So wo nso wo yafunu mu yɛ wo yaw kɛse mpofirim? (Acute Yafunu) .

So woanya yafunu mu yaw mpofirim a wuntumi nnyina ano pɛn? Ɛtɔ mmere bi a, wubetumi anya yafunu mu yaw mpofirim. Nnuruyɛfo frɛ tebea yi "yafunu a emu yɛ den." Ɛtɔ mmere bi a, ebetumi ayɛ aniberesɛm araa ma ɛho behia sɛ wɔyɛ no oprehyɛn ntɛm ara. Enti ɛho hia sɛ wohu eyi.

Dɛn ankasa ne Acute Abdominal Pain?

Sɛ yɛbɛka no tiawa a, yafunu mu yaw a emu yɛ den yɛ yafunu mu yaw a ɛba mpofirim a emu yɛ den yiye. Ɛtɔ mmere bi a eyi betumi ayɛ tebea a egye ntɛmpɛ a ɛde ne nkwa to asiane mu. Eyi kyerɛ sɛ ebia ebehia sɛ wɔyɛ wo oprehyɛn ntɛm ara. Nanso, ɛnyɛ yafunu mu yaw a emu yɛ den nyinaa na ɛsɛ sɛ wɔyɛ oprehyɛn. Ayaresa mu tebea horow bi nso betumi de ɛyaw a ɛte sɛɛ aba.

Nnuruyɛfo de asɛmfua "acute abdomen" di dwuma de kyerɛkyerɛ yafunu mu yaw a emu yɛ den a ɛba mpofirim yi mu. Ɛkyerɛ sɛ ɛsɛ sɛ wuhu nea ɛrekɔ so ntɛm ara na sɛ ɛho hia a, wufi ase sa yare.

Hena na ɛda adi sɛ tebea yi bɛka no kɛse?

Nokwarem no, yafunu mu yaw a ɛba mpofirim yi betumi ato obiara . Nanso, nea ɛde ba no betumi ayɛ soronko a egyina mfe a woadi, sɛ́ woyɛ ɔbarima anaa ɔbea, ne ayaresa tebea afoforo a ebia wowɔ so.

Susuw ho saa kwan yi so:

• Appendicitis yɛ tebea a ɛtaa ka mmerante ne mmabaa a wɔadi mfe 18 ne 20.
• Diverticulitis abu so wɔ nnipa a wɔadi boro mfe 60 mu.
• Wɔ ɔbea fam no, ɛtɔ mmere bi a ɛyaw a ɛte sɛɛ a ɛba mpofirim no betumi aba esiane nyinsɛn a ɛwɔ awotwaa no akyi a ɛpaapae nti.
• Ebia ɔbarima bi bɛte ɛyaw mpofirim esiane ne mmadwoa a ɛkyinkyin nti.

Afei nso, sɛ wowɔ aduruyɛ ho abakɔsɛm a, ebia wubehyia yafunu mu haw te sɛ eyi nso.

Saa tebea yi abu so dɛn?

Ɛyɛ den sɛ yɛbɛka nnipa dodow pɔtee a wonya yafunu mu yaw a ɛba mpofirim yi. Nanso wobu akontaa sɛ nnipa 100 biara a wɔba dwumadibea a wɔhwɛ ntɛmpɛ so no mu bɛyɛ 7 kosi 10 yafunu yɛ wɔn yaw . Enti, ɛno ma wunya adwene wɔ sɛnea eyi abu so no ho.

Dɛn ne yafunu mu yaw a emu yɛ den ho sɛnkyerɛnne?

Mpɛn pii no, sɛnkyerɛnne titiriw ne yafunu a ɛyɛ yaw mpofirim a wontumi nnyina ano . Nanso, sɛnkyerɛnne afoforo nso betumi aba. Eyinom bi ne:

• Yafunu a atrɛw: Eyi kyerɛ sɛ yafunu no ahonhon kɛse sen sɛnea ɛte daa, te sɛ balloon.
• Ahodwiriw ho sɛnkyerɛnne: Nea ɛka eyi ho ne koma a ɛbɔ ntɛmntɛm, mogya mmoroso a ɛba fam, fifiri, ne ɛtɔ mmere bi a adwenem naayɛ. Eyi yɛ sɛnkyerɛnne a ɛyɛ hu paa.
• Nsɛnkyerɛnne a ɛkyerɛ sɛ obi anya peritonitis:Sɛ yɛn yafunu mu ntini no nya ɔyare mmoawa (peritonitis) a, ebia ɛyaw bɛkɔ so. Anaasɛ ɛyaw no betumi ayɛ kɛse bere a wɔde wɔn nsa ka yafunu no anaa wɔabɔ no wɔ baabi no.

