Ua komo anei nā ʻōpū o kāu keiki liʻiliʻi i loko o ka ʻōpū? E aʻo kākou e pili ana i ka intussusception!

Ke uē mau nei kāu keiki liʻiliʻi? Ke kani nei anei ia me he ʻeha ʻōpū lā? I kekahi manawa, he mea maʻamau ia no kākou ma ke ʻano he mau mākua ke hopohopo ke ʻike kākou i nā mea e like me kēia. Eia nō naʻe, aia kekahi mau hōʻailona e pono ai kākou e hopohopo nui. I kēia lā, e kamaʻilio kākou e pili ana i ka intussusception, kahi maʻi ʻōpū koʻikoʻi e pono ai ka mālama olakino ulia pōpilikia , ʻoiai no nā keiki liʻiliʻi. Mai hopohopo, inā ʻike ʻoe i kēia, hiki iā ʻoe ke hana koke a hoʻopakele i kāu keiki.

He aha kēia intussusception?

I ka ʻōlelo maʻalahi, ʻo ka intussusception ka wā e pelu ai kekahi ʻāpana o kou ʻōpū, e like me nā ʻāpana o kahi telescope, i loko o ka ʻāpana aʻe o kou ʻōpū. E noʻonoʻo e like me kahi sock e ʻōwili ana i loko. Hoʻopilikia kēia i ka ʻōpū . ʻO ka hapa pinepine, hoʻopilikia kēia ʻano i ka ʻōpū liʻiliʻi .

Ke hana ʻia kēia, e pau ka neʻe ʻana o ka meaʻai a me ka mea inu ma o ka ʻōpū . Hoʻemi pū ia i ke kahe koko i kēlā wahi. Inā ʻaʻole mālama ʻia, hiki i kēia paʻa ke hoʻoulu i ka pehu ʻana o ka ʻōpū, e hōʻeha ʻia , a e hoʻoulu i nā pilikia koʻikoʻi e hiki ke hoʻoweliweli i ke ola.

No laila, he pilikia olakino ka intussusception . Eia nō naʻe, inā ʻike ʻia a mālama koke ʻia, hiki ke ho'ōla ʻia.

Pehea ka maʻamau o kēia ʻano?

Hiki i ka intussusception ke hana i kekahi, ʻoiai nā pākeke. Eia nō naʻe, ʻoi aku ka maʻamau i nā keiki ʻōpio ma waena o 3 mahina a me 3 makahiki.

ʻO ka intussusception ka mea e pili ana i kahi 1% o nā poloka ʻōpū āpau i nā pākeke. Eia nō naʻe, ʻo ia ke kumu nui o nā poloka ʻōpū i nā keiki ma lalo o 3 mau makahiki. Ma ʻAmelika Hui Pū ʻIa wale nō, ma kahi o 1 i loko o 2,000 mau pēpē e loaʻa i kēia maʻi i ko lākou makahiki mua o ke ola.

He aha nā hōʻailona? Pehea e ʻike ai?

He mea nui e ʻike inā loaʻa i kāu keiki ka intussusception . A, i ka hanana kakaikahi e loaʻa ai kēia maʻi iā ʻoe, he manaʻo maikaʻi nō hoʻi e makaʻala i nā hōʻailona.

Nā hōʻailona i nā keiki ʻōpio

ʻIke nā pēpē a me nā keiki me ka intussusception i ka ʻeha ʻōpū koʻikoʻi a ʻūlū e nalowale ana ma hope o kekahi manawa a laila hoʻomaka hou. Hiki i kēia ʻeha ke mau no 15-20 mau minuke a ʻoi aku paha. Hiki i nā pēpē hiki ʻole ke hōʻike i ko lākou ʻeha ke uē, e paʻa ana i ko lākou mau kuli i ko lākou ʻōpū.A laila, ke pau ka ʻeha (ma kahi o 20-30 mau minuke), hiki iā ʻoe ke hoʻohālike me he mea lā ʻaʻohe mea i hana ʻia a hoʻomaka e pāʻani. Akā, ma hope o kekahi manawa, hoʻomaka hou ka ʻeha weliweli .

I ka hoʻomau ʻana o ka ʻeha, hiki i ke keiki ke luhi, hiamoe, a palaualelo . Hiki iā lākou ke loaʻa i ke kuni a komo i ka haʻalulu .

