Dɛn ne eyi (Boerhaave’s Syndrome)?
Sɛ yɛbɛka no tiawa a, saa `(Boerhaave's Syndrome)` yi yɛ tebea a yɛn aduan paipu no fasu, kyerɛ sɛ, `(esophagus),` no pae mpofirim. Eyi ba bere a nhyɛso bi a wontumi nsusuw ho, kyerɛ sɛ, biribi a wɔde piapia, wɔ aduan paipu no mu no. Sɛ yɛbɛka no pɛpɛɛpɛ a, ɛda adi kɛse sɛ eyi bɛba bere a wofe denneennen anaasɛ wobɔ mmɔden wɔ ɔkwan foforo biara so no. Nnuruyɛfo nso frɛ eyi `(mmɔdenbɔ a ɛpaapae)` anaa `(paepae a ɛba ara kwa)`, efisɛ eyi nyɛ biribi a ɛba aduan paipu no so tẽẽ. Saa tebea yi ho yɛ na ankasa, kyerɛ sɛ, ɛka nnipa dodow bɛyɛ 0.0003%. Nanso, akwanhyia a ɛba aduane afiri mu nyinaa mu 15% firi saa `(Boerhaave's Syndrome)` yi mu.Nsonsonoe bɛn na ɛda (Boerhaave Yare) ne (Mallory Weiss Yare) ntam?
Seesei ebia woredwen ho sɛ, ‘So eyi ne nea mate ho asɛm bere a mete sɛ ntetewmu wɔ menewam?’ Nsonsonoe kakra wɔ abien no ntam ankasa. Mallory Weiss tear yɛ nusu a ɛba bere a wofe denneennen anaa bere a woreyɛ den no. Ɛyɛ ntetewmu a ɛwɔ aduannuru a ɛwɔ aduan mu no mu. Nneɛma abien no nyinaa abu so wɔ nnipa a wɔnom nsa pii mu . Obi a Mallory Weiss nusu betumi afe mogya. Nanso, aduannuru no mpaapae koraa. Nanso, Boerhaave Syndrome no yɛ nea anibere wom kɛse . Eyi yɛ nusu a ɛtrɛw fa aduan mu ɔfasu no mu duru nyinaa mu . Nnuruyɛfo nso frɛ no transmural tear. Sɛ ɛpae koraa a, ɛsɛ sɛ wɔde oprehyɛn a egye ntɛmpɛ siesie . Ebetumi ayɛ nkwa anaa owu tebea.Sɛ aduan afiri bi pae a, dɛn na ɛba?
Wo de susuw nea ɛba bere a yɛn aduan a yɛnom no pae no ho hwɛ. Eyi yɛ tebea a egye ntɛmpɛ ankasa, na sɛ wɔansa no ntɛm a , ebetumi de nkwa ato asiane mu . Wunim nea enti a ɛte saa? Yɛn aduan a yɛde di dwuma no yɛ yɛn aduan mu nneɛma (yafunu mu kwan) no fã. Enti, sɛ aduannuru no pae a, aduan mu nneɛma nketenkete, mmoawa, ne nnuru a ɛma aduan mu yɛ den betumi akɔ yɛn koko anaa yafunu mu. Sɛ ɛba saa a, ɔyare mmoawa a emu yɛ den betumi aba.Sɛ saa ɔyare mmoawa yi hyɛn yɛn nipadua nyinaa mogya mu a, tebea horow a wɔfrɛ no ``septiceemia'' ne ``sepsis'' betumi aba. Saa ``sepsis'' yi yɛ adeyɛ a ɛde nkwa to asiane mu. Ebetumi de ``ahodwiriw'', akwaa ahorow pii adi huammɔ, na awiei koraa no owu aba.
Henanom na eyi ka wɔn kɛse?
Obiara betumi anya saa `(Boerhaave's Syndrome) yi. Mmom,Ɛtaa ba mmarima ne nnipa a wɔadi boro mfeɛ 50. Wɔn a ɛka wɔn no mu bɛyɛ 80% yɛ mmarima a wɔadi mfeɛ mfimfini. Ɛtaa ba nnipa a wɔnom nsa boro so nso so .Dɛn ne Boerhaave Yare no ho sɛnkyerɛnne ahorow?
