Ingabe amathumbu akho ayeke ukusebenza ngokuzumayo? Masiqaphele lesi simo esiyingozi (i-Ogilvie Syndrome)!

Wake waba nomuzwa wokugcwala ngokuzumayo kanye nomuzwa wokuqina esiswini sakho? Kufana nokuthile okubambeke esiswini sakho, kodwa akunjalo. Yilolo hlobo lwesimo esingajwayelekile, esingaba yingozi esizokhuluma ngaso namuhla. Sibizwa ngokuthi i-Ogilvie Syndrome. Ake sibheke ukuthi siyini, kungani senzeka, ukuthi singasibona kanjani, nokuthi singaselapha kanjani.

Iyini i-Ogilvie Syndrome?

Kalula nje, i-Ogilvie Syndrome yilapho ikholoni yakho iyeka ukusebenza ngokuzumayo ngaphandle kwesizathu esibonakalayo. Odokotela baphinde bakubize ngokuthi i-acute colonic pseudo-obstruction (ACPO) . "I-pseudo-obstruction" isho ukuthi ikholoni yakho isebenza sengathi ivinjiwe okuthile, kodwa empeleni , akukho lutho oluvinjiwe ngokomzimba . Inkinga isesimisweni esilawula ukunyakaza kwekholoni. Okusho ukuthi, iyeka ukusunduza ukudla nokuphuza phambili ngekholoni. Bese, izinto ezifana nokudla nomoya ziqoqana ngaphakathi kwekholoni, okubangela ukuthi izindonga zekholoni zande, noma zivuvukale. Cabanga ngakho njengokuminyana kwezimoto, lapho izimoto ziyeka ukuhamba khona futhi umgwaqo uvinjiwe.

I-Ogilvie Syndrome ihluke kanjani kwezinye izithiyo zamathumbu?

I-Ogilvy syndrome yisimo esibi kakhulu . Lokhu kusho ukuthi ifika ngokuzumayo futhi ingeyesikhashana. Ithinta kuphela ikholoni . Igama elithi "intestinal pseudo-obstruction" liyigama elijwayelekile. Libhekisela kunoma yikuphi ukungasebenzi kahle okwenzeka ngaphandle kokuvinjelwa ngokomzimba emathunjini. Abanye abantu bane-pseudo-obstructions yamathumbu engapheli , ngezinye izikhathi ngenxa yesifo esithile sesikhathi eside noma isimo sokuzalwa.

Uyini umehluko phakathi kwe-Ogilvie Syndrome kanye ne-Paralytic Ileus?

I-Paralytic ileus nayo iyisivimbelo esibi samathumbu. Kodwa-ke, ivame ukuthinta amathumbu amancane namakhulu. Lesi simo sivame kakhulu ngemva kokuhlinzwa kwesisu . Lokhu kwenzeka lapho amathumbu eqala ukusebenza kancane ngemva kokuhlinzwa. Ngokuvamile kuyazixazulula ngokwawo ezinsukwini ezimbalwa.

Kodwa-ke, i-Ogilvy syndrome ithinta ngqo ikholoni yakho, futhi ngokuvamile ingxenye yekholoni yakho ebizwa ngokuthi i-cecum , lapho iqala khona. Ayivamile njenge-paralytic ileus, futhi ingaba yinkimbinkimbi kakhulu.

Ubani okungenzeka kakhulu ukuthi athole i-Ogilvie Syndrome?

Nakuba lokhu kungenzeka kunoma ubani, kuvame kakhulu kubantu abadala kanye nalabo abanezinkinga zempilo ezingaphezu kweyodwa.Cabanga ngomuntu oye wahlinzwa kakhulu, waba nengozi, waba nesifo senhliziyo, noma waba nokutheleleka okukhulu. Lezi zinto zingabangela i-Ogilvy syndrome. Futhi, ukungalingani kwama-electrolyte , izifo zemizwa , kanye nokuphuza imithi eminingi ngesikhathi esisodwa kuyizinto eziyingozi. Konke lokhu kuthinta isimiso sethu sezinzwa . Leso simiso sezinzwa yisona esitshela imisipha emathunjini ethu amakhulu ukuthi iqhubekisele phambili ukudla.

