Manaʻo paha ʻoe he mea paʻa i loko o kou puʻu a i ʻole he puʻupuʻu i loko o kou puʻu ke moni ʻoe? I kekahi manawa, ma hope o kekahi manawa, ʻoiai ke kūlou ʻoe a wili paha, manaʻo anei ʻoe e hoʻi mai ana ka meaʻai āu i ʻai ai i loko o kou puʻu? ʻO ke kumu o kēia paha he ʻeke liʻiliʻi e hana ʻia ana i loko o kou esophagus, ka ʻōmole e moni ai mākou i ka meaʻai. Ma nā ʻōlelo lapaʻau, kapa mākou i kēia he Esophageal Diverticulum . Mai makaʻu i kou lohe ʻana i kēia inoa, e kamaʻilio maʻalahi kākou e pili ana.
I ka ʻōlelo maʻalahi, he aha kēia Esophageal Diverticulum?
E noʻonoʻo i kou esophagus, ka ʻōmole ʻiʻo e lawe ana i ka meaʻai mai kou waha a i kou ʻōpū, e like me ka huila ma ke kaʻa. I kekahi manawa, inā he wahi nāwaliwali i loko o ka huila, ʻo ke kaomi ea i loko e hoʻoulu ai i kahi pehu liʻiliʻi e puka mai ana mai kēlā wahi nāwaliwali, ʻeā? Pēlā nō kēia me kēia.
Inā he wahi nāwaliwali i loko o ka uhi mucous o ko kākou esophagus, ʻo ke kaomi i hana ʻia i ka wā e ale ai kākou i ka meaʻai e hana ai i kahi ʻeke liʻiliʻi, a i ʻole lua, e hana ma waho o kēlā wahi nāwaliwali. ʻO ia ka mea a mākou e kapa nei he Esophageal Diverticulum . Hiki i kekahi o ka meaʻai a me nā wai āu e ale ai ke paʻa i loko o kēia ʻeke.
He aha nā ʻano nui o kēia maʻi?
Hoʻokaʻawale nā kauka i kēia mau ʻeke (diverticula) i kekahi mau ʻano ma muli o ke ʻano o ko lākou hana ʻana a me ko lākou wahi. E nānā kākou i nā ʻano nui.
ʻO ka mea mua, aia ʻelua ʻano o kēia: "ʻoiaʻiʻo" a me "wahaheʻe".
- ʻO Diverticulum ʻoiaʻiʻo: I kēia hihia, ua hoʻokumu ʻia ka ʻeke ma ka puka ʻana i waho mai nā papa āpau o ka paia esophageal, me nā ʻiʻo.
- Diverticulum wahaheʻe: Ma kēia, he kakaikahi wale nō o nā papa o loko o ka paia e puʻe i waho.
I kēia manawa, e nānā kākou pehea e hoʻokaʻawale ʻia ai kēia mau mea e like me ko lākou wahi ma ka esophagus.
| ʻAno diverticulum | Kahi a me ka wehewehe maʻalahi |
|---|---|
| ʻO ka Diverticulum Zenker | ʻO kēia ke ʻano maʻamau . Hoʻomohala ia ma ka ʻaoʻao o luna o ka esophagus, kokoke i ka hoʻomaka ʻana o ka puʻu. ʻO ka hapa pinepine, he mau diverticula "wahaheʻe" kēia. ʻO ke kumu nui, ʻo ia ke kaomi i hoʻokumu ʻia e ka paʻakikī o ka ale ʻana i ka meaʻai. |
| ʻO ke kīʻaha ʻo Killian-Jamieson | He ʻuʻuku iki kēia ma mua o Zenker Diverticulum. Loaʻa ia ma ka ʻāʻī. ʻIke pinepine ʻia ia he ʻeke liʻiliʻi hoʻokahi. Hiki ke hana ʻia e ka nāwaliwali hānau ʻana i loko o nā ʻiʻo ma ia wahi. |
| ʻO ka Diverticulum waena o ka esophageal | Hoʻomohala kēia mau mea ma waenakonu o ka esophagus, ʻo ia ka ʻāpana i loko o ka lua o ka umauma. Ua kapa pinepine ʻia kēia mau mea he "ʻoiaʻiʻo" diverticula. Hoʻokumu ʻia lākou e ka traction waho. Hiki i nā maʻi ma ka umauma ke hana i kēia mau mea i ka wā e pehu ai nā ʻiʻo a pili i ka esophagus, e huki ana iā ia i waho. |
| ʻO ka Diverticulum Epiphrenic | Hoʻomohala kēia mau mea ma ka ʻaoʻao haʻahaʻa o ka esophagus, kokoke i kahi e pili ai i ka ʻōpū. Ua kapa ʻia hoʻi kēia mau mea he "wahaheʻe" diverticula, i hoʻokumu ʻia e ke kaomi kūloko. No ka laʻana, inā ua ālai ʻia ka ʻaoʻao haʻahaʻa o ka esophagus, hiki iā lākou ke hana i ka wā e hoʻāʻo ai ka meaʻai e paʻi i loko o ka ʻōpū. |
He kūlana maʻamau loa kēia?
