Ke manaʻo nei ʻoe i kahi puʻupuʻu ma lalo o kou ʻōpū, ma ka ʻaoʻao o kou ʻōpū, ke kū ʻoe i luna? Akā ke moe ʻoe i lalo, nalo aku ia. ʻAʻole paha e ʻeha ke hoʻopā ʻoe iā ia. Ua loaʻa anei iā ʻoe kekahi mea e like me kēia? ʻAʻole kēia he mea e hoʻowahāwahā wale ʻia. No ka mea, ʻoiai he mea liʻiliʻi paha ia, i kekahi manawa hiki ke lilo i maʻi koʻikoʻi. I kēia lā, ke kamaʻilio nei mākou e pili ana i kahi maʻi i kapa ʻia ʻo 'Spigelian Hernia', kahi i lohe ʻole ʻia e ka poʻe he nui, akā he mea nui loa ia e ʻike.
He aha ka Spigelian Hernia?
I ka ʻōlelo maʻalahi, he ʻano hernia kēia. E noʻonoʻo e like me nā ʻōpū i loko o ko kākou ʻōpū, e like me nā ʻōpū, ua pale ʻia e kahi pā ikaika i hana ʻia me nā ʻiʻo. Kāhea mākou i kēia ʻo ka pā ʻōpū. I kekahi manawa, inā he nāwaliwali i loko o kēia pā, ʻo ke kaomi i loko o ka ʻōpū ke kumu o kahi ʻāpana o nā ʻōpū, a i ʻole kahi ʻāpana o ka ʻiʻo momona, e paʻi ma waena o kēlā wahi nāwaliwali. ʻO ia ka mea a mākou e kapa nei he hernia.
ʻO ka 'spigelian hernia' kahi puka ʻana o ka ʻōpū ma o kahi nāwaliwali kikoʻī i loko o nā ʻiʻo ma ke alo o ka ʻōpū. Loaʻa pinepine ia ma lalo o ka pihi ʻōpū, ma ka ʻaoʻao ʻākau a hema paha. ʻAʻole e like me nā hernia ʻē aʻe, hiki i kēia ke paʻakikī iki ke ʻike ʻia no ka mea ʻaʻole ʻike ʻia mai waho.
He aha nā hōʻailona o kēia?
ʻO ka hōʻailona nui i ka hapanui o nā hihia, ʻo ia ka puʻupuʻu a i ʻole ka pehu ʻana e ʻike ʻia ana ma ka ʻōpū, e like me kā mākou i ʻōlelo ai ma mua. Eia naʻe, ʻaʻole ʻike mau ʻia kēia. Loaʻa paha i kekahi poʻe kēia hernia me ka ʻole o nā hōʻailona.
| ʻAno | Wehewehena |
|---|---|
| He puʻupuʻu ma ka ʻōpū lalo | He puʻu e kū mai ana ma ka ʻaoʻao, ma lalo o ka piko. ʻIke ʻia ia ke kū ʻoe i luna, ʻū, a hāpai paha i kahi mea kaumaha. Hoʻi hou ia i loko ke moe ʻoe. |
| ʻEha ʻōpū haʻahaʻa | Hiki ke hele mai a hele aku ka ʻeha. Hiki ke hoʻonui ʻia kēia ʻeha, ʻoiai ke hāpai ʻana i nā mea kaumaha a i ʻole ke kaumaha ʻana i ka wā e hoʻohana ana i ka lua. I kekahi manawa, hiki ke manaʻo ʻia he wahi ʻeha ke hoʻopā ʻia. |
| ʻAʻohe o nā hōʻailona | ʻAʻohe ʻeha o kekahi mau hernia Spigelian liʻiliʻi a ʻaʻohe puʻupuʻu i ʻike ʻia. Hiki ke ʻike ʻia lākou ma kahi hanana i ka wā o kahi scan i hana ʻia no kekahi kumu ʻē aʻe. |
No ke aha i like ai kēia ʻano me kahi hernia?
ʻO ke kumu nui o kēia, ʻo ia ka nāwaliwali o nā ʻiʻo o ka ʻōpū. Aia kekahi mau kumu e hiki ai i kēia mau ʻiʻo ke lilo i mea nāwaliwali.
