Loaʻa i kāu pēpē kēia maʻi laha ʻole? (Cloacal Malformation) E kamaʻilio kākou e pili ana!

ʻAʻole hiki ke wehewehe ʻia ka hauʻoli o ka makuahine a i ʻole ka makuakāne ke nānā aku i kahi pēpē hānau hou. Akā i kekahi manawa, me kēlā hauʻoli, aia nā manawa e manaʻo ai ʻoe i kahi manaʻo nui o ka makaʻu a me ka haʻalulu. ʻO ia ka manaʻo āu e loaʻa ai ke hele mai ke kauka a haʻi iā ʻoe he pilikia hānau keiki kāu keiki. He maʻi kakaikahi loa ka Cloacal Malformation, akā he mea hoʻopūʻiwa nui i nā mākua. I kēia lā, e kamaʻilio maʻalahi mākou e pili ana i kēia, ma ke ʻano hiki iā ʻoe ke hoʻomaopopo.

I ka ʻōlelo maʻalahi, he aha ka Cloacal Malformation?

He maʻi laha ʻole kēia e pili wale ana i nā kaikamahine a ʻike ʻia i ka wā hānau. ʻO ka maʻamau, pono e loaʻa i ka perineum o ke kaikamahine ʻekolu mau puka: ka urethra, ka vagina, a me ka anus.

Eia nō naʻe, ʻaʻole i loaʻa i ke keiki me Cloacal Malformation kēia mau puka ʻekolu. Akā, hoʻokahi wale nō puka . No kēia ʻano maʻi kahi hui o nā maʻi i kapa ʻia ʻo anorectal malformation.

E noʻonoʻo, i ka wā e ulu ana kahi pēpē i loko o ka ʻōpū, ua pili pū ʻia ke ala ʻōpū o ka pēpē, ke ala genital, a me ke ala mimi ma ke ʻano he ʻāpana hoʻokahi. Kāhea mākou i kēia ʻo "cloaca." I ka ulu ʻana o ka pēpē, ua māhele mālie kēia ʻāpana hoʻokahi i ʻekolu ʻāpana, e hana ana i ʻekolu mau puka kaʻawale.

ʻO ke ʻano lapaʻau no kēia maʻi, ʻo ia ke ʻoki ʻana e hana i ʻekolu mau puka kaʻawale ma kahi o ka puka hoʻokahi. Hana pinepine ʻia kēia ʻoki ʻana i loko o ka makahiki mua o ke ola o ke keiki.

Aia kekahi mau ʻano like ʻole o kēia ʻano?

ʻAe, hiki ke ʻike ʻia kēia ʻano me nā ʻano like ʻole i kēlā me kēia keiki. Akā ʻo ka mea maʻamau i nā keiki āpau, ʻo ia ka loaʻa ʻana o hoʻokahi puka ma kahi o ʻekolu. Hoʻopili ʻia kēia puka i loko i ke "kahawai maʻamau" a mākou i ʻōlelo ai ma mua. ʻO ka lōʻihi o kēia kahawai maʻamau e hoʻoholo ai i ke koʻikoʻi o ke ʻano a me ke ʻano o ka lāʻau e pono ai ke keiki. Hiki i kēia kahawai ke loaʻa ma nā wahi āpau mai 1 a 10 kenimika ka lōʻihi.

E wehewehe iki aku kākou i kēia.

Pehea ka maʻamau o kēia kūlana?

He maʻi laha ʻole kēia, e kū ana ma kahi o hoʻokahi i loko o 25,000 a 50,000 mau pēpē hānau hou.

He aha nā hōʻailona o kēia?

ʻO ke ʻano nui a maopopo loa, hoʻokahi wale nō puka i ʻike ʻia i ka wā hānau ma kahi o ʻekolu.

Eia kekahi, hiki i kēia mau keiki ke loaʻa nā pilikia olakino ʻē aʻe.

• Ua like ke ʻano o ka clitoris me ka penis kāne.
• He ʻano ʻē ma ka ʻāpana anal.
• ʻOi aku ma mua o hoʻokahi wahi ma ka vagina, uterus, a i ʻole cervix.
• Nā pilikia ʻē aʻe me nā puʻupaʻa, nā ureters, a i ʻole ka ʻōnaehana urinary (nā pilikia urological).
• Nā pilikia o ka puʻuwai a i ʻole ke kuamoʻo.
• Nā pilikia ʻē aʻe o ka ʻōnaehana hoʻoheheʻe (Nā pilikia Gastrointestinal).

No ke aha lā kēia e hana nei? He aha ke kumu?

ʻAʻole i loaʻa i nā kauka kahi kumu kikoʻī no kēia. Ua manaʻo ʻia he hanana ulia pōpilikia ia, a i ʻole kekahi mea e hana ʻia me ke kumu ʻole.