ʻAʻole, he maʻi laha ʻole kēia. Hoʻopilikia ia ma kahi o 1% o ka heluna kanaka. ʻOi aku ka maʻamau i ka poʻe ma luna o 50 mau makahiki, ʻoi aku hoʻi ma hope o 70 mau makahiki. ʻOi aku ka maʻamau i nā kāne ma mua o nā wahine.
Loaʻa iā ʻoe kēia mau hōʻailona?
He nui ka poʻe i loaʻa i kēia diverticulum akā ʻaʻole lākou e ʻike i kekahi mau hōʻailona. ʻAʻole paha ʻoe e ʻike ua loaʻa iā ʻoe no ke koena o kou ola. Akā inā loaʻa iā ʻoe, ʻo ia paha he Zenker diverticulum. E nānā inā ʻike ʻoe i kekahi o kēia mau hōʻailona:
- Me he mea lā e ʻū ana i ka puʻu a ʻo ia ke kumu e ʻū ai ʻoe .
- Ke manaʻo nei he puʻupuʻu i loko o kou puʻu i ka wā e moni ai i ka meaʻai.
- Manaʻo e like me ka meaʻai i paʻa i loko o ka puʻu .
- ʻO Regurgitation ka hoʻi ʻana o ka meaʻai i loko o ka puʻu ke kūlou ʻoe a i ʻole ke kīloi.
- Hanu ʻino no ke kumu ʻole.
- I kekahi manawa puka mai ke kani ʻana o ka hanu ʻana mai ka umauma mai.
No ke aha e hana ʻia ai kekahi mea e like me kēia? He aha nā kumu?
ʻElua ʻano kumu nui no kēia mau mea. ʻO kekahi ka pulsion kūloko, a ʻo kekahi ka traction kūwaho.
1. Ma muli o ke kaomi (Pulsion Diverticula)
Hoʻomohala ka hapa nui o nā diverticula esophageal i kēia ʻano. ʻO kēia ka manawa e mau ana ke kaomi ma kahi like i loko o ka esophagus. ʻO ka hapa nui o ka manawa, hana ʻia kēia kaomi i ka wā e ale ai mākou. Hiki ke hana ʻia kēia kaomi kūpono ʻole e nā kūlana olakino ʻē aʻe e paʻakikī ai ke ale.
ʻO kekahi o ia mau kūlana:
- ʻAkalasia: Hiki ʻole ke hoʻomaha i nā ʻiʻo ma ka ʻaoʻao haʻahaʻa o ka esophagus.
- ʻO nā spasms esophageal: Nā ʻūmiʻi kūpono ʻole o nā ʻiʻo i loko o ka esophagus.
- ʻO nā koʻikoʻi o ka esophagus: He ʻūmiʻi a ʻūmiʻi paha o ka esophagus.
- ʻEosinophilic esophagitis: Ka mumū o ka esophagus ma muli o kahi maʻi allergy.
2. Ma muli o ke kahakiʻi (Traction Diverticula)
ʻO kēia ka manawa e hoʻokuke ai kekahi mea ma waho o ka esophagus i ka paia i waho. Hoʻokumu kēia i ka diverticula "maoli", ʻo ia hoʻi, ua hoʻokuke ʻia ka mānoanoa holoʻokoʻa o ka paia i loko. Hoʻokumu pinepine ʻia kēia mau mea ma waenakonu o ka esophagus. Hoʻokumu ʻia kēia e ka pehu ʻana o nā ʻiʻo mai loko mai o ka lua umauma, e pipili ana i ka esophagus, a laila huki iā ia i waho.
ʻO nā maʻi e hiki ai ke hoʻoulu i ka pehu ʻana o ka ʻiʻo umauma:
- ʻO ka maʻi puʻupuʻu
- ʻO ka Histoplasmosis (kahi maʻi fungal)
ʻO ka mea nui, ʻo ia ka ulu pinepine ʻana o kēia maʻi ma muli o kekahi maʻi olakino ʻē aʻe. He mea kākaʻikahi loa ka ulu ʻana o kahi diverticulum ma kāna iho.
He aha nā pilikia e hiki ai i kēia ke hana?