ʻO nā hōʻailona ʻē aʻe e hiki ke kū mai:

• Pehu ʻōpū.
• Ka luaʻi a me ka luaʻi (hiki i ka luaʻi ke melemele-ʻōmaʻomaʻo ke kala).
• ʻUlaʻula, e like me ka jelly. He kahe koko kēia mai ka rectum , hiki ke hui pū ʻia me ka mucus.

I ka manawa pinepine, ʻike ʻia kēia mau hōʻailona i kekahi mau pule ma hope o ka loaʻa ʻana o kahi keiki i kahi mea e like me ke kuni viral. No laila, ʻo ka ʻike ʻia ʻana o kēia mau hōʻailona i ka hala ʻana o ka manawa e hoʻāla ai i ka kānalua o ka intussusception .

Eia nō naʻe, hiki ke paʻakikī ke ʻike i nā hōʻailona o ka intussusception i loko o kahi keiki, ʻoiai ʻaʻole i loaʻa nā hōʻailona āpau i kēlā me kēia keiki. Eia kekahi, ʻaʻole ia e loaʻa mau i ka wā e maʻi ai ke keiki.

Eia kekahi mea e hoʻomanaʻo ai: Inā ʻeha ka ʻōpū o kāu pēpē a keiki liʻiliʻi paha me ke kumu ʻole, e ʻike koke i ke kauka.

Nā hōʻailona i nā pākeke

Loaʻa pū kekahi i nā pākeke ka ʻeha o ka ʻōpū ke loaʻa iā lākou ka intussusception . Akā hiki ke hele mai a hele aku, e like me nā keiki, a i ʻole hiki ke mau. He mea maʻamau nō hoʻi ka luaʻi ʻana, ka pehu ʻana, a me nā ʻōpala koko. Eia nō naʻe, no ka mea he mea maʻamau kēia mau hōʻailona i nā maʻi gastrointestinal (GI) , nui ka poʻe e kali ana. Akā i ke ʻano o ka intussusception, ʻaʻole ia he manaʻo maikaʻi e kali. He ʻano kēia e pono ai ka mālama lapaʻau ulia pōpilikia i nā keiki a me nā pākeke.

No ke aha e hana ai ka intussusception? He aha nā kumu?

I ka hapanui o ka manawa, ʻaʻole hiki i nā kauka ke loaʻa kahi kumu kikoʻī no ka intussusception .

Nā kumu no ka hānai ʻana i nā keiki

I nā keiki, me he mea lā ua pili kēia kūlana i nā maʻi viral . Hoʻomohala ka hapa nui o nā keiki i ka intussusception i ka hāʻule a me ka hoʻoilo, i ka wā e maʻamau ai ka gastroenteritis viral . Eia kekahi, loaʻa paha i kekahi mau keiki nā ʻano hana ʻē a i ʻole nā ​​​​puʻupuʻu i loko o ko lākou ʻōpū, e like me ka Michels diverticulum .Hiki i nā mea e like me ka diverticulum a Meckel a me nā polyps ke lilo i kumu.

Nā kumu o ka ʻāʻī makua

He mea maopopo iki nā kumu e loaʻa ai i nā pākeke kēia. ʻOi aku ka nui o ka poʻe pākeke e loaʻa i ka intussusception inā loaʻa iā lākou ka maʻi ʻaʻai colon ( nā ʻōpū malignant ) a i ʻole nā ​​​​​​ulu maikaʻi ʻole i loko o ka colon . Eia kekahi, ʻaʻole hiki ke hana ʻia e nā maʻi maʻi lōʻihi e like me ka maʻi Crohn .

He aha nā kumu pilikia? ʻO wai ka mea i ʻoi aku ka paʻakikī o ka loaʻa ʻana?

Aia kekahi mau kumu pilikia e kōkua i ka ulu ʻana o kēia maʻi:

• Makahiki: Hoʻomohala ka hapa nui o nā keiki i kēia ma waena o 3 mau mahina a me 3 mau makahiki.
• Kāne: ʻOi aku ka nui o ka loaʻa ʻana o kēia maʻi i nā keikikāne ma mua o nā kaikamahine ma mua o nā kaikamahine. ʻAʻole maopopo i nā mea noiʻi ke kumu o kēia.
• Manawa: Loaʻa i ka hapa nui o nā keiki kēia i ka hāʻule a me ka hoʻoilo, ʻo ia ka manawa e loaʻa pinepine ai nā maʻi ʻōpū i ka maʻi palū.

