Umthambo we-Mesenteric ischemia

I-Mesenteric artery ischemia yenzeka lapho kunokuncipha noma ukuvinjelwa komunye noma ngaphezulu kwemithambo emithathu emikhulu enikezela amathumbu amancane namakhulu. Lezi zibizwa ngokuthi yimithambo ye-mesenteric.

Imithambo ehambisa igazi emathunjini igijima ngqo isuka kwi-aorta. I-aorta ingumthambo oyinhloko osuka enhliziyweni.

Ukuqina kwemithambo yegazi kwenzeka lapho amafutha, i-cholesterol, nezinye izinto zakha ezindongeni zemithambo. Lokhu kuvame kakhulu kubantu ababhemayo nakubantu abanomfutho wegazi ophakeme noma i-cholesterol ephezulu yegazi.

Lokhu kunciphisa imithambo yegazi futhi kunciphisa ukugeleza kwegazi kuya emathunjini. Njengazo zonke izingxenye zomzimba, igazi liletha umoya-mpilo emathunjini. Lapho ukunikezwa kwe-oksijini kuhamba kancane, izimpawu zingavela.

Ukunikezwa kwegazi emathunjini kungavinjwa ngokuzumayo yi-clot yegazi (embolus). Amahlule ngokuvamile avela enhliziyweni noma e-aorta. Lawa mahlule abonakala kakhulu kubantu abanesigqi senhliziyo esingajwayelekile.

Izimpawu ezibangelwa ukuqina kancane kancane kwemithambo ye-mesenteric zifaka:

• Ubuhlungu besisu ngemuva kokudla
• Uhudo

Izimpawu ze-artery ischemia engazelelwe (ebukhali) ye-mesenteric ngenxa yegazi elihambayo lihlanganisa:

• Kungazelelwe ubuhlungu obukhulu besisu noma ukuqunjelwa
• Uhudo
• Ukuhlanza
• Imfiva
• Isicanucanu

Lapho izimpawu ziqala ngokuzumayo noma ziba nzima, ukuhlolwa kwegazi kungakhombisa ukwanda kwesibalo samaseli amhlophe nezinguquko ezingeni le-asidi yegazi. Kungahle kube nokopha kupheshana le-GI.

I-Doppler ultrasound noma i-CT angiogram scan ingakhombisa izinkinga ngemithambo yegazi nangamathumbu.

I-mesenteric angiogram isivivinyo esifaka ukujova idayi ekhethekile egazini lakho ukugqamisa imithambo yamathumbu. Ngemuva kwalokho ama-x-ray athathwa endaweni. Lokhu kungakhombisa indawo yokuvinjelwa emthanjeni.

Lapho ukunikezwa kwegazi kuvinjelwe engxenyeni ethile yemisipha yenhliziyo, imisipha izofa. Lokhu kubizwa ngokuthi yisifo senhliziyo. Uhlobo olufanayo lokulimala lungenzeka kunoma iyiphi ingxenye yamathumbu.

Lapho ukunikezwa kwegazi kunqunywa kungazelelwe yiqhwa legazi, kuba yisimo esiphuthumayo. Ukwelashwa kungabandakanya imithi yokuqothula amahlule egazi nokuvula imithambo yegazi.

Uma unezimpawu ngenxa yokuqina kwemithambo ye-mesenteric, kunezinto ongazenza ukulawula inkinga:

• Yeka ukubhema. Ukubhema kunciphisa imithambo yegazi. Lokhu kunciphisa ikhono legazi lokuthwala umoya-mpilo futhi kwandisa ubungozi bokwenza amahlule (thrombi kanye ne-emboli).
• Qiniseka ukuthi umfutho wegazi uyalawuleka.
• Uma ukhuluphele ngokwehlisa isisindo sakho.
• Uma i-cholesterol yakho iphezulu, yidla ukudla okune-cholesterol ephansi kanye namafutha amancane.
• Bheka izinga likashukela egazini lakho uma unesifo sikashukela, futhi uligcine lilawulwa.

Ungahlinzwa uma inkinga inkulu.

• Ukuvinjelwa kuyasuswa futhi imithambo ibuye ixhunywe kwi-aorta. Ukudlula eduze kokuvinjelwa kungenye inqubo. Kuvame ukwenziwa nge-plastic tube graft.
• Ukufaka i-stent. I-stent ingasetshenziswa njengenye indlela yokuhlinzwa ukukhulisa ukuvinjelwa emthanjeni noma ukuletha umuthi ngqo endaweni ethintekile. Lena inqubo entsha futhi kufanele yenziwe kuphela ngabahlinzeki bezempilo abanolwazi. Umphumela uvame ukuba ngcono ngokuhlinzwa.
• Ngezinye izikhathi, ingxenye ethile yamathumbu akho izodinga ukususwa.

Umbono we-mesenteric ischemia engapheli muhle ngemuva kokuhlinzwa okuphumelelayo. Kodwa-ke, kubalulekile ukwenza izinguquko endleleni yokuphila ukuze kuvinjelwe ukuqina kwemithambo yegazi ekubeni kubi.

Abantu abanenkani yemithambo ehambisa amathumbu bavame ukuba nezinkinga ezifanayo emithanjeni yegazi enikezela inhliziyo, ubuchopho, izinso, noma imilenze.

Abantu abane-acent mesenteric ischemia bavame ukwenza kabi ngoba izingxenye zamathumbu zingafa ngaphambi kokuba kwenziwe ukuhlinzwa. Lokhu kungabulala. Kodwa-ke, ngokuxilongwa nokwelashwa okusheshayo, i-acent mesenteric ischemia ingelashwa ngempumelelo.

Ukufa kwezicubu ngenxa yokuntuleka kokugeleza kwegazi (infarction) emathunjini kuyinkinga enkulu kakhulu ye-mesenteric artery ischemia. Ukuhlinzwa kungadingeka ukuze kususwe ingxenye efile.

Shayela umhlinzeki wakho uma une:

• Izinguquko kwimikhuba yamathumbu
• Imfiva
• Isicanucanu
• Ubuhlungu obukhulu besisu
• Ukuhlanza

Lezi zinguquko ezilandelayo zokuphila zinganciphisa ubungozi bokuncipha kwemithambo yegazi:

• Vivinya umzimba njalo.
• Landela ukudla okunempilo.
• Thola izinkinga zesigqi senhliziyo ziphathwe.
• Gcina i-cholesterol yegazi lakho noshukela wegazi ulawulwa.
• Yeka ukubhema.

Isifo semithambo iMesenteric; Ischemic colitis; Ischemic wamathumbu - mesenteric; Amathumbu afile - mesenteric; Amathumbu afile - mesenteric; I-atherosclerosis - umthambo we-mesenteric; Ukuqina kwemithambo - umthambo we-mesenteric

• Umthambo we-Mesenteric ischemia ne-infarction

IHolscher CM, Reifsnyder T. Acute mesenteric ischemia. Ku: UCameron AM, uCameron JL, ama-eds. Ukwelashwa Kwamanje. Umhlaka 13. IPhiladelphia, PA: Elsevier; 2020: 1057-1061.

IKahi CJ. Izifo ze-Vascular zomgudu wamathumbu. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 134.

I-Lo RC, iShermerhorn ML. Isifo seMesenteric arterial: i-epidemiology, i-pathophysiology, kanye nokuhlolwa komtholampilo. Ku: Sidawy AN, Perler BA, ama-eds. Rutherford’s Vascular Surgery and Endovascular Therapy. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2019: isahluko 131.