Wan ‘lik’ insay afta dɛn dɔn du ɔpreshɔn? (Anastomotic Leak) Lɛ wi lan bɔt am simpul wan!

Yu dɔn ɛva tink se afta dɛn dɔn du big ɔpreshɔn , prɔblɛm dɛn kin kam insay di bɔdi we wi nɔ kin ivin tink bɔt? Jɔs lɛk we yu put tu wata paip dɛn togɛda, sɔntɛnde smɔl wata kin lik frɔm di jɔyn, na so di sem tin kin apin we tu blɔd vesel dɛn na wi bɔdi kɔnɛkt tru ɔpreshɔn. Insay mɛrɛsin, wi kin kɔl dis anastomotic leak . Bikɔs dis kin rili siriɔs, i rili impɔtant fɔ mek yu ɛn di wan dɛn we yu lɛk no bɔt am.

Wetin rili na anastomotic leak?

Fɔ tɔk am simpul wan, anastomosis na di ɔspitul we dɛn kin kɔnɛkt di ɛnd dɛn fɔ tu bɔdi tiub dɛn togɛda. Imajin se yu bin gɛt fɔ pul wan pat pan yu intestinal. Dɔn yu fɔ kɔnɛkt bak di tu pat dɛn na di intestin we yu dɔn kɔt. Dɛn kɔl da kɔnekshɔn de anastomosis.

naw, dis anastomotic lik na we di kכnεkshכn nכ de sial fayn, εn di tin dεm we de insay da tכb de lik kכmכt. Dis kin denja, bikɔs i nɔ fayn fɔ mek di tin dɛn we de insay wi bɔdi in tiub dɛn go na ɔda say. Fɔ ɛgzampul, baktri dɛn de na di tin dɛn we de insay yu dijestiv sistɛm. If dɛn tin ya rich ɔda say dɛn na yu bɛlɛ, dɛn kin mek yu gɛt infɛkshɔn.

Wetin kin apin if lik de afta dɛn dɔn ɔpreshɔn di intestinal ?

bכ wel rεsεksh כn na kכmכn we dεn de du anastomosis, εn anastomotic lik kin apin. if di tin dεm we de insay di bכdi lik insay di bכdi, di layn na di bכdi (peritoneum) kin gεt infεkshכn εn swεla. Dɛn kɔl dis peritonitis . Dis infεkshכn kin spre to כda כgan dεm na di bכdi εn insay di bכdi. If i tranga, i kin mek yu gɛt wan sik we de mek yu layf de pan denja we dɛn kɔl sɛpsis . Sepsis na di bɔdi in ɔva riakshɔn to infɛkshɔn. Dis kin mek pɔsin shɔk , in bɔdi nɔ wok fayn, ɔ ivin day.

Imajin wetin go apin if di tin dɛn we de na wi kichin dɔti go rɔn go na di living rum. Di sem tin go apin if di tin dɛn we de na wi intestinal go tɔn to wi bɛlɛ. Na dat mek dis rili denja.

Wan ɔda tin we kin lik insay di bɛlɛ na yu urinary tract. Fɔ ɛgzampul, we dɛn de transplant yu kidni ɔ we dɛn de pul yu prɔstat, yu go nid fɔ du anastomosis. if dis lik, di urine kin kכlekt insay di bכdi. Dɛn kɔl dis urinoma . Risk de bak fɔ gɛt infɛkshɔn ɛn sɛpsis na do na di bɛlɛ. Fɔ ɛgzampul, if yu gɛt anastomotic lek na yu esophagus, we na pat pan yu it paip, i kin mek yu gɛt infekshɔn na yu chɛst.

Ustɛm anastomotic lek kin apin?

