Ukopha kwangaphakathi esiswini? (Hemoperitoneum) Ake sixoxe ngalokhu!

Wake waba nobuhlungu besisu obungachazeki, umuzwa wokugcwala, kanye nomuzwa osheshayo wesiyezi? Mhlawumbe lokhu kuyisimo esiphuthumayo. Namuhla sizokhuluma nge-hemoperitoneum, ephuma igazi ngaphakathi esiswini. Lokhu akuyona into elula ukuyenza, ngakho-ke kubalulekile ukulalela ngokucophelela.

Kalula nje, i-Hemoperitoneum ukuqongelela kwegazi endaweni engenalutho ngaphakathi kwesisu sakho, umgodi we-peritoneal. I-'Hemo' isho igazi, kanti i-'peritoneum' isho ulwelwesi olumboze lo mgodi wesisu. Ngakho-ke, ukopha ngaphakathi emzimbeni kanje (sikubiza nangokuthi ukopha kwangaphakathi noma ukopha kwegazi) kuyingozi kakhulu futhi kudinga ukulaliswa esibhedlela ngokushesha.

Kungani lokhu kungathi sína kangaka?

Cabanga nje, kwenzekani uma igazi emzimbeni wethu liphuma emithanjeni bese liqoqana kwenye indawo? Inani legazi elifinyelela ezithweni nasezicutshini zethu ezibalulekile liyancipha. Uma igazi ligeleza ngaphakathi emzimbeni, asiboni ukuthi ligeleza malini nokuthi lihamba ngokushesha kangakanani. Ikakhulukazi kulesi sitho sesisu, inani elikhulu legazi lingaqongelela. Uma ukopha kungamiswa ngale ndlela, kunengozi yokulahlekelwa igazi elanele kuze kube sezingeni lokuthi kungaba yingozi empilweni. Yingakho lokhu kuyingozi kangaka.

Ziyini izimpawu?

Izimpawu ze-hemoperitoneum zingahluka kumuntu nomuntu, kuye ngokuthi imbangela ikuphi.

• Ungase uzwe ubuhlungu obukhulu besisu noma ubuhlungu be-pelvic ngokuzumayo.
• Kodwa ngezizathu ezithile, ubuhlungu bungase bunciphe njengoba ufika.
• Isisu sakho singase sizizwe sivuvukile futhi sibuhlungu uma usithinta .
• Uma ukopha kuqhubeka, izimpawu ze-anemia enzima zizoqala ukuvela kancane kancane.
• Ungase uzizwe unesiyezi, unekhanda elibuhlungu, futhi unesicanucanu .
• Ungase uzizwe nokushaya kwenhliziyo yakho kunyuka .

Uma uhlangabezana nalezi zimpawu, kufanele nakanjani ufune iseluleko sezokwelapha ngokushesha.

Zingaba yini izizathu?

Kunezimbangela eziningi ezingaba khona ze-hemoperitoneum, kodwa ezinye yizona ezivame kakhulu. Odokotela bahlukanisa lezi zimbangela zibe yizigaba ezintathu:

1. Okubuhlungu

2. Okuzenzakalelayo

3. Njengomphumela ongemuhle wokwelashwa (i-Iatrogenic)

Kulokhu, ukulimala okubangelwa izingozi kanye nokukhulelwa ngaphandle kokukhulelwa yizona zimbangela eziyinhloko ze-hemoperitoneum.

1. I-Hemoperitoneum Ebuhlungu

Lokhu kwenzeka uma isitho noma umthambo wegazi esiswini sakho ulimele. Izindawo ezivame kakhulu ukuthinteka yisibindi kanye ne-spleen.Lezi zitho ezimbili zingopha igazi kakhulu. Kungabangelwa ukushaywa kanzima (ukuhlukumezeka okukhulu) noma into ehlabayo ngaphakathi (ukuhlukumezeka okungena) ngesikhathi sengozi.

