Ingabe unesikhwama esincane emqaleni wakho? (Esophageal Diverticulum)?

Ingabe ngezinye izikhathi uzizwa sengathi kukhona okubhajwe emphinjeni wakho uma ugwinya ukudla? Noma ingabe umane unuka iphunga elibi eliphuma emlonyeni wakho? Lezi kungaba izimpawu zesimo esibizwa ngokuthi i-esophageal diverticulum, esizokhuluma ngaso namuhla. Ungakhathazeki, akuvamile kangako. Kodwa kuhle ukwazi okuncane ngakho. Ake sixoxe ngakho kalula, ngendlela ongayiqonda.

Iyini le sikhwama esincane esiku-esophagus (Esophageal Diverticulum)?

Kulungile, ake siqale sibone ukuthi lokhu (i-Esophageal Diverticulum) kuyini. Uyazi, sinepayipi elithatha ukudla emlonyeni wethu liye esiswini sethu, silibiza ngokuthi i -esophagus . Lifana nepayipi lamanzi, kodwa lenziwe ngemisipha. Ngaphakathi kwaleli payipi lokudla, ngezinye izikhathi liphuma ezindaweni ezibuthakathaka odongeni, bese lenza into efana nesikhwama esincane, noma iphakethe elincane. Yingakho silibiza kanje. Cabanga ngalo njengethayi emotweni eliguga futhi liqhume kancane endaweni eyodwa. Yilokho okufana nakho lokhu.

Kunezinhlobo ezimbili zalezi zikhwama ezincane.

• Isikhwama 'seqiniso': Lokhu kusho ukuthi zonke izendlalelo zodonga lomphimbo , okuhlanganisa nesendlalelo semisipha, ziyaphuma.
• Isikhwama 'Esingamanga': Lokhu kwenzeka lapho kuvela khona izendlalelo ezithile zodonga, njenge-mucosa kanye nesendlalelo esingaphansi (i-submucosa). Kufana nokuthi kukhishwa imicu embalwa yendwangu.

Odokotela bahlonza la ma-cyst ngokusekelwe ekutheni akuphi emhubheni. Izimbangela zama-cyst ezindaweni ezahlukene zingahluka.

Yiziphi izinhlobo ze-esophageal diverticulum?

Ake sibone ukuthi yiziphi izinhlobo eziyinhloko ezingabonakala.

I-diverticulum kaZenker

Lolu uhlobo oluvame kakhulu . Lwakheka phezulu komphimbo, lapho umphimbo uhlangana khona nomlomo. Ngokuvamile, lezi yizikhwama 'ezingamanga'. Isizathu esiyinhloko ukuthi lapho ukudla kunzima ukugwinya , lapho imisipha yomphimbo ingasebenzi kahle, ingcindezi ngaphakathi komphimbo iyanda bese iwusunduza endaweni ebuthakathaka. Cabanga ngepayipi lamanzi elivalekile ngesikhathi esithile, futhi lapho amanzi efika ngokushesha, ipayipi liyavuvukala ngaphambi kwendawo evalekile.

Killian-Jamieson Diverticulum

Lokhu akuvamile kangako. Kwenzeka emqaleni womlomo wesibeletho, ingxenye yentamo yethu ehambisana nomgogodla. Ngokuvamile kubhekwa njengesikhwama esincane 'esingamanga' esisodwa. Kucatshangwa ukuthi kubangelwa ubuthakathaka bokuzalwa ezicutshini ezikuleyo ndawo.

I-Midesophageal Diverticulum

Lezi yizikhwama 'zeqiniso'. Zakha engxenyeni yomphimbo odlula phakathi kwesifuba sethu. Zibizwa nangokuthi (i-thoracic diverticula) , okusho ukuthi zakha esifubeni. Ngezinye izikhathi zibizwa ngokuthi (i-traction diverticula).Isizathu salokhu ukuthi zakheka lapho amandla athile angaphandle edonsa odongeni lwe-esophagus (traction). Isibonelo, ama-lymph node esifubeni angavuvukala futhi anamathele ku-esophagus, bese kuthi lapho ukuvuvukala kuncipha, udonga lwe-esophagus lungadonsa.

I-Epiphrenic Diverticulum

Lokhu kwenzeka ekugcineni komhubhe, ngaphambi nje kokuba ukudla kungene esiswini (i-distal esophagus). Lezi zivame ukuba yizikhwama 'zamanga'. Nalapha futhi, imbangela ingcindezi. Isibonelo, uma ingxenye engezansi yomhubhe ivinjiwe, isikhwama singakheka ngenxa yengcindezi edalwa lapho ukudla kuzama ukudlula kuso siye esiswini.

