Omusuwa gwo gukutuse? (Esophageal Rupture) Kino kya maanyi, ka tuzuule ebisingawo!

Wali ofunye obulumi obw’amaanyi mu kifuba mu bwangu, okukaluubirirwa okumira, n’okukaluubirirwa okussa? Mu biseera ng’ebyo, tetukirowoozaako wadde, naye kiyinza okuba eky’akabi ennyo. Embeera emu ey’amaanyi bwetyo gye tugenda okwogerako leero kwe kukutuka kw’omumwa gwa nnabaana, oba `(Esophageal Rupture)`. Kino kikulu nnyo okukimanya, kubanga obujjanjabi obw’amangu busobola n’okutaasa obulamu.

Okukutuka kw’omumwa gwa nnabaana kye ki? Mu ngeri ennyangu...

Omumwa gwa nnabaana gwe tubu etambuza emmere gye tulya n’okunywa okuva mu kamwa kaffe okutuuka mu lubuto lwaffe. Kilowoozeeko nga payipu y’amazzi. Kale, singa wabaawo ekituli, okukutuka oba okukunya wonna mu bbugwe w’omusuwa guno, ekyo kye tuyita okukutuka kw’omumwa gwa nnabaana.

Kati osanga olowooza nti, "Kale kiki ekinene ennyo ku kino?" Nedda, eno mbeera ya maanyi nnyo . Lowooza ku kino, omukka gwaffe ogw’omukka gubeera munda mu kifuba, wakati w’amawuggwe. Si mmere yokka gye tulya n’okunywa, wabula n’obuwuka n’eddagala erikwatagana n’enkola yaffe ey’okugaaya emmere biyita mu nnyindo eno. Kale, singa wabaawo ekituli mu nnyindo, ebintu bino byonna bisobola okukuŋŋaanyizibwa munda mu kifuba, mu mawuggwe oba mu musaayi. Singa ekyo kibaawo , yinfekisoni ez’amaanyi ziyinza okubaawo, ekiyinza okutta obulamu.

Eno y’ensonga lwaki kyetaagisa okugenda mu basawo amangu ddala nga bwe kisoboka, mu ssaawa 24, bw’oba ​​oteebereza embeera eno. Oluusi, kiyinza okujjanjabibwa n'enkola nga ``Endoscopy'' oba okulongoosa.

Embeera eno ya bulijjo etya?

Mu butuufu, ennyindo ekutuse mbeera ya bbula nnyo . Ekyo kitegeeza nti si kintu buli muntu ky’afuna. Naye singa omuntu akifuna, kiba kya maanyi nnyo, n’olwekyo kikulu okukimanya.

Njawulo ki eriwo wakati w’ennyindo eyatika n’embeera zino endala?

Oluusi abantu kino bakitabula n’embeera endala ezirina obubonero obufaananako bwe butyo. Ka tulabe ebyo bye biruwa.

Okukutuka kw’omumwa gwa nnabaana n’okukutuka kwa Mallory-Weiss

``Maziga ya Mallory-Weiss`` kwe kukutuka oba okunyiga kwokka mu lining y'omumwa gwa nnabaana. Tebuyita mu bbugwe w’omumwa gwa nnabaana , ekitegeeza nti tebukola kinnya. Kyokka mu nnywanto ekutuse, ekisenge kikutuse ddala.

Okukutuka kw’omumwa gwa nnabaana n’okukutuka kw’omumwa gwa nnabaana

Wano emisuwa mu nseke z’omusulo bwe gizimba, ne gigaziwa era ne gikutuka. Kino kiyinza okuvaako omusaayi omungi , naye tekitegeeza nti omusulo gwennyini gukutuse. Bbugwe w’omusulo teyononeka.

Omukutu guno ogw’amaziga gubaawo gutya?

Ebiseera ebisinga, okukutuka mu nnywanto kubaawo ng’omumwa gwa nnabaana gwonoonese mu ngeri emu oba endala . Okwonooneka kuno kuyinza okuba okw’ebweru oba okw’omunda. Obuvune obumu busobola okubaawo mu bwangu, okuva ku kabenje, ate obulala busobola okukula mpolampola ng’ekiseera kigenda kiyitawo.

