Isifo se-Hirschsprung

Isifo se-Hirschsprung ukuvaleka kwamathumbu amakhulu. Kwenzeka ngenxa yokungahambi kahle kwemisipha emathunjini. Kuyisimo sokuzalwa, okusho ukuthi sikhona kusukela ekuzalweni.

Ukuncipha kwemisipha emathunjini kusiza ukudla okugayiwe kanye neziphuzo ezihamba emathunjini. Lokhu kubizwa nge-peristalsis. Imithambo phakathi kwezendlalelo zemisipha ibangela ukucindezela.

Esifo se-Hirschsprung, izinzwa azikho engxenyeni yamathumbu. Izindawo ezingenazo lezi zinzwa azikwazi ukudlulela ngaphakathi. Lokhu kubangela ukuvinjelwa. Okuqukethwe kwamathumbu kuyakha ngemuva kokuvinjelwa. Amathumbu nesisu kuvuvukala ngenxa yalokho.

Isifo se-Hirschsprung sidala cishe ama-25% azo zonke izigaxa zamathumbu ezisanda kuzalwa. Kwenzeka kaningi kakhulu kwabesilisa kunabesifazane. Isifo se-Hirschsprung kwesinye isikhathi sixhunyaniswa nezinye izimo ezizuzwe njengefa noma zokuzalwa, njenge-Down syndrome.

Izimpawu ezingaba khona ezinganeni ezisanda kuzalwa nezinsana zifaka:

• Kunzima ngokunyakaza kwamathumbu
• Ukwehluleka ukudlula i-meconium ngemuva nje kokuzalwa
• Ukwehluleka ukwedlula indle yokuqala kungakapheli amahora angama-24 kuye kwangama-48 ngemuva kokuzalwa
• Izitulo ezingavamile kodwa eziqhumayo
• I-jaundice
• Ukudla okungafanele
• Ukuzuza kwesisindo okubi
• Ukuhlanza
• Uhudo lwamanzi (enganeni esanda kuzalwa)

Izimpawu ezinganeni ezindala:

• Ukuqunjelwa okuya ngokuya kuba kubi
• Impaction fecal
• Ukungondleki
• Ukukhula kancane
• Isisu esivuvukile

Amacala amabi kungenzeka angatholakali ingane ize ikhule.

Ngesikhathi sokuhlolwa komzimba, umhlinzeki wezokunakekelwa kwempilo angakwazi ukuzwa izihibe zamathumbu esiswini esivuvukile. Ukuhlolwa kwe-rectal kungaveza ithoni yemisipha eqinile emisipheni engunxande.

Ukuhlolwa okusetshenziselwa ukuxilonga isifo se-Hirschsprung kungafaka:

• I-x-ray yesisu
• I-anal manometry (ibhaluni ligcwala ku-rectum ukukala ukucindezela endaweni)
• I-Barium enema
• I-Rectal biopsy

Inqubo ebizwa nge-serial rectal irrigation isiza ukudambisa ingcindezi ku (decompress) emathunjini.

Isigaba esingajwayelekile sekholoni kufanele sikhishwe kusetshenziswa ukuhlinzwa. Ngokuvamile, ingxenyeni engunxande futhi engavamile yekholoni iyasuswa. Ingxenye enempilo yekholoni bese idonswa phansi bese inamathiselwa endunu.

Kwesinye isikhathi lokhu kungenziwa ekusebenzeni okukodwa. Noma kunjalo, kuvame ukwenziwa ezingxenyeni ezimbili. I-colostomy yenziwa kuqala. Enye ingxenye yenqubo yenziwa kamuva onyakeni wokuqala wokuphila kwengane.

Izimpawu ziyathuthuka noma ziyahamba ezinganeni eziningi ngemuva kokuhlinzwa. Inani elincane lezingane lingaba nokuqunjelwa noma izinkinga zokulawula indle (ukungabi namandla kokungcola). Izingane ezilashwa kusenesikhathi noma ezinezingxenye ezimfushane zamathumbu ezithintekayo zinomphumela ongcono.

Izinkinga zingafaka:

• Ukuvuvukala nokutheleleka kwamathumbu (i-enterocolitis) kungenzeka ngaphambi kokuhlinzwa, futhi kwesinye isikhathi phakathi konyaka wokuqala kuya kwemibili emva kwalokho. Izimpawu zinzima, kufaka phakathi ukuvuvukala kwesisu, uhudo olunamanzi olunephunga elibi, ubuthakathaka nokungondli kahle.
• Ukubola noma ukuqhekeka kwamathumbu.
• Isifo samathumbu esifushane, isimo esingaholela ekungondlekeni nasekuphelelweni amanzi emzimbeni.

Shayela umhlinzeki wengane yakho uma:

• Ingane yakho iba nezimpawu zesifo i-Hirschsprung
• Ingane yakho inezinhlungu esiswini noma ezinye izimpawu ezintsha ngemuva kokwelashwa kwalesi simo

I-megacolon ezalwa naso

IBass LM, iWershil BK. I-anatomy, i-histology, i-embryology, kanye nokukhubazeka kokukhula kwamathumbu amancane namakhulu. Ku: Feldman M, Friedman LS, Brandt LJ, ama-eds. ISleisenger neFordtran's Gastrointestinal and Liver Disease: IPathophysiology / Diagnosis / Management. Umhlaka 10. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 98.

IKliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM. Ukuphazamiseka kwemotility nesifo seHirschsprung. Ku: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Incwadi kaNelson Yezingane. Umhlaka 21. IPhiladelphia, PA: Elsevier; 2020: isahluko 358.