Sivame kangakanani lesi simo?

I-Esophageal diverticula empeleni ayivamile kakhulu . Kucatshangwa ukuthi ithinta cishe u-1% wabantu. Ivame kakhulu kubantu abangaphezu kweminyaka engu-50 , ikakhulukazi ngemva kweminyaka engu-70. Ivame kakhulu futhi kwabesilisa kunabesifazane.

Ziyini izimpawu ze-esophagus diverticulum?

Esikhathini esiningi, la ma-diverticula awabangeli zimpawu . Ungase ungazi nokuthi unawo. Kodwa-ke, uhlobo olubizwa ngokuthi i-Zenker's diverticulum luvame ukubangela izimpawu. Uma unalezi zimpawu, ungase ubhekane nalokhu:

• Kuzwakala sengathi ukukhwehlela okunomphimbo obuhlungu.
• Ukuzwa sengathi kukhona okubambeke emphinjeni lapho ugwinya ukudla.
• Umuzwa sengathi ukudla kunamathele emphinjeni.
• Ukudla kubuyela phezulu emphinjeni (ukubuyela emuva) uma ugoba phambili noma ulala phansi.
• Umoya omubi ngaphandle kwesizathu.
• Ukuphefumula kuwumsindo wokukhala kwekhwela lapho uphefumula ngaphandle kwesizathu.

Abanye abantu abanazo lezi zimpawu futhi batholakala ngengozi kuphela ngesikhathi sokuhlolwa okwenziwe ngesinye isizathu.

Yini ebangela i-esophageal diverticulum?

Kunezinhlobo ezimbili eziyinhloko zezimbangela. Eyokuqala yizimbangela zokudonsa umoya , kanti enye yizimbangela zokudonsa umoya .

Amaphakethe okudonsa umoya: Amaphakethe amaningi okudonsa umoya awela kulesi sigaba. Igama elithi 'Pulsion' lisho "ukusunduza." Lokhu kusho ukuthi kukhona ingcindezi yangaphakathi eqhubekayo emhubheni. Lokhu kuvame ukwenzeka uma sigwinya ukudla. Ezinye izimo zezokwelapha emhubheni ezenza kube nzima ukugwinya ukudla zingabangela lokhu kucindezela okungavamile. Isibonelo:

• (i-Achalasia) (ukuntuleka kokukhululeka kwemisipha yomphimbo ongezansi)
• Ukuqaqamba komlomo wesibeletho
• Ukuqina komlomo wesibeletho
• I-Eosinophilic esophagitis

Izikhwama zokudonsa:Lokhu kwakheka lapho into ethile idonsa ngaphandle kodonga lomphimbo bese iyidonsa. Yilokhu okubangela izikhwama 'zeqiniso', okuyizo zonke ubukhulu bodonga lomphimbo oludonselwa ngaphakathi. Lezi zivame ukutholakala phakathi kwesifuba. Ukutheleleka esifubeni (i-mediastinitis) kungabangela ukuvuvukala, okunganamathela kumphimbo, bese kudonsa umphimbo njengoba ukuvuvukala kwehla. Izibonelo zalezi zifo zifaka:

• Isifo sofuba
• I-Histoplasmosis , ukutheleleka kwesikhunta

Zombili lezi zimbangela ziyizimila ezintsha ezikhula phakathi nesikhathi sethu sokuphila. Akuvamile ukuthi kube khona ezinye izikhwama zendunu lapho kuzalwa. Noma, ubuthakathaka bokuzalwa ezicutshini zomsele wendunu bungenza kube lula ukuthi isikhwama sikhule kamuva. Kodwa isikhathi esiningi, lesi sikhwama asikhuli ngaphandle kokuba kuvele esinye isimo sezempilo kuqala.

Yiziphi izinkinga ezingaba khona zalesi sifo se-esophagus diverticulum?

Njengoba lesi sikhwama siba sikhulu ngokuhamba kwesikhathi, ukudla kuba sengozini enkulu yokubhajwa ngaphakathi . Lokhu kungazwakala njengeqhubu emphinjeni wakho, noma kungatheleleka futhi kube buhlungu . Ukudla okubhajwe kungabangela umoya omubi kanye nokunambitheka okubi emlonyeni wakho. Uma kutheleleka, kungaphuma igazi futhi kuvuvuke. Ezimweni ezimbi kakhulu, kungazwakala njengeqhubu elingazwakala ngaphandle kwentamo yakho.

