Wake wazizwa sengathi kukhona okubambeke esiswini sakho, isisu sakho siyakhula, futhi uzizwa sengathi kuzoqhuma? Kwakungathi amathumbu akho avalekile ngokuphelele. Ngokuvamile, lokho kwenzeka lapho okuthile kuvalekile emathunjini akho. Kodwa-ke, kunesimo esingajwayelekile nesingavamile lapho amathumbu akho eyeka ukusebenza ngokuzumayo ngaphandle kokuthi kukhona okubambeke ngaphakathi. Namuhla, sizokhuluma ngesimo abantu abaningi abangakaze basizwe. Ngokwezokwelapha, sibiza lesi sifo ngokuthi i-Ogilvie Syndrome noma i-Acute Colonic Pseudo-obstruction (ACPO) .
Kalula nje, iyini i-Ogilvie Syndrome?
Cabanga nje, kunezimoto eziningi, kodwa azikho izingozi noma izithiyo emgwaqweni. Izimoto zimane zimile. I-Ogilvie Syndrome iyinto efana naleyo. Ukuhamba kokudla kanye nemfucuza ngaphakathi kwekholoni lakho kuyama ngokuzumayo. Kuzwakala sengathi kukhona okubambeke kukholoni lakho, kodwa empeleni akukho ukuvinjelwa ngokomzimba. Inkinga isesimisweni sezinzwa esilawula imisipha kukholoni lakho. Ngenxa yokuthi ayisebenzi kahle, ukunyakaza kwekholoni (esikubiza ngokuthi "i-peristalsis"`) kuyama, futhi okuqukethwe ngaphakathi kuyabhajwa endaweni eyodwa. Lokhu kubangela ukuthi ikholoni ikhule kancane kancane, noma ikhukhumale.
Igama elithi ``ukuvinjelwa okungamanga'' egameni lalo lisho ``ukuvinjelwa okungamanga.'' Lokhu kusho ukuthi kuveza izimpawu njengokungathi kukhona ukuvinjelwa, yize empeleni kungekho ukuvinjelwa.
Lokhu kuhluke kanjani kwezinye izinkinga zamathumbu?
Kunezimo ezahlukene eziphazamisa ukusebenza kwamathumbu. Ngakho ake sibone ukuthi i-Ogilvie Syndrome ihluke kanjani kuzo.
- Uma kuqhathaniswa nezinye izimo ze-'Intestinal Pseudo-obstruction': I-Ogilvie Syndrome iyisimo 'esibi kakhulu'. Okusho ukuthi, sivela ngokuzumayo, futhi singesesikhashana . Futhi sithinta amathumbu amakhulu kuphela . Kodwa-ke, abanye abantu bangaba nezimo 'ezingapheli' 'ze-pseudo-obstruction'. Ngokuvamile zibangelwa esinye isifo esingapheli noma isimo sokuzalwa.
- Umehluko nge-'Paralytic Ileus': Kungenzeka ukuthi uke wezwa igama elithi 'Paralytic Ileus'. Lisetshenziselwa ukuchaza isimo lapho amathumbu eyeka ukusebenza isikhashana, ikakhulukazi ngemva kokuhlinzwa kwesisu. Kuvamile kakhulu. Kuhilela kokubili amathumbu amancane namakhulu eyeka ukusebenza okwesikhashana bese ephulukisa ngokwawo ezinsukwini ezimbalwa. Kodwa-ke, i-Ogilvie Syndrome iyisimo esiyinkimbinkimbi nesingavamile . Sithinta kakhulu amathumbu amakhulu , ikakhulukazi i-cecum.
Ubani osengozini enkulu yokuthola lesi simo?
Nakuba kungakhula kunoma ubani, kuvame kakhulu kubantu asebekhulile abangaphezu kweminyaka engama-60 abanezinye izinkinga eziningana zempilo.Lesi simo sibikwa cishe kwesiguli esisodwa kweziyi-1,000 ezibhedlela.
Kalula nje, lokhu kungenzeka noma nini lapho umzimba ungaphansi kokucindezeleka okukhulu. Cabanga ngokuhlinzwa okukhulu, ingozi enkulu, ukuhlaselwa yinhliziyo, noma ukutheleleka okukhulu. Lezi zinto zithinta ukusebenza kwesimiso sethu sezinzwa. Lesi simiso sezinzwa yisona esitshela imisipha emathunjini ukuthi "inyakaze." Ngakho-ke uma kukhona ukungalingani lapho, amathumbu ayayeka ukusebenza futhi i-Ogilvie Syndrome ingenzeka.
Ziyini izimpawu ze-Ogilvie Syndrome?