Kuvamile kangakanani lokhu?

Kubikwa ukuthi i-Ogilvy syndrome iyenzeka cishe koyedwa kwabayi-1,000 abangeniswe esibhedlela. Isilinganiso seminyaka yalabo abathintekile sicishe sibe yiminyaka engama-60.

Ziyini izimpawu ze-Ogilvie Syndrome?

Uma ukudla okungagayiwe nomoya kuqala ukuqongelela emathunjini akho amakhulu, ungase ubhekane nezinto ezifana nalezi:

• Ukukhukhumala kwesisu: Umuzwa wokuthi isisu sivuvukele futhi sikhula.
• Ubuhlungu besisu: Kungase kube nobuhlungu obukhulu besisu.
• Ukulahlekelwa yisifiso sokudla: Ukulahlekelwa yisifiso sokudla.
• Ukucanuzela nokuhlanza: Ukuzizwa ugula futhi uhlanza.
• Ukuqunjelwa kanye negesi: Umuzwa wokugcwala esiswini.
• Ukuqunjelwa kanye/noma isifo sohudo: Abanye abantu bangase babe nokuqunjelwa, kanti abanye bangase babe nesifo sohudo.

Cabanga ngoMalume uNimal, uneminyaka engu-65 ubudala, unesifo sikashukela, kanye nesifo senhliziyo. Wahlinzwa isinqe esikhundleni saso. Ngemva kwezinsuku ezimbili noma ezintathu, isisu sakhe sagcwala ngokuzumayo futhi waba nobunzima bokuphefumula. Lapho ethinta isisu sakhe, sasiqinile njengetshe. Wathi wayengenaso isifiso sokudla, futhi wayenesicanucanu. Kwaba yilapho odokotela bemhlola kuphela lapho baqaphela khona ukuthi kwakuyi-Ogilvy syndrome.

Yini ebangela i-Ogilvie Syndrome?

Imbangela eqondile ayikaqondakali ngokugcwele. Kodwa ososayensi bakholelwa ukuthi ibangelwa ukungasebenzi kahle ohlelweni lwethu lwezinzwa oluzimele . Lolu hlelo lwezinzwa oluzimele luyingxenye yomzimba wethu elawula ukunyakaza kwemisipha esingayiqapheli. Luphinde lulawule ukunyakaza kwamagagasi (i-peristalsis) okusunduzela ukudla phambili emathunjini ethu. Njengoba lesi kuyisimo esibi kakhulu, sibangelwa ukucindezeleka okungavamile ohlelweni lwezinzwa oluzimele. Kodwa-ke, ezinye izici zempilo nazo zingase zibe nomthelela kukho.

Kunezimo eziningana zezokwelapha eziyingozi ezingabangela i-Ogilvy syndrome:

• Isifo senhliziyo
• Ukwehluleka kwenhliziyo okubangelwa yisifo senhliziyo (ubuthakathaka bemisipha yenhliziyo ngenxa yesifo senhliziyo)
• Ukulimala okubuhlungu
• Ukutheleleka okukhulu (isb. i-pneumonia noma i-sepsis)
• Ukuhlinzwa kwesisu okuvulekile
• Ukuhlinzwa kwenhliziyo okuvulekile
• Ukuhlinzwa kwamathambo (isib. ukufaka esikhundleni senqulu)
• Ukubeletha ngokuhlinzwa / Ukuhlinzwa ngokuhlinzwa

Izici zempilo ezikhona kakade ezingase zibe nomthelela ku-Ogilvy syndrome:

• Ukwehluleka kwezinso
• Ukwehluleka kokuphefumula
• Isifo sezinzwa
• Isifo senhliziyo
• Umdlavuza
• Izinkinga ze-Metabolic
• Ukungalingani kwe-electrolyte
• Ubudala obukhulile
• Ukuba nobuthakathaka emzimbeni
• Ukuthatha imithi eminingi ngesikhathi esisodwa

Eminye imithi ehlobene ne-Ogilvy syndrome:

• Imithi yokulwa nesifo sengqondo
• Ama-Amphetamine
• Ama-Corticosteroids
• Ama-opioid (izibulala-zinhlungu)
• Izithiyo zokucindezela amasosha omzimba
• Ukubulala izinzwa komgogodla

Yiziphi izinkinga ezingaba khona ze-Ogilvie Syndrome?

