Ðe kotoku sue aɖe le wò nuɖuɖutomea? (Esophageal Diverticulum) ( Nuɖuɖutome ƒe Ʋuʋudedi)?

Ðe nèsena le ɖokuiwò me ɣeaɖewoɣi be nane tsi wò ŋɔti me ne èmi nuɖuɖua? Alo ɖeko ʋeʋẽ gbegblẽ aɖe le dodom tso wò nu mea? Esiawo ate ŋu anye nɔnɔme aɖe si woyɔna be esophageal diverticulum, si ŋu míele nu ƒom tsoe egbea ƒe dzesiwo. Mègatsi dzi o, mebɔ nenema gbegbe o. Gake enyo be nànya nu vi aɖe tso eŋu. Mina míaƒo nu tso eŋu bɔbɔe, le mɔ si gɔme nàte ŋu ase nu.

Nukae nye kotoku sue sia si le nuɖuɖutome (Esophageal Diverticulum)?

Enyo, gbã la, mina míakpɔ nusi esia (Esophageal Diverticulum) nye ɖa. Ènyaa, mɔ̃ aɖe le mía si si tsɔa nuɖuɖu tso míaƒe nu me yia míaƒe dɔgbo me, míeyɔnae be nuɖuɖutome . Ele abe tsi ƒe pɔmpi ene, gake lãmekae wotsɔ wɔe. Le nuɖuɖupɔmpi sia ƒe eme la, ɣeaɖewoɣi la, edona tso teƒe siwo gbɔdzɔ le gli ŋu, eye wòwɔa nane abe kotoku sue aɖe, alo kotoku sue aɖe ene. Esia tae míeyɔa esia ɖo. Bu eŋu abe ʋu ƒe taya si tsi eye wòdo vie le teƒe ɖeka ene. Aleae esia le.

Akplo sue siawo ƒomevi eve li.

• ‘Nyateƒe’ kotoku: Esia fia be nuɖuɖutome ƒe gli ƒe ƒuƒoƒoawo katã , siwo dome lãmekawo hã le, do go.
• ‘Aʋatso’ kotoku: Esia nye esime gli la ƒe ƒuƒoƒo aɖewo, abe lãkusi kple ƒuƒoƒo si le ete (submucosa) ene, dona ɖe gota. Ðeko wòle abe avɔ ƒe ka ʋɛ aɖewo koe woɖena doa goe ene.

Ðɔktawo nɔa te ɖe afisi wole le nuɖuɖutome dzi dea dzesi ƒunukpeƒetetedɔ siawo. Nusiwo hea cysts vɛ le teƒe vovovowo ate ŋu ato vovo.

Nukawoe nye nuɖuɖutome ƒe ʋuka ƒomeviwo?

Na míakpɔ nusiwo nye ƒomevi vevi siwo woate ŋu akpɔ ɖa.

Zenker ƒe ʋuʋudedi si woyɔna be diverticulum

Esiae nye ƒomevi si bɔ wu . Edzɔna le nuɖuɖutome tame, afisi ŋɔti do go kple nu le. Zi geɖe la, esiawo nyea ‘aʋatso’ kotokuwo. Susu vevitɔe nye be ne nuɖuɖu mimi sesẽ , ne ŋɔti ƒe lãmekawo mewɔa dɔ nyuie o la, nyaƒoɖeamenu si le nuɖuɖutome me dzina ɖe edzi eye wòtutunɛ doa goe to teƒe si gbɔdzɔ. Kpɔe ɖa le susu me be tsi ƒe pɔmpi aɖe xe le teƒe aɖe, eye ne tsia ge ɖe eme kabakaba la, pɔmpia vuvu do ŋgɔ na teƒe si woxe.

Killian-Jamieson ƒe Ʋuʋudedi

Esia mebɔ vie o. Edzɔna le vidzidɔ ƒe nuɖuɖutome, si nye míaƒe kɔ ƒe akpa si zɔna ɖekae kple akɔta. Wobunɛ zi geɖe be enye ‘aʋatso’ kotoku sue ɖeka. Wosusu be lãmeka siwo le nuto ma me ƒe gbɔdzɔgbɔdzɔ si wodzina gbɔe wòtso.

