Ua haki anei kou esophagus? (Esophageal Rupture) He mea koʻikoʻi kēia, e ʻike kākou i nā kikoʻī!

Ua loaʻa koke anei iā ʻoe ka ʻeha nui o ka umauma, ka paʻakikī i ke ale ʻana, a me ka paʻakikī i ka hanu ʻana? I kēlā mau manawa, ʻaʻole mākou e noʻonoʻo iki i ia mea, akā hiki ke lilo i mea weliweli loa. ʻO kekahi kūlana koʻikoʻi a mākou e kamaʻilio ai i kēia lā, ʻo ia ka haki ʻana o ka esophageal, a i ʻole `(Esophageal Rupture)`. He mea nui loa ka makaʻala i kēia, no ka mea, hiki i ka mālama koke ke hoʻopakele i ke ola.

He aha ka haki ʻana o ka esophageal? I ka ʻōlelo maʻalahi...

ʻO ka esophagus ka ʻōmole e lawe ana i ka meaʻai a kākou e ʻai ai a inu ai mai ko kākou waha a i ko kākou ʻōpū. E noʻonoʻo iā ia e like me ka paipu wai. No laila, inā he lua, he haehae, a he ʻōpala paha ma kahi o ka paia o kēia esophagus, ʻo ia ka mea a kākou e kapa nei he haki ʻana o ka esophagus.

I kēia manawa, ke noʻonoʻo nei paha ʻoe, "No laila he aha ka mea nui e pili ana i kēia?" ʻAʻole, he maʻi koʻikoʻi loa kēia. E noʻonoʻo e pili ana iā ia, aia ko kākou trachea i loko o ka umauma, ma waena o nā māmā. ʻAʻole wale ka meaʻai a kākou e ʻai ai a inu ai, akā, ʻo nā germs a me nā kemika e pili ana i kā kākou ʻōnaehana hoʻoheheʻe e hele ma kēia trachea. No laila, inā he lua i loko o ka trachea, hiki i kēia mau mea āpau ke hōʻiliʻili i loko o ka umauma, i loko o nā māmā, a i ʻole i loko o ke koko. Inā hana ʻia kēlā , hiki ke loaʻa nā maʻi koʻikoʻi , hiki ke hoʻoweliweli i ke ola.

ʻO ia ke kumu he mea nui e ʻimi koke i ke kōkua lapaʻau, i loko o 24 mau hola, inā kānalua ʻoe i kēia maʻi. I kekahi manawa, hiki ke mālama ʻia me kahi kaʻina hana e like me ka "Endoscopy" a i ʻole ke ʻoki kino.

Pehea ka maʻamau o kēia ʻano?

ʻOiaʻiʻo, he maʻi laha ʻole ka haki ʻana o ka larynx. ʻO ia hoʻi, ʻaʻole ia he mea e loaʻa i nā kānaka a pau. Akā inā loaʻa i kekahi, he mea koʻikoʻi loa ia, no laila he mea nui e makaʻala i ia mea.

He aha ka ʻokoʻa ma waena o ka larynx i haki a me kēia mau kūlana ʻē aʻe?

I kekahi manawa, huikau ka poʻe i kēia me nā kūlana ʻē aʻe i loaʻa nā hōʻailona like. E nānā kākou i ke ʻano o ia mau mea.

Ka haki ʻana o ka Esophageal a me ka waimaka ʻo Mallory-Weiss

ʻO ka "haehae Mallory-Weiss" he haehae wale nō ia a i ʻole ka ʻāʻī ʻana i loko o ka ʻōpū o ka esophagus. ʻAʻole ia e hele a pau ma waena o ka paia o ka esophagus , ʻo ia hoʻi, ʻaʻole ia e hana i lua. Eia nō naʻe, i loko o kahi esophagus i haki, ua haehae loa ʻia ka paia.

ʻO ka haki ʻana o ka Esophageal a me ka haki ʻana o ka Variceal Esophageal

ʻO kēia ka manawa e pehu ai nā kīʻaha koko i loko o ka urethra, e palahalaha, a e pohā. Hiki i kēia ke hana i ka nui o ke kahe koko , akā, ʻaʻole ia he manaʻo ua pohā ka urethra ponoʻī. ʻAʻole i hōʻino ʻia ka paia o ka urethra.

Pehea lā e hiki mai ai kēia ʻauwai waimaka?

ʻO ka hapa pinepine, loaʻa ka haehae ma ka esophagus ke hōʻino ʻia ka esophagus ma kekahi ʻano . Hiki i kēia pōʻino ke kūwaho a i loko paha. Hiki ke hiki koke mai kekahi mau ʻeha, mai kahi ulia, aʻo nā mea ʻē aʻe e ulu mālie i ka hala ʻana o ka manawa.

