Isophageal atresia

I-Esophageal atresia ukuphazamiseka kokugaya ukudla lapho i-esophagus ingakhuli kahle. I-esophagus yishubhu elijwayele ukuthwala ukudla lisuke emlonyeni liye esiswini.

I-Esophageal atresia (EA) yisici sokuzalwa. Lokhu kusho ukuthi kwenzeka ngaphambi kokuzalwa. Kunezinhlobo eziningana. Ezimweni eziningi, umphimbo ophezulu uyaphela futhi awuxhumani nomphimbo ophansi nesisu.

Iningi lezinsana ezine-EA linenye inkinga ebizwa nge-tracheoesophageal fistula (TEF). Lokhu ukuxhumana okungavamile phakathi kwe-esophagus ne-windpipe (trachea).

Ngaphezu kwalokho, izinsana ezine-EA / TEF zivame ukuba ne-tracheomalacia. Lokhu kungubuthakathaka nokuntengantenga kwezindonga zensimbi yomoya, okungadala ukuphefumula kuzwakale kuphezulu noma kunomsindo.

Ezinye izingane ezine-EA / TEF zinokunye ukukhubazeka futhi, imvamisa ukukhubazeka kwenhliziyo.

Izimpawu ze-EA zingafaka:

• Umbala we-Bluish esikhumbeni (i-cyanosis) ngokuzama ukudla
• Ukukhwehlela, ukugoqana imilomo, nokuklinya ngokuzama ukondla
• Ukumunca amathe
• Ukudla okungafanele

Ngaphambi kokuzalwa, i-ultrasound yomama ingakhombisa uketshezi oluningi lwe-amniotic. Lokhu kungaba uphawu lwe-EA noma okunye ukuvinjelwa komgudu wokugaya ingane.

Lesi sifo sivame ukutholwa ngemuva nje kokuzalwa lapho usana luzama ukuncelisa bese lukhwehlela, luklinya futhi lube luhlaza okwesibhakabhaka. Uma i-EA isolwa, umhlinzeki wezokunakekelwa kwempilo uzozama ukudlulisa ipayipi elincane lokudla ngomlomo noma ekhaleni lengane esiswini. Uma ithubhu yokondla ingakwazi ukudlulela esiswini, ingane izotholakala ukuthi ine-EA.

Ngemuva kwalokho kwenziwa i-x-ray futhi izokhombisa noma yikuphi kokulandelayo:

• Isikhwama esigcwaliswe ngomoya esiswini.
• Umoya esiswini nasemathunjini.
• Ipayipi lokuphakela lizovela lihlanganiswe ku-esophagus engenhla uma lifakwe ngaphambi kwe-x-ray.

I-EA yisimo esiphuthumayo sokuhlinzwa. Ukuhlinzwa ukulungisa umphimbo kwenziwa ngokushesha okukhulu emva kokuzalwa ukuze amaphaphu angalimali nengane ikwazi ukondliwa.

Ngaphambi kokuhlinzwa, ingane ayiphakelwa ngomlomo futhi izodinga umsoco we-intravenous (IV). Ukunakekelwa kuyathathwa ukuvimbela ukuhamba kwemfihlo yokuphefumula emaphashini.

Ukuxilongwa kusenesikhathi kunika ithuba elingcono lomphumela omuhle.

Usana lungaphefumula amathe nolunye uketshezi emaphashini, kubangele ukufiphala kwenyumoniya, kuminyanise, futhi mhlawumbe nokufa.

Ezinye izinkinga zingafaka:

• Izinkinga zokondla
• I-Reflux (ukukhuphula okuphindwe kabili kokudla okuvela esiswini) ngemuva kokuhlinzwa
• Ukunciphisa (ukuqina) kwesimila ngenxa yesibazi sokuhlinzwa

Ukukhulelwa ngaphambi kwesikhathi kungasenza sibe nzima isimo. Njengoba kushiwo ngenhla, kungahle kube khona nokukhubazeka kwezinye izindawo zomzimba.

Lesi sifo sivame ukutholakala ngemuva nje kokuzalwa.

Shayela umhlinzeki wengane yakho ngokushesha uma ingane ihlanza iphindelela ngemuva kokuphakelwa, noma uma ingane iba nobunzima bokuphefumula.

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IRothenberg SS. I-Esophageal atresia kanye ne-tracheoesophageal fistula malformations. Ku: Holcomb GW, Murphy JP, St Peter SD, ama-eds. Ukuhlinzwa Kwezingane zeHolcomb ne-Ashcraft. Umhla wesi-7. IPhiladelphia, PA: Elsevier Saunders; 2020: isahluko 27.

Impisi RB. Ukucabanga kwesisu. Ku: Resnik R, Lockwood CJ, Moore TR, Greene MF, Copel JA, Silver RM, abahleli. ICreasy neResnik's Maternal-Fetal Medicine: Izimiso kanye Nokuzijwayeza. Umhlaka 8. IPhiladelphia, PA: Elsevier Saunders; 2019: isahluko 26.