Tekitera nnyo, omumwa gwa nnabaana guyinza okukutuka mu bwangu olw’okunyigirizibwa okuyitiridde. Kino era kiyitibwa ``Boerhaave's syndrome.'' Kino kitera okubaawo nga waliwo okusesema okuyitiridde, okumala ebbanga eddene.

Kiki ekisinga okuvaako emimiro okukutuka?

Ebiseera ebisinga, okukutuka kw’omumwa gwa nnabaana kuva ku kwonooneka okubaawo mu kiseera ky’obujjanjabi (`iatrogenic ruptures`). Kino kiyinza okubaawo naddala mu bujjanjabi obuzingiramu okuyingiza ``endoscope`` mu nnywanto. ``Endoscope`` ye ttanka entono nga kuliko kkamera. Guyingizibwa mu kamwa ne gukozesebwa okwekebejja n’okujjanjaba omusulo.

Waliwo ensonga endala?

Yee, waliwo ensonga endala eziwerako:

• Okulongoosa mu nnywanto naddala Nissen fundoplication ne myotomy.
• Okunyigirizibwa okuyitiridde: embeera ezirimu okunyigirizibwa ennyo, gamba ng’okusesema obutasalako, okusitula ebintu ebizito, okukonziba oba okuzaala.
• Okumira ekintu ekigwira oba eddagala erikambwe: Oluusi abaana abato basobola okumira mu butanwa ssente, ebitundu by’ebintu eby’okuzannyisa, oba singa omuntu anywa ekintu ekikambwe, nga asidi.
• Obuvune ebweru w’omumwa gwa nnabaana: Ebintu ng’ekiwundu ekifumitiddwa, ekiwundu ky’amasasi oba ekiwundu olw’akabenje k’emmotoka.
• Chronic acid reflux (GERD): Asidi w’olubuto bw’addamu okuyingira mu nnywanto asobola okuvaako amabwa okutondebwa, ekiyinza okugenda nga kizitowa mpolampola ne kivaako okukutuka kw’omumwa gwa nnabaana.
• Puleesa ereetebwa ekizimba oba ekintu ekigwira ekikwatiddwa mu musulo: Kino kiyinza okuvaako okufa kw’ebitundu by’omubiri (necrosis) mu musulo.

Ani ali mu bulabe obw’amaanyi olw’ensonga eno?

Omusulo gwaffe gwa njawulo katono ku bitundu by’omubiri ebirala. Kwe kugamba, obutafaananako bitundu birala , omusulo tegulina kibikka kikuuma (serosal layer) kungulu . Kino kifuula omusulo okusobola okwonooneka. Obulabe buno buba bungi naddala singa wabaawo yinfekisoni, okuzimba oba obuvune munda mu musulo.

Bw’oba ​​obadde n’embeera emu ku zino wammanga emabegako, obulabe bwo obw’okufuna ekikuta ekikutuse buyinza okweyongera katono:

• Obulwadde bw’olubuto obutawona (`Obulwadde bwa asidi obutawona / GERD`).
• Eosinophilic esophagitis (embeera ereeta okuzimba mu nnywanto).
• Esophageal diverticulum (akatundu akatono akafuluma nga kalinga ensawo mu bbugwe w’omumwa gwa nnabaana).
• Okubeera ne kookolo w’omumwa gwa nnabaana oba ng’ofunye obujjanjabi obw’amasannyalaze (radiation therapy) okutuuka ku nnywanto.
• Okunywa omwenge ekisusse.
• Olw’okuba yalongoosebwa emimiro emabegako.

Bubonero ki obulaga kino? Ka tuzuule ddala!

Obubonero obusinga okulabika ng’ennyindo ekutuse bwe buno:

• Obulumi obw’amaanyi mu kifuba - Buno bwe bubonero obukulu.
• Okukaluubirirwa okumira .
• Okussa obubi .
• Omutima okukuba amangu .
• Ekikeeto .
• Okusesema omusaayi .
• Puleesa eya wansi .
• Omusujja .

Ebiseera ebisinga, okukutuka kubaawo mu kitundu kya wakati oba ekya wansi mu kifuba. Mu mbeera eno, obulumi buwulirwa mu kifuba. Kyokka singa okukutuka kubaawo mu kitundu eky’okungulu oba ekya wansi ennyo eky’emimiro, obulumi buno buyinza okuwulira mu bulago, mu lubuto olwa waggulu oba mu kibegabega ekya ddyo.