He mea kākaʻikahi loa, hiki koke ke poha ka esophagus ma muli o ke kaomi nui. Ua kapa ʻia hoʻi kēia ʻo "Boerhaave's syndrome." Hana pinepine ʻia kēia i ka wā e nui ai ka luaʻi ʻana a lōʻihi.

He aha ke kumu maʻamau o ka puʻu māwae?

ʻO ka hapa pinepine, hana ʻia nā haki ʻana o ka esophagus e ka pōʻino i loaʻa i ka wā o ka mālama ʻana i ke olakino (`iatrogenic ruptures`). Hiki ke hana ʻia kēia i ka wā o nā mālama ʻana e pili ana i ka hoʻokomo ʻana i kahi ``endoscope`` i loko o ka esophagus. ʻO ka ``endoscope`` he ʻōmole liʻiliʻi me kahi kāmela i hoʻopili ʻia iā ia. Hoʻokomo ʻia ia ma o ka waha a hoʻohana ʻia e nānā a mālama i ka esophagus.

Aia kekahi mau kumu ʻē aʻe?

ʻAe, aia kekahi mau kumu ʻē aʻe:

• Nā ʻoki ʻana i ka esophagus, ʻoiai ʻo Nissen fundoplication a me myotomy.
• Ke hoʻokano nui ʻana: nā kūlana e pili ana i ke hoʻokano nui ʻana, e like me ka luaʻi mau ʻana, ka hāpai kaumaha, ka hopu ʻana, a i ʻole ka hānau keiki ʻana.
• Ke ale ʻana i kahi mea ʻē a i ʻole kemika ʻino: I kekahi manawa hiki i nā keiki ʻōpio ke ale i nā ʻāpana kālā, nā ʻāpana mea pāʻani, a inā inu kekahi i kahi mea ʻino, e like me ka waikawa.
• Nā ʻeha ma waho o ka esophagus: Nā mea e like me kahi ʻeha hou, kahi ʻeha pū, a i ʻole kahi palapū mai kahi ulia kaʻa.
• ʻO ka reflux waikawa mau loa (GERD): ʻO ka refluxing acid o ka ʻōpū i loko o ka esophagus hiki ke hana i nā ʻeha, hiki ke hohonu a hoʻoulu i ka perforation o ka esophagus.
• Kaomi i hoʻokumu ʻia e kahi puʻupuʻu a i ʻole kahi mea ʻē i paʻa i loko o ka urethra: Hiki i kēia ke make i nā ʻiʻo (necrosis) i loko o ka urethra.

ʻO wai ka mea i ʻoi aku ka pilikia no kēia?

He ʻokoʻa iki ko kākou urethra mai nā kino ʻē aʻe. ʻO ia hoʻi, ʻaʻole like me nā kino ʻē aʻe , ʻaʻohe uhi pale o ka urethra (papa serosal) ma waho . ʻOi aku ka maʻalahi o ka urethra i ka hōʻino ʻia. Kiʻekiʻe loa kēia pilikia inā he maʻi, pehu, a ʻeha paha ma loko o ka urethra.

Inā ua loaʻa iā ʻoe kekahi o kēia mau kūlana ma mua, hiki ke hoʻonui iki ʻia kou pilikia o ka hoʻomohala ʻana i kahi uvula i haki ʻia:

• ʻO ka gastritis mau loa ('Chronic acid reflux / GERD').
• ʻO ka esophagitis eosinophilic (kahi kūlana e hoʻoulu ai i ka mumū i loko o ka esophagus).
• ʻO ka diverticulum esophageal (kahi ʻeke liʻiliʻi e like me ka ʻeke i loko o ka paia o ka esophagus).
• Loaʻa i ke kanesa esophageal a i ʻole ua loaʻa ka radiation therapy i ka esophagus.
• Ka hoʻohana nui ʻana i ka waiʻona.
• Ma hope o ke ʻoki ʻana i ka ʻāʻī ma mua.

He aha nā hōʻailona o kēia? E ʻike pono kākou!

ʻO nā hōʻailona maʻamau o ka larynx i haki ʻia:

• ʻEha nui o ka umauma - ʻO kēia ka hōʻailona nui.
• Paʻakikī ke ale ʻana .
• Pōkole o ka hanu .
• Ka wikiwiki o ka puʻuwai .
• Ka luaʻi .
• Ke luaʻi ʻana i ke koko .
• Ke koko haʻahaʻa .
• Kuni .

ʻO ka hapa pinepine, ʻike ʻia ka haehae ma ka ʻaoʻao waena a i ʻole lalo o ka umauma. I kēia hihia, ʻike ʻia ka ʻeha ma ka umauma. Eia nō naʻe, inā ʻike ʻia ka haehae ma ka ʻaoʻao luna a i ʻole lalo loa o ka puʻu, hiki ke ʻike ʻia ka ʻeha ma ka ʻāʻī, ka ʻōpū o luna, a i ʻole ka ʻūhā poʻohiwi ʻākau.