- Ka ʻelemakule ʻana: I ko kākou ʻelemakule ʻana, nāwaliwali maoli nā mākala o ko kākou kino.
- Hāpai keiki: I ka wā hāpai keiki, hiki i nā ʻiʻo o ka paia ʻōpū ke lilo i nāwaliwali ma muli o ke kīkoʻo ʻana.
- Nā ʻeha i ka ʻōpū: Inā loaʻa iā ʻoe kahi hahau ikaika i ka ʻōpū a i ʻole he ulia paha, hiki ke hōʻino ʻia nā ʻiʻo a hiki ke hana ʻia kahi hernia.
Eia kekahi, ʻo kekahi mau kūlana e hoʻonui mau ana i ke kaomi i loko o ka ʻōpū e hoʻonui pū i ka pilikia o ka loaʻa ʻana o kēia hernia. E noʻonoʻo i ka mea e hana ʻia inā ʻoe e puhi mau i ka ea i loko o kahi pōpō. Pēlā nō ia.
Nā mea e hoʻonui ai i ke kaomi intra-abdominal:
- ʻŪhū mau: ʻO ka ʻūhū mau, ʻoiai i nā poʻe me nā maʻi e like me COPD , hoʻokau pinepine i ke kaomi ma nā ʻiʻo o ka ʻōpū.
- ʻO ka paʻa mau ʻana: ʻO ka mimi pinepine ʻana a me ke kaumaha i ka wā e hele ana i ka lua e hoʻonui ai i ke kaomi o ka ʻōpū.
- Maʻi akepaʻa: ʻO kekahi mau maʻi akepaʻa ke kumu o ka piha ʻana o ka ʻōpū me ka wai. Kāhea mākou i kēia he ascites . He kaomi nui nō hoʻi kēia.
- Momona: I ka piʻi ʻana o ke kaumaha o ke kino, piʻi pū ke kaomi ma ka paia o ka ʻōpū.
- Ka hāpai kaumaha: ʻO ka poʻe e hana ana i nā hana e pono ai ka hāpai kaumaha pinepine e pilikia pū kekahi.
He aha nā pilikia e hiki ke loaʻa?
ʻOiai hoʻomaka pinepine ia me he puʻupuʻu liʻiliʻi ʻole, ʻeha ʻole, aia ʻekolu mau kūlana e hiki ai i kēia hernia ke lilo i mea weliweli. He mea nui loa ia e makaʻala i kēia mau mea.
1. Ka Pale ʻana o ka ʻōpū: Ua ālai ʻia ka ʻāpana o ka ʻōpū i puka mai i waho o ka hernia, e pale ana i ka hele ʻana o ka meaʻai a me nā ʻōpala ma waena.
2. Hoʻopaʻahao ʻia: Ua paʻa kahi ʻāpana o ka ʻōpū i puka mai i waho a ʻaʻole hiki ke hoʻi hou i loko. Hiki i kēia ke hōʻeha nui.
3. ʻUmi ʻia: ʻO kēia ke kūlana weliweli loa a wikiwiki hoʻi . Inā e ʻūmiʻi ʻia nā kīʻaha koko e hoʻolako ana i ke koko i ka ʻāpana i paʻa ʻia o ka ʻōpū a pau ke kahe koko, e hoʻomaka ana kēlā ʻāpana o ka ʻōpū e make. Kāhea mākou i kēia ma ka lāʻau lapaʻau (mesenteric ischemia) . He kūlana hoʻoweliweli ola kēia e pono ai ke ʻoki kino ulia pōpilikia.
Inā loaʻa koke iā ʻoe ka ʻeha nui ma kahi o kou hernia, inā ʻaʻole hiki iā ʻoe ke hoʻihoʻi i ke knot, inā lilo ia i ʻulaʻula a poni paha, a inā hoʻomaka ʻoe e luaʻi, hiki ke lilo i pilikia.
| Inā loaʻa iā ʻoe kēia mau hōʻailona, e hele koke i ka Emergency Treatment Unit (ETU) o ka haukapila! | |
|---|---|
| 🔴 | ʻEha nui a hiki ʻole ke hoʻomanawanui ma kahi o ka hernia. |
| 🔴 | Ka pehu ʻana o ka ʻōpū lalo a me ka ʻūmiʻi. |
| 🔴 | Paʻa paʻa loa (a hiki i ka hoʻōki ʻana i ke kahe ʻana o ka ea). |
| 🔴 | Ka luaʻi a me ka luaʻi. |
| 🔴 | Lilo ka ʻili ma kahi o ka puʻu i ʻulaʻula, poni, a ʻeleʻele paha. |
Pehea ʻoe e ʻike ai i kēia, e Kauka?
