Ukopha ngaphakathi esiswini? (Hemoperitoneum) Masithethe ngale nto!

Ngaba wakha waba nesisu esibuhlungu ngendlela engachazekiyo, ukuziva ugcwele, kunye nokuziva unesizungu ngequbuliso? Mhlawumbi le yimeko engxamisekileyo. Namhlanje siza kuthetha nge-hemoperitoneum, ephuma igazi esiswini. Oku akulula ukuyenza, ngoko ke kubalulekile ukumamela ngononophelo.

Ngamafutshane, iHemoperitoneum kukuqokelelana kwegazi kwindawo engenanto ngaphakathi kwesisu sakho, umngxuma we-peritoneal. Igama elithi 'Hemo' lithetha igazi, kwaye elithi 'peritoneum' lithetha ulwelwesi olujikeleze lo mngxuma wesisu. Ngoko ke, ukopha ngaphakathi emzimbeni ngolu hlobo (sikubiza nangokuba kukopha ngaphakathi okanye ukopha kwegazi) kuyingozi kakhulu kwaye kufuna ukulaliswa esibhedlele ngokukhawuleza.

Kutheni oku kunzulu kangaka?

Khawucinge nje, kwenzeka ntoni ukuba igazi emzimbeni wethu liphuma emithanjeni lize liqokelele kwenye indawo? Ubungakanani begazi elifikelela kwizitho zethu ezibalulekileyo kunye nezicubu buyancipha. Xa igazi lihamba ngaphakathi emzimbeni, asiboni ukuba lingakanani igazi elihambayo kwaye lihamba ngesantya esingakanani. Ingakumbi kule ndawo yesisu, inani elikhulu legazi linokuqokelelana. Ukuba ukopha akupheli ngale ndlela, kukho umngcipheko wokulahlekelwa ligazi elaneleyo kangangokuba kunokuba yingozi ebomini. Yiyo loo nto oku kunzulu kangaka.

Zithini iimpawu?

Iimpawu ze-hemoperitoneum zingahluka ukusuka kumntu ukuya komnye, kuxhomekeke kwisizathu.

• Usenokuva iintlungu eziqatha zesisu okanye intlungu ye-pelvic ngequbuliso.
• Kodwa ngenxa yezizathu ezithile, intlungu ingancipha njengoko usiza.
• Isisu sakho sisenokuvakala sidumbile kwaye sibuhlungu xa usichukumisa .
• Ukuba ukopha kuyaqhubeka, iimpawu ze-anemia enzima ziya kuqala ukubonakala kancinci kancinci.
• Usenokuziva unesiyezi, unentloko ebuhlungu, kwaye unesicaphucaphu .
• Usenokuziva nokunyuka kwesantya sentliziyo yakho .

Ukuba ufumana ezi mpawu, ngokuqinisekileyo kufuneka ufune uncedo lwezonyango ngokukhawuleza.

Zingaba zeziphi izizathu?

Zininzi izinto ezinokubangela i-hemoperitoneum, kodwa ezinye zezona zixhaphakileyo. Oogqirha bahlula ezi zizathu zibe ziindidi ezintathu:

1. Ukonzakala

2. Okuzenzekelayo

3. Njengesiphumo esingesiso sonyango lwezonyango (i-Iatrogenic)

Kwezi zinto, ukwenzakala ngenxa yeengozi kunye nokukhulelwa ngaphandle kwesisu zezona zinto ziphambili ezibangela i-hemoperitoneum.

1. I-Hemoperitoneum ebuhlungu

Oku kwenzeka xa ilungu okanye umthambo wegazi esiswini sakho wonzakele. Iindawo ezixhaphakileyo zisibindi kunye nepleen.La malungu mabini anokopha kakhulu. Oku kungenzeka ngenxa yokubethwa kakhulu (ukudumba okubukhali) okanye ngenxa yento ehlabayo ngaphakathi (ukudumba okungenayo) ngexesha lengozi.