Okay, afei momma yɛnhwɛ nea ɛyɛ `(Boerhaave's Syndrome)` ho sɛnkyerɛnne. Ɛho hia paa sɛ wubehu eyinom.- Koko mu yaw a emu yɛ den mpofirim. Eyi ne sɛnkyerɛnne titiriw no.
- Akisikuru ne ɔfe . Ɛtɔ da bi a, mogya betumi agu ɔfe no mu.
- Ɛnyɛ hwee sɛ wobɛte ɛyaw nka bere a woremene anaasɛ wobɛfefe.
- Ahome a wɔhome no yɛ tiaa na ɛyɛ ntɛmntɛm.
- Mframa anaa nsu hyɛ ntini a ɛwɔ koko no mu ma, na ɛma ɛho ahon.
- Me yafunu te nka sɛ ɛyɛ den, te sɛ ɔbotan.
- Nsɛnkyerɛnne a ɛkyerɛ sɛ obi anya ɔyare mmoawa te sɛ atiridiinini ne fifiri .
Sɛ saa sɛnkyerɛnne ahorow yi mu biako anaa nea ɛboro saa da adi mpofirim, titiriw bere a woafe denneennen akyi a, ɛho hia yiye sɛ wohwehwɛ aduruyɛfo afotu ntɛm ara .
Ɛyaw no te dɛn?
Ɛyaw a ɛwɔ `(Boerhaave's Syndrome)` mu no nye dɛn? Nnipa binom ka sɛ ɛyɛ nea wontumi nnyina ano ankasa . Wɔte ɛyaw no nka wɔ baabi a mpaapaemu no bae no ara. Mpɛn pii no, saa mpaapaemu yi ba yɛn ɛwo kotoku mu nkyem abiɛsa mu biako a ɛwɔ fam no mu. Ɛne sɛ, ɛda koko a ɛwɔ fam ne yafunu a ɛwɔ soro ntam. Nanso, ebetumi nso akɔ soro asen saa. Saa ɛyaw yi nso betumi atrɛw akɔ akyi anaa mmati so .Dɛn ne nsɛnnennen a ebetumi aba?
Sɛ wɔanni tebea yi ho dwuma yiye a, nsunsuanso bɔne pii wɔ hɔ a ebetumi aba:- Ɔfe ne wo koko a ɛho ahonhon .
- Nsõ a wɔboaboa ano wɔ koko mu (empyema) .
- .
- Pleural effusion ( nsu a ɛboaboa ano wɔ koko no mu) .
- Ɔhome mu Ahokyere a Ɛyɛ Den ( ARDS ) .
- Septicemia, sepsis, ne ahodwiriw. Eyinom betumi de nkwa ato asiane mu.
Dɛn na ɛde Boerhaave Yare no ba?
Dɛn nti na Boerhaave Syndrome no ba? Nneɛma atitiriw abien nti na ɛte saa. Biako ne sɛ nhyɛso a ɛwɔ aduan no mu no kɔ soro esiane nhyɛso anaa nhyɛso a ɛyɛ soronko nti . Ɔfoforo nso ne sɛ, sɛ cricopharyngeus ntini a ɛwɔ yɛn menewa atifi (ɛwono mu ntini a ɛwɔ soro) no ntumi nnye n’ahome wɔ nhyɛso yi ho mmuaema mu a, nhyɛso bɔne bi ba wɔ aduan no akyi .. Nea ɛde saa `(Boerhaave Syndrome)` yi ba titiriw ne ɔfe a ano yɛ den anaasɛ ɛkɔ so . Nea ɛka ho no, awo, akisikuru, nneɛma a emu yɛ duru a wɔma so, ne nneɛma a ɛyɛ hyew anaa nea ɛporɔw a wɔmene nso betumi de aba. Mpɛn pii no, wɔ tebea horow a ɛtete saa mu no, ɛsɛ sɛ ntini mu nsɛnkyerɛnne no ma `(cricopharyngeus ntini)` no dwo na ɛma nhyɛso a ɛwɔ mu no fi hɔ. Nanso, wɔ `(Boerhaave's Syndrome)` mu no, biribi nti saa ntini mu ntini nhyehyɛe yi `(ntini mu ntini mu nkitahodi)` nyɛ adwuma yiye.So nsa a wɔnom no nya nkɛntɛnso?
