Kua pakaru tō korokoro? (Patukoro) He tino kino tēnei, kia mōhio tātou ki ngā taipitopito!

Kua pāngia koe e te mamae nui o te uma, te uaua ki te horomi, me te uaua ki te manawa? I ēnei wā, kāore tātou e whakaaro ki tēnā, engari he tino morearea. Ko tētahi mate kino ka kōrerohia e tātou i tēnei rā ko te pakaru o te korokoro, te '(Esophageal Rupture)' rānei. He mea tino nui kia mōhio koe ki tēnei, nā te mea ka taea e te maimoatanga tere te whakaora i te ora.

He aha te pakaru o te korokoro? He māmā noa iho...

Ko te korokoro te ngongo e kawe ana i te kai e kainga ana e tātou, e inuhia ana e tātou mai i te waha ki te puku. Whakaarohia he rite ki te paipa wai. Nō reira, ki te mea he kōhao, he haehae, he rakuraku rānei kei hea i roto i te pakitara o tēnei korokoro, koinei te mea e kiia nei e tātou he pakaru korokoro.

Inaianei kei te whakaaro pea koe, "Nā, he aha te take nui o tēnei?" Kāore, he mate tino kino tēnei. Whakaarohia, kei roto i te uma tō tātou trachea, i waenganui i ngā pukahukahu. Ehara i te mea ko te kai anake e kainga ana e tātou, e inu ana hoki, engari ko ngā iroriki me ngā matū e pā ana ki tō tātou pūnaha nakunaku ka haere mā roto i tēnei trachea. Nō reira, ki te mea he kōhao kei roto i te trachea, ka taea e ēnei mea katoa te kohikohi ki roto i te uma, ki roto i ngā pukahukahu, ki roto rānei i te toto. Ki te tupu tēnā , ka puta he mate kino , ka mōrearea pea te ora.

Koia te take he mea nui kia rapu awhina hauora i te wā e taea ai, i roto i ngā haora 24, mēnā kei te whakapae koe kei te pāngia koe e tēnei mate. I ētahi wā, ka taea te rongoā mā te tikanga pēnei i te "Endoscopy" me te pokanga rānei.

He pēhea te noa o tēnei āhuatanga?

He tino onge te pakaru o te arai. Arā, ehara i te mea ka pā ki te katoa. Engari ki te pāngia tetahi, he tino kino, nō reira he mea nui kia mōhio koe ki tēnei.

He aha te rerekētanga i waenga i te pakaru o te arai me ēnei atu āhuatanga?

I ētahi wā ka pohehe te tangata i tēnei me ētahi atu mate he rite ngā tohu. Me titiro tātou ki ērā.

Te Pakaru o te Esophagus me te Roimata o Mallory-Weiss

Ko te "roimata Mallory-Weiss" he roimata, he pakaru rānei i te arai o te korokoro. Kāore e puta katoa i roto i te pakitara o te korokoro , arā, kāore e hanga he kōhao. Heoi, i roto i te korokoro pakaru, ka pakaru katoa te pakitara.

Te Pakaru o te Esophagus me te Pakaru o te Variceous Esophageal

Koinei te wā e pupuhi ai, e pūwero ai, e pakū ai ngā oko toto i roto i te urethra. Ka nui te toto e puta mai i tēnei, engari ehara i te mea kua pakaru te urethra tonu. Kāore te pakitara o te urethra i pakaru.

Me pēhea te puta o tēnei awa roimata?

I te nuinga o te wā, ka pakaru te korokoro ina pakaru te korokoro i tētahi ara . Ka taea e tēnei kino te puta mai i waho, i roto rānei. Ka taea e ētahi whara te puta ohorere mai i tētahi aituā, ko ētahi ia ka taea te whanake haere i roto i te wā.

He tino onge te pakaru ohorere o te korokoro i te nui rawa o te pēhanga. Ka kiia hoki tēnei ko te "mate a Boerhaave". Ka puta pinepine tēnei ina nui rawa te ruaki, roa hoki.

He aha te tino take o te korokoro ngatata?

I te nuinga o te wā, ka puta ngā pakaru o te korokoro i ngā kino e puta ana i te wā e rongoatia ana ('iatrogenic ruptures'). Ka taea tēnei te tupu inā koa i ngā wā e rongoatia ana he "endoscope" ki roto i te korokoro. Ko te "endoscope" he ngongo iti me te kāmera e piri ana ki a ia. Ka whakaurua mā te waha, ā, ka whakamahia hei tirotiro me te rongoā i te korokoro.

He take anō kei reira?