Cinga ngezinto ezinje:

• Ukuwa ukusuka phezulu.
• Iingozi zezithuthi.
• Ukungqubana ngexesha lokudlala.
• Ukubethelwa ngqo esiswini.
• Ukuhlatywa ngemela.
• Ukudubula ngesibhamu.

Ukuba ufumana iintlungu zesisu kunye nezinye iimpawu emva kwengozi enkulu efana nale, eyona nto ingcono onokuyenza kukuya esibhedlele ngoko nangoko.

2. I-Hemoperitoneum ezenzekelayo

Oku kubizwa ngokuba yiSpontaneous okanye iNontraumatic Hemoperitoneum. Oku kukopha okwenzeka ngokuzenzekelayo, ngaphandle kwengozi. Kunokubangelwa sisifo okanye yenye inkqubo emzimbeni. Ngamanye amaxesha isitho okanye umthambo wegazi unokuqhekeka ngaphakathi, ngenxa yokudumba ngaphakathi, okanye ngenxa yokwenzakala kwangaphambili. Ukukhula okungaqhelekanga kwezicubu (ezifana neethumba) nako kuyenzeka ngaphakathi esiswini kwaye kophe.

Makhe sijonge izizathu ezimbalwa:

• Umthambo wegazi oqhekekileyo (i-Ruptured Aneurysm).
• Ukuqhuma kwe-arteriovenous malformation (AVM).
• Iintsholongwane zesisu eziqhekekileyo.
• Ukuqhekeka kweHematoma.
• Iithumba ziyaqhuma.
• I-cyst ye-ovarian eqhekekileyo.
• Ukukhulelwa okuqhambukileyo kwe-ectopic - oku kwenzeka kubafazi kuphela.
• Ukuqhekeka kwe-Splenic okuzenzekelayo.
• Ukugqobhoka kwesisu okanye kwamathumbu (Ukugqobhoka kwesisu).
• Inyongo eneembobo.
• I-pancreatitis ephuma igazi.

3. Njengesiphumo esingesihle sonyango lwezonyango (i-Iatrogenic Hemoperitoneum)

Oku kwenzeka njengesiphumo esingesihle sonyango oluthile. Oku kunqabile kakhulu, kodwa kunokwenzeka. Oku kwenzeka ukuba ilungu okanye umthambo wegazi wonakele ngengozi ngexesha lonyango.

Eminye imizekelo:

• Utyando lwesisu, olufana ne-laparoscopy, utyando olususa ilungu lomzimba, okanye xa umntwana ezalwa ngotyando lotyando.
• Uvavanyo lokuthatha isampuli yethishu (iBiopsy), umzekelo, kwisibindi (iLiver Biopsy) okanye kwizintso (iKidney Biopsy).
• Iindlela zokufaka ityhubhu (i-catheter) ngesisu, oko kukuthi, xa usenza i-PEG okanye i-Paracentesis.
• Uvavanyo lwe-Endoscopy, umzekelo, i-endoscopy ephezulu okanye i-colonoscopy.

Ukuba ufumana naziphi na iimpawu ezingaqhelekanga emva kwento efana nale, kubalulekile ukuxelela ugqirha okunyangileyo ngayo.

Ibachaphazela njani ngokukodwa abafazi?

Izitho zokuzala zabasetyhini nazo zifumaneka ngaphakathi kwesi singxobo sesisu. Ngoko ke, zinokopha ziye esiswini ngale ndlela. Umzekelo, izinto ezifana ne -ovarian cysts (ii-ovarian ruptured ovaries) kunye nokukhulelwa kwe-ectopic zinokwenzeka . Ezi ziimeko ezingxamisekileyo kakhulu.

Umngcipheko we-hemoperitoneum ngexesha lokukhulelwa unokwanda ngeendlela ezahlukeneyo. Ezinye iintlobo zeethumba zesibindi zinokukhula ngokukhawuleza kwaye ziqhume ngexesha lokukhulelwa. Kwakhona, ukopha kunokwenzeka ngexesha lokuzala, nokuba kwenzeka ngokuzenzekelayo okanye ngenxa yezizathu zonyango.