Bw’oba ​​olina obubonero buno obumu oba obusingawo, tobubuusa maaso. Kikulu okugenda ew’omusawo amangu ddala naddala ng’obubonero buno buwerekerwako obulumi obw’amangu obw’amaanyi mu kifuba.

Bizibu ki eby’akabi kino bye kiyinza okuleeta?

Ebirimu mu lubuto n’obuwuka bwe bikulukuta nga biyita mu kinnya ekiri mu nnywanto, embeera ez’akabi eza buli ngeri ziyinza okubaawo. Teebereza, kiringa ttanka y’amazzi encaafu ng’erina ekituli era ng’amazzi gakulukuta wonna.

• Okuzimba kw’eddagala (pleurisy) ku lining y’ekifuba kuyinza okubaawo.
• Amazzi gakuŋŋaanyizibwa munda mu kifuba (pleural effusion), ekiyinza n’okukutuka.
• Empewo esobola okusibira mu kifo ekiri wakati w’amawuggwe (the `mediastinum`) (`mediastinal emphysema`).
• Okuzimba kuno kuyinza okuvaako okufa kw’ebitundu by’omubiri (necrosis) mu kifuba oba wakati w’amawuggwe.
• Obulwadde bwa bakitiriya mu musaayi (`septicemia`) buyinza okubaawo.
• Embeera eno eya ``septicemia'' bw'efuuka ey'amaanyi, eyinza okuvaako embeera eyinza okutta obulamu eyitibwa ``sepsis'', ekiyinza okutuuka ekiseera ne kivaako ``septic shock'' n'okulemererwa kw'ebitundu by'omubiri.

Bino byonna biraga engeri ennyindo eyatika gyeri ey’amaanyi.

Omanya otya mu bukakafu oba omusuwa gwo gwakutuse? Ddi lw’osaanidde okulaba omusawo?

Bw’oba ​​olina ky’oteebereza nti olina embeera eno, genda mu kisenge ky’abalwadde ab’amangu mu ddwaaliro (ER) mu bwangu. Obulumi obw’amaanyi, okukaluubirirwa okumira, n’okukaluubirirwa okussa byonna kabonero akalaga nti waliwo embeera ey’amangu. Kakasa nti obuulira omusawo wo engeri entuufu obubonero bwo gye bwatandika n’ebyo ebyaliwo mu kiseera ekyo.

Singa obubonero buno bwatandika oluvannyuma lw’akabenje, okumira ekintu ekitasaana, oba okusesema ennyo, kiyinza okuba ng’omumwa gwa nnabaana gukutuse. Omusawo ajja kunoonya obujulizi ku kino.

Abasawo kino bakizuula batya?

Omusawo agenda kulagira okukeberebwa okuwerako okukebera oba waliwo okukutuka mu nnywanto.

• Okusooka, kitera okukolebwa X-ray y’ekifuba okukebera oba amazzi gakulukuta oba ebiwujjo by’empewo mu kifuba.
• Okusobola okukakasa kino, oyinza okusabibwa okukeberebwa okulala okukwata ku X-ray okuyitibwa esophagogram . Mu kukebera kuno, onywa amazzi aga langi (contrast dye) ne bakubwa X-ray. Kino kikusobozesa okulaba obulungi munda mu nnywanto yo. Singa amazzi gano aga langi gakulukuta okuva mu kinnya, gajja kulabika bulungi ku X-ray. Kino nakyo kisobola okumanya ekituli we kiri n’amangu bwe kikulukuta.
• OluusiEra kiyinza okulagirwa okukeberebwa CT scan. Kino kikulu nnyo naddala singa kiteeberezebwa nti waliwo okukutuka mu nnywanto eya waggulu oba eya wansi. CT scan esobola okuyamba okuzuula ebitundu amazzi agakuŋŋaanyiziddwa mu bulago oba mu lubuto n’okuzuula oba byetaaga okuggyibwamu.

Bujjanjabi ki eri kino?

