He lua anei kou i loko o kou ʻōpū hoʻoheheʻe? (Gastrointestinal Perforation) Mai hopohopo, e makaʻala kākou i kēia!

ʻAuē, ua loaʻa anei iā ʻoe kahi ʻeha ʻōpū koʻikoʻi koke? Me he mea lā e hou ana kekahi iā ʻoe me ka pahi mai loko mai, e like me ka ʻeha hiki ʻole ke hoʻomanawanui e hoʻopiha ana i kou ʻōpū? I kekahi manawa hiki i kēia mau hōʻailona ke hōʻailona o kahi mea koʻikoʻi. I kēia lā e kamaʻilio mākou e pili ana i ka perforation o ke ala ʻai, a i ʻole `(Gastrointestinal Perforation)` , kahi kūlana e pono ai ka mālama olakino ulia pōpilikia.

He aha kēia perforation gastrointestinal?

I ka ʻōlelo maʻalahi, ʻo `(Gastrointestinal Perforation)` ʻo ia hoʻi he lua a i ʻole he puncture ma kekahi wahi o kā mākou ʻōnaehana digestive. E noʻonoʻo i ka mea e hana ʻia inā puka kahi lua i loko o kahi paipu wai. Ua like kēia.

I kēia manawa ke nīnau nei ʻoe, "He aha kēia ʻōnaehana ʻauwai meaʻai?"

ʻO kā mākou ʻōnaehana hoʻoheheʻe (`(Gastrointestinal tract)` a i ʻole `(GI tract)`) he ʻōnaehana o nā ʻōkana i hoʻopili ʻia e lawe i ka meaʻai a mākou e ʻai ai, hoʻoheheʻe iā ia, omo i nā meaola, a hoʻokuke aku i nā huahana ʻōpala. Ua like ia me kahi paipu lōʻihi. ʻO ka hapa nui o ia mau ʻōkana:

• ʻEsophagus: ʻO ka ʻōmole e lawe ai i ka meaʻai mai ko mākou waha a i ko mākou ʻōpū.
• ʻŌpū: ʻO kahi nui e hoʻoheheʻe ʻia ai ka meaʻai.
• ʻŌpū liʻiliʻi: Kahi e hoʻoheheʻe hou ʻia ai ka meaʻai a komo ʻia nā meaola i loko o ke kino.
• ʻŌpū nui (koloni): Kahi e hoʻololi ʻia ai nā ʻāpana meaʻai i hoʻoheheʻe ʻole ʻia i loko o nā ʻōpala.

No laila, inā puka kahi lua ma ka paia o kekahi o kēia mau ʻōkana, ʻo ia ka mea a mākou e kapa nei he perforation gastrointestinal .

No ke aha he mea weliweli loa kēia? He aha ka mea e hana ʻia i ko kākou kino?

ʻO ka puka ʻana o ke ala ʻai he maʻi koʻikoʻi e pono ai ka mālama olakino ulia pōpilikia . No ka laʻana, inā loaʻa kahi lua i loko o ka ʻōpū nui, ʻo ia hoʻi, ka ʻōpū (`(Bowel perforation)`), hiki i ka ʻōpala ke komo i loko o ka ʻōpū. Inā he lua i loko o ka ʻōpū a i ʻole ka ʻōpū liʻiliʻi, hiki i nā mea e like me ka meaʻai i ʻeli ʻia a me nā wai gastric ke komo i loko o ka lua ʻōpū.

Eia nā mea e hiki ke hana ke komo kēia mau mea i loko o ka ʻōpū:

• Ke kahe koko kūloko a me ke kahe koko nui: I kekahi manawa hiki ke hoʻoweliweli i ke ola.
• Peritonitis: He maʻi kēia a me ka mumū o ka paia o loko o ka lua ʻōpū. He mea weliweli loa nō hoʻi kēia.
• Ka hōʻino mau loa i ka ʻōnaehana hoʻoheheʻe: I kekahi manawa, inā koʻikoʻi ka hōʻino, hiki i kēlā ʻāpana ke lilo i kīnā mau loa.
• Sepsis: He maʻi ʻino e laha ana ma ke kino holoʻokoʻa. He mea hoʻoweliweli nō hoʻi kēia i ke ola.