Esikhathini esiningi, i-Ogilvy syndrome iphela yodwa noma ngokunakekelwa okusekelwayo. Kodwa-ke, ngezinye izikhathi kudingeka ukungenelela . Uma ingatholakali isikhathi eside, ingaholela ezinkingeni ezinkulu uma isimo siba sibi kakhulu. Izifundo zibonisa ukuthi izinkinga zingase zenzeke uma ikholoni ivulekile (ngaphezu kwamasentimitha angu-12). Ububanzi obujwayelekile bekholoni bungamasentimitha angu-8.

Uma amathumbu evuleka kakhulu, ingozi iba nkulu. Izingozi Ezingaba Khona:

• I-Ischemia: Ukucindezela ngokweqile ezindongeni zekholoni kungabangela ukuthi igazi linqamuke . Lokhu kungaholela ekuvuvukeni okukhulu, okubizwa ngokuthi i-ischemic colitis . Uma kungelashwa, ukufa kwezicubu (i-necrosis) kungenzeka. Cabanga ngakho njengokucindezela ipayipi lamanzi kanzima kangangokuthi amanzi ayeka ukugeleza.
• Ukubhoboka: Izindawo zezicubu ezifile zingadabuka noma ziqhume kalula . Uma kuvela ukubhoboka kwesisu, ubuthi namagciwane kungasakazeka esiswini, okubangela ukutheleleka okukhulu okubizwa ngokuthi i-peritonitis .
• I-Sepsis: I-Peritonitis ingasakazeka kalula iye egazini (i-septicemia) . Lesi yisimo esiphuthumayo! I-Sepsis yilapho ukutheleleka kusakazeka emzimbeni wonke futhiKungaba nesimo esibizwa ngokuthi ukushaqeka kwe-septic, okungaholela ekuhlulekeni kwezitho eziningi.

Lezi zinkinga ziyingozi kakhulu, yingakho kubalulekile ukufuna iseluleko sezokwelapha ngokushesha nje lapho ubona izimpawu ze-Ogilvy syndrome.

I-Ogilvie Syndrome ihlolwa kanjani?

Ukuxilongwa kuncike kulezi zici:

• Ukuhlolwa kwe-X-ray kuqinisekisa ukuthi ikholoni ivulekile nokuthi akukho ukuvinjelwa kwamathumbu ngokomzimba.
• Ukuhlolwa okukhethekile ukuze kunqunywe ezinye izifo ezingase zibangele isimo sakho.

Hlobo luni lokuhlolwa kwe-radiological olungakuxilonga lokhu?

Ukuze uthole umbono oningiliziwe ngaphakathi kwekholoni lakho, odokotela basebenzisa inqubo ebizwa ngokuthi i-internal contrast agent kanye ne-radiology. Le nto yokuhlukanisa imbozwe ngaphakathi kwekholoni lakho futhi ibonakala ngokucacile ezithombeni ze-X-ray. Le contrast inganikezwa ukuthi uyiphuze, njenge-enema, noma njengoketshezi olufakwa emthanjeni (IV). I-Contrast CT scan kanye ne-contrast fluoroscopy yizindlela ezimbili ezisetshenziswa kulokhu.

Kukhona ukuhlolwa okubizwa ngokuthi i-gastrografin enema , okungasetshenziswa ngezinye izikhathi njengokwelashwa. Lokhu kuhilela ukufaka isisombululo sokungafani esincibilika emanzini esibizwa ngokuthi i-gastrografin ku-colon yakho nge-rectum yakho, bese uthatha i-fluoroscopic X-rays. (I-Fluoroscopy ifana ne-video X-ray engabona ukuthi ikhambi lihamba kanjani.) Njengomphumela ongemuhle, i-gastrografin ingasebenza futhi njengomuthi wokudambisa ukuvuvukala ku-colon, isize amathumbu akho ukuthi aphinde anyakaze.

