Ukuthungwa kwePortacaval

I-Portacaval shunting iyindlela yokwelashwa yokwakha ukudala ukuxhumana okusha phakathi kwemithambo yegazi emibili esiswini sakho. Isetshenziselwa ukwelapha abantu abanezinkinga ezinzima zesibindi.

I-Portacaval shunting ukuhlinzwa okukhulu. Kubandakanya ukusika okukhulu (imbobo) endaweni yesisu (isisu). Udokotela ohlinzayo ube esenza ukuxhumana phakathi kwe-portal vein (enikeza iningi legazi lesibindi) ne-vena cava engezansi (umthambo okhipha igazi engxenyeni engaphansi yomzimba.)

Ukuxhumeka okusha kuphambukisa ukuphuma kwegazi esibindini. Lokhu kunciphisa ukucindezelwa kwegazi emgodini we-portal futhi kunciphisa ingozi yokudabuka (ukuqhekeka) nokuphuma kwegazi emithanjeni esemgogodleni nasesiswini.

Imvamisa, igazi elivela emgodleni wakho, esiswini nasemathunjini aqala ukugeleza phakathi kwesibindi. Lapho isibindi sakho sonakele kakhulu futhi kunama-blockages, igazi alikwazi ukugeleza kalula kulo. Lokhu kubizwa ngokuthi yi-portal hypertension (ingcindezi eyandisiwe kanye nokugcinwa kwesibindi kwe-portal vein.) Imithambo ingahle ivuleke (idabuke), ibangele ukopha kakhulu.

Izimbangela ezivamile ze-portal hypertension yilezi:

• Ukusetshenziswa kotshwala kubanga ukusha kwesibindi (i-cirrhosis)
• Ukuqina kwegazi emthanjeni ogeleza usuke esibindi uye enhliziyweni
• Insimbi eningi kakhulu esibindi (hemochromatosis)
• IHepatitis B noma C

Lapho i-portal hypertension ivela, ungahle ube:

• Ukopha okuvela emithanjeni yesisu, imiphetho, noma amathumbu (ukuphuma kwegazi)
• Ukwakhiwa koketshezi esiswini (ascites)
• Ukwakhiwa koketshezi esifubeni (i-hydrothorax)

I-Portacaval shunting idlulisela ingxenye yokugeleza kwegazi lakho esibindini. Lokhu kuthuthukisa ukugeleza kwegazi esiswini sakho, emphinjeni nasemathunjini.

I-Portacaval shunting ivame ukwenziwa lapho i-transjugular intrahepatic portosystemic shunting (TIPS) ingasebenzi. AMACEBISO inqubo elula kakhulu futhi engangenisi kakhulu.

Izingozi ze-anesthesia nokuhlinzwa ngokujwayelekile yilezi:

• Ukungezwani komzimba nemithi, izinkinga zokuphefumula
• Ukopha, amahlule egazi, noma ukutheleleka

Izingozi zalokhu kuhlinzwa zifaka:

• Ukuhluleka kwesibindi
• Ukuwohloka kwe-hepatic encephalopathy (ukuphazamiseka okuthinta ukugxila, isimo sengqondo, nenkumbulo - kungaholela ku-coma)

Abantu abanesifo sesibindi basengozini enkulu kakhulu yezinkinga ngemuva kokuhlinzwa.

Abantu abanezifo ezinzima zesibindi eziya ziba zimbi kakhulu kungadingeka ukuthi bacatshangelwe ukufakelwa kwesibindi.

Shunt - i-portacaval; Ukwehluleka kwesibindi - i-portacaval shunt; I-Cirrhosis - i-portacaval shunt

IHenderson JM, iRosemurgy AS, iPinson CW. Amasu we-portosystemic shunting: portocaval, distal splenorenal, mesocaval. Ku: Jarnagin WR, ed. Ukuhlinzwa kukaBlumgart kwesibindi, iBiliary Tract, namaPancreas. Umhlaka 6. IPhiladelphia, PA: Elsevier; 2017: isahluko 86.

Shah VH, Kamath PS. Umfutho wegazi ophezulu we-portal kanye nokuphuma kwegazi. Ku: Feldman M, Friedman LS, Brandt LJ, ama-eds. ISleisenger neFordtran's Gastrointestinal and Liver Disease: IPathophysiology / Diagnosis / Management. Umhlaka 10. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 92.