Midesophageal Diverticulum ƒe ʋuʋudedi

Esiawo nye ‘nyateƒe’ kotokuwo. Wodzɔna le nuɖuɖutome ƒe akpa si to míaƒe akɔta titina. Wogayɔa wo be (thoracic diverticula) , si fia be wowɔa wo le akɔta ƒe do me. Woyɔa wo ɣeaɖewoɣi be (traction diverticula).Nusitae nye be wodzɔna ne gotagome ŋusẽ aɖe he nuɖuɖutome ƒe gli (traction). Le kpɔɖeŋu me, ʋuka siwo le akɔta ate ŋu avuvu ahalé ɖe nuɖuɖutome ŋu, eye emegbe ne vuvua nu fa la, nuɖuɖutome ƒe gli ate ŋu ahe.

Epiphrenic Diverticulum ƒe Dɔlékuiwutike

Esia dzɔna le nuɖuɖutome ƒe nuwuwu, hafi nuɖuɖua nage ɖe dɔgboa me teti (distal esophagus). Zi geɖe la, esiawo nyea ‘aʋatso’ kotokuwo. Le afisia hã la, nusi gbɔ wòtsoe nye nyaƒoɖeamenu. Le kpɔɖeŋu me, ne nuɖuɖutome ƒe akpa si le anyime xe la, kotokua ate ŋu adzɔ le nyaƒoɖeamenu si dona tso eme ne nuɖuɖu di be yeato eme ayi dɔgboa me ta.

Aleke gbegbee nɔnɔme sia bɔe?

Le nyateƒe me la, nuɖuɖutome ƒe ʋukawo mebɔ kura o . Wosusu be wodzea ame siwo ade 1% ko dzi. Wobɔ ɖe amesiwo xɔ wu ƒe 50 me wu , vevietɔ ne woxɔ ƒe 70. Wobɔ ɖe ŋutsuwo hã me vie wu nyɔnuwo.

Nukae nye nuɖuɖutome ƒe ʋuka si me ʋu sina tona ƒe dzesiwo?

Zi geɖe la, diverticula siawo mehea dzesi aɖeke vɛ o . Ðewohĩ mànya gɔ̃ hã be ɖe le ye si o. Gake ƒomevi aɖe si woyɔna be Zenker ƒe diverticulum ate ŋu ahe dzesiwo vɛ wu. Ne dzesi siawo le ŋuwò la, àte ŋu akpɔe be:

• Ewɔna nam abe kɔdzidɔ si me ʋuʋudedi le le ŋɔti me ene.
• Sese le ɖokuiwò me abe ɖe ƒu aɖe le wò ŋɔti me ne èmi nuɖuɖu.
• Seselelãme abe ɖe nuɖuɖu tsi ŋɔti me ene.
• Nuɖuɖu gatrɔna yia dzi vaa ŋɔti me (regurgitation) ne èbɔbɔ ɖe ŋgɔ alo mlɔ anyi.
• Gbɔgbɔ vɔ̃ le susu aɖeke manɔmee.
• Gbɔgbɔtsixe nye ɣlidodo ne wole gbɔgbɔm le susu aɖeke manɔmee.

Dzesi siawo dometɔ aɖeke mele ame aɖewo ŋu o eye le vome koe wokpɔna le dodokpɔ aɖe si wowɔ le susu bubu aɖe ta me.

Nukae hea nuɖuɖutome ƒe ʋuʋu vɛ?

Nu vevi evee li siwo gbɔ wòtsona. Ðeka nye nusiwo hea ʋu ƒe sisi vɛ, eye evelia nye nusiwo hea ʋu ƒe sisi vɛ.

Pulsion pouches: Nuɖuɖutome kotoku akpa gãtɔ dzena le hatsotso sia me. 'Pulsion' gɔmee nye "tutu." Esia fia be ememe ƒe nyaƒoɖeamenu si yia edzi le nuɖuɖutome. Esia dzɔna zi geɖe ne míemi nuɖuɖu. Atikewɔwɔ ƒe nɔnɔme aɖewo le nuɖuɖutome si nana wòsesẽna be woami nuɖuɖu ate ŋu ahe nyaƒoɖeamenu sia si mesɔ o vɛ. Le kpɔɖeŋu me:

• (Achalasia) (lãmeka siwo le nuɖuɖutome ƒe akpa si le ete ƒe ɖiɖiɖememanɔmanɔ) .
• Nuɖuɖutome ƒe ʋuʋu
• Nuɖuɖutome ƒe ʋuʋu
• Eosinophilic nuɖuɖutome dɔléle