Sɛ wowɔ saa sɛnkyerɛnne ahorow yi mu biako anaa nea ɛboro saa a, mfa nyɛ hwee.

Dɛn na ɛde yafunu mu yaw a ɛba mpofirim yi ba (Acute Abdomen)?

Akwahosan tebea ahorow pii betumi ama yafunu mu yaw a ɛba mpofirim yi aba. Ebia nneɛma a ɛde ba yi bi fi oprehyɛn mu . Ɛne sɛ, ɛda adi kɛse sɛ wobehia oprehyɛn. Ebia afoforo nso yɛ nneɛma a ɛnyɛ oprehyɛn de ba .

Ntease ahorow a enti ebia ɛho behia sɛ wɔyɛ oprehyɛn

Nea ɛka eyi ho titiriw ne mogya a ɛtɔ, ɔyare mmoawa, mogya a ɛtɔ, dwensɔtwaa a esiw, ne ntokuru.

1. Mogya a ɛtɔ (Mogya a ɛtɔ) .

Mogya a ɛtɔ ne bere a mogya fi mogya ntini bi mu esiane sɛ asɛe nti. Eyi betumi afi:

• Esophageal tear (Mallory-Weiss tetew) .
• Nyinsɛn a ɛpaapae wɔ awotwaa no akyi
• Akwanhyia bi (Trauma) .
• Akisikuru a apaapae
• Yafunu mu aortic aneurysm a apaapae

2. Nyarewa a wɔde nyarewa ba

Yafunu mu yaw mpofirim betumi afi ɔyare mmoawa ahorow mu aba:

• Appendicitis - appendicitis a yen nyinaa nim
• Cholecystitis a ɛma obi ho kyere no
• Peptic ulcer disease (yafunu anaa dwensɔtwaa ketewaa mu akuru) .
• Pancreatitis a emu yɛ den
• Nyarewa a ɛba dwensɔtwaa kɛse no afã horow (Diverticulitis) .

3. Mogya a ɛkɔ nipadua no mu a wosiw (Ischemia) .

Ischemia ba bere a mogya a ɛkɔ nipadua no fã bi so tew anaasɛ wogyae no.

• Buerger yare no
• Ɔyare kɛse a ɛba dwensɔtwaa mu (Colitis) .
• Mogya ntini a ɛma dwensɔtwaa no siw (mesenteric ischemia) .
• Hynia a wɔabɔ no akuturuku
• Testicular torsion a ɛyɛ mmerɛw

4. Akwanside ahorow

Akwanside ne bere a biribi kɔhyɛ aduan mu, na ɛmma aduan ne nsu a yedi no ntumi mfa mu yiye.

• Yare a ɛma obi ho hyehye no (IBD) .
• Intussusception (dwensɔtwaa mu a ɛkɔ nipadua no mu) .
• Dwonku ketewa a ɛsiw
• Dwonku kɛse a ɛsiw

5. Ntuo a ɛwɔ ntokuru mu

Eyi ne nea ɛba bere a ntokuru sisi yɛn nipadua akwaa afasu mu no.

• Esophageal a ɛpaapae (Boerhaave yare) .
• Yafunu mu a ɛyɛ tokuru
• Yafunu mu akisikuru a wɔatoto mu
• Dwensɔtwaa no a ɛkyinkyin yiye

Ntease ahorow a enti mpɛn pii no ɛho nhia sɛ wɔyɛ oprehyɛn

Mpɛn pii no, nneɛma a ɛde yafunu mu yaw ba yi nhia oprehyɛn. Ebetumi afi endocrine ne nipadua mu nneɛma a ɛsakra, mogya mu nyarewa, ne awuduru anaa nnuru mu aba.

1. Endocrine ne nipadua mu nneɛma a ɛsakra no mu ɔhaw ahorow

Eyinom yɛ nsɛm a ɛfa hormone, nnuru, ne ntini a ɛwɔ yɛn nipadua mu (Endocrine system) ho.