Uma umoya, uketshezi, nokudla okungagaywanga kubhajwa emathunjini akho, ungase ube nezimpawu ezinjengalezi. Lezi zingase ziqale ngokuzumayo futhi zikhule kancane kancane.
| Isibonakaliso | Incazelo |
|---|---|
| Ukuvuvukala kwesisu | Lolu uphawu oluyinhloko nolusobala kakhulu. Isisu sivuvukele njengebhaluni futhi sizwakala siqinile. |
| Ubuhlungu besisu | Ungase ube nobuhlungu besisu obungapheli. Ngezinye izikhathi lobu buhlungu bungase buzwakale sengathi buhamba lapha nalaphaya. |
| Isifiso sokudla | Angifuni ukudla ngoba isisu sami sigcwele. |
| Isicanucanu nokuhlanza | Njengoba okuqukethwe emathunjini kungakwazi ukuqhubeka, kungabuya futhi kuhlanzwe. |
| Ukuqunjelwa noma isifo sohudo | Esikhathini esiningi, ukunyakaza kwamathumbu kanye nokuqunjelwa kuyayeka ngokuphelele. Kodwa-ke, ngezinye izikhathi, izingxenye zoketshezi ezivalelekile kuphela ezingadlula, okubangela isimo esifana nesifo sohudo. |
Kungani lokhu kwenzeka? Ake sibheke izizathu ngokujulile.
Nakuba imbangela eqondile yalokhu ingakacaci ngokuphelele, ososayensi bakholelwa ukuthi kubangelwa ukungasebenzi kahle ohlelweni lwethu lwezinzwa oluzimele . Cabanga ngakho, izinto ezenzeka ngokuzenzakalelayo emzimbeni wethu, njengokushaya kwenhliziyo, ukuphefumula, nokugaya ukudla, zilawulwa yilolu hlelo lwezinzwa, olusebenza njenge-"auto-pilot." Ngakho-ke, ngenxa yokucindezeleka okukhulu emzimbeni, lolu hlelo lwe-"auto-pilot" lungangalingani, futhi izimpawu ezilawula ukunyakaza kwamathumbu zingaphazamiseka.
Izizathu eziyinhloko ezibangela lesi simo zingahlukaniswa ngezigaba eziningana.
| Izinto eziyinhloko ezibangela i-Ogilvie Syndrome | |
|---|---|
| 1. Izimo zezokwelapha eziphuthumayo kanye nokuhlinzwa | |
| Isifo senhliziyo | Ukutheleleka okukhulu (isb. i-pneumonia, i-sepsis) |
| Ukwehluleka kwenhliziyo okubangelwa ukuminyana | Ukuhlinzwa kwenhliziyo okuvulekile |
| Ukulimala okubuhlungu | Ukuhlinzwa kwamathambo, njengokufakelwa izinqe esikhundleni |
| Ukuhlinzwa okukhulu kwesisu | Ukuhlinzwa kwesisu `(ukuhlinzwa kwesisu C)` |
| 2. Izinkinga zempilo ezazikhona ngaphambili | |
| Ukwehluleka kwezinso | Izifo zesistimu yokuphefumula `(Ukwehluleka kokuphefumula)` |
| Izifo zesimiso sezinzwa (isib. isifo sikaParkinson) | Isifo senhliziyo |
| Umdlavuza | Ukungalingani kwe-electrolyte emzimbeni |
| 3. Eminye imithi | |
| Eminye imithi yokwelapha isifo sengqondo (ama-Antipsychotics) | Amaphilisi okudambisa izinhlungu anamandla (ama-opioid) |
| Izinhlobo zama-steroid `(ama-Corticosteroids)` | Ukubulala izinzwa komgogodla |
Ingabe lokhu kungaba yinto engathi sína? Yiziphi izinkinga?
Yebo, uma lokhu kungahlolwanga futhi kungaphathwa kahle, kungaholela ezinkingeni ezinkulu kakhulu futhi ezisongela ngisho nokuphila . Cabanga nje, kwenzekani uma uqhubeka nokufutha umoya ungene ebhaluni? Liyaqhuma. Amathumbu ayafana.
Ububanzi obujwayelekile bekholoni bungamasentimitha angu-8. Kodwa-ke, ku-Ogilvie Syndrome, uma iba nkulu kune-12 centimeters, ingozi yezinkinga iphezulu kakhulu.
Izinkinga eziyinhloko ezingaba khona yilezi:
- I-Ischemia: Ukwelula kakhulu izindonga zamathumbu kubangela ukuthi imithambo yegazi ethambile enikeza igazi kubo inciphe, okunciphisa ukutholakala kwegazi . Lokhu kubangela ukuvuvukala kwamathumbu (ischemic colitis), okungathi uma kungelashwa, kuholele ekufeni kwezicubu (necrosis).
