Ke luaʻi nei kāu pēpē hānau hou ma hope koke iho o ka inu ʻana i ka waiū? He ʻōmaʻomaʻo melemele anei ka luaʻi? Ma ke ʻano he makuahine, he mea maʻamau ke makaʻu loa ke ʻike ʻoe i kahi mea e like me kēia. Akā i kekahi manawa hiki ke kumu kēia o kahi maʻi i kapa ʻia ʻo 'Duodenal Atresia', a mākou e kamaʻilio nei i kēia lā. Mai makaʻu ke lohe ʻoe i kēia inoa. He maʻi kēia e hiki ke mālama ʻia a hoʻōla loa ʻia. E kamaʻilio kākou e pili ana i nā mea āpau me ka maʻalahi a me ka maopopo.
He aha ka Atresia Duodenal?
I ka ʻōlelo maʻalahi, ʻo ia hoʻi, aia kahi paʻa i ka wā hānau ma ka hoʻomaka ʻana o ka ʻōpū liʻiliʻi o kā mākou pēpē, ʻo ia hoʻi, ma kahi ʻāpana o ka duodenum. E noʻonoʻo e like me kahi paipu wai e paʻa ana i waenakonu. Ma hope o ka waiū a ka pēpē e inu ai e komo i loko o ka ʻōpū, pono ia e iho i lalo i ka ʻōpū e hoʻoheheʻe ʻia. Akā ma muli o kēia paʻa, ʻaʻole hiki i ka waiū a me nā wai hoʻoheheʻe ke hele ma laila. ʻO ia ke kumu e luaʻi ai ka pēpē.
He maʻi hānau kēia. ʻO ke ʻano kēia, hiki mai ka pilikia i ka wā e noho ana ke pēpē i loko o ka ʻōpū. I kekahi manawa, loaʻa paha i nā pēpē me kēia maʻi nā pilikia olakino ʻē aʻe, e like me ka maʻi puʻuwai a i ʻole Down syndrome.
ʻOiai he maʻi koʻikoʻi kēia, hiki ke mālama pono ʻia inā ʻike ʻia a mālama ʻia i ka wā mua. ʻO ka mea nui loa, ʻo ia ka loaʻa ʻana o ke kōkua lapaʻau i ka pēpē i ka wā hikiwawe loa.
Aia kekahi mau ʻano like ʻole o kēia?
ʻAe, aia kekahi mau ʻano nui o kēia ālai ʻana, ma muli o ke ʻano o kona hana ʻana. ʻAʻole pono ʻoe e hopohopo nui e pili ana i kēia mau mea, akā maikaʻi ke ʻike inā kamaʻilio kāu kauka e pili ana i ia mea.
| ʻAno | Ua wehewehe maʻalahi ʻia |
|---|---|
| ʻAno 1 | Ua ālai ʻia ka ʻaoʻao o loko o ka ʻōpū e kahi mea e like me ka membrane lahilahi. E like me kahi paipu i uhi ʻia me kahi membrane. |
| ʻAno 2 | Ua kaʻawale nā ʻāpana ʻelua o ka ʻōpū, akā ua hoʻopili ʻia e kahi mea e like me ke kaula. |
| ʻAno 3 | Ua kaʻawale loa nā ʻāpana ʻelua o ka ʻōpū, me ka ʻole o ka pilina ma waena o lākou. |
| ʻO ka Stenosis Duodenal | I kēia hihia, ʻaʻole i paʻa loa ka ʻōpū, akā ua lilo kēlā ʻāpana i mea haiki loa, kahi e keakea ai i ka neʻe ʻana o ka meaʻai. |
He aha nā hōʻailona o kēia maʻi?
He mea nui loa ka ʻike ʻana i kēia mau ʻano.
ʻO ka hapa nui o ka manawa, ʻike ʻia kēia mau hōʻailona i loko o nā hola mua ma hope o ka hānau ʻana o ke pēpē.
- Luaʻi: ʻO kēia ka hōʻailona nui. Hiki ke hana ma hope o ka hānai ʻia ʻana o ka pēpē no ka manawa mua. Hiki i kēia luaʻi ke ʻōmaʻomaʻo, melemele, a ʻeleʻele māmā paha ke kala . Inā ʻaʻole mālama ʻia, e hoʻonui ʻia ka luaʻi.
- Pehu ʻana o ka ʻōpū o luna: Ma muli o kahi ālai ʻana i loko o ka ʻōpū, hōʻiliʻili ka meaʻai a me ka wai, e hoʻolilo ana i ka ʻōpū o luna i pehu.
