Ukuma kweplenorenal shunt

I-distlen spnorenal shunt (i-DSRS) luhlobo lotyando olwenziwe ukunciphisa uxinzelelo olongezelelweyo kwi-portal vein. I-portal vein ithwala igazi ukusuka kumalungu akho okugaya kwisibindi sakho.

Ngexesha le-DSRS, umthambo osuka kudakada lwakho uyasuswa kwi-portal vein. Umthambo ke uqhotyoshelwe emthanjeni kwizintso zakho zasekhohlo. Oku kunceda ukunciphisa ukuhamba kwegazi nge-portal vein.

I-portal vein izisa igazi elivela emathunjini, i-spleen, i-pancreas, kunye ne-gallbladder kwisibindi. Xa ukuhamba kwegazi kuvaliwe, uxinzelelo kulo mthambo luba phezulu kakhulu. Oku kubizwa ngokuba yi-portal hypertension. Ihlala isenzeka ngenxa yomonakalo wesibindi obangelwa:

• Ukusetyenziswa kotywala
• I-hepatitis yentsholongwane engapheliyo
• Amahlwili egazi
• Ezinye iingxaki zokuzalwa
• I-cirrhosis yaseprayimari yokuqala (ukusilela kwesibindi okubangelwa kukuvalwa kwe-bile ducts)

Xa igazi lingakwazi ukuhamba ngesiqhelo nge-portal vein, lithatha enye indlela. Ngenxa yoko, imithambo yegazi idumbile ebizwa ngokuba zii-varices form. Bahlakulela iindonga ezincinci ezinokuqhekeka kunye nokuphuma kwegazi.

Unokuba nalo olu vavanyo ukuba iimvavanyo zokucinga ezifana ne-endoscopy okanye i-x-ray zibonisa ukuba uphuma egazini. Utyando lweDSRS linciphisa uxinzelelo kwii-varices kwaye linceda ukulawula ukopha.

Umngcipheko we-anesthesia kunye notyando ngokubanzi zezi:

• Ukunyangeka kwamayeza okanye iingxaki zokuphefumla
• Ukopha, amahlwili egazi, okanye usulelo

Iingozi zolu tyando zibandakanya:

• Ukwakhiwa kolwelo esiswini (ascites)
• Phinda ukopha kwi-varices
• I-Encephalopathy (ukulahleka kwengqondo ngenxa yokuba isibindi asikwazi ukususa i-toxins egazini)

Ngaphambi kotyando, unokuvavanywa:

• I-Angiogram (ukujonga ngaphakathi kwimithambo yegazi)
• Uvavanyo lwegazi
• Endoscopy

Nika umboneleli wakho wezempilo uluhlu lwawo onke amayeza owathathayo kubandakanya amayeza kunye ne-counter-counter, iherbs kunye nezibonelelo. Buza ukuba yeyiphi na ekufuneka uyeke ukuyithatha ngaphambi kotyando, kwaye yeyiphi ekufuneka uyithathile ngentsasa yoqhaqho.

Umboneleli wakho uya kuchaza inkqubo kwaye akuxelele ukuba uyeke nini ukutya nokusela ngaphambi kotyando.

Lindela ukuhlala iintsuku ezisi-7 ukuya kwezi-10 esibhedlele emva kotyando ukuze uphinde ubuye.

Xa uvuka emva kotyando uya kuba:

• Umbhobho emthanjeni wakho (IV) oya kuthi uthwale ulwelo kunye namayeza kwigazi lakho
• I-catheter kwi-bladder yakho ukucoca umchamo
• Ityhubhu ye-NG (nasogastric) ehamba ngeempumlo zakho isisu sakho ukususa igesi kunye nolwelo
• Impompo enamaqhosha ungayicofa xa ufuna iyeza lentlungu

Njengoko ukwazi ukutya nokusela, uyakunikwa izinto ezingamanzi kunye nokutya.

Unokuba novavanyo lokucinga ukuba i-shunt iyasebenza na.

Unokudibana nengcali yokutya, kwaye ufunde indlela yokutya ukutya okunamafutha asezantsi, ukutya okunetyuwa encinci.

Emva kotyando lweDSRS, ukopha kulawulwa kuninzi lwabantu abanexinzelelo lwegazi. Umngcipheko ophakamileyo wokopha kwakhona ukwinyanga yokuqala emva kotyando.

I-DSRS; Inkqubo ye-splenorenal shunt; I-renal - i-splenic venous shunt; UWarren shunt; Ukuqina - distlenorenal distal; Ukungaphumeleli kwesibindi - i-splenorenal distal; Uxinzelelo lwe-vein portal-distant splenorenal shunt

Dudeja V, Fong Y. Isibindi. Ku: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, ii-eds. Incwadi yeSabiston yoNyango. Umhla we-20. IPhiladelphia, PA: Elsevier; Ngo-2017: isahluko 53.

Iiveki ze-SR, i-Ottmann SE, i-Orloff MS. Uxinzelelo lwe-portal: indima yeenkqubo zokususa. Ku: UCameron JL, uCameron AM, ii-eds. Unyango lwangoku lonyango. Umhla we-13. IPhiladelphia, PA: Elsevier; Ngo-2020: 387-389.