• Urea dodow a ɛkɔ soro wɔ mogya mu (Uremia) .
• Ketoacidosis (DKA) a ɛde asikreyare ba .
• Addison yare no
• Porphyria a ɛba bere ne bere mu a emu yɛ den

2. Mogya mu nyarewa

Eyinom yɛ nyarewa a ɛfa yɛn mogya, nkwammoaa a ɛwɔ yɛn mogya mu, ntini a ɛma mogya tu, nnompe mu ntini, ne mogya mu nkwammoaa a ɛwɔ mogya mu no ho.

• Sickle cell yare a ɛma obi nya yare
• Leukemia a emu yɛ den
• Awosu mu nyarewa ahorow bi
• Mogya a ɛtɔ kɔ nipadua mu

3. Awuduru a ɛwɔ nipadua no mu

Nnuru, nnuru, ne awuduru bi a efi mmoa a wɔaka wɔn mu nso betumi ama yafunu ayɛ wo yaw mpofirim.

• Awuduru a wɔde kɔbere ayɛ
• Dade a emu yɛ duru a wɔde bow nsa afoforo
• Nicotine a wɔtwe wɔn ho fi ho
• Okunafo tuntum akɔre a ɛka awuduru
• Akɔkoraa binom keka wɔn

Wobɛyɛ dɛn ahu yafunu mu yaw a ɛba mpofirim yi (Acute Abdomen)?

Sɛ wokɔ baabi a wɔhwɛ wɔn a wɔwɔ yafunu mu denneennen (ETU) a, nnuruyɛfo ne ayarehwɛfo a wɔwɔ hɔ no bɛbɔ mmɔden ntɛm ara sɛ wobehu nea ɛde ba. Oduruyɛfo no bebisa wo nsɛm kakraa bi:

• W’ayaresa ho abakɔsɛm: GI nsɛm a atwam ne nyarewa afoforo.
• Baabi a ɛyaw no wɔ pɛpɛɛpɛ: Ɛyɛ yaw wɔ yafunu no mu baabi.
• Bere a ɛyaw no fi ase ne ɛyaw no ho nkyerɛkyerɛmu: Bere bɛn na efii ase ne ɛyaw ko a ɛyɛ (ɛyaw, twa, piapia).
• Nea ɛsɛ sɛ yɛyɛ na ama ɛyaw no so atew, ne nea ɛsɛ sɛ yɛyɛ na ama ɛyaw no ayɛ kɛse.
• So woanya yare no ho sɛnkyerɛnne a ɛte sɛɛ pɛn?
• So nneɛma foforo bi wɔ hɔ?
• Nnuru bɛn na (nnuru a wɔkyerɛw ma obi ne nea wɔmfa nkyerɛw mma) na wonom?
• So wɔayɛ wo yafunu oprehyɛn bi pɛn?
• So woanya nsakrae bi nnansa yi wɔ wo dwensɔtwaa anaa wo nsu mu?

Afei nso, akyinnye biara nni ho sɛ wobebisa sɛ ebia woanyinsɛn anaasɛ ebetumi aba sɛ wubenyinsɛn anaa.

Afei oduruyɛfo no bɛyɛ wo nipadua mu nhwehwɛmu, titiriw wo yafunu. Ɔbɛhwɛ wo yafunu honam ani hwɛbea sɛ ebia biribiara a ɛnteɛ a wotumi hu anaa. Ɔde afiri a wɔde tie asɛm bedi dwuma de atie wo dwensɔtwaa mu nnyigyei. Afei ɔde ne nsa bɛka wo yafunu no mu ahwɛ sɛ ebia wo yafunu anaa akuru biara wɔ hɔ anaa.

Beae a wote yaw no betumi aboa wo duruyɛfo ma wahu nea ɛde wo yaw no ba. Sɛ nhwɛso no, wɔtaa te ɛyaw a emu yɛ den wɔ wo yafunu no benkum fam, bere a wɔtaa te ɛyaw a ɛwɔ wo yafunu no fã a ɛwɔ soro nifa so no nka.

Sɛ wosusuw sɛ aduan mu yare anaa prostate mu haw bi wɔ hɔ a, wobetumi ayɛ dijitaal rectal nhwehwɛmu. Sɛ wosusuw sɛ mmea ho haw bi wɔ hɔ a, wobetumi ayɛ akyi berɛmo mu nhwehwɛmu. Sɛ wosusuw sɛ awotwaa no akyeakyea a, wobetumi ayɛ awotwaa mu nhwehwɛmu.