Āe, he maha atu anō ngā take:

• Ngā pokanga ki te korokoro, inā koa ko te Nissen fundoplication me te myotomy.
• Te taumaha rawa: ngā āhuatanga e nui rawa ai te taumaha, pērā i te ruaki tonu, te hiki taumaha, te haurangi, te whānautanga rānei.
• Te horomi i tētahi mea tauhou, i tētahi matū kino rānei: I ētahi wā ka horomi pōreareatia e ngā tamariki nohinohi ngā moni, ngā taonga takaro, te inu rānei i tētahi mea kino pērā i te waikawa.
• Ngā whara i waho o te korokoro: Ngā mea pēnei i te patunga wero, te patunga pū, te marō rānei i puta mai i tētahi aituā motuka.
• Te rerenga waikawa mau tonu (GERD): Ka taea e te rerenga waikawa o te puku ki roto i te korokoro te hanga i ngā mate pukupuku, ka taea te hohonu haere, ka puta ai te poka o te korokoro.
• Te pēhanga i puta mai i te pukupuku, i te mea tauhou rānei e piri ana ki roto i te urethra: Ka mate pea ngā kiko (necrosis) i roto i te urethra.

Ko wai kei te nui ake te mōrearea mō tēnei?

He rerekē te āhua o tō tātou urethra i ētahi atu okana. Arā, kāore he hipoki tiaki (paparanga serosal) o waho o te urethra . Nā tēnei ka ngāwari ake te pakaru o te urethra. He nui rawa te mōrearea mena he mate, he pupuhi, he whara rānei kei roto o te urethra.

Mena kua pāngia koe e tētahi o ngā āhuatanga e whai ake nei i mua, tera pea ka paku piki ake tō tuponotanga ki te pakaru o te uvula:

• Te mate kapia mau tonu ('Chronic acid reflux / GERD').
• Te esophagitis eosinophilic (he āhuatanga e puta ai te mumura i roto i te esophagus).
• Te diverticulum esophageal (he pupū iti rite ki te putea i roto i te pakitara o te esophagus).
• Kei te pāngia koe e te mate pukupuku korokoro, kua whiwhi rānei koe i te rongoā irahiko ki te korokoro.
• Te nui rawa o te whakamahi waipiro.
• Nō te mea kua pokangahia tōna korokoro i mua.

He aha ngā tohu o tēnei? Kia mōhio tātou!

Ko ngā tohu tino kitea o te pakaru o te larynx ko:

• Te mamae nui o te uma - Koinei te tohu matua.
• Te uaua ki te horomi .
• Te poto o te manawa .
• Te tere o te manawa .
• Whakapairuaki .
• Te ruaki toto .
• Te toto toto iti .
• Kirika .

I te nuinga o te wā, ka pakaru te uma i waenganui, i raro rānei. I tēnei wā, ka pā te mamae ki te uma. Heoi, ki te pakaru te uma i te taha whakarunga, i raro rawa rānei o te korokoro, ka pā pea te mamae ki te kaki, ki te puku whakarunga, ki te pakihiwi matau rānei.

Ki te pā mai tētahi, ētahi rānei o ēnei tohu ki a koe, kaua e warewaretia. He mea nui kia rapu awhina hauora tonu, ina koa mēnā ka haere tahi mai ēnei tohu me te mamae ohorere, te mamae nui o te uma.

He aha ngā raruraru kino ka pā mai?

Ina turuturu mai ngā mea o roto i te puku me ngā huakita mā roto i te kōhao o te korokoro, ka puta ngā momo āhuatanga morearea katoa. Whakaarohia, he rite ki tētahi tāke wai paru he kōhao kei roto, ā, e maringi ana te wai ki waho.

• Tērā pea ka puta te mumura matū (pleurisy) o te arai o te uma.
• Ka kohia te wai i roto i te kōhao o te uma (te rerenga wai i roto i te pleural), ka taea hoki te pahū.
• Ka mau pea te hau i te āputa i waenganui i ngā pukahukahu (te 'mediastinum') (te 'mediastinal emphysema').
• Ka taea e tēnei mumura te mate o ngā kiko (necrosis) i roto i te uma, i waenganui rānei i ngā pukahukahu.
• Tērā pea ka pā mai he mate kitakita ki te toto (septicemia).
• Ina kino rawa atu tēnei āhua "septicemia", ka arahi pea ki tētahi āhua morearea ki te ora e kiia nei ko te "sepsis", ā, i te mutunga ka arahi pea ki te "septic shock" me te ngoikore o ngā okana.

E whakaatu ana tēnei katoa i te kino o te pakaru o te araikoro.

Me pēhea koe e tino mōhio ai mēnā kua pakaru tō korokoro? Āhea koe me toro atu ki te tākuta?

Ki te whakapae koe kei a koe tēnei mate, haere tonu ki te rūma ohorere o te hōhipera (ER). Ko te mamae nui, te uaua ki te horomi, me te uaua ki te manawa he tohu katoa o tētahi āhuatanga ohorere. Kia tino kōrero ki tō tākuta me pēhea te tīmatanga o ō tohu me te mea i tupu i taua wā.

Mena i tīmata ēnei tohu i muri i tētahi aituā, i te horomitanga i tētahi mea kāore i te tika, i te ruaki nui rānei, tera pea he pakaru te korokoro. Ka rapu te tākuta i ngā taunakitanga mō tēnei.

Me pēhea te tautuhi a ngā tākuta i tēnei?

Ka whakahau te tākuta i ētahi whakamātautau hei tirotiro mēnā he pakaru i roto i te korokoro.