- Ukubhoboka: Lapho izicubu zifa, udonga lwamathumbu luyabuthaka futhi kungakheka imbobo encane . Lokhu kuyingozi kakhulu ngoba amagciwane kanye nemikhiqizo engcolile evela emathunjini kungavuza ingene esiswini, okubangela ukutheleleka okukhulu (i-peritonitis).
- I-Sepsis: Ukutheleleka okusakazeke esiswini akugcini lapho. Kungangena egazini futhi kusakazeke emzimbeni wonke.Lesi yisimo esisongela ukuphila esidinga ukwelashwa okuphuthumayo. Singabangela ngisho nokwehluleka kwezitho zomzimba, ngasinye ngasinye.
Uma kwenzeka lezi zinkinga, kuyisimo esiphuthumayo nesibucayi kakhulu. Ngakho-ke, kubaluleke kakhulu ukuqaphela izimpawu nokufuna iseluleko sezokwelapha ngokushesha. Uma unezinye zalezi zimpawu, ikakhulukazi uma uthola ukwelashwa esibhedlela, yazisa udokotela wakho noma umhlengikazi ngokushesha.
Ungasithola kanjani lesi sifo ngokunembile?
Odokotela bakhathazeka kakhulu ngezinto ezimbili lapho bexilonga lesi sifo.
1. Okokuqala, sihlola ukuthi kukhona yini ukuvinjelwa okungokomzimba emathunjini.
2. Uma kungekho sithiyo esinjalo, kunqunywa ukuthi imbangela yalezi zimpawu yi-Ogilvie Syndrome noma okunye.
Kuqhutshwa izivivinyo ezahlukene zalokhu.
- Ama-X-ray nama-CT scan: I-X-ray noma i-CT scan yesisu ingabonisa ngokucacile amathumbu amakhulu, avuvukele futhi agcwele umoya. Ngezinye izikhathi, kunikezwa uketshezi olukhethekile ('i-contrast agent') ukuze kutholakale izithombe ezicacile.
- I-Gastrografin Enema: Lokhu ukuhlolwa okukhethekile kakhulu. Ngoba kokubili ukuhlolwa futhi ngezinye izikhathi ukwelashwa. Lapha, uketshezi oluncibilika emanzini olubizwa ngokuthi 'i-gastrografin' lufakwa emathunjini nge-rectum, futhi indlela oluhamba ngayo emathunjini ibukwa ngevidiyo ye-X-ray `(fluoroscopy)`. Lokhu kunganquma ngokunembile ukuthi kukhona yini ukuvinjelwa emathunjini noma cha. Futhi, lolu ketshezi lwe-`gastrografin` lunezakhiwo zokuhlanza. Ngakho-ke, ngezinye izikhathi umphumela walo usiza ukuqala kabusha umsebenzi wamathumbu oye wema.
Yiziphi izindlela zokwelapha lokhu?
Ukwelashwa kuncike ekutheni ikholoni yakho ivuvukele kangakanani nokuthi usengozini yokuthola izinkinga yini. Noma nini lapho kungenzeka, odokotela bazama ukuyelapha ngemithi elula yokusekela ('ukwelashwa okulondolozayo') kunokuba basebenzise izinto ezifana nokuhlinzwa.
Ukwelashwa Okungaguquguquki
Ekuqaleni, lokhu kwelashwa kwenziwa ngenkathi kubhekwa ngokucophelela isimo sesiguli.
- Ukwelapha izimo ezingaphansi: Uma kukhona isimo esingaphansi, njengokutheleleka noma isifo senhliziyo, esilashwa kuqala.
- Ukuyeka imithi: Imithi okusolwa ukuthi ibangela i-Ogilvie Syndrome iyamiswa okwesikhashana.
- Ukuphumula amathumbu: Ukuyeka ngokuphelele ukudla okuphuzwayo kanye noketshezi.
- I-IV Saline: Inani loketshezi nosawoti oludingekayo emzimbeni linikezwa ngemithambo yegazi (i-IV fluids).
- Ukuhamba nokushintsha izikhundla: Uma kungenzeka, khuthaza isiguli ukuba sihambe kancane futhi sishintshe izikhundla embhedeni. Lokhu kungakhuthaza ukunyakaza kwamathumbu.