Hiki i kekahi mau kūlana olakino ke hoʻonui i ka pilikia o kāu keiki:

• Ka loli ʻole o ka ʻōpū
• ʻO ka diverticulum o Meckel
• Nā polyps a i ʻole nā ​​​​cysts i loko o ka colon
• ʻO ka maʻi vasculitis Immunoglobulin A (IgA)

ʻO nā kūlana e hoʻonui ai i kou pilikia ma ke ʻano he makua:

• ʻO nā ʻōpū kolona (pinepine i ka maʻi kanesa, akā hiki nō hoʻi ke lilo i mea ʻaʻole kanesa)
• ʻO ka maʻi ʻōpū mumū (IBD)
• ʻO ka Endometriosis
• Inā he ʻōmole hānai kāu.

He aha nā pilikia e hiki mai ana inā ʻaʻole mālama ʻia?

Inā mālama koke ʻia, hiki ke hoʻihoʻi ʻia ka intussusception i ka maʻamau. Eia nō naʻe, inā ʻaʻole mālama ʻia, hiki i ka intussusception ke alakaʻi i nā pilikia koʻikoʻi e hoʻoweliweli ana i ke ola, a hiki i ka make.

Nā pilikia e hiki mai ana:

• Ka puka ʻana o ka ʻōpū : Ke ālai ʻia ka ʻōpū ma muli o ka intussusception , hiki i ka meaʻai a me nā wai ʻai ke hoʻi i hope ma hope ona. Hiki i kēia ke hoʻonui i ka ʻōpū, pehu, a laila pohā, e hana ana i lua.
• ʻO ka maʻi koʻikoʻi a me ka pehu ʻana (peritonitis) : Ke pehu ka ʻōpū a puka i loko o kēia ʻano, hiki i nā mea o loko o ka ʻōpū ke komo i loko o ka lua ʻōpū. Hiki i kēia ke hana i kahi maʻi koʻikoʻi a hoʻoweliweli i ke ola i kapa ʻia ʻo sepsis .
• ʻO ka necrosis o ka ʻōpū : Hiki i ka hōʻino ʻana i ka ʻōpū ke make ai nā ʻiʻo ma ia wahi.

Hiki ke hiki koke mai kēia mau pilikia i ka wā e ʻoi aku ai ka ʻino o ke kūlana o kāu keiki. No laila he mea nui e ʻimi koke i ka mālama ulia pōpilikia inā manaʻo ʻoe ua hewa kekahi mea.

Pehea ʻoe e ʻike pololei ai i kēia maʻi? (Diagnosis)

ʻO ka hapa nui o ka manawa, hana ʻia ka ʻike i ka wā o ka mālama olakino ulia pōpilikia. ʻO nā hoʻokolohua i hoʻohana ʻia e hōʻoia i ka ʻike, ʻo ia ka ultrasound (no nā keiki) a me ka CT scan ( no nā pākeke). Hiki i ka ultrasound ke ʻike i ka intussusception me ka pololei 100%. ʻO kēia ka hoʻokolohua mua a nā kauka e hana ai e nānā no ka intussusception i nā keiki.

Hiki paha i ke kauka o kāu keiki ke kauoha i kahi enema ea a i ʻole ka enema contrast . Ma kēia hoʻāʻo, hoʻokomo ke kauka i kahi wai e loaʻa ana ka ea a i ʻole kahi mea palekana i kapa ʻia ʻo barium i loko o ka rectum o kāu keiki. ʻO ke kaomi mai ka ea a i ʻole ka wai e hoʻonui ai i ka colon, e nalowale ana kekahi ʻāpana i loko o kekahi. Hoʻopaʻa wikiō ʻia kēia kaʻina hana me ka hoʻohana ʻana i kahi mīkini X-ray .

ʻAʻole wale kēia ʻano hana e hōʻoia i ka hōʻoia, akā i nā manawa he nui hiki iā ia ke ho'ōla i ka intussusception i nā keiki.

Pehea e mālama ai? (Lapaʻau)

ʻO ka lāʻau lapaʻau e pili ana i ka hoʻohana ʻana i ka enema ea a i ʻole ka enema contrast i hoʻohana ʻia no ka ʻike ʻana i ke kūlana e hoʻopololei i ka paʻa ʻana i loko o ka colon o kāu keiki. He hana radiologic (e like me ka scan) kēia, ʻaʻole he hana ʻoki kino. No laila, ʻaʻole pono kāu keiki i ka anesthesia .

