Hei hi eng nge ni (Boerhaave’s Syndrome)?
A awlsam zawngin, he `(Boerhaave’s Syndrome)` hi kan ei tur pipe bang, chu chu `(esophagus),` a puak nghal mai thinna dinhmun a ni. Hei hi ei tur pipe-ah hian ngaihtuah phak loh khawpa pressure, chu chu thrust a awm hian a thleng thin. A dik tak chuan, hei hi chak taka i luak emaw, kawng danga i thawhrim emaw hian a thleng tam ber. Doctor-te chuan hei hi `(effort rupture)` emaw `(spontaneous rupture)` emaw an ti bawk a, a chhan chu hei hi ei tur pipe-a thil thleng direct a nih loh vang a ni. Hetiang dinhmun hi a takah chuan a tlem hle a, chu chu mipui 0.0003% vel a ni tihna a ni. Mahse, food pipe accident zawng zawng zinga 15% chu he `(Boerhaave's Syndrome)` vang a ni.(Boerhaave’s Syndrome) leh (Mallory Weiss Syndrome) hi eng nge an danglamna?
Tunah chuan, ‘Esophagus-a mittui tla ka hriat hian hei hi a ni em?’ tiin i ngaihtuah mai thei. A nihna takah chuan an pahnih inkarah hian danglamna tlem a awm. Mallory Weiss tear chu chak taka i luak emaw, i strain emaw a lo awm thin a ni. Esophagus lining-a mittui tlakna a ni. Zu in tam tak zingah hian an pahnih hian a awm ve ve a ni . Mallory Weiss mittui nei chuan thisen a chhuak thei. Mahse, chaw kawng chu a chhe vek lo. Mahse, Boerhaave’s Syndrome hi a na zawk . Hei hi mittui tlakna a ni a, esophagus wall thickness zawng zawngah a inzar pharh a ni . Doctor te pawhin transmural tear an ti bawk. A chhe vek chuan emergency surgery hmanga siamthat a ngai a ni . Nunna emaw thihna emaw dinhmun a ni thei.Food tube a puak chuan eng nge thleng?
Kan chaw kawng (esophagus) a puak chuan eng nge thleng tih han ngaihtuah teh. Hei hi emergency tak tak a ni a, enkawl vat loh chuan nunna atana hlauhawm tak a ni thei . A chhan i hria em? Kan chaw kawng (esophagus) hi kan chaw ei (digestive system) (gastrointestinal tract)-a tel a ni. Chuvangin, chaw kawng (esophagus) a puak chuan ei tur chi hrang hrang, bacteria leh chaw ei tur chemical te chu kan rilru chhungah emaw, kan pum chhungah emaw a luang lut thei a ni. Chutiang a nih chuan bacteria infection na tak a awm thei a ni.He natna hi kan taksa pum thisenah a lut a nih chuan ``septiceemia'' leh ``sepsis'' tih ang chi natna a awm thei a ni. He ``sepsis'' hi nunna atana hlauhawm tak a ni. ``Shock'' a thlen thei a, taksa peng hrang hrang a tichhe thei a, a tawpah chuan thihna a thlen thei bawk.
Hei hian tute nge nghawng lian ber?
He `(Boerhaave's Syndrome) hi tu pawhin an nei thei. Engpawhnise,Mipa leh kum 50 chunglam ah a tam ber a, a vei zinga 80% vel chu mipa kum chanve vel an ni. Zu in tam lutuk te zingah pawh a awm fo thin .Boerhaave’s Syndrome natna lan chhuahna chu engte nge ni?
Awle, tunah chuan `(Boerhaave's Syndrome)` symptoms chu eng nge ni tih i en ang u. Hengte hi hriat a pawimawh hle.- Vawikhatmah, rilru na tak. Hei hi a symptom ber a ni.
- Nausea leh luak chhuak . A châng chuan luaknaah thisen a awm thei bawk.
- Chaw ei lai emaw, khuh emawa natna hriat chu a pawi lo.
- Thâwk hi a tawi a, a rang bawk.
- Chest cavity chhunga tissue te chu boruak emaw tui emaw in a khat a, chu chuan a hring chhuak thin.
- Ka pum chu a tight hlein ka hria, lungpui ang maiin.
- Infection chhinchhiahna te chu khawsik leh thawk hahna te .
Heng chhinchhiahna pakhat emaw a aia tam emaw a lo lang nghal a nih chuan, a bik takin luak chhuak nasa tak hnuah, damdawi lam thurawn lak nghal a pawimawh hle .
Eng ang nge a natna chu?
`(Boerhaave's Syndrome)` natna hi engtiang chiahin nge a na? Mi thenkhat chuan tuar theih loh hrehawm tak a ni an ti . A natna chu a rupture awmna hmunah chiah a awm. A tam zawkah chuan he rupture hi kan esophagus hmun thuma ṭhena hnuai lam a ni. Chu chu rilru hnuai lam leh pum chunglam inkar a ni. Mahse, chu aia sang pawh a ni thei. He natna hi hnungzang emaw kekawrte thlengin a darh thei bawk .Eng harsatna nge awm thei?