Sɔntɛnde dis lik kin de di tɛm we dɛn de du di ɔpreshɔn. Bɔt dɔktɔ dɛn we de du ɔpreshɔn kin chɛk fɔ am da tɛm de. Bɔrku tɛm, dis kin apun di tɛm wae pɔrsin de wɛl. Bɔku pan di lik dɛn kin apin insay di fɔs wik afta dɛn dɔn du di ɔpreshɔn , bɔt sɔm kin delay. Dɔktɔ dɛn go de wach dis fɔ sɔm wiks afta dɛn dɔn du di ɔpreshɔn. Smɔl smɔl lik kin tek lɔng tɛm fɔ sho dɛn ifɛkt. Lik we kin apin afta 30 dez (`(Delayed Anastomotic Leak)`) nɔ kin bɔku.

Aw dis sik kin kɔmɔn?

dεn ripot se anastomotik lik de apin insay lεk 5% pan di anastomosis כpεrayshכn dεm. Fɔ dɛn wan ya, 75% gɛt fɔ du wit kɔlektɔmi ɔpreshɔn. dis risk kin bכku pan כpεrayshכn dεm we dεn kin du na di εnd כf di kכlon, di rεktum כ sigmoid kכlon. Dis na bikɔs di eria smɔl ɛn i nɔ izi fɔ ɔpreshɔn pan, mɔ pan man dɛn.

Udat kin gɛt anastomotic lek mɔ?

Infakt, ɛnibɔdi we dɔn du anastomosis kin gɛt dis kɔmplikeshɔn. Bɔt sɔm tin dɛn de we kin mek i gɛt mɔ chans fɔ mek dis apin.

Di tin dɛn we kin mek pɔsin gɛt dis sik na:

• Fɔ smok.
• Malnutrishɔn ɔ anemia.
• Yuz di tin dɛn we de mek pɔsin nɔ ebul fɔ fɛt di sik.
• Fɔ gɛt di tɔŋ dɛn we nɔ gɛt bɛtɛ lɛvɛl.
• Afta dɛn dɔn du redyushɔn tɛrapi.
• כlrεdi we yu gεt wan kכndyushכn we dεn kכl ``Sepsis`` כ ``Septic Shock`` na di bכdi.
• We dɛn dɔn gi am blɔd we dɛn de du ɔpreshɔn (`(Intraoperative Blood Transfusion)`).
• Fɔ gɛt fat ɔ dayabitis (`(Diabetes Mellitus)`).
• Imejɛnsi ɔpreshɔn we dɛn kin du.
• Di ɔpreshɔn kin tek tumɔs lɔng.
• Anastomosis we de na di rεktal.
• Fɔ bi man we dɛn bɔn am (`(Assigned Male Sex)`).

Wetin kin mek dis lik?

wan anastomosis lik kin kכz fכ di fεil na di wund hεl prכsεs . I nɔ kin izi fɔ no wan rizin we mek i apin, bɔt bɔku tin dɛn kin mek i apin. Fɔ ɛgzampul:

• Tɛnshɔn pasmak na di say we dɛn de du di ɔpreshɔn: Dis na wetin di dɔktɔ dɛn kin tray fɔ avɔyd fɔ mek i nɔ lik. Dis kɔnekshɔn kin pul ɔ tayt we yu de muv. Dis risk kin big if di say we dɛn de du di ɔpreshɔn smɔl ɔ i at fɔ rich.
• Infεkshכn we bin de bifo na di bכdi kכva: If infεkshכn bin de bifo, i kin mek di tisu swel εn inflam. If yu inflamɛns fɔ lɔng tɛm, dat kin mek bak di kolagen go dɔŋ . Di dɔktɔ dɛn we de du ɔpreshɔn go was di say wit antiseptik sɔlvushɔn ɛn gi dɛn antibayɔtik.Ivin if yu tray fɔ kɔntrol di infekshɔn wit antibayɔtik, di tisu kin stil wik di tɛm we dɛn de du di ɔpreshɔn.
• di bכdi fכ fכlכ di rεdכks to di kכnekt vεsεl (`(Ischemia)`): `(Ischemia)` kin bi kכndishכn we bin de bifo כ i kin apin as rεspכns to כpεrayshכn.
• di imyuniti we wik: Sɔm wɛlbɔdi kɔndishɔn, smok, nɔ it fayn, ɔ we yu de yuz `(Immunosuppressants)` kin mek di imyun sistɛm wik. Radieshɔn tɛrapi kin pwɛl di tisu dɛn bak ɛn i kin mek di imyun sistɛm wik. Dis na bikɔs bak bɔku pipul dɛn we de du `(Anastomosis)` ɔpreshɔn na kansa pasɛnt.

