ʻAʻole anei i ʻō ʻia kāu pēpē hānau hou no ʻelua a ʻekolu paha lā ma hope o ka hānau ʻana? A i ʻole ua pehu wale ko lākou ʻōpū a paʻakikī ke pā? He mea maʻamau no ka makuahine a makua kāne hou ke makaʻu iki i ka wā e ʻike ai lākou i kahi mea e like me kēia. ʻO ka hapa nui o ka manawa, ʻaʻole kēia he mau mea koʻikoʻi. Eia nō naʻe, i nā hihia kakaikahi, hiki ke hana ʻia kēia mau hōʻailona e kahi maʻi i kapa ʻia ʻo ka maʻi ʻo Hirschsprung , a mākou e kamaʻilio nei i kēia lā. No laila, e kamaʻilio kākou e pili ana i kēia me ka kikoʻī me ka makaʻu ʻole.
I ka ʻōlelo maʻalahi, he aha ka maʻi ʻo Hirschsprung?
He maʻi laha ʻole ka maʻi Hirschsprung, he maʻi hānau hānau kahi i hānau ʻia ai kahi pēpē me ka ʻole o nā hunaola aʻalolo ma ka ʻāpana hope o ka kolona e kōkua ana i ka hoʻokuke ʻana i ka ʻōpala i waho.
E noʻonoʻo i ko kākou ʻōpū me he paipu lā. Hoʻoheheʻe ʻia ka meaʻai a kākou e ʻai ai, a hele nā huahana ʻōpala, i kapa ʻia he feces, i lalo o kēia paipu. Kōkua ʻia kēia huakaʻi e nā hunaola nerve i loko o nā paia o nā ʻōpū. Hoʻouna kēia mau hunaola i nā hōʻailona i nā ʻiʻo i loko o nā ʻōpū, e hoʻoulu ana iā lākou e ʻūlū a hoʻomaha, e hoʻokuke ana i nā feces i mua.
ʻAʻohe o kēia mau hunaola aʻalolo o ka pēpē me ka maʻi Hirschsprung ma ka hopena o ka ʻōpū nui. No laila, ke komo mai ka ʻōpala, ʻaʻole hiki ke neʻe a paʻa. E like me nā kaʻa e paʻa ana i ke kaʻa. ʻO kēia ke kumu o ka hōʻiliʻili ʻana o ka ʻōpala a hana i kahi poloka nui i loko o ka ʻōpū. Hiki i kēia ke kumu i ka pēpē e loaʻa i ka paʻa paʻa nui, ka pale ʻana o ka ʻōpū, a i kekahi manawa nā maʻi weliweli .
ʻO ka maʻamau, loaʻa i kahi pēpē olakino ko lākou neʻe ʻōpū mua i loko o nā hola 24-48 mua o ka hānau ʻana. Ua kapa ʻia kēia ʻōpala mua ʻo 'meconium'. He mea ʻeleʻele a mānoanoa hoʻi ia. Eia nō naʻe, ʻaʻole hiki i kahi pēpē me ka maʻi Hirschsprung ke loaʻa i kēia ʻano neʻe ʻōpū.
He aha ke kumu kikoʻī o kēia kūlana?
ʻAʻole maopopo i nā kauka ke kumu e loaʻa ai kēia maʻi i kekahi mau pēpē, akā ua manaʻo nui ʻia he pili ia i nā genes .
I ka ʻōlelo maʻalahi, i loko o nā pule mua o ka ulu ʻana o kahi pēpē i loko o ka ʻōpū, ulu nā hunaola aʻalolo ma loko o ke ala ʻai holoʻokoʻa o ka pēpē, mai ka waha a i ka anus. Akā i loko o kahi pēpē me ka maʻi Hirschsprung, pau koke ka ulu ʻana o kēia hunaola aʻalolo ma ka hopena o ka ʻōpū nui.
Hiki paha kēia ma muli o kekahi mau loli (nā hoʻololi ʻana) i loko o ka DNA o ko kākou kino, e like me ka puke kuhikuhi. I kekahi manawa hiki ke hoʻoilina ʻia kēia mau loli genetic mai nā mākua a i nā keiki. Eia kekahi, ʻoi aku ka nui o ka pilikia o nā keiki me nā maʻi hānau ʻē aʻe, e like me Down syndrome, a me kekahi mau maʻi puʻuwai, i ka loaʻa ʻana o ka maʻi Hirschsprung.
Pehea mākou e ʻike ai i kēia mau hōʻailona?
ʻO ka hapa nui o ka manawa, ʻike ʻia kēia mau hōʻailona i loko o nā pule 6 mua o ke ola, ʻoi aku hoʻi i loko o nā hola 48 mua. Eia nō naʻe, i kekahi mau keiki, hiki ke hala kekahi mau makahiki e ʻike ʻia ai nā hōʻailona.