Iphathwa kanjani i-Ogilvie Syndrome?

Ukwelashwa kuncike ekutheni ikholoni yakho ivuleke kangakanani nokuthi usengozini yokuthola izinkinga. Noma nini lapho kungenzeka, odokotela bazama ukuyelapha ngokunakekelwa okusekelayo nangokuyibhekisisa . Lokho kusho ukusiza umzimba ukuthi ululame ngokwawo ngaphandle kokungenelela okuningi. Kodwa uma kudingeka, basebenzisa imithi noma izinqubo zokunciphisa ikholoni nokunciphisa ingozi yezinkinga. Uma kuvela izinkinga, zidinga ukwelashwa okuphuthumayo.

Ukwelashwa okulondolozayo kungafaka:

• Ukwelapha izifo eziyisisekelo ezibangela lesi simo.
• Ukuyeka imithi kungaba nomthelela kulesi simo.
• Ukuphumula kwamathumbu: Ukunciphisa ingcindezi ngokungadli ngomlomo.
• Uketshezi olufakwa emthanjeni (uketshezi lwe-IV):Ukugcina umswakama kanye nokulungisa ukungalingani kwama-electrolyte ngokufaka izinto ezifana nosawoti emthanjeni.
• Khuthaza ukuhamba kwamathumbu ngokuhamba noma ukushintsha izikhundla.
• Ipayipi le-Nasogastric: Ukususa umoya ongaphezulu kanye noketshezi esiswini.
• Ipayipi elingaphakathi: I-catheter efakwa nge-rectum ukuze isuse umoya noketshezi ngokusebenzisa amandla adonsela phansi.
• Ukuqapha isimo ngokuthatha izithombe njalo kanye nokuhlolwa kwegazi.

Lokhu kuvame ukubonwa izinsuku ezimbili kuya kwezintathu (cishe amahora angu-72). Kodwa-ke, uma ikholoni selivele linwebekile ngaphezu kwamasentimitha angu-12, noma uma kungekho ntuthuko ngemva kwalezi zindlela zokwelapha ezilondolozayo, udokotela angase anqume ukungenelela ukuze anciphise ingcindezi kukholoni.

Ukungenelela kufaka phakathi:

• Ukususwa kwe-Colonoscopy: I-Colonoscopy inqubo yokuxilonga nokwelapha. Ihilela ukufaka ikhamera encane ekugcineni kwethubhu elide elibizwa ngokuthi i-colonoscope emathunjini amakhulu nge-anus. Umgomo we-colonoscopy yokususwa kwe-compression ukukhipha umoya omningi emathunjini amakhulu ngethubhu bese unikeza i-enema ngethubhu. Le nqubo ingaqeda ukuvinjelwa okungamanga uma imithi yehluleka noma ingaphephile kuwe. Kodwa-ke, odokotela bayisebenzisa ngokuqapha ngoba kunzima ukuyenza futhi inengozi encane yezinkinga. Kwezinye izimo, i-colonoscope ingabangela imbobo emathunjini amakhulu (ukubhoboza kwamathumbu).
• Umjovo we-Neostigmine: Lo muthi unikezwa nge-IV. Uyisishukumisi semisipha. Uvame ukusetshenziselwa ukusiza imisipha iphumule ngemva kokuhlinzwa. Kuye kwabonakala kusebenza kahle "ekuvuseni" imisipha emathunjini amakhulu kanye nokuqala kabusha i-peristalsis kubantu abane-Ogilvy syndrome. Kodwa-ke, ngoba umuthi onamandla kakhulu , unikezwa kuphela ngaphansi kokubhekwa eduze egunjini lokunakekelwa okujulile (ICU) . Odokotela bazoqapha inhliziyo yakho ukuqinisekisa ukuthi ukushaya kwenhliziyo yakho akuyehlisi kakhulu ngenkathi uthola i-neostigmine.
• Ukuhlinzwa Kokuhlinza Isisu/Ukuhlinzwa Kokuhlinza Isisu: Uma ikholoni yakho iqhubeka nokukhula naphezu kwalezi zindlela zokungenelela, noma uma kuvela izinkinga ezifana nokubhoboka noma i-necrosis, kungadingeka ukuhlinzwa ukuze kususwe ingxenye ethintekile yekholoni yakho . Lena yindlela yokugcina . Ngokuhlinza isisu, ungase ube nokuhlinzwa kokukhipha isisu okwesikhashana noma okuhlala njalo.Kungadingeka futhi ukwenza okukodwa. Okusho ukuthi, ukudala imbobo ehlukile yokungena kwendle. Ngezinye izikhathi, i-colostomy ingaguqulwa ngemva kokuphela kokuhlinzwa.