Wetin na di simptom dɛm fɔ anastomotic leak?

Di fɔs ɛn kɔmɔn sayn dɛm wae dɛn kin si pan dis sik na:

• Bεlε Pen (`(Bεlε Pen)`) .
• Fiva (`(Fiva)`) .
• Abdominal swelling (i kin bi bikɔs ɔf Pɛritonitis).
• Persistent paralytic ileus (intestinal dysfunction) afta di ɔpreshɔn .

Wae de sik kin wɔs smɔl, sɔm kayn sik lɛk dis kin apin bak:

• At bit kwik kwik wan (Tachycardia) .
• Delirium (`(Dɛlirium)`) .
• Sepsis `(Sɛpsis)` .
• Shok .

Aw yu no dis klia wan?

We yu go to yu dɔktɔ afta dɛn dɔn du yu ɔpreshɔn, i go tek tɛm chɛk yu sik. Dɛn go de chɛk yu impɔtant sayn dɛn (lɛk yu puls, di we aw yu de blo, di tɛmpracha, ɛn blɔd prɛshɔn), blɔd tɛst, ɛn di we aw yu bɔdi de wok ɔltɛm. If yu gɛt ɛni sayn fɔ se yu gɛt di sik ɔ yu bɔdi nɔ de wok fayn afta dɛn dɔn du yu kɔlon ɔpreshɔn, yu dɔktɔ kin sɔprayz se anastomotic lik. Dɛn go yuz imej tɛst (lɛk skan) fɔ kɔnfɔm dis – bɔku tɛm na CT skan , we dɛn kin yuz kɔntrast day .

Aw dɛn kin trit am?

If dɛn no se yu gɛt dis kayn lik, dɛn go trit yu wit antibayɔtik fɔ kɔntrol di infekshɔn. Dɔn di tritmɛnt go dipen pan di sayz fɔ di lik ɛn aw yu sik siriɔs. Dis kin inklud:

• Drenaj: Di bɔdi nid fɔ dreyn di wata ɛn/ɔ swɛlin we dɔn gɛda bikɔs ɔf di infɛkshɔn. If i pɔsibul, di dɔktɔ go du dis bay we i de yuz di skin – dat na, tru wan ol nidul we dɛn put insay wan smɔl ol na di skin.
• Bɔwel Rɛst: If di lik de na di insay, yu go nid fɔ stɔp fɔ it ɔ drink wit yu mɔt we yu de trit yu. Yu dɔktɔ kin gi yu wata we dɛn kin put insay yu bɛlɛ.go gi am, ɛn if nid de, dɛn go gi am it we dɛn go put insay di bɛlɛ.
• Ripit Ɔpreshɔn: Di dɔktɔ kin nid fɔ chɛk di anastomosis bak ɛn du ɔda ɔpreshɔn. If i pɔsibul, dɛn go yuz wan tin we nɔ go ambɔg dɛn, lɛk fɔ du laparoskɔpi . Dis involv fɔ put kamɛra tru wan smɔl say we dɛn kɔt fɔ chɛk di bɛlɛ. Dɛn kin yuz smɔl smɔl tin dɛn bak fɔ pul wata we gɛt abses ɔ was di ol wit antiseptik sɔlvushɔn. if dis nכ wok, di bכdi kin nid fכ opin bak fכ go na di lik. di anastomosis kin nid fכ riinfors כ nyu wan kin nid fכ mek na difrεn ples wit hεlty tisu. sכmtεm, dεn nid fכ gi di bכdi mכr tεm fכ hεl bifo dεn du di anastomosis bak. We dɛn de du ɔpreshɔn pan di bɔdi, di dɔktɔ kin nid fɔ chenj sɔm pat pan di bɔdi fɔ sɔm tɛm to ostomy (nyu opin we de baypas di anastomosis ɛn alaw fɔ gɛt mɔ tɛm fɔ wɛl).

