Ekyenda kyo kyalekera awo okukola mu bwangu? Tumanye embeera eno ey'akabi (Ogilvie Syndrome)!

Wali ofunyeeko ku kuwulira ng’ojjudde mu bwangu n’owulira ng’olubuto lunyiga? Kiringa ekintu ekikusibye mu lubuto, naye si bwe kiri. Ekyo kye kika ky’embeera eyeewuunyisa, eyinza okuba ey’akabi gye tugenda okwogerako leero. Kiyitibwa obulwadde bwa Ogilvie Syndrome. Ka tulabe kiki kye kiri, lwaki kibaawo, engeri y’okukitegeera n’engeri y’okukijjanjaba.

Obulwadde bwa Ogilvie Syndrome kye ki?

Mu ngeri ennyangu, Ogilvie Syndrome ye colon yo bw’ekoma okukola mu bwangu awatali nsonga. Abasawo era bakiyita acute colonic pseudo-obstruction (ACPO) . "Pseudo-obstruction" kitegeeza nti ekyenda ekinene kyo kikola nga bwe kizibiddwa ekintu, naye mu butuufu , tewali kintu kyonna kizibiddwa mu mubiri . Obuzibu buli mu nkola efugira entambula y’ekyenda ekinene. Kwe kugamba, ekoma okusika emmere n’ebyokunywa mu maaso ng’eyita mu kyenda ekinene. Olwo, ebintu ng’emmere n’empewo bikuŋŋaanyizibwa munda mu kyenda ekinene ne kivaako ebisenge by’ekyenda ekinene okugaziwa oba okubumbulukuka. Kilowoozeeko ng’akalippagano k’ebidduka, mmotoka gye zilekera awo okutambula n’oluguudo ne luzibikira.

Ogilvie Syndrome ya njawulo etya ku bizibu ebirala eby’obulimba eby’ekyenda?

Ogilvy syndrome mbeera ya maanyi nnyo . Kino kitegeeza nti kijja mu bwangu ate nga kya kaseera buseera. Kikosa ekyenda ekinene kyokka . "Okuziyiza okw'obulimba mu byenda" kigambo kya bulijjo. Kitegeeza obutakola bulungi bwonna obubaawo nga tewali kiziyiza kyonna mu mubiri mu byenda. Abantu abamu balina obuzibu bw’ekyenda obutawona , oluusi nga buva ku bulwadde obulala obw’ekiseera ekiwanvu oba embeera ey’obuzaale.

Njawulo ki eriwo wakati w’obulwadde bwa Ogilvie Syndrome ne Paralytic Ileus?

Paralytic ileus nayo nsonga ya acute intestinal pseudo-obstruction. Wabula ebiseera ebisinga kikwata ekyenda ekitono n’ekinene. Embeera eno etera okubeerawo naddala oluvannyuma lw'okulongoosebwa olubuto . Kino kibaawo ng’ebyenda bitandika okukola mpola katono oluvannyuma lw’okulongoosebwa. Ebiseera ebisinga kiwona ku bwakyo mu nnaku ntono.

Wabula, Ogilvy syndrome specifically affects your colon , era emirundi mingi ekitundu ky’ekyenda ekinene kyo ekiyitibwa cecum , gye kitandikira. Si kya bulijjo nga paralytic ileus, era kiyinza okubeera ekizibu katono.

Ani asinga okulwala obulwadde bwa Ogilvie Syndrome?

Wadde nga kino kiyinza okutuuka ku muntu yenna, kisinga kubeera mu bakadde n’abo abalina ebizibu ebirala ebisukka mu kimu.. Lowooza ku muntu eyalongoosebwa ennyo, eyagwa ku kabenje, obulwadde bw’omutima, oba yinfekisoni ey’amaanyi. Ebintu bino bisobola okuleeta obulwadde bwa Ogilvy syndrome. Ate era, obutakwatagana na masanyalaze , endwadde z’obusimu , n’okumira eddagala eringi mu kiseera kye kimu biyinza okuvaako akabi. Bino byonna bikosa enkola yaffe ey'obusimu . Enkola eyo ey’obusimu y’egamba ebinywa ebiri mu kyenda kyaffe ekinene okusika emmere mu maaso.