ʻO ka mea nui loa: Inā hana ʻia kēia, he mea nui e ʻimi koke i ke kōkua lapaʻau. ʻAʻole lawa ka noho ʻana ma ka home.

He aha paha ke kumu o kēia?

Nui nā kumu e hiki ai ke puka ka ʻōpū. Hoʻokumu ʻia kekahi e nā ulia pōpilikia, aʻo kekahi e nā maʻi ʻē aʻe.

Nā ulia pōpilikia a me nā kumu o waho

• Ka ʻai ʻana i kahi mea ʻino: I kekahi manawa hiki i nā keiki liʻiliʻi ke ale i nā ʻāpana liʻiliʻi o nā pila, nā kālā, nā ʻāpana magnet, a i ʻole nā ​​​​mea ʻoi (e like me ke pine a i ʻole ka iwi iʻa). Hiki i nā pākeke ke loaʻa kēia mau mea. Eia kekahi, inā komo kahi kemika ʻawaʻawa (e like me ka waikawa) i loko o ka ʻōpū, hiki iā ia ke hana i kahi perforation o ka esophagus, ka ʻōpū, a i ʻole nā ​​​​​​naʻau.
• Ka paʻa ʻana o ka ʻōpū ('Bowel impaction'): Inā paʻa ka ʻōpala i loko o nā ʻōpū no ka manawa lōʻihi, e hana ana i puʻupuʻu a lilo i paʻakikī, hiki iā ia ke kau i ke kaomi ma luna o nā ʻōpū a hana i ka perforation.
• Nā ʻeha ulia pōpilikia: Inā loaʻa iā ʻoe kahi hahau ʻoi i ka ʻōpū, e like me kahi ulia kaʻa a i ʻole ka hāʻule ʻana mai kahi kiʻekiʻe.
• Luaʻi nui: ʻO ka luaʻi mau a ikaika hoʻi e hiki ke hōʻino i ka esophagus i kekahi manawa.
• Nā ʻeha ʻoi o kahi mea kaua: Inā ua ʻeha ʻoe ma ka ʻōpū a i ʻole ka umauma e kekahi mea e like me ka pahi a i ʻole ka pū kī.
• Nā kaʻina hana lapaʻau: I kekahi manawa, hiki ke hana ʻia kēlā mau perforations i ka wā o nā ʻoki kino a i ʻole nā ​​​​hoʻokolohua ma ke ala ʻai (e.g., nā hoʻokolohua endoscopic e like me "colonoscopies"). Eia naʻe, he mea kakaikahi loa kēia.

Hiki ke hana ʻia kēia ʻano ma muli o kekahi mau maʻi?

ʻAe, hiki i kekahi mau kūlana olakino ke hoʻonui i ka pilikia o ka perforation esophageal. Eia kekahi mau laʻana:

• ʻĀpenikiki: Ka mumū o ka ʻāpenikiki.
• Nā maʻi ʻaʻai o ka ʻōnaehana hoʻoheheʻe: e like me ke kanesa colorectal, ke kanesa esophageal, a me ke kanesa ʻōpū.
• Diverticulitis: Maʻi o nā ʻeke liʻiliʻi (diverticula) i loko o nā ʻōpū.
• Hernia: Ka puka ʻana o kahi ʻāpana o ke kino, e like me ka ʻōpū, ma o kahi nāwaliwali.
• ʻŌpū ʻōpū: Ka ālai ʻana o ke ala ʻōpū.
• Nā pōhaku Gallstones: Hiki i kēia ke hōʻino i nā ʻōpū i ko lākou hele ʻana ma nā ʻāpana bile.
• ʻO ka maʻi mumū o ka ʻōpū (IBD): Hoʻokomo pū kēia i nā kūlana e like me ka maʻi a Crohn a me ka colitis ulcerative .
• Maʻi ʻōpū peptic: Nā ʻeha e hana ʻia ana i loko o ka ʻōpū a i ʻole ka ʻāpana mua o ka ʻōpū liʻiliʻi. Hiki i kēia mau ʻeha ke lilo i hohonu a hiki ke hana i ka perforation.

