I-hernia yokuzala, eyaziwa nangokuthi isisu sayo, isoloko ichaphazela abantu abangaphezu kwama-50. Inani elinabantu abangama-90 ekhulwini abanokuze bafumane iimpawu. Phakathi kwalabo bawenzayo, ukugubha intlungu, ukuphazamiseka kwesisu, ukucasula umqala, ukuxubha, nokuphindaphinda. Nangona iimpawu ezifana nalezi zinokunyusa, abaqhelekanga. Xa kuthethwa oko, kwiimeko ezinqabileyo, izilwanyana ezinkulu zingahlakulela, kubangela iingxaki ezinzima kwaye zifuna unyango olungxamisekileyo.
Iimpawu Zamaxesha amaninzi
Ngokuqhelekileyo, ukuhlanjululwa okuncane kwesisu akuyona into eyingozi kwaye akunakwenzeka ukuba kubangele nayiphi na intlungu okanye ingakhathazeki. Yisiphi i-hernia yokuzala engayenzayo iguqula izakhiwo kunye neendlela ezigcina ukutya kunye nama-acids apho abakho.
Ingundoqo kule ngxaki isakhiwo esibizwa ngokuba yi- sphincter esezantsi (LES). Xa i-herniation yokubeleka ivela, inokutshintsha isikhundla sale valve, ukuvumela ukuba isiqulatho sesisu siphindele kwi-esophagus (eyaziwa ngokuba yi- reflux ). Iimpawu ezinxulumene nazo ziquka:
- Ukuguquka
- Ukuphindaphinda
- Ukubhinqa okanye ukuhamba ngokukhawuleza emva kokutya
- Inzwa ehlabayo emqaleni
- Umtya omuncu okanye onomsindo emlonyeni
- Ukuphefumula
Ngokuqhelekileyo, kuthetha kuphela xa i-hernia ikhula ngakumbi ukuba ingabonakalisa ngale ndlela. Ukuba i-LES iyancipha ngakumbi, njengoko iyakwenzeka ngokudala, iimpawu ezinxulumene nazo zingaqhubeka zibi kakhulu.
Abantu abane-hernia yokuzalwa bayakwazi ukuhlakulela isifo se-reflux ye-gastroesophageal (GERD) , uhlobo olungapheliyo lwe-reflux engaphazamisa umgangatho wobomi.
Ukunyamezela kweempawu zeGERD kunokukhokelela ekukhwehleleni okungapheliyo, intlungu yesifuba, i-asthma, kunye nomonakalo oqhubekayo kwi-eyinyosi yakho yamazinyo.
Iingxaki
Ukuthetha ngokubanzi, kukho iindidi ezimbini ze-hiynia: i-hernia ye-hiatal ehambayo kunye ne-hersophageal hernia. Nangona i-hernia ehambayo iyona eqhelekileyo, ibalwa malunga neepesenti ezingama-95 zazo zonke izifo, i-heresophageal hernia inokuba yinto ebaluleke kakhulu kubini.
Ngomhla wokulala olahlayo , umxube we-esophagus nesisu (ekuthiwa yi-gastroesophageal junction) kwaye inxalenye yesisu iya kuhamba ngentshonalanga kwisithintelo, esibizwa ngokuba yi-hiatus. Le yithuba ekudlula kuyo isophu. Kubizwa ngokuba "ukulahla" ngenxa yokuba inxalenye yesisu isenokungena ngaphakathi nangaphandle kwesiqhwenga njengoko uginya.
Nge- hernia ephageal hernia , kuphela isisu esiswini. Nangona amaninzi e-paraesophageal hernias nje kuphela ukuqhubela phambili kwe-hernia ehambayo, abanye bangabonakala ngokukhawuleza ukuba kukho ubuthathaka obuthile kwisithintelo.
Ngokungafani ne-hernia ehambayo, i-paresophageal hernia ayifaki ngokukhawuleza ngaphakathi nakwi-hiatus. Kunoko, inokukhula ngokukhawuleza kwaye iqhube phambili ngakumbi kwisithandwa somfuba njengoko ixesha lihamba. Kule nqanaba lokugqibela ukuba iingxaki zinokuthi zibe zizinzulu kwaye, kwiimeko ezinqabileyo, ukusongela ubomi.
Iingxaki zingabandakanya ukuxinwa kwe-esophageal, ukuvinjelwa kwesisu, ukucwenga, kunye nesimo esinqabileyo kakhulu esaziwayo njengesisu sangaphakathi.
Uxinzelelo lwe-Esophageal
Ukunyanzeliswa kwe-esophag kungenzeka njengoko i-hernia igxininisa eludongeni lwe-tube yokutya. Xa oko kwenzeka, ukutya kunokunamathela kwisisu, kubangela intlungu yesifuba emva kokutya kunye nobunzima bokugwinya ( dysphagia ).
Nangona uxinzelelo lwe-esophageal lungaqwalaselwa ngongxamiseko lwezonyango, lungafuna imithi yokunciphisa okanye yokuthintela ukugqithisa kweempawu.
Hatalia yaseHermania
Ukuvalelwa kwintlanganiso kwenzeka xa isahlulo sesisu sesisu sithinjwa ngexesha le-hiatus. Kwezinye iimeko, iimpawu zokuvalelwa zingagqirha kodwa zingancinci (ngokukodwa ukuvalelwa kwengcinezelo yesifuba njengoko ukutya kudlula kwindlela ephezulu yokugaya). Kwabanye, kunokubangela ukuphazamiseka okanye ukuphazamisa ukujikeleza kwegazi. Ukuvalelwa ngokwaso akuyona yimeko engxamisekileyo yonyango ngaphandle kokuba kubekho umqobo omkhulu.