Kino kya bulijjo kitya?

Kigambibwa nti obulwadde bwa Ogilvy syndrome bubaawo mu bantu nga omu ku buli bantu 1,000 abaweebwa ebitanda mu ddwaaliro. Emyaka gy’abo abakwatibwa giri nga 60.

Bubonero ki obulaga obulwadde bwa Ogilvie Syndrome?

Emmere n’empewo ebitagaaya bwe bitandika okukuŋŋaanyizibwa mu kyenda kyo ekinene, oyinza okufuna ebintu nga:

• Okugaziwa kw’olubuto: Okuwulira ng’olubuto lufuukuuse n’okugaziwa.
• Obulumi mu lubuto: Obulumi obw’amaanyi mu lubuto buyinza okubaawo.
• Okubulwa apetite: Okubulwa okwagala kwonna okulya.
• Okuziyira n’okusiiyibwa: Okuwulira ng’olwadde n’okusesema.
• Okuzimba ne ggaasi: Okuwulira ng’ojjudde mu lubuto.
• Okuziyira ne/oba ekiddukano: Abantu abamu bayinza okuziyira, ate abalala bayinza okufuna ekiddukano.

Teebereza Uncle Nimal, alina emyaka 65, alina obulwadde bwa sukaali, era alina obulwadde bw’omutima. Yalongoosebwa n’amukyusa ekisambi. Oluvannyuma lw’ennaku bbiri oba ssatu, olubuto lwe lwajjula mangu era n’afuna obuzibu okussa. Bwe yakwata ku lubuto lwe, lwakaluba ng’olwazi. Yagambye nti talina bwagazi bwa kulya, era yatuuka n’okuziyira. Abasawo bwe baamukebedde ne bakitegeera nti bulwadde bwa Ogilvy syndrome.

Kiki ekivaako obulwadde bwa Ogilvie Syndrome?

Ekituufu ekivaako kino tekinnategeerekeka bulungi. Naye bannassaayansi balowooza nti kiva ku butakola bulungi mu nkola yaffe ey'obusimu obuyitibwa autonomic nervous system . Enkola eno ey’obusimu (autonomic nervous system) kye kitundu ky’omubiri gwaffe ekifuga entambula y’ebinywa gye tutamanyi. Era efuga entambula y’amayengo (peristalsis) esika emmere mu maaso mu byenda byaffe. Okuva bwe kiri nti eno embeera ya acute, eva ku situleesi ezimu ezitali za bulijjo ku autonomic nervous system. Kyokka, ensonga endala ez’obulamu nazo ziyinza okukiviirako.

Waliwo embeera z’obujjanjabi ez’amaanyi eziwerako eziyinza okuvaako obulwadde bwa Ogilvy syndrome:

• Omutima okulwala
• Okulemererwa kw’omutima okuzimba (okunafuwa kw’ebinywa by’omutima olw’obulwadde bw’omutima) .
• Obuvune obw’ekikangabwa
• Yinfekisoni ez’amaanyi (e.g. ekifuba oba sepsis) .
• Okulongoosa olubuto oluggule
• Okulongoosa omutima muggule
• Okulongoosa amagumba (e.g. okukyusa ekisambi) .
• Okuzaala mu ngeri ya caesarean / C-section

Ensonga z’ebyobulamu ezibaddewo edda eziyinza okuvaako obulwadde bwa Ogilvy syndrome:

• Okulemererwa kw’ekibumba
• Okulemererwa okussa
• Obulwadde bw’obusimu
• Obulwadde bw’emisuwa n’emisuwa
• Kookolo
• Obuzibu mu nkyukakyuka y’emmere
• Obutakwatagana mu busannyalazo
• Emyaka egy’obukulu
• Okubeera n’obunafu mu mubiri
• Okumira eddagala eringi mu kiseera kye kimu

Eddagala erimu erikwatagana n’obulwadde bwa Ogilvy syndrome:

• Eddagala eriweweeza ku bwongo
• Ebirungo ebiyitibwa Amphetamines
• Eddagala eriyitibwa corticosteroids
• Opioids (eddagala eriweweeza ku bulumi) .
• Eddagala eriziyiza obusimu obuziyiza endwadde
• Okubudamya omugongo

Bizibu ki ebiyinza okuva mu bulwadde bwa Ogilvie Syndrome?