So nsa a wɔnom betumi ama aduan mu awotwaa mu apaapae? Nsã a wɔnom boro so yɛ asiane a ɛde ba . Boerhaave’s Syndrome a ɛtaa ba ne sɛ obi bɛfe bere a wadi aduan pii awie anaasɛ wanom nsa awie no. Asanom ho haw, adidi mmoroso, ne bulimia yɛ nneɛma a ɛde asiane ba. Asiane afoforo ne aduruyɛ mu tebea horow a ɛda adi wɔ aduan mu, te sɛ aduan mu yare ne eosinophilic esophagitis, Barrett aduan mu yare, ne yare a ɛma akisikuru. Nanso, nnipa dodow no ara a wɔwɔ Boerhaave’s Syndrome no wɔ wɔn aduan a wɔde di dwuma wɔ ɔkwan a ɛfata so.Ɔkwan bɛn so na wohu sɛ obi anya Boerhaave Syndrome?
Boerhaave Syndrome betumi ayɛ den sɛ wobehu , nanso ɛho hia sɛ wunya no ntɛm ara . Ɛnyɛ den sɛ wubehu bere a wowɔ sɛnkyerɛnne abiɛsa a wɔfrɛ no Mackler triad no. Eyinom ne: 1. Ɔfe a emu yɛ den anaasɛ ɛsan ba bio. 2. Koko mu yaw a efi ase mpofirim. 3. Honam ani akisikuru a ɛba nipadua no ase. Saa sɛnkyerɛnne a etwa to yi kyerɛ titiriw sɛ aduannoa mu apaapae. Nanso, ɛnyɛ obiara na obenya saa sɛnkyerɛnne ahorow a wɔtaa hu yi. Sɛ mpaapaemu no ba wɔ beae a ɛyɛ soronko a, ebia wobɛte ɛyaw wɔ beae a ɛyɛ soronko, te sɛ kɔn anaa wo kɔn mu nnompe. Ebia biribi foforo a ɛnyɛ ɔfe na ɛde ba, anaasɛ ebia ɛde ɔhaw ahorow a ɛyɛ soronko ka ho. Ebia koko so X-ray a ɛnyɛ den bɛma woahu, nanso ɛho hia sɛ wɔyɛ mfonini mu nhwehwɛmu a ɛyɛ mmerɛw kɛse na ama wɔahu tebea no.Radiological nhwehwɛmu a wɔde di dwuma de hu yare no
Nhwehwɛmu bɛn na wɔde radiological yɛ de hu ``Boerhaave's Syndrome''?`(Esophagram)` (Esophagram) .
Sɛ oduruyɛfo bi susuw sɛ ɔwɔ Boerhaave’s Syndrome a, ade a edi kan a wɔtaa yɛ ne sɛ wɔbɛyɛ X-ray. Wɔde aduru a wɔde yɛ nneɛma a ɛne ne ho bɔ abira na edi dwuma. Wɔsan frɛ eyi sɛ esophagram. Eyi yɛ sɔhwɛ a wɔyɛ no ntɛmntɛm a ɛnyɛ nea wɔde hyɛ nipadua mu a ɛyɛ pɛpɛɛpɛ kɛse. Wɔ sɔhwɛ yi mu no, wonom aduru bi a nsu mu aduru a ɛne ne ho bɔ abira wom. Eyi ma wotumi hu w’aduan paipu no mu wɔ X-ray no so. Sɛ nusu bi tetew a, wobetumi ahu baabi a aduru a ɛne ne ho bɔ abira no retu.(CT scan) .