Oduruyɛfo no betumi agyina nsɛmmisa yi ho mmuae ne nea wuhu wɔ nipadua mu nhwehwɛmu no mu so anya nea ebia yare no yɛ ho adwene. Obegyina ɛno so asi nhwehwɛmu a wɔde hu yare a ɔbɛyɛ ho gyinae.

Sɔhwɛ ahorow bɛn na wɔyɛ ma eyi?

Ɛtɔ mmere bi a, sɛ wo duruyɛfo tumi hu nea ɛde wo sɛnkyerɛnne ahorow no ba pefee a, ebia obetumi de wo akɔ oprehyɛn tẽẽ a ɔnyɛ nhwehwɛmu foforo biara. Nanso, sɛ wunnim nea ɛde ba no a, ebia ebehia sɛ woyɛ nhwehwɛmu mpɛn pii na ama woahu sɛ woahu. Sɔhwɛ ahorow a ebehia sɛ woyɛ no begyina nea wubehu bere a woreyɛ wo nipadua mu nhwehwɛmu ne tebea a wosusuw sɛ wowɔ no so.

Mogya ne nsu mu nhwehwɛmu (Laboratory nhwehwɛmu) betumi ayɛ:

• Mogya dodow a wɔde ma a edi mũ (CBC) .
• Nneɛma a ɛma nipadua no yɛ adwuma yiye (CMP) .
• Mogya mu mframa a ɛwɔ ntini mu (ABG) mu nhwehwɛmu
• Amylase nhwehwɛmu
• Mmɛn dwumadi ho nhwehwɛmu
• Asaabo dwumadi ho nhwehwɛmu
• Nsu mu nhwehwɛmu

Ebia mfoninitwa sɔhwɛ ahorow no bi ne:

• Yafunu mu ultrasound a wɔde yɛ nhwehwɛmu
• Yafunu mu kɔmputa so tomography (CT scan) .
• Endoscopic ultrasound a wɔde hwɛ nipadua no mu

Ɔkwan bɛn so na wosa yafunu mu yaw a ɛba mpofirim yi (Acute Abdomen)?

Ɛsono sɛnea wɔde sa yare no gyina nea ɛde ba no so . Ɛmfa ho nea ɛde ba biara no, ɛho hia sɛ wohu tebea no na wofi ase sa yare ntɛm ara sɛnea wubetumi. Sɛ ɛho hia sɛ wɔyɛ oprehyɛn ntɛm a, oduruyɛfo no de wo bɛkɔ oduruyɛfo a ɔyɛ oprehyɛn nkyɛn ntɛm ara ma wagye wo fo na ebia ɔde wo bɛkɔ baabi a wɔyɛ oprehyɛn mpo.

Sɛ ɛnyɛ oprehyɛn na ɛde yafunu mu yaw mpofirim ba a, wobetumi akamfo ayaresa a edidi so yi akyerɛ:

• Wo sɛnkyerɛnne ahorow a ɛho hia a wobɛma agyina pintinn na woahwɛ so.
• Nsu ne electrolytes a nipadua no hia a ɛbɛma nipadua no anya.
• Nnuru a ekum ɔyare mmoawa a ɛtrɛw a wɔde ma.
• Ɛyaw ano aduru a wɔde ma.
• Nnuru a ɛko tia akisikuru a wɔde ma na ama ɔfe ne akisikuru so atew.

Sɛ me yafunu yɛ me yaw mpofirim (Acute Abdomen) a, dɛn na ɛba?

Wo nkɔmhyɛ gyina nea ɛde yare no ba so. Dodow a wunya ayaresa ntɛm no, dodow no ara na hokwan a wowɔ sɛ wo ho bɛtɔ wo no yɛ kɛse.

Sɛ wɔannya yafunu mu yaw mpofirim a, ɔhaw ahorow a asiane wom betumi aba. Eyinom bi ne:

• Nkitahodi a ɛnteɛ a ɛda nipadua no afã horow a ɛnsɛ sɛ ɛka bom (Fistula) ntam.
• Necrosis a ɛba wo dwensɔtwaa mu.
• Mogya mu awuduru (Sepsis).
• Owu mpo betumi aba.

Enti, sɛ wo yafunu yɛ wo yaw mpofirim a, mmu w’ani ngu so da. Ade a eye sen biara a ɛsɛ sɛ woyɛ ne sɛ wobɛhwehwɛ aduruyɛfo afotu ntɛm ara.