ʻAʻole nā ​​kānaka a pau me kēia mau kūlana e loaʻa i kahi perforation o ka esophagus. Eia nō naʻe, ʻoi aku ka kiʻekiʻe o ka pilikia . No laila he mea nui e makaʻala i kēia mau hōʻailona a e ʻimi koke i ke kōkua lapaʻau inā loaʻa iā ʻoe.

Pehea ko mākou manaʻo no kēia? He aha nā hōʻailona?

Inā loaʻa iā ʻoe kahi perforation gastrointestinal, hiki iā ʻoe ke ʻike i hoʻokahi a ʻoi aku paha o nā hōʻailona penei:

• ʻEha nui o ka ʻōpū a i ʻole ka ʻūmiʻi: ʻO kēia ka hōʻailona nui a koʻikoʻi loa. Hoʻomaka koke ia a ʻaʻole hiki ke hoʻomanawanui.
• ʻŌpū pehu a pehu paha: Hiki i kou ʻōpū ke manaʻo ua pehu loa.
• Kuni a ʻūlū paha: He hōʻailona o ka maʻi.
• Ka luaʻi a me ka luaʻi.
• Ke ʻeha a ʻūmiʻi paha i ka wā e pā ai i ka ʻōpū.

Inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona, ​​e hele koke i ka haukapila . Mai hoʻonele i ka manawa.

Pehea e ʻike ai ke kauka i kēia? (Diagnosis)

Ke hele ʻoe i ka haukapila, e nānā mua ke kauka iā ʻoe.

• E hoʻopā lākou i kou ʻōpū a kaomi ma luna e ʻike i kahi e ʻeha ai a inā he ʻeha i loko o kou ʻōpū.
• Ua nānā ʻia kāu mau hōʻailona koʻikoʻi:
• Ke koko
• Mahana kino
• Pulse a me ka helu o ka puʻuwai
• Ka helu hanu

A laila e nīnau paha ke kauka iā ʻoe i nā nīnau e like me:

• He mau maʻi ʻē aʻe kāu?
• Ua hana ʻia anei kekahi ʻoki kino a i ʻole nā ​​hoʻokolohua lapaʻau iā ʻoe i kēia mau lā iho nei?
• I ka manawa hea i hoʻomaka ai nā hōʻailona? Pehea kou manaʻo?
• Ua loaʻa i kekahi o kou ʻohana ke kanesa a i ʻole ka maʻi ʻōpū mumū (IBD)?

He aha nā hoʻokolohua e hana ʻia nei?

Ma hope o ka hoʻokolokolo kino, hiki i ke kauka ke hana i kekahi mau hoʻokolohua e hoʻoholo ai inā loaʻa kahi perforation:

• Nā hoʻāʻo koko: E nānā i nā maʻi a pehea e hana ai kou mau puʻupaʻa a me ke akepaʻa.
• Nā kukuna X: E nānā i ka ea i loko o ka lua o ka ʻōpū. Inā he lua i loko o ka esophagus, hiki i ka ea ke komo i loko o ka lua o ka ʻōpū. He hōʻailona nui kēia o ka perforation.
• CT scan: Hiki i kēia ke hana i nā kiʻi maopopo a kikoʻī hoʻi. He mea kōkua nui kēia i ke kuhikuhi ʻana i kahi kikoʻī o ka lua.
• ʻO ka endoscopy kiʻekiʻe: Hoʻokomo ʻia kahi paipu me kahi kāmela i hoʻopili ʻia ma o ka waha e nānā i ka esophagus, ka ʻōpū, a me ka ʻaoʻao o luna o ka ʻōpū liʻiliʻi.
• Colonoscopy: Hoʻokomo ʻia kahi ʻōmole me kahi kāmela i hoʻopili ʻia ma o ka anus e nānā i ka ʻōpū nui (colon).

Ma ka hana ʻana i hoʻokahi a ʻoi aku paha o kēia mau hoʻokolohua, hiki i nā kauka ke ʻike pono inā he lua kou i loko o kou esophagus, kahi o ia mea, a pehea ke koʻikoʻi.

He aha nā lāʻau lapaʻau no kēia?