I ka hala ʻana o ka manawa, hiki i kēia ʻeke (diverticulum) ke ulu mālie aʻe. Hoʻonui kēia i ka pilikia o ka paʻa ʻana o ka meaʻai i loko. Ke paʻa ka meaʻai e like me kēia, hiki iā ʻoe ke manaʻo he puʻu i loko o kou puʻu. Eia kekahi, hiki i ka meaʻai i paʻa ke hoʻoulu i ka maʻi, ka ʻeha, a me ka pehu .
Hiki i ka meaʻai i paʻa ke hana i ka hanu ʻino a me ka ʻono ʻino i loko o ka waha. I nā hihia koʻikoʻi, hiki ke manaʻo ʻia e like me kahi puʻu ma ka ʻāʻī.
ʻO kekahi mea ʻē aʻe, hiki i ka meaʻai i paʻa ke piʻi hou i luna i loko o ka puʻu ke hoʻololi ʻoe i nā kūlana, no ka laʻana ke kūlou ʻoe. Hiki i kēia ke kumu i ka ʻū ʻana a me ka pōkole o ka hanu. ʻO ka mea weliweli loa, inā hana ʻia kēia i ka pō i kou hiamoe ʻana , hiki i nā ʻāpana meaʻai ke komo i loko o kou mau māmā me ka ʻike ʻole ʻoe. I ka lāʻau lapaʻau, kapa mākou i kēia he silent aspiration . Hiki i kēia ke hana i kahi maʻi i loko o nā māmā, i kapa ʻia ʻo Aspiration Pneumonia .
He maʻi ʻaʻai anei kēia? Aia kekahi pilikia?
Ua hiki mai paha kēia nīnau iā ʻoe. ʻAʻole kēia maʻi he maʻi kanesa maoli. Akā, he mea kākaʻikahi loa ia , ʻo ia hoʻi, i nā poʻe me kēia diverticulum.Ua ʻike ʻia he hapa liʻiliʻi loa, ma kahi o 0.05%, e hoʻomohala i ka squamous cell carcinoma i loko o kēia ʻeke. ʻAʻole maopopo inā paha he kumu ka huhū mau mai ka mālama ʻana i ka meaʻai i loko o kēia ʻeke. Akā e hoʻomanaʻo, he haʻahaʻa loa kēia pilikia .
Pehea ʻoe e ʻike ai i kēia kūlana?
ʻO ka hapa nui o ka manawa, ʻike ʻia kēia ma ka manawa kūpono. ʻIke wale ʻia kēia ʻeke ke nānā ʻia kou esophagus no kekahi maʻi ʻē aʻe. Eia nō naʻe, inā loaʻa iā ʻoe nā hōʻailona, e kauoha kāu kauka i kahi hoʻāʻo e nānā i kou esophagus. ʻElua mau ʻano nui no kēia. ʻO kēia ka radiology a me ka endoscopy.
Eia kekahi mau ʻano hoʻāʻo hiki iā ʻoe ke hana:
- ʻEsophagram (Hoʻāʻo ʻAi ʻia e ka Barium): Ua like kēia me kahi X-ray. Hāʻawi ʻia ʻoe i kahi wai ʻōniʻoniʻo i kapa ʻia ʻo barium e inu. Ke ale ʻia kēia, hiki ke ʻike maopopo ʻia ka ʻaoʻao o loko o ka esophagus. A laila, i kou ale ʻana, lawe ʻia kahi wikiō X-ray (fluoroscopy). E hōʻike kēia iā ʻoe inā he ʻeke.
- ʻO ka Endoscopy Kiʻekiʻe (Hoʻāʻo EGD): Pili kēia i ke komo ʻana i kahi ʻōmole liʻiliʻi i lako me ke kāmela ma kou waha e nānā i kou esophagus a me kou ʻōpū. E hāʻawi ʻia ʻoe i ka anesthesia e hōʻoia ʻaʻole ʻoe e ʻoluʻolu i ka wā o kēia kaʻina hana. Hiki ke nānā ʻia nā kiʻi mai ke kāmela ma kahi pale kamepiula, e ʻae ana i ke kauka e ʻike pono i kahi a me ka nui o ka diverticulum.
- Hoʻāʻo Manometry Esophageal: Hiki ke hana ʻia kēia hoʻāʻo inā manaʻo ʻoe e pilikia ana ka diverticulum i ka ale ʻana. Nānā kēia hoʻāʻo i ka ikaika o kou mau ʻiʻo a me ka maikaʻi o kā lākou hana.
He aha nā lāʻau lapaʻau no kēia?
ʻO ka nūhou maikaʻi, ʻaʻole pono ka hapa nui o nā diverticula esophageal i kekahi lāʻau lapaʻau . Inā ʻaʻohe ou hōʻailona a pilikia paha, hiki iā ʻoe ke hoʻokuʻu wale.
