Omphalocele

I-omphalocele ukukhubazeka kokuzalwa lapho amathumbu wosana noma ezinye izitho zesisu zingaphandle komzimba ngenxa yomgodi endaweni yenkinobho yesisu (inkaba). Amathumbu ambozwe kuphela ungqimba oluncane lwezicubu futhi angabonakala kalula.

I-Omphalocele ibhekwa njengokukhubazeka kodonga lwesisu (imbobo odongeni lwesisu). Amathumbu engane avame ukuphuma (aphume) emgodini.

Isimo sibukeka sifana ne-gastroschisis. I-omphalocele ukukhubazeka kokuzalwa lapho amathumbu wosana noma ezinye izitho zesisu ziphuma ngembobo endaweni yenkinobho yesisu futhi zimbozwe ulwelwesi. Ku-gastroschisis, alukho ulwelwesi lokumboza.

Ukukhubazeka kodonga lwesisu kuyakhula njengoba ingane ikhula ngaphakathi kwesibeletho sikanina. Ngesikhathi sokukhula, amathumbu nezinye izitho (isibindi, isinye, isisu, nama-ovari noma ama-testes) akhula ngaphandle komzimba ekuqaleni bese evame ukubuyela ngaphakathi. Ezinganeni ezine-omphalocele, amathumbu nezinye izitho zihlala ngaphandle kodonga lwesisu, zimbozwe ulwelwesi. Isizathu esiqondile samaphutha odonga esiswini asaziwa.

Izinsana ezine-omphalocele zivame ukuba nezinye izinkinga zokuzalwa. Amaphutha afaka izinkinga zofuzo (ukungajwayelekile kwe-chromosomal), ukuzalwa kwe-diaphragmatic hernia, nenhliziyo nezinkinga zezinso. Lezi zinkinga zithinta nombono jikelele (isibikezelo) sempilo yengane nokuphila kwayo.

I-omphalocele ingabonakala kahle. Lokhu kungenxa yokuthi okuqukethwe yisisu kuyanamathela (kuphumele ngaphandle) endaweni yenkinobho yesisu.

Kunosayizi abahlukahlukene bama-omphaloceles. Kwezincane, amathumbu kuphela ahlala ngaphandle komzimba. Kokukhulu, isibindi noma ezinye izitho zingaba ngaphandle futhi.

Ama-ultrasound angaphambi kokubeletha ngokuvamile akhomba izinsana ezine-omphalocele ngaphambi kokuzalwa, imvamisa amasonto angama-20 ekhulelwe.

Ukuhlolwa kaningi akudingekile ukuxilonga i-omphalocele. Kodwa-ke, izingane ezine-omphalocele kufanele zihlolwe ezinye izinkinga ezivame ukuhamba nayo. Lokhu kufaka phakathi ama-ultrasound wezinso nenhliziyo, nokuhlolwa kwegazi kwezifo zofuzo, phakathi kokunye ukuhlolwa.

Ama-Omphaloceles ayalungiswa ngokuhlinzwa, yize kungenzeki ngaso sonke isikhathi ngokushesha. Isaka livikela okuqukethwe yisisu futhi lingavumela isikhathi sezinye izinkinga ezinkulu kakhulu (njengokukhubazeka kwenhliziyo) ukubhekana naso kuqala, uma kunesidingo.

Ukulungisa i-omphalocele, isaka limbozwe ngento enezintambo eziyinyumba, ebese ithungwa ukuze yakhe lokho okubizwa ngokuthi yisilo. Njengoba ingane ikhula ngokuhamba kwesikhathi, okuqukethwe esiswini kufakwa esiswini.

Lapho i-omphalocele ikwazi ukungena kahle ngaphakathi kwesisu, isisilo siyasuswa bese isisu siyavalwa.

Ngenxa yengcindezi ethintekayo ekubuyiseleni amathumbu esiswini, ingane ingadinga ukwesekwa ukuze iphefumule ngomshini wokuphefumula. Ezinye izindlela zokwelapha ingane zifaka izakhi zomzimba nge-IV kanye nemithi elwa namagciwane ukuvikela ukutheleleka. Ngisho nangemva kokukhubazeka kuvaliwe, umsoco we-IV uzoqhubeka njengoba ukondla ubisi kufanele kwethulwe kancane.