Pehea e ʻike ai i kēia maʻi?

Hiki ke ʻike ʻia kēia kūlana ma nā ʻano ʻelua.

1. Ma mua o ka hānau ʻana o ka pēpē (i ka wā hāpai)

I kekahi manawa, hiki ke ʻike ʻia kēia i ka wā o kahi scan anomaly a i ʻole ultrasound ma kahi o 20 mau pule o ka hāpai ʻana. ʻIke pinepine ʻia kēia i ka wā e pehu ai ka vagina o ke pēpē a piha i ka wai. Inā pono e hōʻoia ʻia kēia, hiki ke hana ʻia kahi scan MRI i ka wā hāpai.

2. Ma hope o ka hānau ʻana o ka pēpē

Hoʻomaopopo pinepine ʻia kēia ma hope o ka hānau ʻana o ka pēpē i ka wā e nānā ai ke kauka lapaʻau i ka pēpē. Hiki ke ʻike ʻia kēia kūlana ke loaʻa hoʻokahi puka ma kahi o ʻekolu. Hiki ke pehu ka ʻōpū o ka pēpē. A laila e kauoha ke kauka i kekahi mau hoʻokolohua e ʻike pono i ka mea e hana nei i loko o ke kino.

• Hoʻokolokolo Ultrasound: E nānā i nā puʻupaʻa o ke pēpē, ka ʻōpū mimi, a me ka iwi kuamoʻo.
• Nā hoʻāʻo X-ray: E hoʻohana i ka ʻenehana X-ray kūikawā, e like me ka fluoroscopy, e ʻike ai pehea e hana ai ka ʻōnaehana mimi o kāu keiki.
• Echocardiogram: He hoʻāʻo e nānā i nā pilikia me ka puʻuwai.

Pehea e mālama ʻia ai? E aʻo kākou e pili ana i ke ʻoki kino

ʻO ke ʻoki kino wale nō ka lāʻau lapaʻau no kēia maʻi. ʻO ka pahuhopu nui o ke ʻoki kino, ʻo ia ka hana ʻana i ʻekolu mau puka kaʻawale ma kahi o ka puka hoʻokahi, e ʻae ana i ke keiki e mimi a hoʻokahe maʻamau a e kāohi i kēia mau mea.

ʻO ka maʻamau, hana ʻia kēia kaʻina hana i kekahi mau pae.

Kahua mua: Ma hope koke iho o ka hānau ʻana o ke pēpē

Hana ʻia kēia i loko o 48 mau hola o ka hānau ʻana o ka pēpē. ʻO ka pahuhopu nui ma ʻaneʻi, ʻo ia ke hoʻopaʻa i ke olakino o ka pēpē a hana i kahi ala no ka ʻōpala a me ka mimi e puka ai i waho o ke kino.

• Colostomy: Ma kēia kaʻina hana, lawe mai ke kauka lapaʻau i kahi ʻāpana o ka ʻōpū nui o ke keiki i ka ʻili o ka ʻōpū a hana i kahi puka. A laila puka mai ka ʻōpala mai ka puka a hōʻiliʻili i loko o kahi ʻeke kūikawā i hoʻopili ʻia iā ia. He kaʻina hana manawa pōkole kēia a hiki i ka wā e hana ʻia ai ke ʻoki nui o ke keiki.
• Catheterization: Hoʻokomo ʻia kahi catheter e kōkua i ke keiki e hoʻohele i ka mimi no ka mea ua pehu a paʻa paha ka ʻōpū mimi.
• Ka hoʻokahe ʻana o ka wai o ka ʻōpū: Inā pehu ka wai o ka ʻōpū o ke keiki a ua hōʻiliʻili ʻia ka wai, hiki ke hoʻokahe ʻia ma ke ʻoki ʻana.

Pae ʻElua: ʻoki kino hana hou nui

Hana ʻia kēia ʻoki kino nui ma waena o 6 a me 12 mau mahina o ka makahiki, i ka wā e paʻa ai ke olakino o ke keiki. Maanei kahi e hoʻokaʻawale ʻia ai nā ʻōnaehana ʻekolu i hui pū ʻia a hana ʻia ʻekolu mau puka kaʻawale (anus, vagina, a me urethra).

• Inā pōkole ka ʻōmole fallopian maʻamau (ʻaʻole iʻoi aku ma mua o 4 cm), he maʻalahi kēia ʻoki ʻana.
• Inā lōʻihi ka duct maʻamau, e lilo ke ʻoki ʻana i mea paʻakikī iki.

He mea nui kekahi kauka ʻoki keiki a me kekahi kauka urologist pediatric me ka ʻike kūikawā a me ka ʻike ma kēia wahi no ia mau ʻoki kino.