Aw lɔng i kin tek fɔ mek i wɛl?

Anastomotic lek kin mek yu de na ɔspitul fɔ 4 wik ɔ mɔ.

Dɛn nɔ go ebul fɔ mek dɛn lik dɛn ya nɔ apin?

bכku tin dεm de we kin mek di anastomotic lik de apin, bכku pan dεm dεn nכ kin chenj. Fɔ ɛgzampul, di pɔsin in wɛlbɔdi, aw i nɔ kin izi fɔ du di ɔpreshɔn, ɛn ɔda tin dɛn we kin apin we i de wɛl. Bɔt di dɔktɔ dɛn we de du ɔpreshɔn kin chɛk fɔ si if tin lik we dɛn de du di ɔpreshɔn.

Skrin we dɛn de du

di tεst dεm we dεn kin du fכ chεk fכ lik afta dεn dכn anastomosis na:

• di tεst fכ di briz: di bכdi kכva de fulכp wit salin sכlushכn εn di briz de kכmכt insay di bכdi tכb. If yu si bɔbul dɛn na di sɔlv, lik de na di kɔnɛkshɔn. Bɔku tɛm, dɛn kin mek dɛn lik dɛn ya bay we dɛn kin tay di kɔnɛkshɔn bak ɔ sutura am.
• Fluid Test: Dɛn kin injɛkt wan disinfectant sɔlvushɔn insay bɔdi tiub ɛn chɛk fɔ si if i lik.
• Kɔntrast Tɛst: If dɛn du ɔpreshɔn pan di intestinal, di dɔktɔ kin yuz CT skan ɛn kɔntrast day fɔ si if lik de. di kכntrast day de pas tru di ans to di anastomosis fכ si if eni lik de.

Pan ɔl we dɛn tɛst ya we dɛn kin du di tɛm we dɛn de du di ɔpreshɔn nɔ kin ebul fɔ mek ɔl di lik dɛn nɔ kam, dɛn kin ridyus dɛn nɔmba ɛn no di wan dɛn we gɛt ay risk fɔ mek dɛn lik bak.

Prɛvɛntiv Stoma (`(Prɛvɛntiv Stoma)`)

We dɛn de du ɔpreshɔn pan di bɔdi, di dɔktɔ dɛn kin pul di stɔl kɔmɔt na di intestinal di tɛm we i de wɛl, ɛn dis kin mek di bad bad tin dɛn we kin apin we di gut we de lik nɔ apin. Dɛn kin du dis bay we dɛn kin mek wan tɛmporari colostomy ɔ ileostomy.dεn mek wan, dεn de pul di tin dεm we de insay di intestכn frכm di kכnεkshכn pכynt εn dεn dεn dεn dεn go insay wan bag. pan ɔl we dis nɔ de mek anastomotic lik, i de mek di tin dɛn we de insay di intestin nɔ go insay di bɛlɛ if lik apin.

wan ostomy de mek wan nyu, atifishal opin fɔ mek di stɔl pas, we dɛn kɔl stoma . dis de mek di intestinal dεm fכ hεl witout di diskomfot fכ pas stכl. Sɔntɛnde, dɔktɔ dɛn we de du ɔpreshɔn kin mek wan tɛmporari, prɛvɛntiv ostomy. dεn rεkomεnd fכ tεmporari ostomy as prεvεntεtiv mεzhɔ fכ pipul dεm we de pan hεy risk fכ divεlכp anastomotic lik.

Wetin na di luk fɔ di wan dɛn we dɔn gɛt anastomotic leak?

