Yala i kɔnɔbara bɛ kɛ i n’a fɔ a bɛ wuli ka kɛ kabakurun ye wa? An ka nin bana in dɔn min man teli ka sɔrɔ (Syndrome de Ogilvie) .

Yala i delila k’a ye ko fɛn dɔ sirilen bɛ i kɔnɔbara la, i kɔnɔbara bɛ ka bonya, ani i y’a ye ko a bɛna pɛrɛn wa? A tun bɛ i n’a fɔ i banakɔtaa tun datugulen don pewu. A ka ca a la, o bɛ kɛ ni fɛn dɔ datugulen don tiɲɛ na i banakɔtaa la. Nka, bana kabakoma dɔ bɛ yen, min man teli ka kɛ, i banakɔtaa bɛ baara dabila yɔrɔnin kelen k’a sɔrɔ foyi ma siri a kɔnɔ. Bi, an bɛna kuma bana dɔ kan, mɔgɔ fanba ma deli ka min mɛn. Furakɛcogo siratigɛ la, an bɛ o wele ko Ogilvie Syndrome walima Acute Colonic Pseudo-obstruction (ACPO) .

N’an y’a fɔ cogo nɔgɔman na, Ogilvie Syndrome ye mun ye?

Miiri k’a filɛ, siraba ka ca, nka kasaara wala bali si tɛ sira kan. Mobiliw jɔlen bɛ dɔrɔn. Ogilvie Syndrome ye o ɲɔgɔnna fɛn ye. Dumuni ni fɛnɲɛnamafagalanw lamagacogo aw ka kolotuguda kɔnɔ, o bɛ barika sɔrɔ ka jɔ. A bɛ kɛ i n’a fɔ fɛn dɔ sirilen bɛ i kɔnɔbara la, nka tiɲɛ yɛrɛ la, farikolo balilan si tɛ yen. Gɛlɛya bɛ sɔrɔ farikolojidɛsɛ la min bɛ aw ka kolotuguda farikolo yɔrɔw mara. Komin a tɛ baara kɛ ka ɲɛ, kolotuguda lamagacogo (an b’o wele ko ``peristalsis``) bɛ jɔ, a kɔnɔfɛnw bɛ nɔrɔ yɔrɔ kelen na. O bɛ kɛ sababu ye ka kolotuguda bonya dɔɔni dɔɔni, walima ka kurukuru.

Daɲɛ ``pseudo-obstruction'' min bɛ a tɔgɔ la, o kɔrɔ ye ``false obstruction.'' O kɔrɔ ye ko a bɛ taamasiɲɛw jira i n'a fɔ balili bɛ yen, hali ni tiɲɛ na, balili tɛ yen.

O ni banakɔtaa gɛlɛya tɔw tɛ kelen ye cogo di?

Bana suguya wɛrɛw bɛ yen minnu bɛ banakɔtaa baara tiɲɛ. O la, an k’a lajɛ Ogilvie Syndrome ni u tɛ kelen ye cogo min na.

• Ni aw ye a suma ni `Intestinal Pseudo-obstruction` bana tɔw ye: Ogilvie Syndrome ye `acute` bana ye. O kɔrɔ ye ko a bɛ na yɔrɔnin kelen, wa a bɛ kɛ waati dɔɔnin dɔrɔn kɔnɔ . Wa a bɛ banakɔtaa dɔrɔn de minɛ . Nka, mɔgɔ dɔw bɛ se ka `kɔrɔlen` `pseudo-obstruction` banaw sɔrɔ. A ka ca a la, u bɛ sɔrɔ bana basigilen wɛrɛ fɛ walima bangekɔlɔsi bana dɔ fɛ.
• Danfara min bɛ `Paralytic Ileus` ni ɲɔgɔn cɛ: N’a sɔrɔ aw ye `Paralytic Ileus` daɲɛ mɛn. A bɛ kɛ ka bana dɔ ɲɛfɔ, banakɔtaa bɛ baara dabila waati dɔ kɔnɔ, kɛrɛnkɛrɛnnenya la kɔnɔbara opereli kɔfɛ. A ka ca kosɛbɛ. A bɛ kɛ sababu ye banakɔtaa fitini ni banakɔtaa belebele fila bɛɛ ka baara dabila waati dɔɔni, ka sɔrɔ ka kɛnɛya a yɛrɛ ma tile damadɔ kɔnɔ. Nka, Ogilvie ka bana ye bana ye min ka gɛlɛn kosɛbɛ ani min man teli ka sɔrɔ . A bɛ banakɔtaa de minɛ kosɛbɛ , kɛrɛnkɛrɛnnenya la sekumu.