Inā hōʻoia ke kauka he perforation gastrointestinal kou, pono pinepine ke ʻoki kino ulia pōpilikia e pani i ka lua.

ʻO ke ʻano o ke ʻoki kino e pili ana i ka nui o ka lua, kona wahi, a me kou olakino holoʻokoʻa. Aia kekahi mau ʻano o ke ʻoki kino:

• Ke kaʻina hana endoscopic:Hiki ke hoʻoponopono ʻia kekahi mau lua liʻiliʻi me ka ʻole o kahi ʻoki nui me ka hoʻohana ʻana i nā mea hana liʻiliʻi i hoʻokomo ʻia ma o ka endoscope (ka ʻōmole me ke kāmela).
• ʻO ke ʻoki Laparoscopic: Pili kēia i ka hana ʻana i kekahi mau ʻoki liʻiliʻi ma ka ʻōpū a me ke komo ʻana i kahi kāmela a me nā mea hana ʻoki ma o lākou. Ua kapa ʻia hoʻi kēia ʻo "keyhole surgery." ʻOi aku ka wikiwiki o ka hoʻōla ʻana.
• ʻO ke ʻoki kino kuʻuna: He hana kēia kahi e hana ʻia ai kahi ʻoki nui aʻe ma ka ʻōpū. Hoʻohana ʻia kēia ʻano hana inā nui ka lua a inā paʻakikī ke kūlana.

I kekahi manawa, i mea e ho'ōla ai kou ʻōpū, pono paha ʻoe e hana i kahi ala no ka manawa pōkole no kou ʻōpala e hele ai . Ua kapa ʻia kēia he hana ʻana i kahi stoma . A laila e hana ke kauka lapaʻau:

1. Hana ʻia kahi puka liʻiliʻi (`stoma`) i loko o ka ʻili o kou ʻōpū.

2. Ua pili kahi ʻāpana o kou ʻōpū liʻiliʻi a i ʻole ka ʻōpū nui i kēia puka.

3. Ua hoʻopili ʻia kahi ʻeke (ʻeke Colostomy) ma waho o kēia stoma.

He ʻeke pani ʻole ʻia ka ʻeke colostomy e hōʻiliʻili ana i ka ʻōpala. Hiki iā ʻoe a i ʻole kekahi mea nāna ʻoe e mālama ke hoʻokahe i ka ʻeke i kēlā me kēia lā. Ma hope o ka ho'ōla ʻana o kou ʻōpū, e wehe pinepine kāu kauka i ka stoma a me ka ʻeke .

ʻAʻole anei e hoʻomaikaʻi kēia me ke ʻoki ʻole ʻana?

Hiki i nā puka liʻiliʻi loa o ke ala ʻai ke ho'ōla i kekahi manawa me ka ʻole o ke ʻoki ʻana. Eia naʻe, ʻaʻole kēia kahi mea hiki iā ʻoe ke hoʻoholo ma ka home. ʻAʻole ʻoe i ʻike i ke koʻikoʻi o ke kūlana a hiki i ka loaʻa ʻana o kahi hōʻailona. No laila, he mea nui e ʻimi koke i ke kōkua lapaʻau .

Inā mālama ʻia me ke ʻoki ʻole ʻana, e hāʻawi pinepine ʻia ʻoe i nā lāʻau antibiotic intravenous (IV) a mālama ʻia i ka haukapila no ka nānā pono ʻana.

E hoʻomanaʻo! Hiki i nā puka ʻana o ka esophagus ke hoʻoweliweli i ke ola. Mai ho'āʻo e mālama i kēia ma ka home. Inā loaʻa iā ʻoe nā hōʻailona, ​​e hele koke i ka haukapila.

He aha nā lāʻau lapaʻau i hoʻohana ʻia no ka mālama ʻana?