Sɛ wuntumi nyɛ esophagogram, anaasɛ wo duruyɛfo pɛ sɛ ohu akwaa a atwa wo ho ahyia no ho nsɛm pii a, wobetumi ayɛ CT scan. Ɛwom sɛ entumi nkyerɛ beae pɔtee a nusu no wɔ de, nanso etumi hu ade ketewaa bi a wɔde yɛ nneɛma a ɛne ne ho bɔ abira anaa mframa a afi aduan mu akɔ ntini a atwa ho ahyia no mu. Wobetumi de adi dwuma nso de ahu nsu a aboaboa ano wɔ koko anaa yafunu mu a ɛsɛ sɛ wɔtwe fi mu.Ɔkwan bɛn so na wɔsa Boerhaave Yare no?
Okay, afei momma yɛnhwɛ sɛnea wɔbɛsa `(Boerhaave's Syndrome)`. Anamɔn a ɛsɛ sɛ wudi akyi ni:- Nsu a wɔde fa ntini mu (IV nsu): Nnipa pii nsu nnim, enti ɛsɛ sɛ wɔde IV nsu ma ntɛm.
- Nnuru a ekum ɔyare mmoawa : Wɔde nnuru a ekum ɔyare mmoawa a ɛtrɛw fa ntini mu de siw ɔyare mmoawa ano.
- Oprehyɛn a wɔde ma: Wɔ nnipa dodow no ara fam no, oprehyɛn ne ayaresa a wɔtaa yɛ. Wobetumi asa nnipa binom a akisikuru nketenkete a ɛwɔ baabiara no yare a wɔnyɛ wɔn oprehyɛn, na wɔde nnuru a ekum ɔyare mmoawa a wɔde fa IV anaa endoscopy ahwɛ wɔn. Nanso, wɔ nsɛm yi mu mpo no, nnuruyɛfo benya nhyehyɛe a wɔayɛ ama oprehyɛn a egye ntɛmpɛ bere nyinaa.
- Oprehyɛn a wɔde siesie: Ɛyɛ papa sɛ wubesiesie nea apaapae no wɔ nnɔnhwerew 24 akyi bere a apaapae no. Ebia wo duruyɛfo no de oprehyɛn a ɛnyɛ den pii bedi dwuma, a egyina wo tebea no so. Sɛ nhwɛso no, video a wɔde boa ahurututu mu oprehyɛn (VATS). Wɔ tebea horow bi a egye ntɛmpɛ mu no, ebia ɛho behia sɛ wotwa ahurututu a wɔabue mu na ama wɔatumi akɔ koko no mu ntɛmntɛm na wɔadi mũ.
- Drainage/debridement: Wɔ nusu no a wobesiesie akyi no, ɛsɛ sɛ wɔtwe nsu biara a ɔyare mmoawa wom a aboaboa ano wɔ abura no mu no na wɔde kum mmoawa. Ɛsɛ sɛ woyi ntini biara a ɔyare anaasɛ awu (necrotic) nso fi hɔ. Wɔ tebea horow bi a emu yɛ den mu no, ebia ɛho behia sɛ woyi wo menewam no fã bi.
- Ahwɛyiye a ɛkɔ akyiri: Sɛ wontumi nyɛ oprehyɛn wɔ nnɔnhwerew 24 akyi wɔ bere a wɔapaapae no akyi a, ebia nsiesie tẽẽ no rentumi nyɛ yiye. Ebetumi aba sɛ kuru no anoano afi ase reyɛ den anaasɛ asɛe. Sɛ eyi ba a, ebia ɛho behia sɛ wo duruyɛfo yi wo menewam no fã bi anaa ne nyinaa (esophagectomy). Sɛ wuhia aduan a wɔde si ananmu a, wobetumi ayɛ eyi wɔ adapɛn asia akyi.
- Akwan foforo a wobɛfa so ama wo aduan: Enkosi sɛ w’aduan paipu no bɛsa no, worentumi nmene aduan mfa mu, enti ebehia sɛ wunya aduannuru wɔ ɔkwan foforo so. Eyi betumi afa afiri bi mu anaasɛ ɛnam ntini bi mu.