Jɔn de farati ka bon kosɛbɛ ka nin bana in sɔrɔ?

Hali ni a bɛ se ka kɛ mɔgɔ bɛɛ la, a ka ca mɔgɔkɔrɔbaw la minnu si tɛmɛna san 60 kan, kɛnɛyako gɛlɛya caman wɛrɛw bɛ minnu na.Nin bana in bɛ fɔ banabagatɔ 1000 o 1000 la minnu bɛ dɔgɔtɔrɔso la, kelen ɲɔgɔn na.

N’an y’a fɔ cogo nɔgɔman na, o bɛ se ka kɛ waati o waati ni farikolo bɛ degun caman na. Miiri opereliba dɔ la, kasaara jugu dɔ la, dusukun tantanni dɔ la, walima bana juguman dɔ la. O fɛnw bɛ nɔ bila an ka farikolo-ɲɛnajɛ-yɔrɔw baara la. O farikolo-ɲɛnajɛ in de b’a fɔ banakɔtaa farikolo yɔrɔw ye u ka “lamaga”. O la ni balanbaliya bɛ yen, banakɔtaa bɛ baara dabila ani Ogilvie Syndrome bɛ se ka sɔrɔ.

Ogilvie ka bana taamasiɲɛw ye jumɛnw ye?

Ni fiɲɛ, ji ani dumuni dunbaliw sirilen don aw banakɔtaa la, aw bɛ se ka nin taamasiɲɛ suguw sɔrɔ. Olu bɛ se ka daminɛ yɔrɔnin kelen ka caya dɔɔni dɔɔni.

Mun na o bɛ kɛ? An ka kunw lajɛ ka ɲɛ.

Hali ni o sababu tigitigi ma jɛya hali bi 100%, dɔnnikɛlaw dalen b’a la ko a bɛ sɔrɔ an ka farikolo yɛrɛmahɔrɔnyalen baarakɛbaliya fɛ . Aw ye miiri a la, fɛn minnu bɛ kɛ an farikolo la u yɛrɛma, i n’a fɔ dusukun tantanni, ninakili, ani dumunikɛcogo, olu bɛ mara nin farikoloɲɛnajɛ in fɛ, min bɛ baara kɛ i n’a fɔ ``auto-pilot.'' O la, ka da degun caman kan farikolo kan, nin ``auto-pilot'' in bɛ se ka bɔ balansi la, wa taamasiɲɛ minnu bɛ banakɔtaa kɔlɔsi, olu bɛ se ka tiɲɛ.

Kunba minnu bɛ kɛ sababu ye ka nin ko in kɛ, olu bɛ se ka tila ka kɛ kulu caman ye.

Yala o bɛ se ka kɛ ko jugu ye wa? Gɛlɛya jumɛnw bɛ o la?

Ɔwɔ, ni o ma sɛgɛsɛgɛ ani ni a ma furakɛ ka ɲɛ, o bɛ se ka kɛ sababu ye ka gɛlɛya jugumanbaw lase mɔgɔ ma, wa hali gɛlɛya minnu bɛ se ka mɔgɔ ka ɲɛnamaya bila farati la . Miiri k’a filɛ, mun bɛ kɛ n’i tora ka fiɲɛ fiyɛ ka don balon kɔnɔ? A bɛ pɛrɛn. Banakɔtaa fana bɛ o cogo kelen na.

Kɔnɔnatumu cɛmancɛ hakɛ bɛ se santimɛtɛrɛ 8 ɲɔgɔn ma. Nka, Ogilvie Syndrome la, ni a bonyalen don ka tɛmɛ santimɛtɛrɛ 12 kan, gɛlɛyaw sɔrɔli farati ka bon kosɛbɛ.