Akplo siwo hea nu:Esiawo dzɔna ne nane he nuɖuɖutome ƒe gli ƒe gota hehee. Esiae hea kotoku ‘vavãtɔwo’ vɛ, siwo nye nuɖuɖutome ƒe gli ƒe titrime bliboa si wohena yia eme. Zi geɖe la, wokpɔa esiawo le akɔta titina. Dɔlékui aɖe si le akɔta (mediastinitis) ate ŋu ana ame navuvu, si ate ŋu alé ɖe nuɖuɖutome ŋu, eye emegbe wòahe nuɖuɖutome ne abi la le ɖiɖim. Dɔlékui mawo ƒe kpɔɖeŋu aɖewoe nye:

• Yɔmekpe ƒe dɔléle
• Fungi ƒe dɔléle aɖe (Histoplasmosis) .

Nu siawo evea siaa nye tsitsi yeye siwo dona le míaƒe agbenɔɣi. Ƒã hafi akɔtakotoku aɖewo ate ŋu anɔ anyi le vidzidzi me. Alo, gbɔdzɔgbɔdzɔ si wodzina le aɖuɖɔtoe ƒe lãkusiwo me ate ŋu ana wòanɔ bɔbɔe be kotoku aɖe nava emegbe. Gake zi geɖe la, kotoku sia medzɔna o negbe ɖe atikewɔwɔ me nɔnɔme bubu aɖe dzɔ gbã hafi.

Nukawoe nye kuxi siwo ate ŋu ado tso nuɖuɖutome ƒe ʋuka sia me?

Ne kotoku sia le lolom ɖe edzi le ɣeyiɣi aɖe megbe la, nuɖuɖu va gena ɖe eme . Esia ate ŋu ase le ɖokuiwò me abe ƒunukpeƒetetedɔ aɖe le wò ŋɔti me ene, alo ate ŋu axɔ dɔlékuiwo eye wòase veve . Nuɖuɖu si tsi nu me ate ŋu ana wò nu me naʋẽ eye wòavivi nu gbegblẽ. Ne exɔ dɔa la, ate ŋu ado ʋu eye wòavuvu. Le nɔnɔme sesẽwo me la, ate ŋu ase le eɖokui me abe ƒunukpeƒetetedɔ si woate ŋu ase le wò kɔ ƒe gota ene.

Nu bubue nye be nuɖuɖu ate ŋu anɔ anyi hena ɣeyiɣi aɖe eye emegbe wòagatrɔ ava ŋɔti me ne ètrɔ nɔnɔme (le kpɔɖeŋu me, ne èbɔbɔ). Esia ate ŋu ana ame nakɔ akɔta, gbɔgbɔtsixe natsi ame, eye ŋɔti nase veve. Ne esia dzɔ le zã me esime nèle alɔ̃ dɔm la, nuɖuɖua ƒe akpa suesuesueawo ate ŋu ayi ɖe lãkusi me mànya o (silent aspiration) . Ne edzɔ alea la, ate ŋu ahe dɔlékui aɖe vɛ le lãkusiwo me (aspiration pneumonia) . Esia bɔ ɖe amesiwo ŋu Zenker ƒe diverticulum le la me wu.

Ðe esia nye kansa? Ðe wòate ŋu anye kansa?

Wokpɔe be amesiwo ŋu nuɖuɖutome diverticulum le ƒe alafa memamã sue aɖe ŋutɔ (anɔ abe 0.05%) xɔa nuɖuɖutome ƒe squamous cell carcinoma. Gake womenya haɖe nenye be nusi dzɔ le vome koe esia nye alo nenye be dzikudodo atraɖii si tso diverticulum gbɔe hea kansa vɛ o. Gake afɔku sia le sue ŋutɔ .

Aleke nàwɔ anya ne nuɖuɖutome ƒe ʋuʋudedi le ŋuwò?

Atikewɔwɔ me dodokpɔ si léa ŋku ɖe nuɖuɖutome la me ate ŋu ade dzesi kotoku sia. Zi geɖe la, womeɖea dzesi aɖeke fiana o, eyata wokpɔa wo le vo me le dodokpɔ me le susu bubu aɖe ta. Ne dzesi aɖewo do ƒome kple wò nuɖuɖutome la, wò ɖɔkta awɔ dodokpɔ aɖe si woyɔna be radiology alo endoscopy. Togbɔ be keklẽŋusẽdɔdamɔnu ɖea foto tso gota hã la, endoscopy zãa fotoɖemɔ̃ tsɔ léa ŋku ɖe ememe.

Dodokpɔ ka ƒomevie woawɔ?