Ebiseera ebisinga, obulwadde bwa Ogilvy buwona ku bwabwo oba nga buyambibwako. Kyokka oluusi kyetaagisa okuyingira mu nsonga . Singa kimala ebbanga ddene nga tekizuuliddwa, kiyinza okuvaako ebizibu eby’amaanyi singa embeera eyo yeeyongera okwonooneka. Okunoonyereza kulaga nti ebizibu bitera okubaawo singa ekyenda ekinene kigaziwa (okusukka sentimita 12). Dyaamu ya bulijjo ey’ekyenda ekinene eba sentimita nga 8.

Ekyenda gye kikoma okugaziwa, akabi gye kakoma okubeera akanene. Obulabe Obuyinza okubaawo :

• Ischemia: Puleesa esukkiridde ku bisenge by’ekyenda ekinene kiyinza okuvaako omusaayi okusalako . Kino kiyinza okuvaako okuzimba okw’amaanyi, okuyitibwa ischemic colitis . Singa tebajjanjabwa, okufa kw’ebitundu by’omubiri (necrosis) kuyinza okubaawo. Kilowoozeeko ng’okusika payipu y’amazzi ennyo ne kiba nti amazzi galekera awo okukulukuta.
• Okutomera: Ebitundu by’ebitundu ebifudde bisobola bulungi okukutuka oba okukutuka . Singa wabaawo ekituli mu lubuto, obutwa ne bakitiriya bisobola okusaasaana mu lubuto, ne bivaako yinfekisoni ey’amaanyi eyitibwa peritonitis .
• Sepsis: Obulwadde bw’olubuto busobola bulungi okusaasaana mu musaayi (septicemia) . Kino kya mangu! Sepsis bwe bulwadde buno bwe busaasaana mu mubiri gwonna era...Embeera eyitibwa septic shock esobola okubaawo, ekiyinza okuvaako ebitundu by’omubiri ebingi okulemererwa.

Ebizibu bino bya bulabe nnyo, y’ensonga lwaki kikulu okugenda mu basawo amangu ddala ng’olaba obubonero bw’obulwadde bwa Ogilvy syndrome.

Obulwadde bwa Ogilvie Syndrome buzuulibwa butya?

Okuzuula obulwadde kisinziira ku bintu bino:

• Okukeberebwa mu by’amasannyalaze kukakasa nti ekyenda ekinene kigaziwa era nti tewali kuzibikira kyanda mu mubiri.
• Okukebera okw’enjawulo okusobola okuggyawo endwadde endala eziyinza okuba nga ze zikuleetera embeera.

Kika ki eky’okukebera ebyuma ebikuba ebifaananyi (radiological tests) ekiyinza okuzuula kino?

Okusobola okulaba obulungi munda mu kyenda kyo, abasawo bakozesa enkola eyitibwa internal contrast agent wamu n’okukebera ebifaananyi. Ekintu kino eky’enjawulo kisiigibwa munda mu kyenda kyo era kirabika bulungi ku bifaananyi bya X-ray. Enjawulo eno eyinza okukuweebwa okunywa, nga enema, oba ng’amazzi agaweebwa mu musuwa (IV). Contrast CT scan ne contrast fluoroscopy ze nkola bbiri ezikozesebwa ku kino.

Waliwo okukebera okuyitibwa gastrografin enema , oluusi okuyinza okukozesebwa ng’obujjanjabi. Kino kizingiramu okuyingiza eddagala ery’enjawulo eritabulwa mu mazzi eriyitibwa gastrografin mu kyenda ekinene ng’oyita mu nseke yo, n’okukuba X-rays eziyitibwa fluoroscopic X-rays. (Fluoroscopy eringa vidiyo X-ray esobola okulaba engeri eddagala gye litambulamu.) Ng’ekizibu ekivaako, gastrografin era esobola okukola ng’eddagala erifulumya omusaayi mu kyenda ekinene, okuyamba ekyenda kyo okuddamu okutambula.