Volvulus
I-Volvulus ligama elisetyenziselwa ukuchaza xa isisu se-herniated sichaza ngaphezulu kwama-degrees angama-180, okubangela ukukhutshwa kwesisu esikhulu.
Iimpawu zingabandakanya i-dysphagia, intlungu yesifuba emva kokutya, ukubetha, nokuhlanza.
Ukuba iimpawu zivunyelwe ukuba ziqhube phambili, zingabangela intlungu emathunjini kunye nokuhlanjululwa, ukuhlanza okukhokelela ekuveleni okungenakuvelisa, kunye nokuphuma kwegastric (ngenxa yokunyuka kwengcinezelo yegazi). I-volvulus ephawulekayo impawu ibonakala kubantu abangaphezu kweminyaka engama-50 kwaye ithathwa njengongxamiseko lwezonyango nge-30% ukuya kwi-50 engozini yokufa kwabantu.
Ukumisa
Ukuqhaqhaza kuchaza ukucima igazi kwi-esiswini, mhlawumbi ngenxa yevolvulus okanye ukuvalelwa. Oku, kwakhona, kuthathwa njengongxamiseko lwezonyango njengoko ukukhutshwa kungabangela ukufa kweeseli ngokukhawuleza (necrosis) kunye nomonakalo komzimba.
Iimpawu ziquka intlungu ephosakeleyo, ebukhali besifuba; umkhuhlane; ukukhathala; ukucima; ukuhlanza; ukungakwazi ukupasa igesi; ukuqothulwa; ukufudumala okanye ubomvu phezu kokuhlamba; izinga lentliziyo elikhawulezayo; kunye negazi okanye izitya zokuhlala (ngenxa yokuphuma kwamanzi). Ukuba kungenakuphiliswa ngokukhawuleza, ukutywina kungakhokelela ekugqibeleni , ukuphazamiseka nokufa.
Intrathoracic isisu
Isisu se-intrathoracic sisimo esingavumelekanga apho isisu sitshona ngokupheleleyo kwisibilini sesifuba. Ngokudlulileyo, akuzona zonke iimeko ezibangela iimpawu. Iimpawu eziqhelekileyo ziphefumla ( dyspnea ) kunye neengxaki zesifuba kunye noxinzelelo. Ezinye iimpawu zingabandakanya ukuhlanza, ukufunyanwa, i-dysphagia, ukuphuma kwamanzi, kunye nokuthanda i-pneumonia (kubangelwa xa ukutya kugqitywa kwimiphunga).
I-gap ye-hiatal eyandisiweyo inokubangela ezinye izitho ukuba zingene kwisigubungelo esifubeni, kubandakanywa i-pancreas, isibindi okanye i-colon. Ugqirha kwiindlela ezikuphela zokulungisa lo mbuzo onqabile kodwa onzima.
Nini ukubona iDokotela
Ubuninzi be-hernias yokubeleka bunokulawulwa lula kunye neyeza-counter-counter-counter, ukulahleka kwesisindo kunye nokulungiswa kokutya kwakho. I-heatal hernias ngokuqhelekileyo ayimfuneko ukuba ilawulwe ngamachiza ngaphandle kokuba iimpawu ziqhubeka okanye ziba nzima.
Xa kuthethwa oko, kufuneka ubone ukuba ugqirha ukuba iimpawu zakho zihluleka ukuphucula nangona unyango. Kwezinye iimeko, izidakamizwa ezinomzimba ezinamandla kunye nezinye iindlela zokungenelela zingadingeka.
Ngakolunye uhlangothi, kufuneka ufune unyango lwangonyango olukhawulezileyo ukuba iimpawu zengqondo zihamba kunye nomkhuhlane ophezulu (ngaphezu kwama-degrees angama-100.4), intlungu yesifuba esibi, isantya senhliziyo esiphuthumayo, ukungabonakali kokuvelisa, okanye izitulo zamanzi. Ezi zi nokuba yimpawu zeengxaki ezinobungozi obunobungozi bokuphila.
> Imithombo:
> Polomsky, M .; Jones, C .; Sepesi, B. et al. "Ngaba ukulungiswa komzimba okumele ukhethe ukunyuka kwe-intrathoracic isisu kukhuthazwe?" I- Gastroint Surg Jour Surgery Tract Tract. 2010; 14 (2): 203-10. INGXELO: 10.1007 / s11605-009-1106.
> UmRoma, S. "Ukuxilongwa kunye nokulawulwa kwe-hiatus hernia" . 2014; 349: g6154. INGXELO: 10.1136 / bmj.g6154.
> Shukla, R .; Mandal, K .; Maltra, S. et al. "I-gastric volvulus ene-necrosis epheleleyo kunye nepheleleyo." J Indian Assoc Pediatr Surg . 2014; 19 (1): 49-51. INGXELO: 10.4103 / 0971-9261.125968.
> I-Society of American Gastrointestinal and Endoscopic Surgeons (SAGES). "Izikhokelo zoLawulo lweHernia yamaHatalia." Los Angeles, eCalifornia; ukukhupha ngo-Ephreli 2013.