Dodokpɔ aɖewo siwo ate ŋu adzɔe nye esi:

• Esophagram / Barium Mimi Dodokpɔ:

Esia nye X-ray ƒomevi aɖe. Woɖea wò nuɖuɖutome ƒe video (fluoroscopy) esime nèle nu mimim. Le esia me la, wonaa tsi si le abe chalk ene si woyɔna be barium wò be nàno. Etsyɔa wò nuɖuɖutome ƒe eme. Emegbe, woɖea X-ray esime nèle emim. Esia wɔnɛ be nàte ŋu akpɔ wò nuɖuɖutome ƒe nɔnɔme, alesi nuɖuɖu tona, kple kotoku ɖesiaɖe si ate ŋu anɔ eme la nyuie.

• Dzigbe Endoscopy / EGD Dodokpɔ:

Le esia me la, wotsɔa mɔ̃ didi aɖe si me fotoɖemɔ̃ sue aɖe si woyɔna be endoscope le la toa nu me eye wòtoa nuɖuɖutome yia dɔgboa me. Woana atike si naa ame ƒe dzi dzea eme le ɣeyiɣi sia me, eyata màse veve aɖeke o. Woate ŋu akpɔ nɔnɔmetata siwo tso fotoɖemɔ̃a dzi le kɔmpiuta dzi. Ne kotoku aɖe li la, woate ŋu akpɔe tẽ.

• Nuɖuɖutome ƒe Ʋuʋudedi Dodokpɔ:

Esi wònye be nu mimi ƒe kuxiwoe nye nu vevi aɖe si gbɔ kotoku me kotokuwo tsona ta la, wò atikewɔlawo ate ŋu aɖo aɖaŋu hã be woawɔ dodokpɔ sia. Esia dzidzea alesi wò ŋɔti ƒe lãmekawo tena sesĩe ne èmi. Wozãa nusiwo dea dzesi nu siwo le mɔ̃ aɖe si wotsɔ to wò ŋɔti me yi wò ŋɔti me tsɔ dzidzea nu siawoe.

Nukawoe nye atike siwo wozãna na nuɖuɖutome ƒe ʋuka si me ʋu sina tona?

Mehiã be woawɔ atike na aɖuɖɔtoe ƒe kotoku akpa gãtɔ o . Ne womele dzesi alo kuxi aɖeke hem vɛ o la, woate ŋu agblẽ wo ɖi. Gake ne kotokua le dzesiwo alo kuxiwo hem vɛ la, ahiã be woatue alo aɖee ɖa. Mɔ vovovowo le ɖɔktawo si si dzi woato awɔ esia. Ðewohĩ ahiã be nàda nɔnɔme si gbɔ wòtso si na wò vidzidɔ ƒe kotokua hã.

Aleke wowɔa dɔ na nuɖuɖutome ƒe ʋuka si me ʋu sina tona?

Ðɔkta ate ŋu awɔ esia to amekoko alo to dɔlékuiwo me toto me. Mɔnu vovovowo ate ŋu anyo wu na kotoku ƒomevi vovovowo. Wò ɖɔkta anɔ te ɖe wò lãmesẽ bliboa dzi atso nya me le mɔnu si nyo na wò ŋu. Le kpɔɖeŋu me, ne èdi be yeawɔ dɔ na ye si me womewɔa dɔ boo aɖeke le o la, dɔlékuiwo me toto ate ŋu anye tiatia nyui aɖe. Wò ɖɔkta aƒo nu tso afɔku kple viɖe siwo le mɔnu ɖesiaɖe ŋu na wò.

Amekoko ƒe Dzadzraɖo

Amekola ate ŋu atso kotokua keŋkeŋ (diverticulectomy) alo ahee ayi dzi agbugbɔe alɔ̃ ɖe wò nuɖuɖutome ƒe gli ŋu (diverticulopexy) . Amekokoa ate ŋu abia hã be woawɔ dɔ aɖe si woyɔna be myotomy . Myotomy nye dɔ si wowɔna tsɔ lãa lãmeka aɖe le wò nuɖuɖutome be wòaɖe lãmeka si me mekɔ o dzi akpɔtɔ. Esia ate ŋu ahiã be wòakpe ɖe ŋuwò le nu mimi sesẽ si na wò kotokua ƒo la me.

