Ukugcotshwa kwe-Esophageal

Ukugcotshwa kokuqhuma kungumgodi emgodini. Isimungulu ngukudla kweshubhu okudlula lapho kusuka emlonyeni kuya esiswini.

Okuqukethwe yi-esophagus kungadlulela endaweni ezungezile esifubeni (i-mediastinum), lapho kunembobo emqaleni. Lokhu kuvame ukuholela ekuthelelekeni kwe-mediastinum (mediastinitis).

Isizathu esivame kakhulu sokugcotshwa kwe-esophageal ukulimala ngesikhathi senqubo yezokwelapha. Kodwa-ke, ukusetshenziswa kwezinsimbi eziguquguqukayo kwenze le nkinga ingavamile.

I-esophagus nayo ingahle ibhujiswe njengomphumela we:

• Isigaxa
• I-reflux yesisu nesilonda
• Ukuhlinzwa kwangaphambilini ku-esophagus
• Ukugwinya into yangaphandle noma amakhemikhali abulalayo, afana nokuhlanza indlu, amabhethri e-disk, ne-acid yebhethri
• Ukuhlukumezeka noma ukulimala esifubeni nasemqaleni
• Ukuhlanza okunodlame (Boerhaave syndrome)

Izimbangela ezingavamile kakhulu zibandakanya ukulimala endaweni yomzimba (ukuhlukumezeka okungaqondakali) nokulimala kwesibindi ngesikhathi sokuhlinzwa kwesinye isitho esiseduze ne-esophagus.

Uphawu oluyinhloko ubuhlungu lapho inkinga iqala ukwenzeka.

Ukugcotshwa okuphakathi noma okuphansi kakhulu kwengxenye kungadala:

• Izinkinga zokugwinya
• Ubuhlungu besifuba
• Izinkinga zokuphefumula

Umhlinzeki wakho wokunakekelwa kwezempilo uzobheka:

• Ukuphefumula ngokushesha.
• Imfiva.
• Umfutho wegazi ophansi.
• Ukushaya kwenhliziyo okusheshayo.
• Ubuhlungu bezintamo noma ukuqina namabhamuza omoya ngaphansi kwesikhumba uma ukugcotshwa kusengxenyeni ephezulu yesifo.

Ungaba ne-x-ray yesifuba ongayifuna:

• Umoya ezicutshini ezithambile zesifuba.
• Uketshezi oluye lwaputshuka lusuka emphinjeni luye esikhaleni esizungeze amaphaphu.
• Iphaphu eliwile. Ama-X-ray athathwe ngemuva kokuba uphuze udayi ongeyona ingozi angasiza ukukhomba indawo yokugcotshwa.

Ungase futhi ube nesifuba se-CT scan ukuze ubheke ithumba esifubeni noma kumdlavuza wokuqopha.

Ungadinga ukuhlinzwa. Ukuhlinzwa kuzoya ngendawo nosayizi wokugcotshwa. Uma kudingeka ukuhlinzwa, kungcono ukwenze kungakapheli amahora angama-24.

Ukwelashwa kungafaka:

• Uketshezi olunikezwa ngomthambo (IV)
• Ama-antibiotic e-IV ukuvikela noma ukwelapha ukutheleleka
• Ukukhipha uketshezi oluzungeze amaphaphu ngeshubhu yesifuba
• Mediastinoscopy ukususa uketshezi oluqoqwe endaweni engemuva kwesifuba naphakathi kwamaphaphu (mediastinum)

I-stent ingafakwa emqaleni uma kuphela uketshezi oluncane oluputshukile. Lokhu kungasiza ukugwema ukuhlinzwa.

I-perforation engxenyeni ephezulu (yesifunda sentamo) yengxenye ingaziphilisa yodwa uma ungadli noma ungaphuzi isikhathi esithile. Kulokhu, uzodinga ithubhu yokudla esiswini noma enye indlela yokuthola izakhamzimba.

Ukuhlinzwa kuvame ukudingeka ukulungisa ukungcola ezingxenyeni eziphakathi noma ezansi zomhosha. Ukuvuza kungalashwa ngokulungiswa okulula noma ngokususa i-esophagus, kuya ngobungako benkinga.

Isimo singathuthuka, size sife, uma singelashwa.

I-Outlook yinhle uma inkinga itholakala kungakapheli amahora angama-24 yenzekile. Iningi labantu lisinda lapho ukuhlinzwa kwenziwa kungakapheli amahora angama-24. Izinga lokusinda liyehla uma ulinda isikhathi eside.

Izinkinga zingafaka:

• Ukulimala okungapheli kwesisu (ukunciphisa noma ukuqina)
• Ukwakheka kwamathumba ngaphakathi nangaseduzane nomphimbo
• Ukutheleleka emaphashini naseduze kwawo

Tshela umhlinzeki wakho ngokushesha uma uthuthukisa inkinga lapho usuvele usesibhedlela.

Iya egumbini labezimo eziphuthumayo noma ushayele ku-911 uma:

• Usanda kuhlinzwa noma kufakwe ithubhu esimbeni futhi unezinhlungu esifubeni, unenkinga yokugwinya noma ukuphefumula.
• Unesinye isizathu sokusola ukuthi ungahle ube nokugcotshwa kwe-esophageal.

Lokhu kulimala, nakuba kungavamile, kunzima ukukuvimbela.

Ukugcwala komphimbo; I-Boerhaave syndrome

• Uhlelo lokugaya ukudla
• Izitho zohlelo lokugaya ukudla

UMaxwell R, uReynolds JK. Ukuphathwa kokugcotshwa kwesophageal. Ku: UCameron JL, uCameron AM, ama-eds. Ukwelashwa Kwamanje. Umhla ka-12. IPhiladelphia, PA: Elsevier; 2017: 73-78.

URaja AS. Ukuhlukumezeka Thoracic. Ku: Walls RM, Hockberger RS, Gausche-Hill M, ama-eds. Imithi Ephuthumayo yaseRosen: Imiqondo kanye Nokuzijwayeza Komtholampilo. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2018: isahluko 38.