- Ukufakwa kwepayipi: Ipayipi (`i-Nasogastric tube`) ifakwa ngekhala esiswini ukuze kukhishwe umoya ongaphezulu kanye noketshezi. Ipayipi (`i-Rectal tube`) nayo ifakwa nge-anus ukuze kuvunyelwe umoya ukuthi uphume.
Phakathi nalokhu kwelashwa, odokotela benza njalo ama-X-ray kanye nokuhlolwa kwegazi ukuze baqaphe isimo samathumbu kanye nanoma yiziphi izinkinga.
Kuthiwani uma ukwelashwa okusekelayo kungaphumeleli?
Uma isimo singathuthuki ngemva kwamahora angaba ngu-72, noma uma amathumbu evulekile ngaphezu kwamasentimitha angu-12, odokotela bazodlulela esinyathelweni esilandelayo.
- Ukususwa Kwe-Colonoscopic: Kulokhu, ithubhu enekhamera enamathiselwe (i-`colonoscope`) ifakwa nge-anus bese umoya oqongeleleke ku-colon udonswa ngethubhu. Lokhu kunciphisa ngokushesha ingcindezi ku-colon. Kodwa-ke, njengoba lokhu kuyinqubo engakhululekile futhi ngezinye izikhathi kunengozi encane yokubhoboka kwe-colon, kwenziwa ngokucophelela okukhulu.
- Umjovo we-Neostigmine: Lona umuthi onamandla kakhulu wokuvuselela imisipha. Ngokuvamile usetshenziselwa ukusiza imisipha ukuba ilulame ngemva kokubulala izinzwa. Uma lo muthi unikezwa njengomjovo we-intravenous (IV) kubantu abane-Ogilvie Syndrome, imisipha yamathumbu iqala ukusebenza futhi, futhi imiphumela emihle itholakale. Kodwa-ke, ngenxa yokuthi lo muthi ungabangela ukushaya kwenhliziyo okuhamba kancane kakhulu, unikezwa kuphela ngaphansi kokuqashwa okuseduze kukadokotela egunjini lokunakekelwa okujulile (ICU) .
- Ukuhlinzwa (Ukuhlinzwa Kwe-Colectomy / I-Colostomy): Uma, naphezu kwazo zonke lezi zindlela zokwelapha, amathumbu eqhubeka nokuvuvukala, noma uma kwenzeka inkinga enkulu njengokubhoboka, ukuhlinzwa kungaba yindlela yokugcina. Kulesi simo, ingxenye eyonakele yamathumbu iyasikwa bese isuswa (Ukuhlinzwa Kwe-Colectomy). Ngezinye izikhathi, kudingeka kwenziwe imbobo yesikhashana noma ehlala njalo esiswini ukuze kuvunyelwe indle ukuthi idlule. Lokhu sikubiza ngokuthi i-Colostomy.
Ingabe lesi simo singasongela ukuphila?
Ngaphandle kwezinkinga, ingozi yokufa komuntu one-Ogilvie Syndrome iyodwa icishe ibe yi-15%. Kodwa-ke, leli phesenti lihlanganisa nemiphumela yezinye izimo zezokwelapha isiguli esinazo.
Kodwa-ke, uma kwenzeka inkinga enkulu njengokubhoboka kwamathumbu, izinga lokufa lifinyelela ku-40%. Lokhu kukhombisa ukuthi lesi simo singaba sibi kangakanani.
Into ebaluleke kakhulu ukunaka izimpawu ngokushesha nje lapho zivela, uxilonge lesi sifo ngokushesha, bese uqala ukwelashwa. Uma wenza kanjalo, ungavimbela izinkinga ezinkulu futhi ululame ngokushesha ngokwelashwa okulula.
Umlayezo Wokuya Nawe Ekhaya
- I-Ogilvie Syndrome yisimo esibizwa ngokuthi "ukuvinjelwa okungahleliwe" lapho ukusebenza kwamathumbu kuyeka khona ngokuzumayo ngaphandle kokuvinjelwa kwangempela emathunjini.
- Lokhu kuvame ukubonakala kubantu asebekhulile abaye bahlinzwa futhi abahlushwa ezinye izifo eziningana.
- Izimpawu eziyinhloko ukuqunjelwa (ukugcwala) kanye nobuhlungu besisu.
- Uma lesi simo singahlolwanga kahle, singaholela ezinkingeni eziyingozi kakhulu njengokubhoboka kwamathumbu.
- Uma wena noma othile omaziyo, ikakhulukazi umuntu othola ukwelashwa esibhedlela, eba nanoma yiziphi zalezi zimpawu, kubalulekile ukuzithatha ngokungathi sína bese wazisa udokotela wakho ngokushesha. Ukwelashwa okusheshayo kungasindisa impilo.
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