Endoscopic Diverticulotomy ƒe dɔwɔwɔ

Mɔnu bubu si woate ŋu azã ɖe amekoko teƒee nye be woatsɔ dɔlékuiwutike aɖe ato nu me ade nuɖuɖutome eye woawɔ dɔa to eme. Woyɔa esia be Dohlman ƒe dɔwɔwɔ.Esia bia be woalã ʋuka si le kotokua kple nuɖuɖutome ƒe gli kemɛa dome. Woate ŋu azã laser, elektrikŋusẽ, alo stapler atsɔ awɔ esia. Mɔ̃ siawo ate ŋu atso abi la ahatre enu.

Ɣeyiɣi didi kae wòxɔna hafi wòhayana le amekoko sia megbe?

Ahiã be nànɔ kɔdzi abe ŋkeke ɖeka ene. Emegbe ahiã be nàɖi ɖe eme le aƒeme kwasiɖa ʋɛ aɖewo. Wò ŋɔti ate ŋu anɔ veve sem eye wòavuvu kwasiɖa ʋɛ aɖewo. Esia ate ŋu ana nuɖuɖu mimi nasesẽ. Woate ŋu aɖo aɖaŋu be woaɖe vevesese dzi akpɔtɔ, gake mahiã o. Wò ɖɔkta aɖo aɖaŋu na wò le alesi nàdze nuɖuɖu siwo me tsi le zazã gɔmee kple ɣeyiɣi si nàdze egɔmee ŋu, nàyi nuɖuɖu falɛfalɛwo dzi vivivi, eye emegbe nàzã nuɖuɖu siwo nèɖuna edziedzi.

Nya mamlɛtɔ kae nègblɔ tso nɔnɔme sia ŋu?

Nuɖuɖutome ƒe ʋuka le ame akpa gãtɔ ŋu eye mehea kuxi aɖeke vɛ o . Gake ne edzɔ la, mɔ vovovowo li siwo dzi woato aɖɔe ɖo. Amekoko siawo ƒe dzidzedzekpɔkpɔ wu 90% . Gake afɔku 10% li be kuxiwo abe ʋu si dona le ame ŋu, dɔlékuiwo xɔxɔ, alo nuɖuɖutome ƒe gbegblẽ ene. Wò atikewɔlawo ƒe ƒuƒoƒoa adzro afɔku kple viɖe siwo le atikewɔwɔmɔnu vovovowo me me kpli wò ɖekaɖeka.

Ne nɔnɔme aɖe le ŋuwò si wɔnɛ be nu mimi sesẽna na wò la, àte ŋu axɔ kotoku si le abe esia ene ɖe wò nuɖuɖutome ƒe gli ŋu. Akplo sia ate ŋu adzɔ le teƒe si gbɔdzɔ le wò nuɖuɖutome le nyaƒoɖeamenu si mesɔ o si dzɔna ne èmi ta. Ðewohĩ maɖe fu na wò gbeɖe o. Gake ne dzesi yeye aɖewo dze le wò nuɖuɖutome ŋu la, yi ɖɔkta gbɔ. To mɔ sia dzi la, woate ŋu anya nenye be kotoku alo nu bubu aɖee eye woana atike si hiã la wò.

Nu vevi siwo dzi wòle be woaɖo ŋkui (Take-Home Message) .

• Nuɖuɖutome ƒe diverticulum nye kotoku sue aɖe si dzɔna ɖe nuɖuɖutome ƒe gli me.
• Esiawo mebɔ kura o eye zi geɖe la, womeɖea dzesi aɖeke fiana o.
• Ne dzesiawo dze ƒã la, woate ŋu anye nu mimi sesẽ, nuɖuɖu ƒe gege ɖe ŋɔti me, kple gbɔgbɔtsixe ƒoƒo.
• Zi geɖe la, nusiawo mehiã be woawɔ atike na wo o .
• Gake ne dzesiawo nu sẽ alo kuxiwo do mo ɖa la, woate ŋu ada amekoko alo dɔlékuiwo me toto dzidzedzetɔe.
• Ele vevie be nàdi atikewɔlawo ƒe aɖaŋuɖoɖo ne nu mimi sesẽ na wò alo dzesi yeyewo le ŋuwò. Mègatsi dzi o, ɖɔktawo li be yewoakpe ɖe ŋuwò.

Mele mɔ kpɔm be nyatakaka sia aɖe vi na wò. Nɔ lãmesẽ me!

` Nuɖuɖutome, nuɖuɖutome, diverticulum, nu mimi sesẽ, ŋɔti me veve, tsi si trɔna yia lãme, endoscopy