Cabanga ngezinto ezinjengalezi:

• Ukuwa kusuka phezulu.
• Izingozi zezimoto.
• Ukushayisana ngenkathi idlala.
• Ukushaywa ngqo esiswini.
• Ukugwazwa ngommese.
• Ukudubulana.

Uma uzwa ubuhlungu besisu nezinye izimpawu ngemva kwengozi enkulu efana nale, into engcono kakhulu ongayenza ukuya esibhedlela ngokushesha.

2. I-Hemoperitoneum Ezenzakalelayo

Lokhu kubizwa ngokuthi i-Spontaneous noma i-Nontraumatic Hemoperitoneum. Lokhu ukopha okwenzeka ngokuzenzekelayo, ngaphandle kwengozi. Kungabangelwa yisifo noma enye inqubo emzimbeni. Ngezinye izikhathi isitho noma umthambo wegazi ungaqhekeka ngaphakathi, ngenxa yokuvuvukala ngaphakathi, noma ngenxa yokulimala kwangaphambilini. Ukukhula kwezicubu okungavamile (njengezimila) nakho kungavela ngaphakathi esiswini bese kopha.

Ake sibheke izizathu ezimbalwa:

• Umthambo wegazi oqhekekile (i-Ruptured Aneurysm).
• Ukuqhuma kwe-arteriovenous malformation (AVM).
• Izifo zesisu eziphukile.
• Ukuqhuma kwe-hematoma.
• Izimila ziyaqhuma.
• I-cyst ye-ovarian ephukile.
• Ukukhulelwa okuqhumile kwe-ectopic - lokhu kuqondene nabesifazane.
• Ukuqhuma Kwe-Splenic Okuzenzekelayo.
• Ukubhoboka kwesisu noma kwamathumbu (Ukubhoboka kwesisu).
• Inyongo Enezimbobo.
• I-pancreatitis ebangelwa ukopha.

3. Njengomphumela ongemuhle wokwelashwa (i-Iatrogenic Hemoperitoneum)

Lokhu kwenzeka njengomphumela ongemuhle wokwelashwa okuthile. Lokhu akuvamile kakhulu, kodwa kungenzeka. Lokhu kwenzeka uma isitho noma umthambo wegazi wonakele ngengozi ngesikhathi sokwelashwa.

Ezinye izibonelo:

• Ukuhlinzwa kwesisu, njenge-laparoscopy, ukuhlinzwa okususa isitho, noma lapho umntwana ezalwa ngokuhlinzwa.
• Ukuhlolwa kokuthatha isampula yezicubu (i-Biopsy), isibonelo, esibindini (i-Liver Biopsy) noma ezinso (i-Kidney Biopsy).
• Izindlela zokufaka ithubhu (i-catheter) esiswini, okungukuthi, lapho kwenziwa i-PEG noma i-Paracentesis.
• Ukuhlolwa kwe-Endoscopy, isibonelo, i-endoscopy engenhla noma i-colonoscopy.

Uma uhlangabezana nanoma yiziphi izimpawu ezingavamile ngemva kwento efana nale, kubalulekile ukutshela udokotela okuphathe ngayo.

Kuthinta kanjani abesifazane ngokukhethekile?

Izitho zohlelo lokuzala lwabesifazane nazo zitholakala ngaphakathi kwalesi sikhala sesisu. Ngakho-ke, zingaphuma igazi esiswini ngale ndlela. Isibonelo, izinto ezifana nama-ovarian cyst (ama-ovarian ruptured) kanye nokukhulelwa kwe-ectopic kungenzeka . Lezi yizimo eziphuthumayo kakhulu.

Ingozi ye-hemoperitoneum ngesikhathi sokukhulelwa inganda ngezindlela eziningana. Ezinye izinhlobo zezimila zesibindi zingakhula ngokushesha futhi ziqhume ngesikhathi sokukhulelwa. Futhi, ukopha kungenzeka ngesikhathi sokubeletha, kungaba ngokuzumayo noma ngenxa yezizathu zezokwelapha.