• Tuatahi, ka mahia he hihi-X o te uma hei tirotiro mēnā he turuturu wai, he mirumiru hau rānei i roto i te kōhao o te uma.
• Hei whakaū i tēnei, ka tonoa pea koe kia whai whakamātautau hihi-X tairongo anō e kiia nei ko te esophagogram . I tēnei whakamātautau, ka inu koe i tētahi wai tae (tae rerekē) ka tangohia he hihi-X. Mā tēnei ka taea e koe te kite mārama i roto i tō korokoro. Mena kei te turuturu mai tēnei wai tae i te kōhao, ka kitea mārama i runga i te hihi-X. Ka taea hoki e tēnei te whakaatu kei hea te kōhao me te tere o te turuturu.
• I ētahi wāTērā pea ka tūtohutia he matawai CT. He mea nui rawa tēnei mēnā kei te whakapaetia he pakaru i te korokoro o runga, o raro rānei. Ka taea e te matawai CT te āwhina ki te tautuhi i ngā wāhi e pupū ake ana te wai i te kaki, i te puku rānei, me te whakatau mēnā me tango atu.

He aha te rongoā mō tēnei?

He maha ngā maimoatanga paerewa mō tēnei:

• Wai i roto i ngā uaua (wai i roto i te uaua): Hei whakakapi i ngā wai i ngaro i te toto, i te ruaki, i te kore rānei e taea te inu.
• Ngā paturopi IV me/ranei ngā rongoā harore: Hei ārai i tētahi mate, hei rongoā rānei i tētahi mate kua pā mai.
• Kai whāngai ā-infus, whāngai ngongo rānei: Kāore e taea e koe te horomi kai mā te waha i te wā e rongoatia ana, ā, kia ora rā anō koe.
• Te tango wai i roto i te kiri: Tērā pea ka hiahiatia tēnei hei tango me te patu i te wai pangia kua kohia i roto i ngā poka o tō tinana. Ka ngana tō tākuta ki te tango i tēnei wai mā te wero i tētahi ngira, i tētahi ngongo rānei ki roto i tō uma i te wā tere rawa atu.
• Maimoatanga endoscopic: Ka taea te rongoā i ētahi roimata iti, kāore he pokanga mā te whakamahi i te endoscope. He ngongo roa te endoscope me te kāmera e piri ana. Ka whakaurua mā te korokoro ki roto i te esophagus, ā, ka taea te whakatika i te roimata mā te whakamahi i ngā topenga, ngā tuitui, te hautai korehau, te stent rānei.
• Pokanga: Me pokanga ētahi tāngata hei whakatika tika i te pakaru. I te wā o te pokanga, ka tangohia e te taote pokanga te wai nui me te kiko mate. I runga i tō āhua, ka whakamahia pea e tō taote pokanga he tikanga iti rawa te whakaekenga, pērā i te Pokanga Ataata-Āwhina-Tāroa (VATS) . Heoi, i ētahi āhuatanga ohorere, ka hiahiatia pea he pokanga tuwhera. Mā tēnei ka taea te tere ake me te pai ake te uru atu ki te wāhi kua pakaru.

E taea ana te mawhiti i tēnei āhuatanga? He aha te tūponotanga o te whakaoranga?

Ae, ka taea te whakaora i te pakaru o te arai. Heoi, ko tō āhua mate ka whakawhirinaki ki te tere o tō rapu maimoatanga. Ko te roa o te horapa o te mate mā roto i te uma me te toto, ko te nui ake o tō mōrearea.

Ko te hunga e whiwhi maimoatanga i roto i ngā haora 24 tuatahi o te pakaru o te wheua, he nui ake te tūponotanga kia ora katoa. Ko te ōrau oranga i roto i tēnei rōpū he tata ki te 85%. Heoi, ki te pahemo ngā haora 48 me te kore maimoatanga, ka heke taua ōrau ki te 50%.

Kāore ianei tēnei e whakaatu ana i te hiranga o te maimoatanga wawe?

Karere Whakamutunga mō te Tango ki te Kāinga

He āhua whakamataku te pakaru o te arai, engari he onge. Heoi, ki te puta, he uaua ki te kite wawe tonu. Koia te mea nui kia kaua e warewarehia te mamae o te uma.

He angiangi tō tātou korokoro, ā, he ngāwari te pakaru. Ka taea te pakaru i ngā huarahi kāore i te tūmanakohia. Ina tupu tēnā, tērā pea kāore koe e mārama ki te pūtake o te mamae, ki tōna tikanga rānei. Heoi, kaua e whakaaro noa, "Ka memeha noa iho tēnei."

Ki te pāngia koe e te mamae ohorere o te uma, te mamae rānei i tō korokoro, i tō puku o runga rānei, haere tonu ki te rūma whawhati tata. Ahakoa he poka iti noa iho, ka taea e te mate te arahi ki ngā raruraru kino katoa i kōrerohia e tātou i mua ake nei. He mea utu nui tō ora, nō reira kia aro ki ngā tohu, me rapu awhina hauora i te wā e taea ai.

Pakaru o te korokoro , Mamae o te uma, Uaua ki te horomi, Uaua ki te manawa, Te mate Boerhaave, Maimoatanga ohorere