Ukuxilongwa kunye nokunyangwa kweDuodenal Atresia
I-Duodenal atresia yintsilelo yokuzalwa yenkqubo yokugaya okanye isisu (GI) eyenzeka rhoqo kwiintsana ezine- Down syndrome . Endaweni ephakathi kwama-5 ekhulwini kunye ne-7 ekhulwini yeentsana ezine-Down syndrome ziya kuzalelwa nge-duodenal atresia, xa kuthelekiswa ne-1 kwi-10,000 kuphela abantwana abangenayo i-Down syndrome.
Akukho mntu uyazi kakuhle ukuba kutheni le nto yenzekayo, kodwa iyaziwa ukuba iyenzeka kusenokwenzeka ekuvelweni kokubeletha komntwana, ngaphambi kweveki ezilishumi elinanye.
Qiniseka ukuba ukuba umntwana wakho unalo i-duodenal atresia, akukho nto oyenzayo ukuyenza okanye ukuyenza ukukhusela. Uninzi lweintsana ezile ngxaki zihamba kakuhle emva kokuhlinzwa.
Yintoni i-Duodenal Atresia?
I-Duodenal atresia yimeko apho inxalenye yesikhumba esincinci (i-duodenum) engenzi kakuhle ngokufanelekileyo. I-duodenum yinkqutyana encinci yesikhuni esenza izinto ezigulweyo zisuke kwisisu esincinci. Ngamanye amaxesha, i-duodenum ayilanga ngokuchanekileyo kwaye ivalwe (i-duodenal atresia) okanye incinane kuncinci (i-duodenal stenosis).
Ukuxilongwa kwangaphambi kokubeletha kweDuodenal Atresia
I-duodenal atresia idla ngokuxilongwa ngexesha lokukhulelwa ngexesha le-ultrasound. Ukuba kunjalo, kukho ithuba eli-30% lokuba umntwana uya kuba ne-Down syndrome. Ngokuqinisekileyo, iindlela ezizodwa zokufumanisa i-Down syndrome kwisibini okanye yesithathu ye-trimester yi-amniocentesis uvavanyo okanye uvavanyo lwe-PUBS (isampuli yegazi).
I-ultrasound iya kubonisa oko kubizwa ngokuba "uphawu oluphindwe kabini". Uphawu lwesibini lombhobho lubangelwa uketshezi olongezelelweyo kwi-duodenum nesisu, okubangela ukuba bavuke. Ekubeni zifumaneka ngaphaya komnye kwaye zihlukaniswe ngokuvulwa kweesetyhula, ezi zimbini zifana ne "bubble double" okanye amabhulu amabini ngapha nangapha, xa ibonwa nge-ultrasound.
I-duodenal atresia inokuthi ifunyenwe yi-ultrasound ekuqaleni kweeveki ezingama-18 ukuya kwe-20 zokukhulelwa, kodwa idlalwa emva kweveki ezingama-24. Esinye isibonakaliso se-duodenal atresia ekukhuleleni i-amniotic. Isilinganiselo somzimba wesisu singaphinda sinyuswe ngenxa yokungena kwamanzi kwisisu. Oku ngokuqhelekileyo akunzeki de kube emva kweeveki ezingama-24.
Ukuxilongwa kweDuodenal Atresia ekuzalweni
Uninzi lweziganeko ze-duodenal atresia ziyafunyanwa ngexesha lokukhulelwa okanye kungekudala emva kokuzalwa.
Ukuba umntwana wakho ufumaneka ngexesha lokukhulelwa kwakho, uya kuthunyelwa kwi-perinatologist (umgqirha ojongene nokukhulelwa okukhuselekileyo) ukuxoxa ngokulawula konke okukhulelwe kwakho. Unokuphinda uhanjiswe kumcebisi wezofuzo, ukuxubusha ukhetho lokuvavanywa kwangaphambi kokubeleka, kunye nodokotela wezilwanyana, ukuxubusha ukulungiswa kwezi ngxaki emva kokuzalwa.
Iintsana kunye ne-duodenal atresia zinakho naziphi na iimpawu ezilandelayo, ezinokubangela ukuxilongwa:
- Ukuguqa kwesisu esiswini
- Ukuhlanza ngokweqile, ngaphandle kokutya okanye ukuhlanza okuluhlaza (bile)
- Ukungabikho kokucoca
- Ukunyuka kwamathumbu emva kweempawu zokuqala ezimbalwa ze-meconium
Xa ukuxilongwa kwe-duodenal atresia kukhankanywa, ugqirha uya kuyala i-x-ray yesisu.
Ukuba ukuxilongwa kukuthi i-duodenal atresia, i-x-ray iya kubonisa umoya kwisisu kunye nxalenye yokuqala ye-duodenum, kodwa akukho moya emva koko kubonisa ukucima.
Unyango lweDuodenal Atresia
Kuphela unyango lwe-duodenal atresia lugqirha, oluqhelekileyo lwenziwa emva nje kokuzalwa. Ngaphambi kokuhlinzwa, ityhubhu ye-nasogastric (NG) iya kufakwa kwisisu somntwana ukucima ukwanda kwamanzi kunye nomoya oye waqokelela, kwaye umntwana uya kufumana i-IV ukwenzela ukuba athathe umbane oza kuthintela ukungcola. Udokotela wakho wezilwanyana kunye nodokotela ogqirha uya kuxubusha umntwana wakho kunye nesicwangciso sokunyamekela nawe phambi kokuhlinzwa.
Iintsana kunye nezinye iziphoso zokuzalwa okanye ezinye iimeko ezingasenakwenzayo kunye neentsana ezinokuba ne-duodenal atresia kuphela. Ininzi insana yenza kakuhle emva kokuhlinzwa kwaye iphinda iphinde ibuyele kulesi siphene sokuzalwa.
Imithombo:
UCassidy, uSuzanne B., Allanson, uJudith E., (2001) Ulawulo lwe-Genetic Syndromes. 1st ed. ENew York, NY; 2001.
Karrer, F., Duodenal Atresia, Emedicine , 2009
I-Newberger, D., Down Syndrome: Uvavanyo lweZithuba zoNyaka ngaphambi koBantwana kunye noGawulayo. WaseMerika ugqirha. 2001.