Waliwo obujjanjabi obuwerako obw’omutindo ku kino:

• Amazzi agayingira mu misuwa (IV fluids): Okukyusa amazzi agabula olw’okuvaamu omusaayi, okusesema oba obutasobola kunywa.
• IV antibiotics ne/oba antifungals: Okuziyiza yinfekisoni yonna oba okujjanjaba yinfekisoni eriwo.
• Endya mu IV oba okuliisa mu ttanka: Tojja kusobola kumira mmere na kamwa ng’ojjanjabwa n’okutuusa ng’owonye.
• Okufulumya amazzi mu lususu: Kino kiyinza okwetaagisa okuggyawo n’okutta obuwuka amazzi agalina obuwuka agakuŋŋaanyiziddwa mu bifo by’omubiri gwo. Omusawo ajja kugezaako okuggyamu amazzi gano ng’ayingiza empiso oba ttanka mu kifuba kyo mu bwangu nga bwe kisoboka.
• Obujjanjabi obuyitibwa endoscopic: Amaziga agamu amatonotono agatonotono gasobola okujjanjabibwa awatali kulongoosebwa nga okozesa endoscope. Endoscope ye ttanka empanvu nga kuliko kkamera. Kiyingizibwa okuyita mu mumiro mu nnywanto era amaziga gasobola okuddaabirizibwa n’ebikwaso, emisono, sipongi ya vacuum oba stent.
• Okulongoosebwa: Abantu abamu beetaaga okulongoosebwa okuddaabiriza obutereevu amaziga. Mu kulongoosa, omusawo alongoosa aggyamu amazzi agasukkiridde n’ebitundu ebifu. Okusinziira ku mbeera yo, omusawo akulongoosa ayinza okukozesa enkola etali ya kuyingirira nnyo, gamba nga Video-Assisted Thoracoscopic Surgery (VATS) . Kyokka, mu mbeera ezimu ez’amangu, kiyinza okwetaagisa okulongoosebwa mu lwatu. Kino kisobozesa okutuuka amangu era obulungi mu kifo ekyonoonese.

Kisoboka okuwona embeera eno? Kiki ekiyinza okuwona?

Yee, ennyindo eyatika esobola okuwona. Kyokka, okuteebereza kwo kisinziira ku ngeri gy’onoonya amangu obujjanjabi. Gy’okoma okutwala ekiseera ekiwanvu obuwuka buno okusaasaana okuyita mu kifuba ne buyingira mu musaayi, gy’okoma okubeera n’akabi akakulu.

Abo abafuna obujjanjabi mu ssaawa 24 ezisooka nga bakutuse balina emikisa mingi okuwona mu bujjuvu. Omuwendo gw’abawangaala mu kibinja kino guli nga 85%. Wabula singa essaawa 48 ziyitawo nga tewali bujjanjabi, omuwendo ogwo gukka okutuuka ku bitundu 50%.

Kino tekiraga ngeri obujjanjabi nga bukyali bwe bukulu?

Obubaka Obusembayo Okutwala Awaka

Ennyindo ekutuse mbeera ya ntiisa naye nga tetera kubaawo. Kyokka, bwe kibaawo, kiyinza okuba ekizibu okukitegeera amangu ago. Eno y’ensonga lwaki kikulu obutabuusa maaso bulumi mu kifuba.

Omusuwa gwaffe gugonvu era kyangu okwonooneka. Kiyinza okwonooneka mu ngeri gy’otosuubira. Ekyo bwe kibaawo, oyinza obutategeera bulumi gye buva oba kye butegeeza. Kyokka, tomala galowooza nti, "Kino kijja kumala kugenda."

Bw’oba ​​obaddeko obulumi obw’amangu, obw’amaanyi mu kifuba, oba okulumwa mu mumiro oba mu lubuto olwa waggulu, genda mu kifo eky’abalwadde ab’amangu amangu ddala. Ne bwe kiba kifumita ekitono kiyinza okuvaako okukwatibwa yinfekisoni n’ebizibu byonna eby’obulabe bye twayogeddeko emabegako. Obulamu bwo bwa muwendo, n’olwekyo faayo ku bubonero era genda mu basawo amangu ddala nga bwe kisoboka.

` Okukutuka kw’omumwa gwa nnabaana, Obulumi mu kifuba, Okukaluubirirwa okumira, Okukaluubirirwa okussa, Boerhaave Syndrome, Obujjanjabi obw’amangu