e like me ka atrial fibrillation, aia i kēia pilikia.
• Pahu o nā aʻa - Hiki i nā aʻa e hāʻawi i ke koko i ka ʻōpū ke hoʻopili a pale ʻia paha mai ka hana kolesterol. Ke hana kēia i loko o nā aʻa i ka puʻuwai, kumu ia i ka puʻuwai puʻuwai. Ke hiki i nā aʻa i ka ʻōpū, kumu ʻia ka ischemia ʻōpū.
• Hoʻopili ʻia o nā uaua - Hiki ke hoʻopaʻa ʻia nā uaua e lawe ana i ke koko mai ka ʻōpū e nā hāʻai koko. Mālama kēia i ke kahe o ke koko i loko o ka ʻōpū. ʻOi aku ka maʻamau o kēia i ka poʻe me ka maʻi akepaʻa, ka maʻi ʻaʻai, a me nā maʻi pūpū koko paha.
• Ke kahe haʻahaʻa - Ke kahe haʻahaʻa o ke koko i nā poʻe i loaʻa ka hoʻopili ʻana o nā aʻa ʻōpū e hiki ai ke lilo i ke kahe o ke koko i ka ʻōpū. Kū pinepine kēia i nā poʻe me nā pilikia olakino koʻikoʻi ʻē aʻe.

ʻO ka ʻōuli nui o ka ischemia ʻōpū ka ʻeha o ka ʻōpū. Nui ka ʻeha, ʻoiai ʻaʻole palupalu ka wahi ke pā. ʻO nā ʻōuli ʻē aʻe e like me:

• Pohā
• Fiva
• ʻO ka luaʻi
• Koko i loko o ka pahu

Hōʻike paha nā hoʻokolohua Laboratory i kahi helu o ke koko kiʻekiʻe keʻokeʻo (WBC) (kahi māka o ka maʻi). Loaʻa paha ke kahe ʻana i ke kahe GI.

ʻO kekahi mau hoʻāʻo e ʻike i ka nui o nā pohō e komo pū ana:

• Hoʻonui i ka waikawa i ke kahe o ke koko (lactic acidosis)
• Angiogram
• CT scan o ka ʻōpū
• ʻO Doppler ultrasound o ka ʻōpū

ʻAʻole ʻike mau kēia mau hoʻāʻo i ka pilikia. I kekahi manawa, ʻo ke ala wale nō e ʻike ai i ka ischemia ʻōpū me kahi kaʻina hana.

I ka hapanui o nā hihia, pono e mālama ʻia ke ʻano me ke ʻoki kino. Lawe ʻia ka ʻāpana o ka ʻōpū i make. Hoʻohui hou ʻia nā koena olakino i koe o ka ʻōpū.

I kekahi mau hihia, pono i kahi colostomy a i ʻole ileostomy e pono ai. Hoʻoponopono ka paʻa o nā aʻa i ka ʻōpū, inā hiki.

ʻO ka hōʻino a make paha o ka ʻōpū kahi maʻi koʻikoʻi. Hiki i kēia ke hopena i ka make inā ʻaʻole mālama koke ʻia. Aia ke kuanaʻike i ke kumu. Hiki i ka mālama koke ʻana ke alakaʻi i kahi hopena maikaʻi.

ʻO ka hōʻino a make paha o ka ʻōpū i koi ʻia i kahi colostomy a i ʻole ileostomy. He wā pōkole paha kēia a paʻa paha. Peritonitis ka mea maʻa mau i kēia mau hihia. Hiki i nā poʻe i loaʻa ka nui o ka make o ka iʻa i loko o ka ʻōpū ke loaʻa i nā pilikia ke omo i nā meaʻai. Hiki iā lākou ke lilo i ka hilinaʻi i ka loaʻa ʻana o ka meaʻai ma o kā lākou veins.

Hiki i kekahi poʻe ke maʻi nui me ka fiva a me kahi maʻi koko (sepsis).

Kāhea i kāu mea mālama ola inā loaʻa iā ʻoe kahi ʻeha o ka ʻōpū koʻikoʻi.

Pākuʻi ʻia nā ana Preventive:

• ʻO ke kaohi ʻana i nā kumu pilikia, e like me ke kuʻi o ka puʻuwai ʻole, ke koko kiʻekiʻe, a me ka kiʻekiʻe o ke kō
• ʻAʻole puhipaka
• Keʻai nei i kahi papaʻai momona
• Mālama koke ʻana i nā hernias

Neko nerosis; ʻŌpū Ischemic - ʻōpū liʻiliʻi; ʻŌpū make - ʻōpū liʻiliʻi; ʻŌpū make - ʻōpū liʻiliʻi; ʻŌpū infarcted - ʻōpū liʻiliʻi; Atherosclerosis - ʻōpū liʻiliʻi; ʻO ka paʻakikī o nā aʻa - ʻōpū liʻiliʻi

• ʻO ka ischemia arter Mesenteric a me ka infarction
• ʻŌnaehana Digestive
• ʻŌpū liʻiliʻi

Holscher CM, Reifsnyder T. Aute mesenteric ischemia. I: Cameron JL, Cameron AM, eds. ʻO ke kaʻoki lāʻau lapaʻau o kēia manawa. 13th ed. Piladelapia, PA: Elsevier; 2020: 1057-1061.

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 Roline CE, Reardon RF. Nā maʻi o ka ʻōpū liʻiliʻi. I: Nā paia RM, Hockberger RS, Gausche-Hill M, nā ʻaoʻao. ʻO Rosen's Emergency Medicine: Nā Manaʻo Manaʻo a me ka hana lapaʻau. 9th ed. Piladelapia, PA: Elsevier; 2018: chap 82.