Gɛlɛya kunbaba minnu bɛ se ka sɔrɔ olu ye:

• Ischemie : Ni banakɔtaa kogow kɔrɔtara kojugu, o bɛ kɛ sababu ye joli sira nɔgɔlen minnu bɛ joli di u ma, olu bɛ gɛlɛya, o bɛ dɔ bɔ joli sɔrɔli la . O bɛ kɛ sababu ye ka banakɔtaa funu (ischemic colitis), ni o ma furakɛ, o bɛ se ka kɛ sababu ye ka farikolo yɔrɔw faga (necrose).
• Perforation: Ni farikolo yɔrɔ sara, banakɔtaa kogo bɛ barika dɔgɔya ani dingɛ fitini bɛ se ka kɛ . O farati ka bon kosɛbɛ barisa tumuw ni fɛnɲɛnamafagalan minnu bɛ bɔ banakɔtaa la, olu bɛ se ka don kɔnɔbara la, ka bana jugumanba bila mɔgɔ la (peritonite).
• Sepsis : Banakisɛ min jɛnsɛnna kɔnɔbara la, o tɛ dan o ma. A bɛ se ka don joli la ka jɛnsɛn farikolo fan bɛɛ la.Nin ye bana ye min bɛ mɔgɔ ka ɲɛnamaya bila farati la, min ka kan ka furakɛli kɔrɔtɔ. A yɛrɛ bɛ se ka kɛ sababu ye ka farikolo yɔrɔw dɛsɛ, kelen kelen.

Bana in bɛ se ka sɛgɛsɛgɛ cogo di ka ɲɛ?

Dɔgɔtɔrɔw hami bɛ fɛn fila de la kosɛbɛ ni u bɛ nin bana in sɛgɛsɛgɛ.

1. Fɔlɔ, an b’a lajɛ ni farikolo-ɲɛnajɛ dɔ bɛ banakɔtaa la tiɲɛ na.

2. Ni o balili sugu tɛ yen, a bɛ dɔn ni nin taamasiɲɛ ninnu sababu ye Ogilvie Syndrome ye walima fɛn wɛrɛ.

Sɛgɛsɛgɛli suguya caman bɛ ka kɛ o kama.

• X-ray ni CT scan: Kɔnɔbara la X-ray walima CT scan bɛ se ka banakɔtaa belebele jira ka jɛya, banakɔtaa min fununna ka fa fiɲɛ na. Tuma dɔw la, ji kɛrɛnkɛrɛnnen dɔ (`contrast agent`) bɛ di ka min walima ka kɛ pikiri ye walasa ka ja jɛlenw sɔrɔ.
• Gastrografin Enema : Nin ye sɛgɛsɛgɛli kɛrɛnkɛrɛnnen ye kosɛbɛ. Sabula a ye sɛgɛsɛgɛli ye ani tuma dɔw la furakɛli fana. Yan, ji la, ji min bɛ wele ko `gastrografin`, o bɛ don banakɔtaa kɔnɔ ka tɛmɛ ɲɛgɛnɛsira fɛ, wa a bɛ taa banakɔtaa fɛ cogo min na, o bɛ kɔlɔsi ni wideyow ye `(fluoroscopy)`. O bɛ se ka a dɔn ka ɲɛ ni banakɔtaa balilan dɔ bɛ yen walima ni a tɛ banakɔtaa la. Ani fana, nin `gastrografin` jilama in bɛ kɔnɔboli kɛ. O la, tuma dɔw la, a nɔ bɛ dɛmɛ ka banakɔtaa min jɔra, o ka baara daminɛ kokura.

O furakɛcogo jumɛnw bɛ yen?

Furakɛli bɛ bɔ aw kɔnɔbara funu cogo la ani ni aw bɛ farati la ka gɛlɛyaw sɔrɔ. Ni a bɛ se ka kɛ tuma o tuma, dɔgɔtɔrɔw b’a ɲini k’a furakɛ ni furakɛli nɔgɔmanw ye minnu bɛ a dɛmɛ (`furakɛli min bɛ kɛ ka fɛnw mara`) sanni u ka taa fɛnw na i n’a fɔ opereli.

Furakɛli min bɛ kɛ ni kɔrɔlen ye

A daminɛ na, o furakɛli bɛ kɛ ka a sɔrɔ a bɛ banabagatɔ ka bana kɔlɔsi kosɛbɛ.