Enye into ukuthi ukudla kungahlala kubambekile isikhashana bese kubuyela phezulu emphinjeni uma ushintsha izikhundla (isibonelo, uma ugoba). Lokhu kungabangela ukukhwehlela, ukuphelelwa umoya, kanye nomphimbo obuhlungu. Uma lokhu kwenzeka ebusuku ngenkathi ulele, izinhlayiya zokudla zingangena emaphashini ngaphandle kokuthi uqaphele (i-buthule aspiration) . Uma lokhu kwenzeka, kungabangela ukutheleleka emaphashini (i-aspiration pneumonia) . Lokhu kuvame kakhulu kubantu abane-Zenker's diverticulum.

Ingabe lo mdlavuza? Ingabe umdlavuza?

Iphesenti elincane kakhulu (cishe u-0.05%) labantu abane-esophagus diverticulum kutholakale ukuthi bane- squamous cell carcinoma ye-esophagus. Kodwa-ke, akukacaci ukuthi lokhu kumane nje kuyingozi noma ukuthi ukucasuka okungapheli okuvela ku-diverticulum kubangela umdlavuza. Kodwa-ke, le ngozi iphansi kakhulu .

Uthola kanjani ukuthi une-esophageal diverticulum?

Ukuhlolwa kwezokwelapha okubheka ngaphakathi komphimbo kungabona lesi sikhwama. Ngokuvamile, azinazo izimpawu, ngakho-ke zitholakala ngengozi ngesikhathi sokuhlolwa ngesinye isizathu. Uma unezimpawu ezihlobene nomphimbo wakho, udokotela wakho uzokwenza ukuhlolwa okubizwa ngokuthi i-radiology noma i-endoscopy. Ngenkathi i-radiology ithatha izithombe ngaphandle, i-endoscopy isebenzisa ikhamera ukubheka ngaphakathi.

Hlobo luni lokuhlolwa oluzokwenziwa?

Nazi ezinye izivivinyo ezingaba khona:

• Ukuhlolwa kwe-Esophagram / Barium Swallow:

Lolu uhlobo lwe-X-ray. Kuthathwa ividiyo (i-fluoroscopy) yomhudo wakho ngenkathi ugwinya. Kulokhu, unikezwa uketshezi olufana ne-chalk olubizwa ngokuthi i-barium ukuze uluphuze. Lumboza ingaphakathi lomhudo wakho. Bese kuba yi-X-ray lapho ugwinya. Lokhu kukuvumela ukuthi ubone kahle ukuma komhudo wakho, indlela ukudla okudlula ngayo, kanye nanoma yiziphi izikhwama ezingaba khona.

• Ukuhlolwa kwe-Upper Endoscopy / EGD:

Kulokhu, kufakwa ithubhu elide elinekhamera encane ebizwa ngokuthi i-endoscope ngomlomo bese lidlula emhubheni liye esiswini. Uzolaliswa phakathi nalesi sikhathi, ngakho ngeke uzizwe ungakhululekile. Izithombe ezivela kukhamera zingabukwa esikrinini sekhompyutha. Uma kukhona isikhwama, singabonakala ngqo.

• Ukuhlolwa kwe-Esophageal Manometry:

Njengoba ubunzima bokugwinya buyimbangela enkulu yezikhwama zomphimbo, ithimba lakho lezokwelapha lingaphakamisa nalokhu kuhlolwa. Lokhu kulinganisa ukuthi imisipha yomphimbo wakho iqina kangakanani uma ugwinya. Lokhu kulinganisa kuthathwa kusetshenziswa izinzwa ezisepayipini elifakwa ngekhala lakho bese lingena emphinjeni wakho.

Yiziphi izindlela zokwelapha i-esophageal diverticulum?

Iningi lama-scrotal sacs alidingi ukwelashwa . Uma engabangeli zimpawu noma izinkinga, angashiywa wodwa. Kodwa-ke, uma i-sac ibangela izimpawu noma izinkinga, kungadingeka ivalwe noma isuswe. Odokotela banezindlela ezahlukahlukene zokwenza lokhu. Kungadingeka futhi welaphe isimo esiyisisekelo esibangele i-scrotal sac yakho.

Iphathwa kanjani i-esophagus diverticulum?