Inā loaʻa iā ʻoe kekahi a ʻoi aku paha o kēia mau hōʻailona, ​​​​mai hoʻowahāwahā iā lākou. He mea nui e ʻimi koke i ke kōkua lapaʻau, ʻoiai inā hele pū kēia mau hōʻailona me ka ʻeha umauma koke a koʻikoʻi.

He aha nā pilikia weliweli e hiki ai i kēia ke hana?

Ke kahe mai nā mea o loko o ka ʻōpū a me nā huakini ma o ka lua o ka esophagus, hiki ke loaʻa nā ʻano kūlana weliweli like ʻole. E noʻonoʻo, ua like ia me kahi pahu wai lepo me kahi lua i loko a me ka wai e ninini ana i waho ma nā wahi a pau.

• Hiki ke loaʻa ka mumū kemika (pleurisy) o ka uhi o ka umauma.
• Hōʻiliʻili ka wai i loko o ka lua o ka umauma (pleural effusion), a hiki ke pahū.
• Hiki ke paʻa ka ea i loko o ka hakahaka ma waena o nā māmā (ka 'mediastinum') ('mediastinal emphysema').
• Hiki i kēia mumū ke hoʻoulu i ka make ʻana o nā ʻiʻo (necrosis) i loko o ka lua o ka umauma a i ʻole ma waena o nā māmā.
• Hiki ke loaʻa kahi maʻi bacteria i ke koko ('septicemia').
• Ke koʻikoʻi kēia kūlana "septicemia", hiki iā ia ke alakaʻi i kahi kūlana hoʻoweliweli i ke ola i kapa ʻia ʻo "sepsis", a hiki i ka hopena ke alakaʻi i ka "septic shock" a me ka hāʻule ʻana o nā ʻōkana.

Hōʻike kēia mau mea a pau i ke koʻikoʻi o ka haki ʻana o ka larynx.

Pehea ʻoe e ʻike pono ai inā ua haki kou esophagus? Āhea ʻoe e ʻike ai i ke kauka?

Inā he kānalua kou no kēia maʻi, e hele koke i ka lumi pilikia o ka haukapila (ER). ʻO ka ʻeha nui, ka paʻakikī i ke ale ʻana, a me ka paʻakikī i ka hanu ʻana he mau hōʻailona ia o kahi pilikia. E hōʻoia e haʻi pololei i kāu kauka pehea i hoʻomaka ai kāu mau hōʻailona a me ka mea i hana ʻia i ka manawa.

Inā hoʻomaka kēia mau hōʻailona ma hope o kahi ulia, ka moni ʻana i kahi mea kūpono ʻole, a i ʻole ka luaʻi nui ʻana, hiki ke lilo i esophagus i haehae ʻia. E ʻimi ke kauka i nā hōʻike o kēia.

Pehea e ʻike ai nā kauka i kēia?

E kauoha ke kauka i kekahi mau hoʻokolohua e nānā i ka haehae ʻana i loko o ka esophagus.

• ʻO ka mea mua, hana pinepine ʻia kahi X-ray umauma e nānā i nā leaka wai a i ʻole nā ​​​​​​pehu ea i loko o ka lua o ka umauma.
• No ka hōʻoia ʻana i kēia, e noi ʻia paha ʻoe e hana i kahi hoʻāʻo X-ray koʻikoʻi ʻē aʻe i kapa ʻia he esophagogram . Ma kēia hoʻāʻo, inu ʻoe i kahi wai kala (contrast dye) a lawe ʻia kahi X-ray. ʻAe kēia iā ʻoe e ʻike maopopo i loko o kou esophagus. Inā e kahe ana kēia wai kala mai loko mai o ka lua, e ʻike maopopo ʻia ma ka X-ray. Hiki i kēia ke haʻi i kahi o ka lua a me ka wikiwiki o ka kahe ʻana.
• I kekahi manawaHiki ke ʻōlelo ʻia he CT scan. He mea nui loa kēia inā manaʻo ʻia he haehae ma ka esophagus o luna a i ʻole lalo. Hiki i ka CT scan ke kōkua i ka ʻike ʻana i nā wahi o ka hōʻiliʻili wai ma ka ʻāʻī a i ʻole ka ʻōpū a hoʻoholo inā pono e wehe ʻia.

He aha ka lāʻau lapaʻau no kēia?

