Mgbasa splenorenal shunt

Splenorenal shunt (DSRS) bụ ụdị ịwa ahụ emere iji belata nrụgide ọzọ na ụzọ mgbochi. Portzọ Portal vein na-eburu ọbara site na akụkụ nri gị na imeju gị.

N’oge DSRS, akwara si na mpi gị ana ewepụ ya n’akwara ọnụ ụzọ. A na-etinyezi eriri ahụ na akwara aka na akụrụ aka ekpe gị. Nke a na - enyere aka belata ọbara na - esite n’oghere ọnụ ụzọ.

Zọ Portal vein na-eweta ọbara site na eriri afọ, splin, pancreas, na gallbladder na imeju. Mgbe agbachiri ọbara, nrụgide dị na akwara a ga-adị oke elu. A na-akpọ nke a ọbara mgbali Portal. Ọ na - abụkarị n'ihi mmebi imeju kpatara site na:

• Mmanya na-aba n'anya
• Adịghị ala ala malitere ịrịa ịba ọcha n'anya
• Ọbara ọbara
• Disordersfọdụ ọrịa na-efe efe
• Primary biliary cirrhosis (imeju ọnya kpatara egbochi bile ducts)

Mgbe ọbara na-enweghị ike ịfefe n'ụzọ kwesịrị ekwesị site na njikọ ụzọ, ọ na-ewe ụzọ ọzọ. N’ihi nke a, akwara ọbara nke aza aza akpọrọ varices na-etolite. Ha na-etolite mgbidi dị warara nke nwere ike ịgbaji ma gbaa ọbara.

May nwere ike ịwa ahụ a ma ọ bụrụ na nyocha ihe onyonyo dịka endoscopy ma ọ bụ x-ray egosi na ị nwere ọbara ọgbụgba. Surgerywa ahụ nke DSRS na-ebelata nrụgide na varices ma na-enyere aka ịchịkwa ọbara ọgbụgba.

Ihe ize ndụ maka ọgwụ nchịkwa na ịwa ahụ n'ozuzu ya bụ:

• Ọrịa na-arịa ọrịa ma ọ bụ nsogbu iku ume
• Ọbara, mkpụkọ ọbara, ma ọ bụ ọrịa

Ihe ize ndụ nke ịwa ahụ a gụnyere:

• Mgbapụta nke mmiri n'ime afọ (ascites)
• Tinyegharịa ọbara ọgbụgba site na iche iche
• Encephalopathy (ụbụrụ arụ ọrụ n’ihi na imeju anaghị enwe ike iwepụ nsị na ọbara)

Tupu ịwa ahụ, ịnwere ike ịnwe ule ụfọdụ:

• Angiogram (ilere n'ime arịa ọbara)
• Nyocha ọbara
• Ọgwụgwụ

Nye onye nlekọta ahụike gị ndepụta nke ọgwụ niile ị na-eri gụnyere ọgwụ ọgwụ na ọgwụ, ahịhịa, na mgbakwunye. Jụọ ndị ikwesiri ịkwụsị ịwa ahụ tupu ịwa ahụ, na ndị ndị ị ga-ewere ụtụtụ nke ịwa ahụ ahụ.

Onye na-enye gị ga-akọwa usoro ahụ wee gwa gị oge ịkwụsị iri nri na ị drinkingụ mmanya tupu ịwa ahụ.

Na-atụ anya ịnọ ụbọchị 7 ruo 10 n'ụlọ ọgwụ mgbe ịwachara ahụ iji gbakee.

Mgbe ị tetachara ịwa ahụ ị ga - enwe:

• Otu ọkpọkọ dị n’akwara gị (IV) nke ga-ebu mmiri na ọgwụ banye n’ọbara gị
• A catheter ke eriri afo ka igbapu mmamịrị
• Otu NG tube (nasogastric) nke na-esi n’imi gị banye n’ime afọ gị iji wepụ gas na mmiri mmiri
• Mgbapụta nwere bọtịnụ ị nwere ike pịa mgbe ịchọrọ ọgwụ mgbu

Dika I nwere ike iri ihe ma drinkụọ, a ga-enye gị mmiri mmiri na nri.

Nwere ike ịnwale ule onyonyo iji hụ ma shunt ahụ ọ na-arụ ọrụ.

Nwere ike izute onye na-eri nri, wee mụta otu esi eri nri nwere obere abụba, nke nwere obere nnu.

Mgbe ịwa ahụ DSRS gasịrị, ọbara na-achịkwa ọtụtụ ndị nwere ọbara mgbali elu. Ihe kachasị dị ize ndụ nke ọbara ọgbụgba ọzọ bụ n'ọnwa mbụ mgbe a wachara gị ahụ.

DSRS; Usoro nhụjuanya nke splenorenal; Gbasara - splenic venous shunt; Warren shunt; Cirrhosis - mgbapu distal; Imeju umeji - splenorenal distal; Portal vein mgbali - distal splenorenal shunt

Dudeja V, Fong Y. Imeju. Na: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Akwụkwọ Sabiston nke gerywa Ahụ. Agba nke 20. Philadelphia, PA: Elsevier; 2017: isi 53.

Izu SR, Ottmann SE, Orloff MS. Ọbara mgbali elu Portal: ọrụ nke usoro shunting. Na: Cameron JL, Cameron AM, eds. Usoro ọgwụgwọ nke oge a. Nke 13. Philadelphia, PA: Elsevier; 2020: 387-389.