- Kaumaha hānau haʻahaʻa.
- Ka paʻa ʻana o ka ʻōpū.
- Jaundice: Melemele o nā maka a me ka ʻili.
I kekahi manawa, inā ʻaʻole i piha ka paʻa ʻana o ka ʻōpū (paʻa hapa), ʻo ia hoʻi he wahi liʻiliʻi wale nō i paʻa, hiki ke ʻike ʻia kēia mau hōʻailona i loko o kahi pēpē ma hope o kekahi mau mahina a i ʻole i ka wā kamaliʻi.
No ke aha lā kēia e hana nei? He aha ke kumu?
ʻO kēia ka hopena o kahi hana paʻakikī loa. Ke ulu nei kahi pēpē i loko o ka ʻōpū, ma kahi o 5-6 mau pule, hana mua ʻia ka duodenum ma ke ʻano he paipu mānoanoa. A laila, make mālie nā pūnaewele i loko o kēlā paipu, e hana ana i kahi paipu hakahaka. Ua kapa ʻia kēia ʻo `(apoptosis)`.
Inā make kekahi ʻano o kēia mau ʻāpana a ʻaʻole hana pololei ke kaʻina hana o ka hana ʻana i kahi ʻōmole hakahaka, hana ʻia kahi paʻa. Ua kapa ʻia kēlā ʻo Duodenal Atresia. Inā ʻaʻole i pau kēia kaʻina hana a pau i ka hapalua, hana ʻia nā kūlana e like me Duodenal Stenosis (ka haiki ʻana o ka ʻōpū).
Pehea e ʻike ai nā kauka i kēia maʻi?
Hiki ke ʻike ʻia kēia maʻi ma mua a ma hope paha o ka hānau ʻana o ke pēpē.
Ka Hōʻailona Ma mua o ka Hānau ʻana
Hiki i nā scan i ka wā hāpai ke hāʻawi i nā hōʻailona e pili ana i kēia.
- ʻO ke kani ultrasound o ka pēpē:I kāu nānā maʻamau, inā ʻike ke kauka i kahi "pehu pālua" i loko o ka ʻōpū o kāu pēpē, ʻo ia hoʻi ua piha ka ʻōpū a me ka hapa mua o ka uterus i ka wai, he mea kānalua paha kēia. Eia kekahi, inā nui loa ka wai amniotic a puni ka pēpē (polyhydramnios), hiki i kēia ke lilo i hōʻailona o kēia ʻano. ʻO kēia no ka mea maʻamau ka ale ʻana o ka pēpē i kekahi o kēia wai, akā ʻaʻole hiki ke hana pēlā ma muli o kahi paʻa i loko o ka ʻōpū.
- MRI Fetal: Inā ʻaʻole maopopo ke scan, hiki ke hana ʻia kahi MRI i kekahi manawa.
Inā kānalua ʻia kēia, hiki i nā kauka ke ʻōlelo aku i nā hoʻokolohua e like me ka amniocentesis e nānā i nā maʻi chromosomal e like me Down syndrome.
Ma hope o ka hānau ʻana o ke pēpē (Postnatal Diagnosis)
Hoʻomaopopo pono ʻia kēia maʻi ma hope o ka hānau ʻana o ke pēpē.
- X-ray ʻōpū: Hōʻike maopopo ka hoʻokolokolo X-ray i ka "hōʻailona pehu pālua" i ʻōlelo ʻia ma mua. ʻO ke ʻano kēia, ua piha ka ʻōpū a me ka duodenum i ka ea, ʻoiai ʻaʻole ʻike ʻia ka ea i loko o nā ʻōpū ma lalo.
- Hoʻāʻo Moli Barium: I kekahi manawa, ʻoiai inā ʻaʻole i pau ka paʻa ʻana, hāʻawi ʻia ka pēpē i kahi wai i kapa ʻia ʻo barium ma o kahi ʻōmole a lawe ʻia kahi X-ray e ʻike pono i kahi a me ke ʻano o ka paʻa ʻana.
Pehea e mālama ʻia ai? Hiki ke ho'ōla ʻia kēia?
ʻAe, ʻo ke ʻoki kino wale nō ka lāʻau lapaʻau maikaʻi loa no kēia maʻi .
Ma mua o ke ʻoki ʻana, ʻaʻole e hāʻawi ʻia ka waiū i ka pēpē ma ka waha. Akā, e hāʻawi ʻia ke kino i ka meaʻai e pono ai ma o ka wai saline (IV). Eia kekahi, e hoʻokomo ʻia kahi ʻōmole liʻiliʻi ma o ka ihu a i ʻole ka waha i loko o ka ʻōpū e wehe i ka ea a me ka wai i hōʻiliʻili ʻia i loko o ka ʻōpū o ka pēpē.