So metumi asiw yafunu mu yaw a ɛba mpofirim yi ano (Acute Abdomen)?

Esiane sɛ nneɛma pii wɔ hɔ a ɛde yafunu mu yaw ba mpofirim nti, ɛyɛ den sɛ wobesiw ne nyinaa ano. Nanso, wubetumi atew asiane yi so denam asetra a ahoɔden wom a wubedi akyi so . Ɛno kyerɛ sɛ:

• Aduan a ɛkari pɛ a wobedi.
• Apɔw-mu-teɛteɛ a wɔyɛ no daa.
• Kɔ a wɔbɛkɔ akɔhwɛ wɔn wɔ aduruyɛ mu daa.
• Sigaretnom a wobegyae.

Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn?

Sɛ wowɔ yafunu mu yaw a enni sabea, a ɛkyerɛ ɛyaw a akɔ so adapɛn pii na ɛte sɛ nea ɛnyɛ yiye a, akyinnye biara nni ho sɛ ɛsɛ sɛ wokɔ oduruyɛfo nkyɛn. Nneɛma pii na ɛde yafunu mu yaw ba. Oduruyɛfo betumi ahu wo yare no na wakamfo ayaresa a ɛfata akyerɛ wo.

Bere bɛn na ɛsɛ sɛ mekɔ Emergency Treatment Unit (ETU) ?

Sɛ wo yafunu mu yɛ wo yaw mpofirim a, frɛ 911 (1990 wɔ Sri Lanka) ntɛm ara, anaa kɔ baabi a ɛbɛn wo a wɔhwɛ wɔn a wɔwɔ ayaresa a egye ntɛmpɛ mu. Eyi betumi ayɛ tebea a ɛde nkwa to asiane mu, enti ayaresa ho hia ntɛm.

Nsɛm bɛn na ɛsɛ sɛ mibisa me duruyɛfo?

Sɛ wo yafunu mu yɛ wo yaw mpofirim a, wubetumi abisa wo duruyɛfo nsɛm yi:

• Dɛn nti na me yafunu yɛɛ me yaw mpofirim?
• So mehia ayaresa foforo?
• Dɛn na metumi ayɛ na amma biribi a ɛte sɛɛ ansi bio?
• Nsonsonoe bɛn na ɛwɔ yafunu mu yaw a emu yɛ den ne yafunu mu yaw a enni sabea ntam?

Ɛkame ayɛ sɛ obiara te yafunu mu yaw wɔ n’asetra mu bere bi. Mpɛn pii no, ɛnyɛ aniberesɛm na ɛno nkutoo bɛkɔ. Nanso, yafunu mu yaw a emu yɛ den betumi ayɛ aduruyɛ mu tebea a egye ntɛmpɛ ho sɛnkyerɛnne. Sɛ wo yafunu mu yɛ wo yaw kɛse mpofirim a, ɛho hia sɛ wokɔ baabi a wɔhwɛ wɔn a wɔwɔ ayaresa a egye ntɛmpɛ mu ntɛm ara. Saa kwan yi so no, nnuruyɛfo betumi ahu nea ɛde wo yaw no ba na wɔafi ayaresa ase ntɛm ara. Sɛ wɔansa a, yafunu mu yaw a emu yɛ den betumi de ɔhaw ahorow a emu yɛ den aba.

Kae ade a ɛho hia sen biara (Take-Home Message) .

Yafunu mu yaw a emu yɛ den mpofirim nyɛ biribi a ɛsɛ sɛ wobu ani gu so da . Ebia biribi a anibere wom wɔ hɔ a ɛde ba. Enti, sɛ wo anaa obi a wunim no yafunu mu yaw kɛse mpofirim a, kɔ oduruyɛfo ntɛm ara . Ayaresa a wɔyɛ no ntɛm betumi agye obi nkwa. Asetra pa a wobɛtra ase nso betumi aboa ma woabɔ wo ho ban afi tebea horow yi ho akodu baabi. Nea ɛsen ne nyinaa no, hwɛ wo nipadua so na hwɛ biribiara a ɛyɛ soronko.

` Yafunu mu yaw, yafunu mu yaw mpofirim, yafunu mu yaw, oprehyɛn, ayaresabea a wɔde obi bɛkɔ, yafunu mu sɛnkyerɛnne, Acute Abdomen