Ukuvalwa kwePacacaval

Ukukhutshwa kwePortacaval lunyango lonyango ukwenza unxibelelwano olutsha phakathi kwemithambo yegazi esiswini sakho. Isetyenziselwa ukunyanga abantu abaneengxaki ezinzima zesibindi.

Ukukhutshwa kwePacacaval lutyando olukhulu. Kubandakanya ukusikwa okukhulu (ukusikwa) kwindawo yesisu (isisu). Ugqirha ke emva koko wenza unxibelelwano phakathi kwe-portal vein (ebonelela ngegazi lesibindi) kunye ne-vena cava engaphantsi (umthambo okhupha igazi kuninzi lwendawo esezantsi yomzimba.)

Unxibelelwano olutsha luguqula ukuhamba kwegazi kude nesibindi. Oku kunciphisa uxinzelelo lwegazi kwi-portal vein kwaye kunciphise umngcipheko wokuqhekeka (ukophuka) kunye nokuphuma kwegazi kwimithambo yesisu kunye nesisu.

Ngokwesiqhelo, igazi eliphuma kwisisu sakho, isisu, kunye namathumbu kuqala lihamba phakathi kwesibindi. Xa isibindi sakho sonakaliswe kakhulu kwaye kukho izithintelo, igazi alinakuhamba ngokulula. Oku kubizwa ngokuba yi-portal hypertension (ukunyuka koxinzelelo kunye nokugcinwa kwe-veal portal vein.) Imithambo iyakwazi ukuvuleka (ukuqhekeka), kubangele ukuphuma kwegazi.

Izizathu eziqhelekileyo zoxinzelelo lwe-portal zezi:

• Ukusetyenziswa kotywala kubangela ukonakala kwesibindi (i-cirrhosis)
• Igazi liyagungqa emthanjeni ophuma kwisibindi uye entliziyweni
• Intsimbi eninzi esibindi (hemochromatosis)
• IHepatitis B okanye uC

Xa uxinzelelo lwexinzelelo lwe-portal lwenzeka, unokuba:

• Ukopha kwimithambo yesisu, isisu, okanye amathumbu (ukuphuma kwegazi)
• Ukwakhiwa kolwelo esiswini (ascites)
• Ukwakhiwa kolwelo esifubeni (hydrothorax)

Ukutshitshiswa kwePacacaval kuphambukisa inqanaba lokuhamba kwegazi lakho kwisibindi. Oku kuphucula ukuhamba kwegazi esiswini sakho, kwi-esophagus, nasemathumbu.

Ukuvalwa kwe-Portacaval kuhlala kwenziwa xa i-transjugular intrahepatic portosystemic shunting (TIPS) ingasebenzi. IINKCUKACHA yinkqubo elula kakhulu kwaye ingenasiphelo.

Umngcipheko we-anesthesia kunye notyando ngokubanzi zezi:

• Ukunyanga amayeza, iingxaki zokuphefumla
• Ukopha, amahlwili egazi, okanye usulelo

Iingozi zolu tyando zibandakanya:

• Ukungaphumeleli kwesibindi
• Ukunyuka kwe-hepatic encephalopathy (ingxaki echaphazela uxinzelelo, imeko yengqondo kunye nenkumbulo- kunokukhokelela kwi-coma)

Abantu abanesifo sesibindi basemngciphekweni omkhulu wokufumana iingxaki emva kotyando.

Abantu abanesifo esibi sesibindi esiya sisiba mandundu banokufuna ukuqwalaselwa ukufakelwa kwesibindi.

Shunt - ipacacaval; Ukungaphumeleli kwesibindi - i-portacaval shunt; Ukuqina kwesibindi - portacaval shunt

IHenderson JM, iRosemurgy AS, iPinson CW. Inkqubo ye-portosstemic shunting: portocaval, distal splenorenal, mesocaval. Ku: Jarnagin WR, ed. Utyando lukaBlumgart lweSibindi, iTeknoloji yeBiliary, kunye neePancreas. Umhla wesi-6. IPhiladelphia, PA: Elsevier; Ngo-2017: isahluko 86.

Shah VH, Kamath PS. Uxinzelelo lwe-portal kunye nokuphuma kwegazi. Ku: UFeldman M, uFriedman LS, uBrandt LJ, ii-eds. Sleisenger kunye neFordtran's Amathumbu kunye nezifo zesibindi: iPathophysiology / Diagnosis / Management. Ngomhla we-10. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 92.