Eia nō naʻe, inā ke hoʻopilikia nei kāu mau hōʻailona i kou ola o kēlā me kēia lā a inā paha he mau pilikia, pono paha e wehe ʻia a pani ʻia paha ka ʻeke. Nui nā ala e hana ai i kēia. Pono paha ʻoe e mālama i ke kūlana kumu i hoʻokumu ai.
Nā ʻano lapaʻau
- Hoʻoponopono ʻoki kino: Hiki i ke kauka ʻoki ke ʻoki a wehe loa i ka ʻeke (diverticulectomy). A i ʻole, hiki iā lākou ke humuhumu hou iā ia i loko o ka paia o ka esophagus (diverticulopexy). I kekahi manawa, inā ʻo ke kumu ka paʻa ʻana o nā ʻiʻo, hiki ke hana ʻia kahi kaʻina hana i kapa ʻia ʻo myotomy (ʻoki a wehe i kahi ʻiʻo) i ka manawa like me kēia ʻoki kino.
- Lapaʻau ma o kahi endoscope (Endoscopic Diverticulotomy):He hana maʻalahi kēia ma mua o ke ʻoki ʻana. Hoʻokomo ʻia kahi endoscope ma o ka waha a ʻoki ʻia ka septum ma waena o ka ʻeke a me ka paia esophageal. Hana ʻia kēia me ka hoʻohana ʻana i ka laser, electrocautery, a i ʻole ka mea stapler. ʻOki a sila kēia mau mea i ka ʻeha i ka manawa like.
E kūkākūkā kāu kauka me ʻoe i ke ʻano lapaʻau e kūpono loa i kou kūlana.
ʻEhia ka lōʻihi e hoʻōla ai ma hope o ka lāʻau lapaʻau?
Ma hope o ka lāʻau lapaʻau, pono ʻoe e noho ma ka haukapila no hoʻokahi lā. A laila pono ʻoe e hoʻi i ka home a hoʻomaha no kekahi mau pule. I nā lā mua, e ʻeha a pehu paha kou puʻu. Hiki i kēia ke paʻakikī iki ke ale.
E hāʻawi kāu kauka iā ʻoe i nā mea hoʻomaha ʻeha. E hāʻawi pū lākou iā ʻoe i nā kuhikuhi no ka hoʻomaka ʻana me nā meaʻai wai, e neʻe mālie i nā meaʻai palupalu, a laila i nā meaʻai maʻamau. He mea nui loa ka hahai ʻana i kēia mau kuhikuhi no ka hoʻōla wikiwiki ʻana.
I ka hopena, ʻaʻole pilikia ka hapa nui o ka poʻe me kēia maʻi. ʻOiai inā loaʻa, aia nā lāʻau lapaʻau kūpono no ia. ʻOi aku ka nui o ka holomua o ka lāʻau lapaʻau ma mua o 90%.
No laila, inā loaʻa iā ʻoe kēia mau hōʻailona, mai makaʻu e ʻike i ke kauka a loaʻa ka ʻōlelo aʻoaʻo. E hana ʻo ia i nā hoʻokolohua e pono ai nou, e wehewehe pono inā loaʻa iā ʻoe kēia maʻi, a inā pēlā, he aha ka mea e hana ai ma hope.
Leka Lawe-Home
- ʻO kahi diverticulum esophageal he ʻeke liʻiliʻi e ulu ana mai kahi nāwaliwali i loko o ka paia o ka ʻōmole kahi a mākou e moni ai i ka meaʻai.
- Nui ka poʻe i loaʻa i kēia akā ʻaʻole lākou i ʻike i kekahi mau hōʻailona.
- Hiki i nā hōʻailona ke komo pū me ka paʻakikī i ka moni ʻana, ka paʻa ʻana o ka meaʻai i loko o ka puʻu, ka hanu ʻino, a me ka manaʻo o kekahi mea e paʻa ana i loko o ka puʻu.
- ʻAʻole kēia he maʻi ʻaʻai, a he haʻahaʻa loa ka pilikia o kona lilo ʻana i maʻi ʻaʻai.
- Inā loaʻa iā ʻoe nā hōʻailona, hiki ke maʻalahi ke ʻike ʻia kēia ʻano me ka Barium Swallow Test a i ʻole Endoscopy.
- ʻO ka hapa nui, ʻaʻohe pono o ka lāʻau lapaʻau. Eia nō naʻe, inā koʻikoʻi nā hōʻailona, hiki ke mālama pono ʻia ke ʻoki kino a i ʻole ka lāʻau endoscopic.
- Inā he kānalua kou e pili ana i kēia, e kamaʻilio pono me kāu kauka.
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