Fistula emathunjini

-Delile

• Izinhlobo zama-GIF
• 1. Fistula yamathumbu
• 2. I-fistula engaphandle kwamathumbu
• 3. I-fistula yangaphandle
• 4. I-fistula eyinkimbinkimbi
• Izimbangela ze-GIF
• Izinkinga zokuhlinzwa
• Ukwakheka kwe-GIF okuzenzakalelayo
• Ukuhlukumezeka
• Izimpawu nezinkinga ze-GIF
• Ukubonana nodokotela nini
• Ukuhlolwa nokuxilongwa
• Ukwelashwa kwe-GIF
• Umbono wesikhathi eside

Yini i-fistula yamathumbu?

I-fistula emathunjini (i-GIF) ukuvula okungajwayelekile emgudwini wakho wokugaya ukudla okwenza ukuthi uketshezi lwesisu lungene ngaphakathi kolwelwesi lwesisu noma lwamathumbu akho. Lokhu kungaholela ekuthelelekeni lapho lolu ketshezi luvuza esikhunjeni sakho noma kwezinye izitho.

I-GIF ivame ukwenzeka ngemuva kokuhlinzwa kwesisu, okuwukuhlinzwa ngaphakathi kwesisu sakho. Abantu abanezinkinga zokugaya ukudla ezingapheli nabo basengozini enkulu yokuthola i-fistula.

Izinhlobo zama-GIF

Kunezinhlobo ezine eziyinhloko zama-GIF:

1. Fistula yamathumbu

Ku-fistula yamathumbu, uketshezi lwesisu luyavuza kusuka engxenyeni ethile yamathumbu kuya kolunye lapho amafolda athinta khona. Lokhu kwaziwa nangokuthi i- "gut-to-gut" fistula.

2. I-fistula engaphandle kwamathumbu

Lolu hlobo lwe-fistula lwenzeka lapho uketshezi lwesisu luvela emathunjini akho luye kwezinye izitho zakho, njengesinye sakho, amaphaphu noma uhlelo lwe-vascular.

3. I-fistula yangaphandle

Ku-fistula yangaphandle, uketshezi lwesisu luvuza esikhunjeni. Kuyaziwa nangokuthi "i-fistula enqamulelayo."

4. I-fistula eyinkimbinkimbi

I-fistula eyinkimbinkimbi yileso esenzeka ezithweni ezingaphezu kwesisodwa.

Izimbangela ze-GIF

Kunezimbangela ezahlukahlukene zama-GIF. Kubandakanya:

Izinkinga zokuhlinzwa

Cishe ama-85 kuya kuma-90 amaphesenti ama-GIF akhula ngemuva kokuhlinzwa kwesisu. Kungenzeka ukuthi uthuthukise i-fistula uma une:

• umdlavuza
• ukwelashwa ngemisebe esiswini sakho
• ukuvinjelwa kwamathumbu
• izinkinga zomthungo wokuhlinzwa
• izinkinga zokubamba indawo
• ithumba
• ukutheleleka
• i-hematoma, noma ihlule legazi ngaphansi kwesikhumba sakho
• isimila
• ukungondleki

Ukwakheka kwe-GIF okuzenzakalelayo

Amafomu e-GIF ngaphandle kwesizathu esaziwayo kumaphesenti angama-15 kuye kwangama-25 wamacala. Lokhu kubizwa nangokuthi ukwakheka okuzenzakalelayo.

Izifo zamathumbu ezivuthayo, njengesifo sikaCrohn, zingadala ama-GIF. Abantu abaningi abanesifo sikaCrohn baba ne-fistula ngesikhathi esithile ezimpilweni zabo. Ukutheleleka kwamathumbu, njenge-diverticulitis, kanye nokungakwazi ukusebenza kahle kwemithambo yegazi (ukugeleza kwegazi okunganele) ngezinye zezimbangela.

Ukuhlukumezeka

Ukuhlukumezeka ngokomzimba, okufana nokudutshulwa noma amanxeba wommese angena esiswini, kungadala i-GIF. Lokhu akuvamile.

Izimpawu nezinkinga ze-GIF

Izimpawu zakho zizohluka ngokuya ngokuthi une-fistula yangaphakathi noma yangaphandle.

Amafistula angaphandle abangela ukuphuma esikhunjeni. Zihambisana nezinye izimpawu, kufaka phakathi:

• ubuhlungu besisu
• ukuvinjelwa kwamathumbu okubuhlungu
• imfiva
• inani eliphakeme lamaseli amhlophe egazi

Abantu abane-fistula yangaphakathi bangathola:

• isifo sohudo
• ukuphuma kwegazi
• ukutheleleka kwegazi noma i-sepsis
• ukumuncwa kabi kwezakhi zomzimba nokuncipha kwesisindo
• ukoma komzimba
• ukwanda kwesifo esiyimbangela

Inkinga ebucayi kakhulu ye-GIF yi-sepsis, isimo esiphuthumayo kwezokwelapha lapho umzimba unempendulo ebukhali kumagciwane. Lesi simo singaholela ekucindezelekeni kwegazi okuyingozi, ukulimala komzimba, nokufa.