Eia nō naʻe, ʻaʻole kūpono kēia ʻano hana no nā pākeke me ka intussusception . Pono pinepine lākou e hana i ke ʻoki kino.

ʻoki kino

Pono nā pākeke me ka intussusception i ke ʻoki kino. A, he mea kākaʻikahi, pono kekahi mau keiki i ke ʻoki kino. No ka laʻana, inā ʻaʻole holo pono ke ʻano enema , a inā he mau pilikia ko ke keiki (e like me ka lua i loko o ka ʻōpū, ka maʻi), pono lākou i ke ʻoki kino.

Hiki i kēia ʻoki kino ke lilo i ʻoki kino "hāmama" kuʻuna, ʻo ia hoʻi, hana ʻia ia ma o kahi ʻoki nui ma ka ʻōpū. A i ʻole, hiki i ke kauka lapaʻau ke hoʻohana i kahi kaʻina hana minimally invasive i kapa ʻia ʻo laparoscopy .

LaparoscopyI ka wā o ke ʻoki ʻana, hana ke kauka lapaʻau i ʻelua a ʻekolu paha mau ʻoki liʻiliʻi ma ka ʻōpū o kāu keiki. Ma o kēia mau ʻoki, hiki i ke kauka lapaʻau ke hiki i ka ʻōpū i huki ʻia i loko a hoʻopaʻa hou iā ia i kona kūlana mua. Inā ʻaʻole hiki kēlā, e wehe lākou i ka ʻāpana i hōʻino ʻia o ka ʻōpū a humuhumu i nā ʻāpana i koe (ʻaʻole i hoʻopaʻa ʻia).

I loko o kēia ʻoki kino, e hoʻomoe ke kauka anesthesiologist pediatric (he kauka loea i ka hāʻawi ʻana i ka hōʻoluʻolu ʻeha i nā keiki) i kāu keiki. No laila, ʻaʻole e ʻeha ke keiki a ʻike paha i ka mea e hana nei.

Pehea ka manaʻo o ke pēpē ma hope o ka mālama ʻana? Pehea ka lōʻihi e hoʻōla ai?

Ma hope o ka enema, e pehu paha kāu keiki no kekahi mau hola. Pono paha ʻoe e hāʻawi i ka acetaminophen (e.g., paracetamol) e hōʻemi i ka ʻeha a me ke kuni.

Ma hope o ke ʻoki ʻana, pono e hāʻawi ʻia kāu keiki i ka lāʻau ʻeha e hōʻoluʻolu ai iā lākou. Pono lākou e hānai ʻia me ka intravenous (IV fluids) no kekahi mau lā a hiki i ka hoʻōla ʻana o ko lākou ʻōpū. Hiki iā lākou ke hoʻomaka hou e ʻai i loko o hoʻokahi a ʻekolu mau lā. Hiki ke hala i kekahi mau pule e hoʻi ai i kā lākou mau hana maʻamau.

Aia kekahi ala e pale aku ai i ka intussusception?

ʻAʻohe ala maopopo e pale aku ai i ka intussusception , akā hiki iā ʻoe ke pale aku i nā hopena ʻino loa ma ka loaʻa koke ʻana o ka mālama ulia pōpilikia no kāu keiki .

He aha kaʻu e manaʻo ai inā loaʻa i kaʻu keiki kēia maʻi? Hiki ke ho'ōla ʻia?

Hiki i ka mālama mua ʻana ke hoʻomaikaʻi i nā hopena i nā keiki. Hoʻomaʻamaʻa pinepine ʻia ka intussusception me kahi enema ea a i ʻole ka enema contrast. Eia nō naʻe, hiki ke hoʻi hou i 10% a 20% o nā keiki. Hiki i nā hōʻailona ke hoʻi hou i loko o nā hola 48 mua ma hope o ke ʻoki ʻana (he mea kākaʻikahi kēia) a i ʻole nā ​​pule a i ʻole nā ​​mahina ma hope (ʻoi aku ka maʻamau o kēia).