Dɛn ne anidaso a ɛwɔ hɔ sɛ obi bɛsan atɔ no?
Dɛn ne nkɔmhyɛ a ɛwɔ hɔ ma obi a ɔwɔ ``Boerhaave's Syndrome''? Sɛ wuhu yare no ntɛm na wosa yare a, ɛno ne nneɛma a ɛho hia sen biara a wubetumi ayɛ na asiw ɔhaw ahorow a owu ka ho a efi ɔyare mmoawa mu ba no ano.. Wɔn a wonya ayaresa wɔ nnɔnhwerew 24 ntam no betumi ahwɛ kwan sɛ wɔn ho bɛtɔ wɔn yiye, a hokwan a ɛwɔ hɔ sɛ wobenya nkwa 75%. Nnɔnhwerew 24 akyi no, owu a ebetumi aba no boro 50%, na nnɔnhwerew 48 akyi no ɛyɛ 90%. Sɛ yɛka ne nyinaa bom a, nnipa dodow a wowuwu no bɛyɛ 35%. Wɔn a wonya ayaresa wɔ bere a ɛsɛ mu na edi mu no betumi ama wɔn ho atɔ wɔn koraa, nanso ebetumi agye asram pii. `(Boerhaave's Syndrome)` yɛ tebea a ɛntaa nsi nanso ɛyɛ soronko koraa a ɛma nneɛma pii susuw ho . Ebetumi aba mpofirim, a kɔkɔbɔ sɛnkyerɛnne biara nni mu – nanso asanom bebrebe a enni sabea yɛ kɔkɔbɔ sɛnkyerɛnne a emu da hɔ a yebetumi asiw ano. Yɛnnim biribiara fa `(Boerhaave's Syndrome)` ho. Yennim nea enti a aduannuru no ntumi mmɔ ne ho ban mfi ɔsɛe ho wɔ nsɛm yi mu. Nanso yenim sɛ sɛ wɔanhu na wɔansa no ntɛm a, ebetumi akum obi.Nneɛma a ɛho hia paa a ɛsɛ sɛ wokae
Okay, enti seesei woanya nteaseɛ pa wɔ deɛ yɛaka ho asɛm no ho, ``Boerhaave's Syndrome.'' Nneɛma a ɛho hia paa a ɛsɛ sɛ wokae nie:- Boerhaave’s Syndrome yɛ aduruyɛ mu tebea a egye ntɛmpɛ a ɛnam ɛwo a ɛpaapae nti.
- Eyi taa ba bere a wɔafe denneennen akyi .
- Nsɛnkyerɛnne titiriw ne koko mu yaw a emu yɛ den mpofirim, ɔfe, ne ɛyɛ den sɛ ɔbɛmene .
- Nnipa a wɔnom nsa pii no wɔ asiane kɛse mu.
- Sɛ wuhu sɛnkyerɛnne ahorow a , hwehwɛ aduruyɛfo afotu ntɛm ara . Dodow a wufi ayaresa ase ntɛm no, dodow no ara na hokwan a wowɔ sɛ wo ho bɛtɔ wo no yɛ kɛse.
- Mpɛn pii no, ɛho hia sɛ wɔyɛ oprehyɛn sɛ ayaresa.
Ɛho hia sɛ wuhu tebea yi. Sɛ wo anaa obi a wunim no nya saa sɛnkyerɛnne yi bi a, mmu w’ani ngu so. Kɔ oduruyɛfo nkyɛn ntɛm ara.
` Borrego syndrome, ɛwo a ɛpaapae, koko mu yaw, ɔfe, nsa, ɛwo a ɛpaapae, Meckler triad, sepsis, ɛwo mu oprehyɛn
💬 Comments (0)
Wɔnnya nyɛɛ nsɛm biara. Fa wo nsɛm no ka ho wɔ ha nea edi kan.
Fa wo nsɛm no ka ho