Pono ʻoe e makaʻala i nā ʻano o lalo.
| ʻAno | Wehewehena |
|---|---|
| ʻAʻole e hoʻohaumia | ʻO kekahi o nā hōʻailona nui o kahi pēpē hānau hou, ʻo ia ka neʻe ʻole ʻana o ka ʻōpū ma hope o 48 mau hola o ka hānau ʻana. Inā ʻoi iki ka nui o ka pēpē, loaʻa paha iā lākou ka paʻa mau ʻana no ka manawa lōʻihi a ʻaʻole pane i ka lāʻau lapaʻau. |
| Pehu ʻōpū | Hiki ke ʻike ʻia ka ʻōpū o ke pēpē he pehu a paʻakikī ma muli o ka ʻōpala a me ka ea i paʻa i loko o nā ʻōpū. |
| Ka luaʻi ʻana | Hiki i ka pēpē ke luaʻi. I kekahi manawa, ʻōmaʻomaʻo a ʻeleʻele paha kēia luaʻi. ʻO ke ʻano paha kēia e piʻi mai ana ka ʻōpū ma muli o kahi paʻa i loko o nā ʻōpū. |
| Ka maʻi kahe koko | He hōʻailona weliweli loa kēia. Hōʻike ia i ka ulu ʻana o kahi maʻi ʻōpū hoʻoweliweli ola i kapa ʻia ʻo enterocolitis . Hiki ke hele pū me ke kuni, ka maʻi pākī nui, a me ka ʻeha ʻōpū. |
| ulu kūpilikiʻi | Inā ua ʻelemakule iki ke keiki a ʻaʻole i ʻike ʻia ua loaʻa iā ia ka maʻi, hiki i ka paʻa pinepine ʻana o ka paʻa ʻana a me ka ʻai pono ʻole ke kumu o ka ulu ʻole ʻana a me ka luhi mau. |
ʻO ka mea nui loa, inā loaʻa i kāu pēpē kekahi o kēia mau hōʻailona, ʻoiai inā ʻaʻole e ʻōpala ana kahi pēpē hānau hou, mai hoʻowahāwahā iā ia. He mea nui e lawe koke i kāu pēpē i ke kauka.
Pehea e ʻike pololei ai ke kauka i kēia maʻi?
Ke lawe ʻoe i kāu keiki i ke kauka, e nānā ʻo ia i kāu keiki, e nīnau iā ʻoe e pili ana i kāu mau hōʻailona, a laila e paipai i kekahi mau hoʻokolohua e hōʻoia i ka maʻi.
- ʻŌpū X-ray: Hiki ke hoʻohana ʻia kēia e nānā no ka pale ʻana o ka ʻōpū a i ʻole ka pehu.
- ʻEnema Hoʻohālikelike: Ma kēia, ua hoʻokomo ʻia kahi wai keʻokeʻo kūikawā (kahi kala i kapa ʻia ʻo barium) ma o ka rectum o ke pēpē a ua lawe ʻia kekahi mau kiʻi X-ray. ʻAe kēia wai i ka ʻike maopopo ʻana i loko o ka ʻōpū. ʻO ka ʻāpana me nā hunaola nerve ʻole e like me ka lahilahi, ʻoiai ʻo ka ʻāpana i piha i ka ʻōpala ma luna e like me ka nui a me ka pehu. Hiki i kēia ke hāʻawi i kahi manaʻo maikaʻi o ka maʻi.
- ʻO ka Rectal Biopsy: ʻO kēia ka hoʻāʻo e hōʻoia i ka maʻi 100%. Ma kēia, lawe ke kauka i kahi ʻāpana liʻiliʻi loa o ka ʻiʻo (laʻana o ka ʻiʻo) mai ka paia o loko o ka rectum o ke keiki a nānā iā ia ma lalo o kahi microscope. Ma ka nānā ʻana inā he mau hunaola nerve i loko o kēlā ʻāpana ʻiʻo, hiki ke hoʻoholo pololei ʻia ka maʻi.
- Anorectal Manometry: Hana pinepine ʻia kēia hoʻāʻo ma nā keiki makua. Pili ia i ke kau ʻana i kahi mea liʻiliʻi e like me ka pōpō i loko o ka rectum a hoʻopiha iā ia e nānā inā e hana pono ana nā ʻiʻo o ka rectum.
He aha nā lāʻau lapaʻau no kēia?
ʻAʻole hiki ke ho'ōla ʻia ka maʻi Hirschsprung me ka lāʻau lapaʻau. ʻO ke ʻoki kino wale nō a mau loa no ia mea . Mai hopohopo, ke hana ʻia nei kēia ʻoki kino me ka holomua nui.
I ka wā o ke ʻoki kino, wehe ke kauka i ka ʻāpana o ka kolona i nele i nā hunaola aʻalolo a hoʻopili pololei i ka ʻāpana olakino a piha i nā aʻalolo o ka kolona i ka rectum. Ua kapa ʻia kēia ʻoki kino he "pull-through procedure."