Inā hoʻi hou ka intussusception , e hana ke kauka o kāu keiki i nā mea like a lākou i hana ai ma mua e ʻike a mālama iā ia. Hiki i kēia ke komo pū me ka hāʻawi ʻana i kahi enema ʻē aʻe.

Ma mua o ka haʻalele ʻana i ka haukapila, e nīnau i ke kauka i ka mea e manaʻo ai inā hana hou kēia, a he aha nā hōʻailona o ka hoʻi hou ʻana.

He aha nā mea e hiki ai ke hoʻopakele i ke ola o kahi pēpē me ka intussusception?

Ma nā haukapila me nā kauka akamai e mālama ana i ka intussusception , ua holomua ka barium a i ʻole ka air enema a hiki i ka 85% o nā keiki. Inā ʻoe e lawe i kāu keiki i ke kauka i ka wā e ʻike ai ʻoe i nā hōʻailona, ​​​​loaʻa kahi hōʻailona, ​​​​a hoʻomaka i ka mālama ʻana, loaʻa iā ʻoe kahi manawa kūpono e hoʻopakele i ke ola o kāu keiki me ka ʻole o nā pilikia.

He pilikia mau anei ka intussusception?

ʻAe. He pilikia olakino mau ka intussusception . He mea nui ka manawa. Inā hōʻike kāu keiki i nā hōʻailona o ka intussusception , e lawe koke iā ia i ka haukapila, i kēlā lā hoʻokahi.

Āhea wau e ʻike ai i ke kauka?

Inā loaʻa i kāu keiki ka ʻeha ʻōpū i wehewehe ʻole ʻia , e kāhea koke aku i kā lākou kauka keiki a e nānā iā lākou. Inā ʻaʻole hiki iā ʻoe ke ʻike iā lākou i kēlā lā, e lawe iā lākou i kahi lumi pilikia (ETU) .

Ma hope o ka mālama ʻana, he mea maʻamau i kāu keiki ke loaʻa kekahi pehu a puni ke kahua ʻoki. Eia nō naʻe, e kelepona i kāu kauka inā loaʻa i kāu keiki kekahi o kēia mau mea:

• Pehu nui, ʻulaʻula, mehana, a kahe paha ka wai mai ka ʻoki ʻia.
• Kuni (ma luna o 101 Fahrenheit / 38 Celsius).
• Ka luaʻi a me ka luaʻi.
• Nā hōʻailona o ka hoʻi hou ʻana (e like me ka ʻeha manawa ʻole, nā ʻōpala e like me ka jelly).

He aha nā nīnau koʻikoʻi e nīnau aku ai i ke kauka?

Hiki iā ʻoe ke nīnau i nā nīnau e like me kēia:

• He aha ke kumu o ka paʻa ʻana o ka ʻōpū o kaʻu keiki?
• ʻEhia ka lōʻihi e ola ai ʻo ia?
• Pono anei iaʻu e hoʻololi i koʻu nohona e kōkua ai i kaʻu keiki e ola maikaʻi?
• He aha nā hōʻailona e pono iaʻu e makaʻala e hiki ke hana hou ʻia kēia?
• Pono anei au e kāhea aku iā ʻoe inā ʻike au i nā hōʻailona o ka hoʻi hou ʻana, a i ʻole e hele pololei i ka ʻOihana Pōpilikia (ETU) ?

ʻO ka mea hope loa, nā mea e hoʻomanaʻo ai (Leka Lawe-Home)

Inā ʻike ʻoe i nā hōʻailona o ka intussusception i kāu pēpē a keiki liʻiliʻi paha, mai noʻonoʻo hou. ʻAʻole maʻamau ka loaʻa ʻana o ka ʻeha ʻōpū e hele mai a hele aku. He hōʻailona paha kēia o kahi maʻi koʻikoʻi e like me ka intussusception . ʻO ka wikiwiki o ka loaʻa ʻana o ka lāʻau lapaʻau i kāu keiki, ʻoi aku ka maikaʻi o ka manawa e ola ai me ka ʻole o nā pilikia. Mai hoʻokaʻulua. E lawe iā ia i ke kauka a i ʻole kahi lumi pilikia. Hiki i kāu hana wikiwiki ke kōkua i ka hoʻopakele ʻana i ke ola o kāu keiki.

Intussusception, pale ʻōpū, ʻeha ʻōpū i nā keiki, nā ʻōpala jelly, pale ʻōpū, mālama ulia pōpilikia, enema