Kahua ʻEkolu: Ke hoʻohuli nei i ka Colostomy

Ke hoʻōla piha ke keiki mai ke ʻoki kino nui, hoʻohuli ʻia ke colostomy mua. ʻO ia hoʻi, ua pani ʻia ka puka i hana ʻia ma ka ʻōpū a ua ʻae ʻia ka ʻōpala e hele maʻamau ma o ka anus i hana hou ʻia.

He aha ke ʻano o ka wā e hiki mai ana a kaʻu keiki?

ʻO kēia ka nīnau nui loa ma ka noʻonoʻo o kēlā me kēia mākua. ʻO ka maʻamau, maikaʻi loa nā hopena.

• ʻO nā keiki me kahi duct pōkole maʻamau, ʻo ia hoʻi nā mea ʻaʻole paʻakikī, he 90% ka manawa kūpono o ka mimi ʻana a me ka neʻe ʻana o ka ʻōpū a me ka kaohi maʻamau.
• ʻOiai nā keiki me kahi duct lōʻihi maʻamau, ʻo ia hoʻi, nā kūlana paʻakikī, he 70% ka manawa kūpono e loaʻa ai ka kaohi maikaʻi ma luna o ka mimi a me ka luaʻi.

Hiki i ka hapa nui o nā keiki ke hoʻokahe maʻamau. Eia nō naʻe, hiki i kekahi mau keiki ke loaʻa i ka incontinence urinary, ʻo ia hoʻi ka nalowale ʻana o ka mimi me ka makemake ʻole. Pono paha kekahi mau keiki e hoʻokahe ʻia ko lākou ʻōpū mimi i nā manawa he nui i ka lā me ka hoʻohana ʻana i kahi catheter.

E pili ana i ke ola moekolohe a me ka hāpai ʻana

Hiki i nā keiki me kēia maʻi ke loaʻa kahi ola moekolohe maikaʻi i ko lākou wā e ulu ana. ʻOiai ʻoi aku ka paʻakikī o ka hāpai ʻana ma mua o ka maʻamau, ʻaʻole ia he manaʻo he hiki ʻole ke loaʻa nā keiki. Inā ʻoe e kali ana i kahi keiki i ka wā e hiki mai ana, hiki iā ʻoe ke ʻimi i ke aʻo lapaʻau e pili ana i ia mea. Manaʻo pinepine ʻia ka ʻoki ʻana o C i ka wā e hānau ai i ke keiki.

He aha kaʻu e hiki ai ke hana ma ke ʻano he makua?

He mea paʻakikī kēia huakaʻi no ke keiki a nou hoʻi.

• E kākoʻo i kāu keiki: E kamaʻilio pinepine me ka hui mālama ola o kāu keiki. E haʻi aku i kou hopohopo a makaʻu paha iā lākou.
• Mai poina i nā keʻena lapaʻau a me nā hoʻokolohua i hoʻonohonoho ʻia: Ma hope o ke ʻoki ʻana, pono ka nānā mau ʻana i ke olakino e hōʻoia i ka hana pono ʻana o nā ʻōnaehana o ke keiki.
• E makaʻala i nā hōʻailona: Inā ʻike ʻoe i kekahi pilikia me ka kaohi ʻana o ka mimi a i ʻole ka ʻōpū i ka wā e ulu ana kāu keiki, e haʻi koke i kāu kauka.

ʻEkahi mau nīnau e nīnau aku ai i kāu kauka:

• Pehea e hana ʻia ai kēia ʻoki kino? I ka makahiki hea e hana ʻia ai?
• E ʻeha anei kaʻu keiki? Ke ʻeha nei ʻo ia i kēia manawa?
• He aha kaʻu e manaʻo ai i ka wā e hoʻōla ai ma hope o ke ʻoki kino?
• E pono anei ke keiki i nā ʻoki kino hou aku i kona wā e ulu ana?
• E loaʻa anei iaʻu nā pilikia me koʻu rectum, urethra, a i ʻole vagina i ka wā e hiki mai ana?
• E hiki anei i kaʻu kaikamahine ke hānau keiki me ka palekana i ka wā e hiki mai ana?

He mea maʻamau ka manaʻo e haki ka puʻuwai ke aʻo ʻoe i kahi mea e like me kēia. Akā e hoʻomanaʻo, ua holomua loa ka ʻepekema lapaʻau i kēia lā. Hiki i ke ʻoki kino ke hoʻoponopono pono i kēia kūlana, e ʻae ana i kāu keiki e ola i kahi ola maʻamau. E lilo kāu kauka a me ka hui mālama ola i kākoʻo nui iā ʻoe a me kāu keiki ma kēia huakaʻi.