Obulwadde bwa Ogilvie Syndrome bujjanjabwa butya?

Obujjanjabi businziira ku ngeri ekyenda ekinene kyo gye kigaziye n’okumanya oba oli mu bulabe bw’okufuna ebizibu. Buli lwe kiba kisoboka, abasawo bagezaako okubujjanjaba n’obwegendereza obuwagira era nga babutunuulira nnyo . Ekyo kitegeeza okuyamba omubiri okuwona ku bwagwo awatali kuyingirira nnyo. Naye bwe kiba kyetaagisa, bakozesa eddagala oba enkola ezikendeeza ku buzibu bw’ekyenda ekinene n’okukendeeza ku buzibu bw’okufuna. Singa wabaawo ebizibu, byetaaga obujjanjabi obw’amangu.

Obujjanjabi obukuuma obutonde buyinza okuli:

• Okujjanjaba endwadde ezisibukamu ezireeta embeera eno.
• Okulekera awo okumira eddagala kiyinza okuvaako embeera eno.
• Okuwummuza ekyenda: Okukendeeza puleesa nga tolya mu kamwa.
• Amazzi agayingira mu misuwa (amazzi aga IV): .Okukuuma amazzi n’okutereeza obutakwatagana bwa electrolyte nga owa ebintu nga saline mu musuwa.
• Kubiriza okufulumya ekyenda ng’otambula oba ng’okyusakyusa mu bifo.
• Nasogastric tube: Okuggya empewo n’amazzi ebisusse mu lubuto.
• Rectal tube: Catheter eyingizibwa mu rectum okuggya empewo n’amazzi nga tukozesa gravity.
• Okulondoola embeera eno nga bayita mu kukuba ebifaananyi buli kiseera n’okukeberebwa omusaayi.

Kino kitera okulabibwa okumala ennaku bbiri oba ssatu (essaawa nga 72). Wabula singa ekyenda ekinene kyagaziwa dda sentimita ezisukka mu 12, oba singa tewabaawo kulongooka oluvannyuma lw’obujjanjabi buno obukuuma, omusawo ayinza okusalawo okuyingira mu nsonga eno okukendeeza ku puleesa eri ku kyenda ekinene.

Ebiyingizibwa mu nsonga mulimu:

• Colonoscopy decompression: Colonoscopy nkola ya kuzuula n’okujjanjaba. Kizingiramu okuyingiza kkamera entono ku nkomerero ya ttanka empanvu eyitibwa colonoscope mu kyenda ekinene ng’oyita mu nseke. Ekigendererwa ky’okukebera ekyenda ekinene (decompression colonoscopy) kwe kusonseka empewo eyitiridde mu kyenda ekinene okuyita mu ttanka n’oluvannyuma okuwa enema okuyita mu ttanka. Enkola eno esobola okumalawo ekiziyiza eky’obulimba singa eddagala liremererwa oba nga teririna bulabe gy’oli. Wabula abasawo bakikozesa n’obwegendereza kubanga kizibu okukikola era kitwala akabi akatono ak’okufuna ebizibu. Mu mbeera ezimu, ekyuma ekikebera ekyenda ekinene kiyinza okuleeta ekituli mu kyenda (okutomera ekyenda).
• Empiso ya Neostigmine: Eddagala lino liweebwa nga bayita mu IV. Kikola ku binywa. Kitera okukozesebwa okuyamba ebinywa okuwummulamu oluvannyuma lw’okubudamya. Kizuuliddwa nti kikola bulungi mu "kuzuukusa" ebinywa mu kyenda ekinene n'okuddamu okutandika obulwadde bwa peristalsis mu bantu abalina obulwadde bwa Ogilvy syndrome. Wabula olw’okuba ddagala lya maanyi nnyo , liweebwa nga litunuuliddwa nnyo mu kisenge ky’abalwadde abayi (ICU) . Abasawo bajja kulondoola omutima gwo okukakasa nti omutima gwo tegukendeera nnyo ng’ofuna eddagala lya neostigmine.
• Colectomy / Colostomy: Singa ekyenda ekinene kyo kyeyongera okugaziwa wadde nga kino kiyingidde mu nsonga, oba singa ebizibu ng’okukutuka oba okufa, oyinza okwetaaga okulongoosebwa okuggyawo ekitundu ky’ekyenda ekinene ekikoseddwa . Kino kye kisembayo . Bw’oba ​​olongoosezza colectomy, oyinza okulongoosebwa colostomy ey’ekiseera oba ey’olubeerera.Era kiyinza okwetaagisa okukola ekimu. Kwe kugamba, okukola ekifo eky’enjawulo omusulo we guyitamu. Oluusi, colostomy esobola okukyusibwa oluvannyuma lw’okulongoosebwa.