Bɔku tɛm, dɛn kin mek di say dɛn we lik we dɛn kin fɛn. Bɔt fɔ no di sik kwik kwik wan ɛn fɔ trit am impɔtant fɔ kɔntrol di infɛkshɔn ɛn fɔ mek yu nɔ gɛt sɛpsis. in jεnarכl, pipul dεm we gεt anastomotic lik gεt hכy risk fכ fכs hεlth kכmplikεshכn dεm εn fכ day. I nɔ klia to us mak dɛn autkam ya de bikɔs ɔf di anastomotic lik insɛf, ɔ if di lik na simptom fɔ wan jenɛral wɛlbɔdi prɔblɛm.

Ustɛm a fɔ go to mi dɔktɔ?

If yu de wɛl frɔm anastomosis, de nia yu dɔktɔ ɛn ripɔt ɛni sayn we yu nɔ bin de ɛkspɛkt. Go to dɔktɔ wantɛm wantɛm if yu gɛt ɛni sayn fɔ se yu gɛt di sik. Fɔ ɛgzampul:

• Fiva.
• Bɛlɛ de at.
• Inflameshɔn (rɛd, swel).

Us kwɛstyɔn dɛn a fɔ aks mi dɔktɔ bifo dɛn du ɔpreshɔn pan mi anastomosis?

If yu de gɛt anastomosis ɛn yu de wɔri bɔt anastomotic lik, yu kin aks yu dɔktɔ bɔt yu pasɔnal risk factors, us prɛvɛnshɔn mɛsej dɛn kin tek, ɛn us intavɛnshɔn dɛn kin rɛkɔmɛnd fɔ yu. Fɔ ɛgzampul:

• Mi ɔpreshɔn de pan ay risk fɔ anastomotic lik?
• Mi sɛf de pan big risk?
• Aw yu kin kɔntrol `(Anastomotic Leak)`?
• Yu kin chɛk fɔ si if i lik we dɛn de du di ɔpreshɔn?
• Aw a kin chɛk fɔ si if lik afta dɛn dɔn du mi ɔpreshɔn?
• Wetin kin apin if a gɛt lik afta dɛn dɔn ɔpreshɔn mi?

If yu nid fɔ du anastomosis, i go mɔs bi se na tin we go sev yu layf. Na dis kayn tɛm, i nɔ kin izi fɔ ivin tink bɔt wan prɔblɛm we go mek pɔsin in layf de pan denja frɔm di ɔpreshɔn insɛf. As di dɔktɔ dɛn kin fred am, anastomotic leak kin apin ɔltɛm. Bɔt ɔltogɛda, di risk nɔ bɔku. Ɛn, wit ɔwe ɛn intavɛnshɔn kwik, dɛn kin ebul fɔ manej bɔku kes dɛm.

Di tin dɛn we impɔtant pas ɔl fɔ mɛmba (Take-Home Message) .

• Anastomotic leak na di lik we di tin dεm we de insay de lik frכm tu kכnekt tכb dεm afta dεn כpεrayshכn.
• Dis kin apin ɛnisay, lɛk di intestinal ɔ di urinary tract.
• If yu gɛt sɔm sayn dɛn lɛk fiva, bɛlɛ pen, ɔ blo, go to dɔktɔ wantɛm wantɛm.
• Dis risk kin bɔku pan tin dɛm lɛk fɔ smok, dayabitis, ɛn nɔr de it fayn.
• If dɛn no se i gɛt am ɛn trit am kwik, bɔku tɛm i kin wɛl. Bɔt if dɛn nɔ trit am, i kin denja.
• If dɛn de du ɔpreshɔn pan yu, tɔk to yu dɔktɔ opin wan bɔt dat. Tɔk klia wan bɔt di prɔblɛm dɛn we yu kin gɛt, wetin fɔ du fɔ mek yu nɔ gɛt dɛn, ɛn wetin fɔ du if lik apin. Awareness na di bɛst difens!

` Anastomotik Lik, Ɔspitul Kɔmplikɛshɔn, Bɔwel Ɔpreshɔn, Pɛritonaytis, Sɛpsis, Pɔstɔparetiv Keya, Ɔspitul Risk