Ingabe i-Ogilvie Syndrome ingaba yingozi?

Yebo, izinkinga zingaba yingozi . Ngezinkinga ezifana nokubhoboka noma ischemia, izinga lokufa lingafinyelela ku-40%. Kodwa-ke, lezi zinkinga zenzeka kubantu abangaphansi kuka-15%. Ngaphandle kwezinkinga, izinga lokufa kwe-Ogilvy syndrome liseduze no-15%. Lesi sibalo kungenzeka singameleli i-Ogilvy syndrome yodwa. Ngoba abantu abaningi abathola i-Ogilvy syndrome banezinye izimo zempilo ezithinta ukufa kwabo.

Ukuvinjelwa kwe-pseudo-obstruction okubukhali kwekholoni kuyisenzakalo esingalindelekile esingaletha izinkinga ezintsha kubantu asebevele bebhekene nezinye izimo zempilo. Akekho olindele i-Ogilvy syndrome, kodwa wonke umuntu kufanele aqaphele izimpawu . Ukuqashelwa kusenesikhathi kuyisihluthulelo sokuvimbela izinkinga ezinkulu ze-Ogilvy syndrome. Uma kungekho zinkinga, ukululama kungenzeka ngokwelashwa okulondolozayo.

Izinto ezibaluleke kakhulu okudingeka sizikhumbule (Umyalezo Wokuya Ekhaya)

Ngakho-ke, i-Ogilvie Syndrome yisimo esingaba sibi kakhulu kunalokho ocabanga ngakho. Kodwa akukho okufanele ukhathazeke ngakho, futhi ukuqaphela kungavimbela izinkinga eziningi.

• Ukuxilongwa: Uma uhlangabezana nezimpawu ezifana nokuqunjelwa okungazelelwe, ubuhlungu obukhulu besisu, ukulahlekelwa yisifiso sokudla, isicanucanu, noma ukuhlanza, qiniseka ukuthi ubona udokotela, ikakhulukazi uma usukhulile, unezinye izimo zezokwelapha, noma usanda kuhlinzwa.
• Izimbangela: Lokhu kungabangelwa ukugula okunye, ukuhlinzwa, noma imithi. Ngakho-ke kubalulekile ukutshela udokotela wakho umlando wakho ogcwele wezokwelapha.
• Izinkinga: Uma kungelashwa ngokushesha, ukwehla kokugeleza kwegazi ku-colon kungaholela ekufeni kwezicubu, ukubhoboka kwe-colon, kanye nokutheleleka okukhulu. Lokhu kungaba yingozi empilweni.
• Ukwelashwa: Izimo eziningi ziyaphela ngokunakekelwa okusekelayo, kodwa ngezinye izikhathi i-colonoscopy, imithi, noma ngisho nokuhlinzwa kungadingeka ukuze kuncishiswe ingcindezi.
• Ukutholwa kusenesikhathi kusindisa izimpilo: Ungazinaki lezi zimpawu nganoma yisiphi isizathu. Into ebaluleke kakhulu ukuzibona kusenesikhathi bese uqala ukwelashwa.

Uma wena noma othile omaziyo enanoma yiziphi zalezi zimpawu, ungangabazi ukufuna iseluleko sezokwelapha. Hlala uphilile!

I- Ogilvie Syndrome, ukuvinjelwa okubukhali kwamathumbu amakhulu, ikholoni elincane, ukungasebenzi kahle kwamathumbu, ukuqunjelwa, ubuhlungu besisu, ukuvinjelwa okungama-pseudo