Ingabe kuyingozi ekhethekile ngesikhathi sokukhulelwa? (I-Spontaneous Hemoperitoneum ekukhulelweni - SHiP)

I-Spontaneous Hemoperitoneum in Pregnancy (SHiP) yisimo esingavamile esenzeka ngesikhathi sokukhulelwa. Ngokuvamile senzeka ku-trimester yesibili noma yesithathu. Imbangela eqondile ayaziwa. Ngokuvamile, kuba ukuqhekeka komthambo wegazi. Kodwa odokotela abakaqiniseki ukuthi kungani kwenzeka. Obunye ubufakazi busikisela ukuthi kungase kuhlotshaniswe ne- endometriosis ekhona noma ukukhulelwa kwe-in vitro (IVF) .

Ingabe zikhona ezinye izinto eziyingozi?

Yebo, ezinye izinto zingandisa le ngozi.

• Uma unesifo sokopha noma ukuntuleka kokujiya kwegazi, kungenzeka kakhulu ukuthi wophe igazi ngokujwayelekile. Lokhu kungafaka ukopha okuzenzekelayo noma ukopha okukhulu okuvela ekulimaleni okuncane. Ungase wophe igazi kakhulu kunabanye.
• Kubantu abanezifo ezithile ezingamahlalakhona, uma lesi sifo siba sibi kakhulu futhi isitho siqhuma, bangopha igazi ngokuzenzekelayo esiswini. Kodwa-ke, lokhu akuvamile kakhulu.

Yiziphi izinkinga ezingaba khona?

Ukopha ngaphakathi esiswini kuyinto engathi sína ngoba kuyinto eyenzekayo emzimbeni futhi ingaba yingozi kakhulu ngesikhathi uqaphela. Izinkinga ziyavela uma ulahlekelwa igazi eliningi ngokushesha. Ukuthi wopha malini nokuthi kwenzeka ngokushesha kangakanani kuncike embangela yokuqala (ukulimala noma ukugula), ukuthi wopha malini ngokuvamile, nokuthi uthola ukwelashwa ngokushesha kangakanani.

Uma ukopha kukhulu, kungaholela esimweni esibizwa ngokuthi i-Hypovolemic Shock. Ngaphandle kwalokho, ukwehluleka kwezitho zomzimba ngisho nokufa kungenzeka. Ngakho-ke, lesi yisimo esiphuthumayo kakhulu, futhi akufanele kuchithwe umzuzwana.

Ukuthola kanjani lokhu? (Ukuxilongwa)

Uma unesifo sokopha ngaphakathi, kubalulekile ukuthi uxilongwe ngokushesha. Uma odokotela bedinga ukubona ngokushesha ukuthi kwenzekani emzimbeni wakho, bavame ukuqala ngokuhlolwa okusheshayo kwezithombe.

• Lokho kusho ukuthi kwenziwa i-ultrasound.Into efana ne-CT scan.
• I-FAST Ultrasound ukuhlolwa okuseceleni kombhede okwenzelwe ngqo ukuhlola ukopha ngaphakathi kwesisu sakho. I-FAST isifinyezo se-Focused Assessment ene-Sonography ye-Trauma.

Esikhathini esiningi, odokotela bangasebenzisa lezi zivivinyo zezithombe ukuze babone ukuthi une-hemoperitoneum nokuthi igazi livelaphi. Kodwa ngezinye izikhathi, izithombe azicacile. Kungase kudingeke bathathe isampula yoketshezi esiswini sakho ngenaliti noma ngepayipi (paracentesis). Uma ugula kakhulu, kungadingeka bakuyise ohlinzweni lokuhlola, okuwukuhlinzwa ukuthola inkinga bese uyilungisa ngokushesha.

Yiziphi izindlela zokwelapha?