Ingaba yingozi ekhethekileyo ngexesha lokukhulelwa? (I-Spontaneous Hemoperitoneum ekukhulelweni - SHiP)

I-Spontaneous Hemoperitoneum in Pregnancy (SHiP) yimeko engaqhelekanga eyenzeka ngexesha lokukhulelwa. Ihlala isenzeka kwi-trimester yesibini okanye yesithathu. Isizathu esichanekileyo asaziwa. Ihlala isenzeka, kukuqhekeka komthambo wegazi. Kodwa oogqirha abakaqiniseki ukuba kutheni oku kwenzeka. Ubungqina obuthile bubonisa ukuba isenokuba inxulumene ne- endometriosis esele ikhona okanye ukuchumisa nge-in vitro (IVF) .

Ngaba zikho ezinye izinto ezibangela umngcipheko?

Ewe, ezinye izinto zinokwandisa le ngozi.

• Ukuba unengxaki yokopha okanye ukungabikho kwegazi eliqinileyo, unamathuba amaninzi okopha ngokubanzi. Oku kungabandakanya ukopha okuzenzekelayo okanye ukopha okukhulu ngenxa yokwenzakala okuncinci. Ungopha kakhulu kunabanye.
• Kubantu abanezifo ezithile ezingapheliyo, ukuba isifo siya sibi kwaye isitho somzimba siqhuma, banokuphuma igazi ngokuzenzekelayo esiswini. Nangona kunjalo, oku akuqhelekanga kakhulu.

Ziziphi iingxaki ezinokubakho?

Ukopha ngaphakathi esiswini kuyinto enzulu kuba yinto eyenzekayo emzimbeni kwaye inokuba yinto enzulu kakhulu ngexesha oyiqondayo. Iingxaki ziyavela ukuba ulahlekelwa ligazi elininzi ngokukhawuleza. Ukuba wopha kangakanani kwaye kwenzeka ngokukhawuleza kangakanani kuxhomekeke kwisizathu sokuqala (ukwenzakala okanye ukugula), ukuba wopha kangakanani, kwaye ufumana unyango ngokukhawuleza kangakanani.

Ukuba ukopha kukhulu, kunokukhokelela kwimeko ebizwa ngokuba yiHypovolemic Shock. Ngaphaya koko, ukungasebenzi kakuhle kwamalungu omzimba kunye nokufa kunokwenzeka. Ke ngoko, le yimeko engxamisekileyo kakhulu, kwaye akufuneki kuchithelwe umzuzwana.

Uyifumana njani le nto? (Ukuxilongwa)

Ukuba ukopha ngaphakathi, kubalulekile ukuba uxilongwe ngokukhawuleza. Xa oogqirha kufuneka babone ngokukhawuleza okwenzekayo emzimbeni wakho, badla ngokuqala ngovavanyo olukhawulezileyo lomfanekiso.

• Oko kuthetha ukuba i-ultrasound.Into efana ne-CT scan.
• I-FAST Ultrasound luvavanyo olusecaleni kwebhedi oluyilwe ngokukodwa ukujonga ukopha ngaphakathi kwesisu sakho. I-FAST sisifinyezo se-Focused Assessment kunye ne-Sonography yeTrauma.

Uninzi lwexesha, oogqirha banokusebenzisa olu vavanyo lokufota ukuze babone ukuba une-hemoperitoneum na kunye nokuba igazi livela phi. Kodwa ngamanye amaxesha, imifanekiso ayicacanga. Kusenokufuneka bathathe isampuli yolwelo oluvela esiswini sakho ngenaliti okanye ityhubhu (paracentesis). Ukuba ugula kakhulu, kunokufuneka bakuse kutyando lokuhlola, olulutyando lokufumana ingxaki kwaye lulungiswe ngoko nangoko.