Ke hele ʻoe e ʻike i ke kauka, e nīnau mua ʻo ia iā ʻoe i kahi nīnau kikoʻī e pili ana i kāu mau hōʻailona. A laila e nānā ʻo ia i kou ʻōpū.
- Hoʻokolokolo kino: E noi aku ke kauka iā ʻoe e kū, e ʻū, a e hoʻoluhi paha e ʻike inā ʻike ʻia ka puʻupuʻu.
- ʻO ka hana Valsalva: Pili kēia iā ʻoe e paʻa i kou hanu, pani i kou waha a me kou ihu, a ʻūmiʻi i kou ʻōpū. E like me kāu e hana ai i kou hele ʻana i ka lua. Hoʻonui kēia i ke kaomi i loko o kou ʻōpū, hiki ke hana i kahi hernia inā loaʻa iā ʻoe kekahi.
- Nā Hoʻāʻo Kiʻi: I kekahi manawa, inā ʻaʻole ʻike maopopo ʻia ka hernia, hiki ke ʻōlelo ʻia kahi CT scan (Computed Tomography scan) a i ʻole kahi ultrasound scan e hōʻoia iā ia.
- Laparoscopy:I kekahi mau hihia kakaikahi, e hōʻoia i ka maʻi, hiki ke hana ʻia kahi ʻoki liʻiliʻi ma ka ʻōpū a hoʻokomo ʻia kahi kāmela e nānā i ka wahi.
He aha kāu e hana nei ma ke ʻano he lāʻau lapaʻau?
ʻO ke ʻoki ʻana ka lāʻau lapaʻau maikaʻi loa a hoʻohana pinepine ʻia no ka hernia Spigelian, ʻo ia ke ʻoki ʻana, no ka mea, ʻaʻole e ho'ōla ʻia kēia ʻano hernia iā ia iho a ke halihali nei i ka pilikia o nā pilikia weliweli a mākou i kūkākūkā ai ma mua.
I ka wā o ke ʻoki kino, ua hoʻihoʻi ʻia ka ʻāpana o ka ʻōpū i puka mai i loko o ka ʻōpū a ua pani ʻia kahi nāwaliwali a i ʻole ka lua i loko o ke ʻiʻo. I kekahi manawa, hoʻohana ʻia kekahi mea e like me ka ʻupena e hoʻoikaika i ka wahi.
Hiki ke hana ʻia kēia ʻoki kino ma nā ʻano he nui. E wehewehe kāu kauka ʻoki kino iā ʻoe i ke ʻano hana kūpono loa iā ʻoe.
Leka Lawe-Home
- Inā he puʻu kou e kū mai ana ma ka ʻaoʻao haʻahaʻa o kou ʻōpū ke kū ʻoe a nalowale ke moe ʻoe, he hōʻailona paha ia o ka hernia Spigelian.
- ʻOiai inā ʻaʻohe ʻeha i ka wā mua, mai hoʻowahāwahā i kēia kūlana, no ka mea hiki ke alakaʻi i nā kūlana koʻikoʻi e like me ke ālai ʻana o ka ʻōpū.
- Inā loaʻa koke iā ʻoe ka ʻeha nui, ka pehu ʻana, ka luaʻi ʻana, a i ʻole ka paʻa ʻana o ka ʻōpū ma kahi o ka hernia, he pilikia ia. E hele koke i ka ʻOihana Pilikia o ka haukapila (ETU).
- ʻO ke ʻoki ʻana ka lāʻau lapaʻau maikaʻi loa no kēia. No laila, inā loaʻa iā ʻoe kēia mau hōʻailona, e ʻike pono i ke kauka a e kiʻi i ka ʻōlelo aʻoaʻo.
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