Obulwadde bwa Ogilvie Syndrome busobola okutta omuntu?

Yee, ebizibu ebiyinza okuvaamu biyinza okutta omuntu . Nga waliwo ebizibu nga okutomera oba okukendeera kw’omusaayi, omuwendo gw’abafa guyinza okuba waggulu nga 40%. Wabula ebizibu bino bibaawo mu bantu abatakka wansi wa 15%. Awatali bizibu, omuwendo gw’abafa olw’obulwadde bwa Ogilvy syndrome gusemberera ebitundu 15%. Omuwendo guno guyinza obutakiikirira bulwadde bwa Ogilvy bwokka. Kubanga abantu bangi abafuna obulwadde bwa Ogilvy syndrome balina embeera endala ez’obulamu ezikosa okufa kwabwe.

Acute colonic pseudo-obstruction kintu ekitali kisuubirwa ekiyinza okuleeta ebizibu ebipya eri abantu abatawaanyizibwa edda embeera z‟obulamu endala. Tewali asuubira bulwadde bwa Ogilvy syndrome, naye buli muntu alina okumanya obubonero . Okutegeera amangu kye kisumuluzo ky’okuziyiza ebizibu eby’amaanyi eby’obulwadde bwa Ogilvy. Singa tewabaawo bizibu, okuwona kuyinza okubaawo ng’ofunye obujjanjabi obw’okukuuma.

Ebintu ebikulu bye twetaaga okujjukira (Take-Home Message) .

Kale, Ogilvie Syndrome mbeera eyinza okuba ey’amaanyi okusinga bw’olowooza. Naye tewali kye weeraliikirira, era okubeera nga omanyi kiyinza okuziyiza ebizibu bingi.

• Okuzuula obulwadde: Bw’ofuna obubonero ng’okuzimba mu bwangu, okulumwa ennyo olubuto, obutayagala mmere, okuziyira oba okusiiyibwa, kakasa nti ogenda ew’omusawo naddala ng’oli mukadde, ng’olina embeera endala ez’obujjanjabi oba nga waakalongoosebwa.
• Ebivaako: Kino emirundi mingi kiyinza okuva ku bulwadde obulala, okulongoosebwa oba eddagala. Kale kikulu okubuulira omusawo wo ebyafaayo byo byonna eby’obujjanjabi.
• Ebizibu ebivaamu: Singa tebujjanjabwa mangu, omusaayi okukendeera mu kyenda ekinene kiyinza okuvaako ebitundu by’omubiri okufa, okutomera ekyenda ekinene, n’okukwatibwa yinfekisoni ez’amaanyi. Bino biyinza okutta omuntu.
• Obujjanjabi: Emisango egisinga gigonjoolwa nga balabirirwa, naye oluusi kiyinza okwetaagisa okukebera ekyenda ekinene, eddagala oba n’okulongoosebwa okusobola okumalawo puleesa.
• Okuzuula amangu kiwonya obulamu: Tobuusa maaso bubonero buno olw’ensonga yonna. Ekisinga obukulu kwe kuzitegeera nga bukyali n’otandika okuzijjanjaba.

Bw’oba ​​ggwe oba omuntu gw’omanyi alina obubonero buno, tolwawo kunoonya magezi ga musawo. Sigala nga oli mulamu bulungi!

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