He nui ka poʻe, inā paha i hana ʻia ke ʻoki kino a i ʻole, ua hāʻawi ʻia i nā lāʻau antibiotic e mālama i ka perforation o ka esophagus. Hāʻawi ʻia kēia mau lāʻau lapaʻau e pale a kāohi i nā maʻi e hiki ke ulu i loko o ka ʻōpū ma muli o ka perforation. Pono paha ʻoe e lawe i kēia mau lāʻau lapaʻau no kekahi mau pule. E lawe i ka lāʻau lapaʻau e like me ka ʻōlelo a kāu kauka iā ʻoe. Mai hoʻōki i ka lawe ʻana i ka lāʻau lapaʻau a hiki i ka wā e ʻōlelo ai kāu kauka iā ʻoe.

He aha kā mākou e hana ai e hōʻemi i kēia pilikia?

ʻAʻole paha e hiki ke pale loa i ka puka ʻana o ka esophagus. Eia nō naʻe, hiki iā ʻoe ke hana i kēia mau mea e hōʻemi ai i kou pilikia:

• E pale i ka puhipaka a me ka hoʻohana ʻana i nā huahana paka.
• E ʻai i ka meaʻai olakino. E hoʻokomo pū i nā meaʻai waiwai i ka fiber (nā mea kanu, nā huaʻai, a me nā legumes) i kāu papaʻai. E kōkua kēia i ka pale ʻana i ka paʻa ʻana o ka ʻōpū a mālama i kāu ʻai ʻana i ka maʻamau.
• Inā loaʻa iā ʻoe nā maʻi olakino ʻē aʻe (e laʻa me ka maʻi ʻōpū peptic, IBD), e hoʻomau i ka launa pū me kāu kauka e mālama iā lākou. E haʻi i kāu kauka e pili ana i kekahi mau hōʻailona hou, ʻoiai ka ʻeha o ka ʻōpū a i ʻole nā ​​​​pilikia o ka ʻai ʻana.

E pili ana i ka ho'ōla hou ʻana a me ka wā e hiki mai ana

Hiki ke hala kekahi mau pule e ho'ōla piha ai ma hope o ke ʻoki ʻana no ka perforation o ka esophagus. Hoʻōla piha ka hapa nui o ka poʻe ma hope o ka mālama ʻana i kūleʻa. Mai poina e hele i nā manawa hoʻopaʻa e like me ke kuhikuhi a kāu kauka.

Hiki ke hana hou ʻia kēia ʻano ma mua o hoʻokahi manawa? ʻAe, hiki. Akā, he mea kākaʻikahi loa ia. E kamaʻilio pinepine me kāu kauka e mālama i kou mau kūlana olakino a hoʻēmi i kou pilikia o ka loaʻa ʻana o kahi lua e like me kēia i ka wā e hiki mai ana.

Āhea mākou e ʻike koke ai i ke kauka?

Hiki i ka puka ʻana o ka esophagus ke hoʻoweliweli i ke ola, no laila inā ʻike ʻoe i kekahi o kēia mau hōʻailona, ​​​​e hele koke i ka lumi pilikia. Mai kali a "e hoʻomaikaʻi wale ia."

I ka hōʻuluʻulu manaʻo, eia nā mea e pono ai mākou e hoʻomanaʻo (Leka Lawe-Home):

ʻAe, ʻo ka perforation gastrointestinal a mākou i kamaʻilio ai i kēia lā he maʻi koʻikoʻi ia e pono ai ka mālama olakino ulia pōpilikia. Akā, mai hopohopo. Me nā ʻano hana ʻokiʻoki holomua a me nā lāʻau lapaʻau o kēia wā, hoʻōla piha ka hapa nui o ka poʻe inā loaʻa koke ka mālama ʻia.

ʻO ka mea nui loa, ʻo ia ka makaʻala i nā hōʻailona a me ka makaʻala i nā kumu pilikia āu e loaʻa ai. Me kēia ʻike, hiki iā ʻoe ke lawe i kahi ala proactive i kou olakino a hoʻonui i kou manawa kūpono no ka mālama ʻana. Inā he kānalua kāu, a inā he ʻeha ʻōpū ʻē kou, e ʻike koke i ke kauka. ʻO ia ka mea maikaʻi loa e hana ai!

ʻO ka puka ʻana o ka ʻōpū, ka lua o ka ʻōpū, ka puka ʻana o ka ʻōpū, ka ʻeha o ka ʻōpū, ka peritonitis, ka sepsis, ke ʻoki kino pilikia, ka colostomy