Aia kekahi mau lāʻau lapaʻau maʻamau no kēia:

• Nā wai intravenous (nā wai IV): E pani i nā wai i nalowale mai ke kahe ʻana o ke koko, ka luaʻi ʻana, a i ʻole ka hiki ʻole ke inu.
• Nā lāʻau antibiotic IV a me/a i ʻole antifungals: No ka pale ʻana i kekahi maʻi a mālama paha i kahi maʻi e kū nei.
• ʻO ka hānai ʻana ma o ka IV a i ʻole ka hānai ʻana ma o ka paipu: ʻAʻole hiki iā ʻoe ke ale i ka meaʻai ma ka waha i ka wā o ka mālama ʻana a a hiki i kou hoʻōla ʻana.
• Ka hoʻokahe wai percutaneous: Pono paha kēia e wehe a hoʻomaʻemaʻe i ka wai i loaʻa i ka maʻi i hōʻiliʻili ʻia i loko o kou mau lua kino. E hoʻāʻo kāu kauka e wehe i kēia wai ma ka hoʻokomo ʻana i kahi nila a i ʻole ka paipu i loko o kou umauma i ka wikiwiki.
• Lapaʻau Endoscopic: Hiki ke mālama ʻia kekahi mau haehae liʻiliʻi me ka ʻole o ke ʻoki ʻana me ka hoʻohana ʻana i ka endoscope. He paipu lōʻihi ka endoscope me kahi kāmela i hoʻopili ʻia. Hoʻokomo ʻia ia ma o ka ʻāʻī i loko o ka esophagus a hiki ke hoʻoponopono ʻia ka haehae me nā clips, sutures, kahi vacuum sponge, a i ʻole kahi stent.
• ʻOki kino: Pono kekahi poʻe i ke ʻoki kino e hoʻoponopono pololei i ka haehae. I ka wā o ke ʻoki kino, wehe ke kauka ʻoki kino i ka wai keu a me nā ʻiʻo make. Ma muli o kou kūlana, hiki i kāu kauka ʻoki kino ke hoʻohana i kahi kaʻina hana minimally invasive, e like me ke ʻoki kino Thoracoscopic Video-Assisted (VATS) . Eia nō naʻe, i kekahi mau pilikia, pono paha kahi ʻoki kino hāmama. ʻAe kēia i ka wikiwiki a me ke komo maikaʻi ʻana i ka wahi i hōʻino ʻia.

Hiki anei ke pakele i kēia kūlana? He aha ka hiki ke ho'ōla ʻia?

ʻAe, hiki ke ho'ōla ʻia kahi larynx i haki. Eia nō naʻe, pili kou prognosis i ka wikiwiki o kou ʻimi ʻana i ka lāʻau lapaʻau. ʻO ka lōʻihi o ka manawa e laha ai ka maʻi ma o ka lua umauma a i loko o ke koko, ʻoi aku ka nui o kou pilikia.

ʻO ka poʻe i loaʻa ka lāʻau lapaʻau i loko o nā hola 24 mua o ka haki ʻana, ʻoi aku ka nui o ka manawa e hoʻōla piha ai. ʻO ka nui o ke ola ma kēia hui ma kahi o 85%. Eia nō naʻe, inā hala nā hola 48 me ka ʻole o ka lāʻau lapaʻau, e hāʻule ana kēlā helu i 50%.

ʻAʻole anei kēia e hōʻike ana i ke koʻikoʻi o ka mālama mua ʻana?

Leka Hoʻihoʻi Hope Loa

He mea weliweli akā he mea laha ʻole ka haki ʻana o ka larynx. Eia nō naʻe, inā loaʻa ia, hiki ke paʻakikī ke ʻike koke ʻia. No laila he mea nui e hoʻowahāwahā ʻole i ka ʻeha o ka umauma.

He lahilahi ko kākou ʻōpū a maʻalahi hoʻi e hōʻino. Hiki ke hōʻino ʻia ma nā ʻano i manaʻo ʻole ʻia. Ke hana ʻia kēlā, ʻaʻole paha ʻoe e maopopo i kahi e hele mai ai ka ʻeha a i ʻole ke ʻano o ia mea. Eia naʻe, mai manaʻo wale, "E nalo wale aku kēia."

Inā loaʻa iā ʻoe ka ʻeha umauma koʻikoʻi a koke paha, a i ʻole ka ʻeha ma kou puʻu a i ʻole ka ʻōpū o luna, e hele koke i ka lumi pilikia. ʻOiai kahi puka liʻiliʻi hiki ke alakaʻi i ka maʻi a me nā pilikia weliweli a pau a mākou i kamaʻilio ai ma mua. He mea waiwai kou ola, no laila e makaʻala i nā hōʻailona a e ʻimi koke i ke kōkua lapaʻau.

Ka haki ʻana o ka Esophagus , ʻEha o ka Umauma, Paʻakikī i ke Ale ʻana, Paʻakikī i ka Hanu ʻana, Boerhaave Syndrome, Lapaʻau Pilikia