Uma udokotela esethole i-hemoperitoneum, uzobheka ukuthi ukuphuma kwegazi kuvela kuphi nokuthi kusaqhubeka yini. Uma kukhona ukuphuma kwegazi, kudingeka kumiswe ngokushesha. Indlela okwenziwa ngayo lokhu izoncika esimweni sakho.

• Esimweni esiphuthumayo, kungadingeka wenze ukuhlinzwa okuphuthumayo ukuze kulungiswe inxeba noma kuvalwe umthambo wegazi.
• Uma isimo sakho sizinzile, ungase ungakwazi ukwenza lutho olukhulu bese umane usilawule ngendlela ehlelekile.

Ukwelashwa kungafaka:

• Ukuphathwa Kobuhlungu.
• Ukumpontshelwa igazi.
• Ukuphuma/Ukukhipha amanzi.
• Ukwelapha isimo esiyisisekelo.
• Ukufakwa kwe-embolization kuyindlela yokwelapha evimba umthambo wegazi.
• Izinqubo ze-Endoscopy zokuvala inxeba.
• I-Laparoscopy inqubo yokuhlinzwa yokuxilonga inkinga kanye/noma ukulungisa inxeba kusetshenziswa indlela efanayo.
• Ukuhlolwa kwe-laparotomy ukuthola inkinga kanye/noma ukulungisa inxeba ngokuhlinzwa kwesisu.

Linjani ithemba lokululama?

Ukululama kwakho kuzoncika ekutheni uthola ukwelashwa ngokushesha kangakanani nokuthi igazi lakho ligeleza kahle kangakanani. Uma unesifo sokujiya kwegazi noma esinye isimo esingamahlalakhona esithinta impilo yakho iyonke, isimo sakho singase sibe sibi kakhulu. Ukuthola ukwelashwa ngokushesha ngangokunokwenzeka kungasiza ekuvimbeleni izinkinga ezibangelwa ukulahlekelwa igazi okukhulu. Uma ungavimbela lezo zinkinga, unethuba elingcono lokululama ngokugcwele.

I-Hemoperitoneum iyisimo esiphuthumayo esenzeka ngokuzumayo nangokungalindelekile. Uma uke waba nengozi, kungenzeka ukuthi usuvele uthola usizo lwezokwelapha. Kodwa ngaphandle kwalokho, ungase ungaqapheli ukuthi kwenzekani lapho kuvela izimpawu.Into ebaluleke kakhulu ukungazinaki izimpawu zakho bese ucela iseluleko sezokwelapha ngaphambi kokuba zibe zimbi kakhulu. Uma usheshe wabamba lesi sifo futhi uthola ukwelashwa, amathuba akho okululama mahle.

Okokugcina, izinto okudingeka uzikhumbule

I-Hemoperitoneum yisimo esiphuthumayo esisongela ukuphila lapho ukuphuma kwegazi kwenzeka ngaphakathi esiswini.

• Uma uzwa izimpawu ezifana nobuhlungu obukhulu besisu obungazelelwe, ukuqunjelwa, isiyezi, noma umuzwa wobuthakathaka , ungakuthathi kalula.
• Lokhu kungenzeka njengomphumela wezingozi, izifo ezithile, izinkinga ezihlobene nokukhulelwa, kanye nokwelashwa.
• Into ebaluleke kakhulu ukuxilonga nokwelapha lesi sifo ngokushesha. Uma wenza kanjalo, ungavimbela izinkinga ezinkulu futhi ululame ngokugcwele.
• Uma unalezi zimpawu, bona udokotela ngokushesha noma uye esibhedlela esiseduze. Isikhathi sibaluleke kakhulu lapha. Ungakhathazeki, kodwa shesha.

I- Hemoperitoneum, ukopha esiswini, ukopha kwangaphakathi, igazi lesisu, ubuhlungu besisu, ukuhlinzwa, ukunakekelwa okuphuthumayo