Kwesinye isikhathi, i-omphalocele inkulu kangangokuba ayikwazi ukubuyiselwa ngaphakathi esiswini sosana. Isikhumba esizungeze i-omphalocele siyakhula futhi ekugcineni simboze i-omphalocele. Imisipha yesisu nesikhumba kungalungiswa lapho ingane isikhulile ngemiphumela yezimonyo engcono.

Ukululama okuphelele kulindelwe ngemuva kokuhlinzwa kwe-omphalocele. Kodwa-ke, ama-omphaloceles avame ukuvela nezinye izinkinga zokuzalwa. Ukuthi ingane yenza kahle kangakanani kuya ngeziphi ezinye izimo ingane enazo.

Uma i-omphalocele ikhonjwa ngaphambi kokuzalwa, umama kufanele abhekwe ngeso lokhozi ukuqinisekisa ukuthi umntwana ongakazalwa uhlala enempilo.

Kufanele kwenziwe izinhlelo zokulethwa ngokucophelela kanye nokuphathwa ngokushesha kwenkinga ngemuva kokuzalwa. Ingane kufanele ilethwe esikhungweni sezokwelapha esinamakhono okulungisa ukukhubazeka kodonga lwesisu. Izingane kungenzeka zenze kangcono uma zingadingi ukuhanjiswa kwesinye isikhungo ukuze zithole ukwelashwa okuqhubekayo.

Abazali kufanele bacabangele ukuhlola ingane, futhi mhlawumbe namalungu omndeni, ukuthola ezinye izinkinga zofuzo ezihambisana nalesi simo.

Ingcindezi eyandisiwe evela kokuqukethwe okungaphakathi kwesisu okungafakwanga kahle kunganciphisa ukugeleza kwegazi kuya emathunjini nasezinsweni. Kungenza futhi ukuthi kube nzima enganeni ukukhulisa amaphaphu, okuholele ezinkingeni zokuphefumula.

Enye inkinga ukubulawa ngamathumbu (necrosis). Lokhu kwenzeka lapho izicubu zamathumbu zifa ngenxa yokugeleza kwegazi okuphansi noma ukutheleleka. Ingcuphe ingancishiswa ezinganeni ezithola ubisi lukamama kunefomula.

Lesi simo siyabonakala lapho kuzalwa futhi sizobonakala esibhedlela ngesikhathi sokubeletha uma singakaze sibonakale esivivinyweni esijwayelekile se-fetus ultrasound ngesikhathi sokukhulelwa. Uma ubelethele ekhaya futhi ingane yakho ibonakala inale nkinga, shayela inombolo ephuthumayo yendawo (efana ne-911) ngaso leso sikhathi.

Le nkinga iyatholakala futhi ilungiswe esibhedlela lapho izalwa. Ngemuva kokubuyela ekhaya, shayela umhlinzeki wakho wezokunakekelwa kwezempilo uma ingane yakho iqala noma yiziphi zalezi zimpawu:

• Ukwehla kokuhamba kwamathumbu
• Izinkinga zokondla
• Imfiva
• Ukuhlanza okuluhlaza okotshani noma okuphuzi
• Indawo yesisu evuvukile
• Ukuhlanza (kwehlukile kunokukhafula kwengane okujwayelekile)
• Izinguquko zokuziphatha ezimbi

Isici sokuzalwa - omphalocele; Isici sodonga lwesisu - usana; Isici sodonga lwesisu - esisanda kuzalwa; Isici sodonga lwesisu - usana olusanda kuzalwa

• Omphalocele wezinsana
• Ukulungiswa kwe-Omphalocele - uchungechunge
• ISilo

I-Islam S. Ukukhubazeka kodonga lwesisu esiswini: i-gastroschisis ne-omphalocele. Ku: Holcomb GW, Murphy P, St. Peter SD, eds. Ukuhlinzwa Kwezingane zeHolcomb ne-Ashcraft. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2020: isahluko 48.

UWalther AE, uNathan JD. Amaphutha odonga esiswini olusanda kuzalwa. Ku: Wyllie R, Hyams JS, Kay M, eds. Izifo Zamathumbu Emathunjini Nesibindi. Umhlaka 5. IPhiladelphia, PA: Elsevier; 2016: isahluko 58.