Ukubonana nodokotela nini

Xhumana nodokotela wakho uma uhlangabezana nalezi zimpawu ngemuva kokuhlinzwa:

• ushintsho oluphawulekayo emikhubeni yakho yamathumbu
• isifo sohudo esibi
• ukuvuza oketshezi kusuka ekuvulekeni esiswini sakho noma eduze kwendunu yakho
• ubuhlungu obungavamile besisu

Ukuhlolwa nokuxilongwa

Udokotela wakho uzoqala abukeze umlando wakho wezokwelapha nokuhlinzwa futhi ahlole izimpawu zakho zamanje. Bangase bahlole ukuhlolwa kwegazi okuningi ukusiza ukuxilonga i-GIF.

Lokhu kuhlolwa kwegazi kuvame ukuhlola ama-electrolyte wakho we-serum nesimo sokudla okunomsoco, okuyisilinganiso samazinga akho e-albumin ne-pre-albumin. Lawa womabili amaprotheni adlala indima ebalulekile ekwelapheni isilonda.

Uma i-fistula ingaphandle, ukukhishwa kungathunyelwa elabhorethri ukuze ihlolwe. I-fistulogram ingenziwa ngokujova udayi wokuqhathanisa embobeni yesikhumba sakho nokuthatha i-X-ray.

Ukuthola i-fistula yangaphakathi kungaba nzima kakhulu. Udokotela wakho angaqhuba lezi zivivinyo:

• I-endoscopy engenhla nephansi ifaka phakathi ukusetshenziswa kwethubhu encane, eguquguqukayo enekhamera enamathiselwe. Lokhu kusetshenziselwa ukubuka izinkinga ezingaba khona kumgudu wakho wokugaya ukudla noma wamathumbu. Ikhamera ibizwa nge-endoscope.
• Kungasetshenziswa i-radiography yamathumbu ephezulu nangaphansi ene-medium medium. Lokhu kungafaka ukugwinya kwe-barium uma udokotela wakho ecabanga ukuthi ungaba nesisu noma i-fistula yamathumbu. I-enema ye-barium ingasetshenziswa uma udokotela wakho ecabanga ukuthi une-colon fistula.
• I-ultrasound noma i-CT scan ingasetshenziselwa ukuthola i-fistula yamathumbu noma izindawo ezingenamuntu.
• I-fistulogram ifaka ukujova udayi ohlukile ekuvulekeni kwesikhumba sakho ku-fistula yangaphandle bese uthatha izithombe ze-X-ray.

Ukuze uthole i-fistula ebandakanya amapayipi amakhulu esibindi noma amanyikwe, udokotela wakho angalawula isivivinyo esikhethekile se-imaging esibizwa nge-magnetic resonance cholangiopancreatography.

Ukwelashwa kwe-GIF

Udokotela wakho uzokwenza ukuhlolwa okuphelele kwe-fistula yakho ukuthola ukuthi kungenzeka yini ukuthi izivale yodwa.

Ama-fistula ahlukaniswa ngokususelwa ekutheni kungakanani uketshezi lwesisu olugcina ukuvuleka. I-fistula ekhipha kancane ikhiqiza ngaphansi kwama-milliliters ama-200 (mL) we-gastric fluid ngosuku. Ama-fistula aphuma kakhulu akhiqiza cishe i-500 mL ngosuku.

Ezinye izinhlobo ze-fistula zivala zodwa lapho:

• ukutheleleka kwakho kuyalawulwa
• umzimba wakho umunca izakhi zomzimba ezanele
• impilo yakho yonke yinhle
• inani elincane kuphela loketshezi esiswini eliza ngokuvula

Ukwelashwa kwakho kuzogxila ekugcineni kwakho ukondleka kahle nokuvimbela ukutheleleka kwesilonda uma udokotela wakho ecabanga ukuthi i-fistula yakho ingazivalela yodwa.

Ukwelashwa kungafaka:

• ukugcwalisa uketshezi lwakho
• ukulungisa i-serum electrolyte yakho yegazi
• ukujwayela ukungalingani kwe-acid ne-base
• ukunciphisa ukuphuma koketshezi okuvela ku-fistula yakho
• ukulawula ukutheleleka nokuqapha i-sepsis
• ukuvikela isikhumba sakho nokunikeza ukunakekelwa okuqhubekayo kwesilonda

Ukwelashwa kwe-GIF kungathatha amasonto noma izinyanga.Udokotela wakho angancoma ukuvala i-fistula yakho ngokuhlinzwa uma ungakathuthuki ngemuva kwezinyanga ezintathu kuya kweziyisithupha zokwelashwa.

Umbono wesikhathi eside

AmaFistula avale yedwa cishe amaphesenti angama-25 esikhathi ngaphandle kokuhlinzwa kubantu abaphilile ngenye indlela nalapho kukhiqizwa amanani amancane oketshezi lwesisu.

Ama-GIFs avame ukukhula ngemuva kokuhlinzwa kwesisu noma ngenxa yokuphazamiseka kokugaya ukudla okungapheli. Khuluma nodokotela wakho ngezingozi zakho nokuthi ungazibona kanjani izimpawu ze-fistula ekhulayo.