I kekahi manawa, ma muli o ke kūlana o ke keiki, hiki ke hana ʻia kahi ʻoki "ostomy" manawa pōkole ma mua o kēia ʻoki nui. Pili kēia i ka hana ʻana i kahi puka (stoma) i hiki ai i kahi ʻāpana o ka ʻōpū olakino ke hele mai i ka ʻili o ka ʻōpū. A laila, hoʻopili ʻia kahi ʻeke ostomy i kēia puka e hōʻiliʻili i ka ʻōpala. Ke hoʻōla iki ke keiki a mākaukau no ke ʻoki nui, pani ʻia kēia puka a hana ʻia kahi ʻoki huki.
He aha nā pilikia e hiki ke hana ma hope o ke ʻoki ʻana?
Hiki i ka hapa nui o nā keiki ke loaʻa nā neʻe ʻōpū maʻamau ma hope o ke ʻoki ʻana a hoʻomau i ke ola olakino. Eia nō naʻe, hiki i kekahi mau keiki ke loaʻa i kekahi mau pilikia ma hope o ke ʻoki ʻana. He mea nui e makaʻala i kēia.
ʻO ka enterocolitis e pili ana iā Hirschsprung
ʻO kēia ka pilikia weliweli loa . Hiki ke hana ma mua a ma hope paha o ke ʻoki ʻana. He maʻi koʻikoʻi ia o nā ʻōpū.
Inā loaʻa i kāu keiki nā hōʻailona ma hope o ke ʻoki ʻana, e like me ke kuni, ka pehu ʻana o ka ʻōpū, ka luaʻi ʻana, ka maʻi kahe nui, a i ʻole ke koko i loko o ka ʻōpala, he pilikia ia. E lawe koke i kāu keiki i ka ʻOihana Pilikia o ka haukapila (ETU).
Ka hoʻōki ʻana o ka fecal
Hiki i kekahi mau keiki ke pilikia i ka hoʻokele ʻana i ko lākou neʻe ʻana o ka ʻōpū ma hope o ke ʻoki ʻana. ʻO ke ʻano kēia, hiki iā lākou ke hele i ka ʻōpala me ka ʻike ʻole. Hiki paha kēia ma muli o nā hopena o ke ʻoki ʻana i nā ʻiʻo o ka rectum. Me ka manawa a me kekahi mau hoʻoikaika kino (pelvic physical therapy), hiki ke hoʻomalu ʻia kēia kūlana i kahi nui.
Ka paʻa ʻana a me nā mea e ālai ai
Hiki i kekahi mau keiki ke loaʻa i ka paʻa ʻōpū ma hope o ke ʻoki ʻana. Hiki paha kēia ma muli o ka haiki ʻana o kahi ʻoki ʻana a i ʻole nā kumu ʻē aʻe. I ia mau hihia, e kuhikuhi kāu kauka i ka lāʻau lapaʻau e pono ai.
ʻOiai inā ua mālama ʻia kēia ʻano ma ke ʻoki ʻana, he mea nui e hoʻomau i ka nānā ʻana i ke kūlana o ke keiki. E kamaʻilio pinepine me ke kauka e pili ana i nā ʻano ʻōpū a me ka ʻai a kāu keiki.
Leka Lawe-Home
- ʻO ka maʻi ʻo Hirschsprung kahi kīnā hānau kakaikahi e kumu ai i ka hiki ʻole ke hoʻokahe i ka ʻōpū ma muli o ka nele o nā hunaola nerve i loko o ka ʻōpū.
- ʻO nā hōʻailona nui o ka ʻōpū ʻole o kahi pēpē hānau hou i loko o 48 mau hola, ka ʻōpū pehu, a me ka luaʻi ʻōmaʻomaʻo/ʻeleʻele: Inā ʻike ʻoe i kēia mau mea, e ʻike koke i ke kauka.
- Ua hōʻoia ʻia kēia maʻi e kahi biopsy.
- ʻO ke ʻoki kino ke ʻano o ka lāʻau lapaʻau. Ma hope o ke ʻoki kino kūleʻa, hiki i ka hapa nui o nā keiki ke ola maʻamau.
- Inā loaʻa iā ʻoe nā hōʻailona e like me ke kuni, ka pehu ʻana o ka ʻōpū, a i ʻole ka maʻi kahe koko ma hope o ke ʻoki ʻana, pono ʻoe e hele koke i ka Emergency Department (ETU) o ka haukapila, no ka mea, he hōʻailona paha kēia o kahi maʻi weliweli i kapa ʻia ʻo enterocolitis.
- He kūlana kēia e pono ai ka nānā ʻana i ke ola holoʻokoʻa. No laila, he mea nui loa e hahai i nā ʻōlelo a ke kauka a e nānā mau ʻia kāu keiki.
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