ʻO ka hapa nui o ka manawa, hana ʻia ke ʻoki ʻana i loko o ʻelua a ʻekolu mau lā ma hope o ka hānau ʻana o ke pēpē.
ʻoki kino
Ua kapa ʻia kēia ʻoki kino he duodeno-duodenostomy. Pili ia i ke kāpae ʻana i ka ʻāpana i paʻa ʻia o ka ʻōpū a me ka hoʻohui ʻana i nā ʻāpana olakino ma luna a ma lalo. Ua like ia me ka wehe ʻana i kahi ʻāpana paipu i paʻa ʻia a me ke kau ʻana i kahi mea hou.
Me ka ʻenehana o kēia wā, hana pinepine ʻia kēia ʻoki kino me ka hoʻohana ʻana i kahi ʻano hana ʻoki kino minimally invasive, kahi e hoʻokomo ʻia ai kahi kāmela ma o kekahi mau ʻoki liʻiliʻi loa, ma mua o ka hana ʻana i kahi ʻoki nui ma ka ʻōpū. ʻO ke ʻano kēia, hoʻōla wikiwiki ka pēpē.
He aha ka mea e hana ʻia ma hope o ke ʻoki kino?
Ma hope o ke ʻoki ʻana, mālama ʻia ke pēpē ma ka ʻāpana mālama koʻikoʻi neonatal (NICU). Hiki ke hala i hoʻokahi pule a ʻoi aku paha no ka hoʻomaka ʻana o nā ʻōpū e hana maʻamau. A hiki i kēlā manawa, hānai ʻia ke pēpē me ka saline.
Ke hoʻomaka ka hana ʻana o nā ʻōpū, e hoʻomaka mālie ʻoe e hāʻawi i ka waiū. Ke inu maikaʻi ke pēpē a hoʻomaka e piʻi ke kaumaha, hiki iā ʻoe ke hoʻi i ka home mai ka haukapila. ʻO ka maʻamau, pono ʻoe e noho ma ka haukapila no ʻelua a ʻekolu pule.
He mea weliweli anei kēia kūlana? He aha kā kākou e noʻonoʻo ai no ka wā e hiki mai ana?
Inā ʻaʻole mālama ʻia, hiki i kēia ke hoʻoweliweli i ke ola o ka pēpē. Eia nō naʻe, maikaʻi loa nā hopena ma hope o ke ʻoki ʻana. ʻO ka wikiwiki o ka ʻike ʻia ʻana o ka maʻi a me ka wikiwiki o ka hāʻawi ʻana i ka lāʻau lapaʻau, ʻoi aku ka maikaʻi o nā hopena.
ʻAʻohe ala e pale aku ai i kēia maʻi i kēia manawa. No laila, mai manaʻo ʻoe he hewa kou. ʻO ka mea nui loa, inā ʻike ʻoe e pili ana i ia mea i ka wā hāpai, hiki i nā kauka ke mākaukau e hāʻawi i ka lāʻau lapaʻau e pono ai ke hānau ʻia ke pēpē. No laila, he mea nui loa ka hahai ʻana i nā ʻōlelo aʻoaʻo lapaʻau kūpono.
Inā loaʻa kēia maʻi i kāu pēpē, e kamaʻilio me kāu kauka a wehewehe i nā mea āpau. Mai hopohopo, e hāʻawi ka hui lapaʻau i nā kōkua āpau āu e pono ai a me kāu pēpē.
Leka Lawe-Home
- ʻO ka Duodenal atresia kahi kīnā hānau e kū ana ma ka ʻāpana mua o ka ʻōpū liʻiliʻi o kahi keiki hānau hou.
- ʻO ka hōʻailona nui, ka luaʻi ʻana, ʻoi aku ka ʻōmaʻomaʻo a melemele paha, ma hope o ka inu ʻana i ka waiū.
- Hiki ke ʻike ʻia kēia ma o nā scan i ka wā hāpai a i ʻole ma o ka hoʻokolokolo X-ray ma hope o ka hānau ʻana o ke pēpē.
- He ʻoki kino ke ʻano o ka mālama ʻana, a ua kūleʻa loa nā hopena.
- Inā loaʻa i kāu pēpē kēia mau hōʻailona, mai hopohopo a hoʻopaneʻe paha, akā e ʻike koke i ke kauka. Hiki i ka lāʻau lapaʻau koke ke kōkua i kāu pēpē e hoʻōla piha.
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