Udokotela angakwenza lokhu ngokuhlinzwa noma nge-endoscopy. Izindlela ezahlukene zingase zibe ngcono kakhulu ezinhlotsheni ezahlukene zezikhwama. Udokotela wakho uzonquma ukuthi iyiphi indlela engcono kakhulu kuwe ngokusekelwe empilweni yakho iyonke. Isibonelo, uma ufuna inqubo engangenisi kakhulu, i-endoscopy ingaba inketho enhle. Udokotela wakho uzokhuluma nawe ngezingozi nezinzuzo zendlela ngayinye.

Ukulungiswa Kokuhlinzwa

Udokotela ohlinzayo angasika ngokuphelele isikhwama (i-diverticulectomy) noma asidonse asithungele odongeni lwe-esophagus yakho (i-diverticulopexy) . Ukuhlinzwa kungase kuhilele nenqubo ebizwa ngokuthi i-myotomy . I-myotomy inqubo esika imisipha e-esophagus yakho ukuze kuncishiswe ukuqina. Lokhu kungadingeka ukuze kusizwe ngobunzima bokugwinya okwenze isikhwama sakho sakheka.

I-Endoscopic Diverticulotomy

Enye indlela yokuhlinzwa ukufaka i-endoscope ngomlomo ungene emhubheni bese wenza ukuhlinzwa ngayo. Lokhu kubizwa ngokuthi inqubo ye-Dohlman.Lokhu kuhilela ukusika i-septum phakathi kwesikhwama nolunye udonga lomphimbo. Lokhu kungenziwa kusetshenziswa i-laser, i-electrocautery, noma i-stapler. Lawa madivayisi angasika futhi avale inxeba.

Kuthatha isikhathi esingakanani ukululama ngemva kwalokhu kuhlinzwa?

Kuzodingeka uhlale esibhedlela cishe usuku lonke. Ngemuva kwalokho kuzodingeka uphumule ekhaya amasonto ambalwa. Umphimbo wakho ungase ube buhlungu futhi uvuvukele amasonto ambalwa. Lokhu kungenza kube nzima ukugwinya ukudla. Kungase kucebiseke ukuthi kuncishiswe ubuhlungu, kodwa kungase kungadingeki. Udokotela wakho uzokweluleka ngokuthi ungaqala kanjani futhi nini ngokudla okumanzi, kancane kancane uqhubekele ekudleni okuthambile, bese udla ukudla okuvamile.

Uthini izwi lakho lokugcina ngalesi simo?

Iningi labantu line-esophagus diverticulum futhi ayibangeli zinkinga . Kodwa uma ibangela, kunezindlela eziningana zokuyilungisa. Izinga lempumelelo lalokhu kuhlinzwa lingaphezu kuka-90% . Kodwa-ke, kunengozi engu-10% yezinkinga ezifana nokopha, ukutheleleka, noma ukulimala komphimbo. Ithimba lakho lezokwelapha lizoxoxa nawe ngezingozi nezinzuzo zezindlela ezahlukene zokwelapha.

Uma unesifo esenza kube nzima ngawe ukugwinya, ungase ube nesikhwama esinjengalesi odongeni lomphimbo wakho. Lesi sikhwama singakheka endaweni ebuthakathaka kumphimbo wakho ngenxa yokucindezela okungavamile okwenzeka lapho ugwinya. Kungase kungakukhathazi nhlobo. Kodwa uma uthola izimpawu ezintsha ezihlobene nomphimbo wakho, bona udokotela. Ngaleyo ndlela, banganquma ngokuqondile ukuthi yisikhwama noma okunye futhi bakunikeze ukwelashwa okudingekayo.

Izinto ezibalulekile okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

• I-esophagus diverticulum iyisikhinjana esincane esakheka odongeni lwe-esophagus.
• Lezi azivamile kakhulu futhi ngokuvamile azibonisi izimpawu.
• Uma kuvela izimpawu, zingase zihlanganise ubunzima bokugwinya, ukudla okubhajwe emphinjeni, kanye nomlomo onuka kabi.
• Esikhathini esiningi, lokhu akudingi ukwelashwa .
• Kodwa-ke, uma izimpawu zinzima noma kuvela izinkinga, ukuhlinzwa noma izinqubo ze-endoscopic zingelashwa ngempumelelo.
• Kubalulekile ukufuna iseluleko sezokwelapha uma unenkinga yokugwinya noma unezimpawu ezintsha. Ungakhathazeki, odokotela bakhona ukuzokusiza.

Ngiyethemba ukuthi lolu lwazi luwusizo kuwe. Hlala uphilile!

Umphimbo , umphimbo, i-diverticulum, ubunzima bokugwinya, umphimbo obuhlungu, i-reflux, i-endoscopy