Zithini iindlela zonyango?

Xa ugqirha efumanise ukuba igazi liphuma phi na, uza kujonga ukuba liphuma phi na, nokuba lisekhona na. Ukuba kukho ukopha, kufuneka kumiswe ngoko nangoko. Indlela okwenziwa ngayo oku iya kuxhomekeka kwimeko yakho.

• Kwimeko yongxamiseko, kunokufuneka wenze utyando olungxamisekileyo ukuze kulungiswe inxeba okanye kuvalwe umthambo wegazi.
• Ukuba imeko yakho izinzile, usenokungakwazi ukwenza nto ibalulekileyo kodwa uyilawule ngendlela egcina imeko yakho intle.

Unyango lungabandakanya:

• Ulawulo lweentlungu.
• Utofelo-gazi.
• Ukukhupha/Ukukhupha amanzi.
• Ukunyanga imeko engaphantsi.
• Ukufakwa kwe-embolization lunyango oluthintela umthambo wegazi.
• Iinkqubo ze-Endoscopy zokuvala inxeba.
• I-Laparoscopy yindlela yotyando yokuxilonga ingxaki kunye/okanye ukulungisa inxeba kusetyenziswa indlela efanayo.
• Utyando lwe-laparotomy lokuhlola ukuze kufunyanwe ingxaki kunye/okanye kulungiswe inxeba ngotyando lwesisu.

Linjani ithemba lokuchacha?

Ukuchacha kwakho kuya kuxhomekeka ekubeni ufumana unyango ngokukhawuleza kangakanani kwaye igazi lakho lihamba kakuhle kangakanani. Ukuba unesifo sokujiya kwegazi okanye esinye isifo esingapheliyo esichaphazela impilo yakho iyonke, imeko yakho inokuba mandundu ngakumbi. Ukufumana unyango ngokukhawuleza kunokunceda ukuthintela iingxaki ezibangelwa kukulahlekelwa ligazi kakhulu. Ukuba unokuthintela ezo ngxaki, unethuba elingcono lokuchacha ngokupheleleyo.

I-Hemoperitoneum yimeko engxamisekileyo eyenzeka ngequbuliso nangokungalindelekanga. Ukuba ukhe waba nengozi, usenokuba sele ufumana unyango. Kodwa kungenjalo, usenokungazi ukuba kwenzeka ntoni xa iimpawu zibonakala.Eyona nto ibalulekileyo kukungazeyiki iimpawu zakho kwaye ufune iingcebiso zonyango ngaphambi kokuba zibe mbi ngakumbi. Ukuba uyifumana kwangethuba le sifo kwaye ufumane unyango, amathuba akho okuchacha mahle.

Okokugqibela, izinto ekufuneka uzikhumbule

I-Hemoperitoneum yimeko engxamisekileyo esongela ubomi apho ukopha kwenzeka ngaphakathi esiswini.

• Ukuba ufumana iimpawu ezinje ngentlungu eqatha yesisu, ukudumba, isiyezi, okanye ukuziva ubuthathaka , musa ukuyithatha lula loo nto.
• Oku kunokwenzeka ngenxa yeengozi, izifo ezithile, iingxaki ezinxulumene nokukhulelwa, kunye nonyango lwezonyango.
• Eyona nto ibalulekileyo kukufumanisa isifo nokusinyanga ngokukhawuleza. Ukuba wenza njalo, ungathintela iingxaki ezinkulu kwaye uphile ngokupheleleyo.
• Ukuba unale mpawu, bonana nogqirha ngoko nangoko okanye uye kwisibhedlele esikufutshane. Ixesha libaluleke kakhulu apha. Ungakhathazeki, kodwa khawuleza.

I- Hemoperitoneum, ukopha esiswini, ukopha ngaphakathi, igazi lesisu, iintlungu zesisu, utyando, ukhathalelo olungxamisekileyo