He natna hi uluk taka enkawl a nih loh chuan side effect engemaw zat a awm thei a:- I rilru chhunga inflammation leh swelling awm .
- A rilru a buai em em a , a rilru a hah em em bawk a.
- Thli chu rilru chhungah emaw, vun hnuaia tissue-ah emaw a tang tlat .
- Pleural effusion ( rilru chhunga tui awm zat ) .
- Acute Respiratory Distress Syndrome ( ARDS ) natna vei te hi a ni.
- Septicemia, sepsis, leh shock te a awm bawk. Chûngte chu nunna atana hlauhawm a ni thei.
Boerhaave’s Syndrome hi engte nge ni?
Engvangin nge Boerhaave’s Syndrome hi a lo awm? Hei hi chhan lian tak pahnih a awm a. Pakhat chu chaw kawng chhunga pressure a sang chhoh chhan chu a danglam bik straining emaw straining emaw vang a ni . A dang chu kan rilru chunglam (upper esophageal sphincter)-a cricopharyngeus muscle (upper esophageal sphincter) chu he pressure chhanna avanga a relax loh chuan esophagus pawnah negative pressure a lo awm thin. He `(Boerhaave’s Syndrome)` lo awm chhan ber chu luak chhuak nasa emaw, luak chhuak chhunzawm zel emaw a ni . Chu bâkah, nau neih te, rilru hahna te, thil rit phurh te, caustic emaw corrosive substance ei te pawhin a thlen thei bawk. A tlangpuiin chutiang hunah chuan nerve signal te hian `(cricopharyngeus muscle)` chu a ti relax tur a ni a, a chhunga pressure chu a chhuah tir tur a ni. Mahse, `(Boerhaave’s Syndrome)` ah chuan eng emaw chhan vangin he neuromuscular coordination `(neuromuscular coordination)` hian hna a thawk tha lo.Zu in hian nghawng a nei em?
Zu in hian chaw kawng (esophagus) a ti chhe thei em? Zu in tam lutuk hi risk factor a ni . Boerhaave’s Syndrome natna langsar ber chu chaw ei tam hnu emaw, zu in hnu emawa luak chhuah hi a ni. Zu insualna, ei tam lutuk leh bulimia te hi a hlauhawmna a ni. Risk factor dangte chu esophagus-a medical conditions hnuaia awm, esophagitis leh eosinophilic esophagitis, Barrett’s esophagus, leh peptic ulcer disease te hi a ni. Mahse, Boerhaave’s Syndrome vei tam zawk chuan chaw kawng (esophagus) pangngai an nei a.Engtin nge Boerhaave’s Syndrome hi an hriat theih?
Boerhaave's Syndrome hi hriat a harsa thei a , mahse a vei nghal a pawimawh . Symptom pathum i neih chuan hriat a awlsam zawk a, chu chu Mackler triad tia hriat a ni. Chungte chu: 1. Luak na tak emaw, luak chhuak leh emaw. 2. Chhung natna lo awm nghal. 3. Vun hnuaia emphysema awm. He symptom hnuhnung ber hian a bik takin esophagus ruptured a nihzia a tilang chiang hle. Mahse, mi zawng zawng hian heng classic symptoms hi an nei vek dawn lo. Hmun danglam takah rupture hi a awm a nih chuan hmun danglam takah, i kawng emaw, i kawr ruh emaw-ah natna i nei thei a ni. Luak chhuak ni lo thil dang vang pawh a ni thei a, side effect danglam tak tak nen pawh a inzawm thei bawk. Chest X-ray awlsam tak chuan clue a pe thei a, mahse a natna hriat theih nan sensitive zawk imaging test a ngai a ni.Radiological test hmanga natna hriat theihna tur
``Boerhaave's Syndrome'' hi eng radiological test nge hman thin?`(Esophagram)` (Esophagram) tih a ni.
Doctor-in Boerhaave’s Syndrome a rinhlelh chuan an tih hmasak ber chu X-ray lak a ni. Contrast dye an hmang thin. Hei hi esophagram an ti bawk. Hei hi test rang tak, non-invasive test a ni a, a dikna sang tak a ni. He test atan hian tuiah a inthiar theih contrast dye awmna solution i in thin. Hei hian i ei tur pipe chhung lam chu X-ray-ah a lang thei a ni. Mittui a awm chuan contrast dye chu khawiah nge a leak tih an hmu thei.(CT scan) hmanga tih a ni.
Esophagogram i tih theih loh chuan, emaw, i doctor-in a chhehvela taksa peng hrang hrangte chungchang hriat belh a duh chuan CT scan pawh tih theih a ni. Mittui awmna hmun dik tak chu a lantir thei lo nachungin, chaw kawng atanga a chhehvel tissue-a contrast dye emaw boruak emaw tlem lo lut chu a hmu thei a ni. Tin, rilru emaw, pum chhunga tui awm zat, tui chhuah ngai zawng zawng hmuh nan pawh hman theih a ni.Boerhaave’s Syndrome hi engtin nge enkawl a nih?
