ʻO ka thrombosis venous Mesenteric

ʻO ka Mesenteric venous thrombosis (MVT) kahi kīʻaha koko i hoʻokahi a ʻoi paha o nā veins nui e hoʻokahe i ke koko mai ka ʻōpū. Hoʻohui pinepine ʻia ka aʻa mesenteric kiʻekiʻe.

ʻO ka MVT kahi ʻōpala e ālai ana i ke kahe o ke koko i kahi aʻa mesenteric. ʻElua mau ʻano uaua e waiho ai ke koko i ka ʻōpū. Hoʻopau ke kūlana i ke kahe o ke kō o ke kō a hiki i ka hopena i ka hopena o ka ʻōpū.

ʻAʻole ʻike ʻia ke kumu kūpono o MVT. Eia nō naʻe, nui nā maʻi i hiki ke alakaʻi iā MVT. ʻO nā maʻi he nui ke kumu o ka pehu (ka mumū) o nā aʻa e hoʻopuni ana i nā uaua, a hui pū me:

• Pākuʻi
• Kanesa o ka ʻōpū
• ʻO Diverticulitis
• ʻO ka maʻi akepaʻa me ka cirrhosis
• ʻO ke koko kiʻekiʻe i nā kīʻaha koko o ke ake
• ʻO ke kīpoki ʻōpū a i ʻole trauma
• ʻO Pancreatitis
• Nā maʻi maʻi ʻōpala
• Hewa puʻuwai
• Nā hemahema Protein C a i ʻole S
• ʻO Polcythemia vera
• Pono thrombocythemia

ʻO ka poʻe i loaʻa i nā maʻi e hoʻopili pinepine i ke koko (clot) e ʻoi aku ka nui o ka makaʻu no ka MVT. Hoʻonui pū ka lāʻau hoʻomalu hānau a me nā lāʻau estrogen i ka makaʻu.

ʻOi aku ka maʻamau o MVT i nā kāne ma mua o ka wahine. Hoʻohui nui ia i ka poʻe ʻelemakule a makua paha.

Pākuʻi ʻia paha nā ʻōuli i kekahi o kēia mau mea:

• ʻO ka ʻeha o ka ʻōpū, ka mea e ʻoi aku ka maikaʻi ma hope o ka ʻai ʻana a ma hope o ka manawa
• Puʻupuʻu
• Konipōpō
• Mākī koko
• Fiva
• Hoʻoweliweli Septic
• Kahe kahe o ka gastrointestinal
• ʻO ka luaʻi a me ka nausea

ʻO kahi CT scan ka hōʻike nui e hoʻohana ai e hōʻoia iā MVT.

Hiki i nā hoʻokolohua ʻē aʻe ke:

• Angiogram (ke aʻo ʻana i ke kahe o ke koko i ka ʻōpū)
• MRI o ka ʻōpū
• ʻO Ultrasound o ka ʻōpū a me nā veins mesenteric

Hoʻohana ʻia nā mea lahilahi o ke koko (ʻo ka heparin a i ʻole nā ​​lāʻau e pili ana) e mālama iā MVT ke ʻaʻohe pili koko. I kekahi mau hihia, hiki ke hāʻawi pololei ʻia ka lāʻau i loko o ka ʻōpala e hoʻopau ia. Kapa ʻia kēia kaʻina hana ʻo thrombolysis.

ʻOi aku ka liʻiliʻi, hemo ka ʻōpala me kahi ʻano o ke ʻoki i kapa ʻia ʻo thrombectomy.

Inā loaʻa nā ʻōuli a me nā ʻōuli o kahi maʻi ʻino i kapa ʻia he peritonitis, hoʻopau ʻia ke kīpē e wehe ai i ka ʻōpū. Ma hope o ke kahakaha ʻana, pono kahi ileostomy (wehe mai ka ʻōpū liʻiliʻi i loko o kahi ʻeke ma ka ʻili) a i ʻole colostomy (kahi puka mai ke kolone i loko o ka ʻili) e pono ai.

Pili ʻo Outlook i ke kumu o ka thrombosis a me nā mea i hōʻino ʻia i ka ʻōpū. ʻO ka loaʻa ʻana o ka lāʻau no ke kumu ma mua o ka make ʻana o ka ʻōpū hiki ke hopena i kahi ola maikaʻi.

ʻO ka ischemia Intestinal kahi pilikia koʻikoʻi o MVT. Make ka ʻāpana a i ʻole āpau paha no ka lako ʻole o ke koko.

E kāhea aku i kāu lawelawe mālama ola inā loaʻa iā ʻoe nā wā koʻikoʻi a i ʻole pinepine o ka ʻeha o kou ʻōpū.

MVT

Kapua A, Dussel JN, Webster-Lake C, Indes J. Mesenteric ischemia. I: Yeo CJ, hoʻoponopono. ʻO Shackelford's Surgery o ke Alimentary Tract. 8th ed. Piladelapia, PA: Elsevier; 2019: chap 87.

ʻO Feuerstadt P, Brandt LJ. Ischemia ʻōpū. 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 118.

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.