• Bana basigilenw furakɛli : Ni bana dɔ bɛ yen, i n’a fɔ banakisɛ walima dusukunnabana, o de bɛ furakɛ fɔlɔ.
• Fura tali dabila: Fura minnu bɛ siga ko olu bɛ kɛ sababu ye ka Ogilvie Syndrome bila mɔgɔ la, olu bɛ dabila waati dɔɔni.
• Banakɔtaa lafiɲɛ : Dumuni ni jimafɛnw dabila pewu.
• IV Kɔgɔjida : Farikolo ka ji ni kɔgɔ hakɛ wajibiyalen bɛ di jolisira fɛ (ji IV).
• Taamacogo ni a jɔyɔrɔ caman cili: Ni a bɛ se ka kɛ, aw bɛ dusu don banabagatɔ kɔnɔ a ka yaala dɔɔni ani ka a jɔyɔrɔ Changer dilan kan. O bɛ se ka banakɔtaa lawuli.
• Intubation : Tubabu (`Nasogastric tube`) bɛ don nugu fɛ ka don kɔnɔbara la walasa ka fiɲɛ ni ji tɛmɛnen bɔ. Tubabufura (`Rectal tube`) fana bɛ don kɔnɔbara la walasa fiɲɛ ka bɔ.

O furakɛli senfɛ, dɔgɔtɔrɔw bɛ to ka X-ray ni joli sɛgɛsɛgɛli kɛ walasa ka banakɔtaa cogoya ni gɛlɛya o gɛlɛyaw kɔlɔsi.

Ni dɛmɛ furakɛli ma ɲɛ do?

Ni bana ma ɲɛ lɛri 72 ɲɔgɔn kɔfɛ, walima ni banakɔtaa janya ka ca ni santimɛtɛrɛ 12 ye, dɔgɔtɔrɔw bɛ taa fɛɛrɛ nata la.

• Kolosinsinnan : O la, tubabufura min kamera sirilen don a la (`kolonoscope`) bɛ don kɔnɔbara la ka fiɲɛ min dalajɛ kolotuguda la, o bɛ sama ka bɔ tubabufura fɛ. O bɛ dɔ bɔ o yɔrɔnin bɛɛ degun na kolotuguda la. Nka, ikomi nin ye fɛɛrɛ ye min tɛ mɔgɔ lafiya dɔɔni, wa tuma dɔw la, kolotuguda sɔgɔli farati ka dɔgɔn, o la, a bɛ kɛ ni hakilijagabɔba ye.
• Neostigmine Pikiri : Nin ye farikolojidɛsɛ fura ye min fanga ka bon kosɛbɛ. A ka ca a la a bɛ kɛ ka farikolo yɔrɔw dɛmɛ u ka kɛnɛya anestezi kɔfɛ. Ni fura in kɛra jolisira fɛ (IV) pikiri ye Ogilvie Syndrome bɛ mɔgɔ minnu na, banakɔtaa fasaw bɛ baara daminɛ tuguni, wa a nɔ ɲuman bɛ sɔrɔ. Nka, ikomi fura in bɛ se ka dusukun tantanni sumaya kosɛbɛ, a bɛ di dɔrɔn dɔgɔtɔrɔ ka kɔlɔsiliba kɔnɔ min bɛ dɔgɔtɔrɔso la (ICU) .
• Opereli (Colectomy / Colostomy): Ni nin furakɛli ninnu bɛɛ n’a ta, banakɔtaa bɛ to ka funu, walima ni gɛlɛya jugumanba dɔ kɛra i n’a fɔ sɔgɔsɔgɔninjɛ, opereli bɛ se ka kɛ fɛɛrɛ laban ye. O cogo la, banakɔtaa yɔrɔ tiɲɛnen bɛ tigɛ ka bɔ a la (Colectomy). Tuma dɔw la, da dɔ ka kan ka kɛ kɔnɔbara la waati dɔɔni walima kudayi walasa banakɔtaa ka tɛmɛ. An b’o wele ko Kolostomi.

Yala o bana bɛ se ka mɔgɔ ka ɲɛnamaya bila farati la wa?

Ni gɛlɛya tɛ a la, Ogilvie Syndrome kelen bɛ mɔgɔ min na, o tigi ka saya farati bɛ se 15% ɲɔgɔn ma. Nka, o kɛmɛsarada la, banabagatɔ bɛ furakɛli cogoya wɛrɛw nɔ fana sen don a la.

Nka ni gɛlɛya jugumanba dɔ kɛra i n’a fɔ banakɔtaa sɔgɔli, mɔgɔ sataw hakɛ bɛ se 40% ma. O b’a jira ko nin bana in bɛ se ka juguya cogo min na.

Min nafa ka bon kosɛbɛ, o ye ka i janto a taamasiɲɛw la ni u bɔra dɔrɔn, ka bana in sɛgɛsɛgɛ joona, ka furakɛli daminɛ. N’aw y’o kɛ, aw bɛ se ka gɛlɛya jugumanw bali ani ka kɛnɛya joona ni furakɛli nɔgɔmanw ye.