Awle, tunah chuan `(Boerhaave's Syndrome)` enkawl dan tur i lo en ang u. Hengte hi a hnuaia mi ang hian a ni:- Intravenous fluids (IV fluids) pek): Mi tam tak chu tui tlakchham an nih avangin IV fluid hi pek vat a ngai a ni.
- Antibiotics : Broad-spectrum antibiotics hi infection control nan thisenah pek thin a ni.
- Surgical consultation: Mi tam zawk tan chuan surgery hi standard treatment a ni. Mi thenkhat, abscesses te tak te, localized abscesses nei te chu operation tel lovin enkawl an ni thei a, observation leh IV antibiotics emaw endoscopy emaw hmangin enkawl an ni thei bawk. Mahse, heng thil thlengah pawh hian doctor-te chuan surgery neihna tur contingency plan an nei reng dawn a ni.
- Surgical repair: A rupture atanga darkar 24 chhunga siam that a tha ber. I dinhmun a zirin i doctor chuan minimally invasive surgery a hmang thei bawk. Entirnan, video-assisted thoracoscopic surgery (VATS) hmanga tih theih a ni. Emergency thenkhatah chuan rilru chhunga rang leh kim taka luh theihna turin open thoracotomy neih a ngai mai thei.
- Drainage/debridement: Mittui te siamthat bakah hian infected fluid eng pawh cavity chhunga awm tawh chu drained leh disinfected a ngai a ni. Tissue hri kai emaw, thi (necrotic) emaw pawh paih chhuah a ngai bawk. A nasat deuhah chuan i chaw kawng (esophagus) thenkhat chu lakchhuah a ngai mai thei.
- Advanced management: A rupture atanga darkar 24 chhunga surgery tih theih loh chuan direct repair hi a hlawhtling lo mai thei. Hliam kilte chu a khauh tan emaw, a chhe tan emaw pawh a ni thei. Chutiang a nih chuan i doctor chuan i esophagus (esophagectomy) thenkhat emaw, a zawng zawng emaw a lak chhuah a ngai mai thei. Esophagus thlak tur i mamawh chuan kar ruk hnuah tih theih a ni.
- Chaw pek dan dang: I ei tur pipe a dam hma chuan chuta tang chuan ei tur i ei thei dawn lo va, chuvangin kawng dangin nutrition i dawng a ngai dawn a ni. Hei hi tube kaltlangin emaw, vein kaltlangin emaw pawh a ni thei.
Dam leh theihna tur chu eng nge ni?
``Boerhaave's Syndrome'' vei tan chuan eng prognosis nge a awm? Hri kai avanga harsatna, thihna telin, invenna atana i tih tur pawimawh ber chu a hmaa hriatchhuah leh enkawl hi a ni.. Darkar 24 chhunga inenkawlna dawngte chuan dam tha an beisei thei a, damchhuah theihna chance chu 75% a ni. Darkar 24 hnuah chuan thihna chance chu 50% aia tam a ni a, darkar 48 hnuah chuan 90% a ni. A pumpuiah chuan thihpui zat hi 35% vel a ni. A hun taka enkawl hlawhtling leh hlawhtlingte chuan an dam kim thei a, mahse thla engemaw zat a la ngai thei. `(Boerhaave's Syndrome)` hi thil awm lo mahse a danglam hle a, ngaihtuah tur tam tak a hnutchhiah a ni . A lo thleng nghal thei a, vaukhânna chhinchhiahna engmah a awm lo – mahse zu in nasa lutuk hi kan ven theih tur vaukhânna chiang tak a ni. `(Boerhaave's Syndrome)` chungchang hi kan hre vek lo. Heng thil thlengah hian esophagus hian chhiatna laka a inven theih loh chhan kan hre lo. Mahse hriat hmasak loh leh enkawl hmasak loh chuan thihna thlen thei a ni tih kan hria.I hriat reng tur pawimawh ber berte
Okay, chuti a nih chuan tunah chuan kan sawi thin, ``Boerhaave's Syndrome'' tih kha i hrethiam tawh zawk a ni.- Boerhaave’s Syndrome hi damdawi lam emergency a ni a, chaw kawng (esophagus) a ruptured vang a ni.
- Hei hi chak taka luak chhuah hnuah a thleng fo thin .
- A lan chhuah dan ber chu rang tak, rilru natna nasa tak, luak chhuak, leh ei harsat te hi a ni .
- Zu in nasa zawkte chu an hlauhawmna a sang zawk.
- Symptom i neih chuan doctor rawn la nghal rawh . Enkawl i tan hma poh leh i dam theihna chance a sang zawk.
- Enkawlna atan zai a ngai fo thin.
Hetiang dinhmun hi hriat chian a pawimawh hle. Nangmah emaw, i hriat miin emaw heng symptoms zinga pakhat tal i neih chuan ngaihthah suh. Doctor hmu nghal rawh.
` Borrego syndrome, chaw kawng hrual, rilru na, luak, zu, chaw kawng rupture, Meckler triad, sepsis, chaw kawng surgery
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