Ukugcotywa kwesophageal

Ukugqobhoza komqala ngumngxunya kwi-esophagus. I-esophagus kukutya kwetyhubhu okudlulayo njengoko isuka emlonyeni iye esiswini.

Umxholo we-esophagus ungadlula kwindawo ejikeleze isifuba (mediastinum), xa kukho umngxunya kwi-esophagus. Oku kuhlala kukhokelela kusulelo lwe-mediastinum (mediastinitis).

Esona sizathu siqhelekileyo sokuqhekeka kwesophage kukwenzakala ngexesha lonyango. Nangona kunjalo, ukusetyenziswa kwezixhobo eziguqukayo kuyenzile le ngxaki inqabile.

I-esophagus inokuthi iphinde ichaphazeleke ngenxa yesiphumo:

• Ithumba
• I-reflux yesisu kunye nesilonda
• Utyando lwangaphambili kwi-esophagus
• Ukuginya into yelinye ilizwe okanye iichemical caustic, ezinje ngezokucoca indlu, iibhetri zediski kunye nebhetri asidi
• Umothuko okanye ukwenzakala kwisifuba kunye nomqala
• Ukugabha okunobundlongondlongo (Boerhaave syndrome)

Izizathu ezimbalwa eziqhelekileyo zibandakanya ukonzakala kwindawo yomqala (ukwenzakala okungathethekiyo) kunye nokulimala kwisophagus ngexesha lotyando lelinye ilungu elikufutshane nomqala.

Uphawu oluphambili ziintlungu xa ingxaki iqala ukubakho.

Ukugqitywa embindini okanye ezantsi kwezona ndawo zinokubangela:

• Ukuginya iingxaki
• Iintlungu zesifuba
• Iingxaki zokuphefumla

Umboneleli wakho wezempilo uya kukhangela:

• Ukuphefumla ngokukhawuleza.
• Ifiva.
• Uxinzelelo lwegazi oluphantsi.
• Inqanaba lentliziyo elikhawulezayo.
• Intlungu yomqala okanye ukuqina kunye namaqamza omoya phantsi kolusu ukuba ukugqobhoza kukwindawo ephezulu yomqala.

Unokuba une-x-ray yesifuba oza kuyikhangela:

• Umoya kwizicubu ezithambileyo zesifuba.
• Ulwelo oluye lwaphuma kwi-esophagus ukuya kwindawo ejikeleze imiphunga.
• Umphunga owileyo. IX-reyi ezithathiweyo emva kokuba usele idayi engenabungozi inokukunceda ekuboneni indawo ekuhlanjululwe kuyo.

Unokuba nesifuba se-CT ukujonga ithumba esifubeni okanye kumhlaza wokuqina.

Unokufuna utyando. Utyando luya kuxhomekeka kwindawo kunye nobungakanani bokugqitywa. Ukuba utyando luyafuneka, kungcono kwenziwe ngaphakathi kweeyure ezingama-24.

Unyango lunokubandakanya:

• Ulwelo olunikwa ngomthambo (IV)
• IV zintsholongwane ukuthintela okanye ukunyanga usulelo
• Ukukhupha ulwelo olujikeleze imiphunga ngetyhubhu yesifuba
• Mediastinoscopy ukususa ulwelo oluqokelelwe kwindawo engasemva kwethambo lesifuba naphakathi kwemiphunga (mediastinum)

I-stent inokufakwa kwi-esophagus ukuba kuphela inani elincinci lamanzi liye lavuza. Oku kunokukunceda ukuphepha ukuhlinzwa.

Ukugqobhoza kwindawo ephezulu (yommandla wentamo) yinxalenye yesophagus kunokuziphilisa ngokwakho ukuba awutyi okanye awuseli kangangexesha elithile. Kule meko, uyakufuna ityhubhu yokondla isisu okanye enye indlela yokufumana izondlo.

Ugqirha luyafuneka rhoqo ukulungisa ukubetheka kwindawo esezantsi okanye esezantsi yomqala. Ukuvuza kunganyangwa ngokulungiswa okulula okanye ngokususa umqala, kuxhomekeke kubungakanani bengxaki.

Imeko inokuqhubela phambili ukothuka, nokufa, ukuba ayinyangwa.

Umbono ulungile ukuba ingxaki ifunyenwe ngaphakathi kweeyure ezingama-24 yenzekile. Uninzi lwabantu luyasinda xa utyando lwenziwe zingaphelanga iiyure ezingama-24. Izinga lokusinda liyehla ukuba ulinda ixesha elide.

Iingxaki zinokubandakanya:

• Umonakalo osisigxina kwi-esophagus (ukunciphisa okanye ukuqina)
• Ukwakheka kwamathumba ngaphakathi nakujikeleze umqala
• Usulelo kunye nemiphunga

Xelela umboneleli wakho kwangoko ukuba uphuhlisa ingxaki xa sele usesibhedlele.

Yiya kwigumbi likaxakeka okanye utsalele umnxeba ku-911 ukuba:

• Kutshanje uye wenza utyando okanye ityhubhu ibekwe emqolo kwaye unentlungu esifubeni, iingxaki zokuginya okanye ukuphefumla.
• Unesinye isizathu sokukrokrela ukuba unokuba ne-esophageal perforation.

Oku kwenzakala, nangona kungaqhelekanga, kunzima ukukhusela.

Ukugqobhoza komqala; Isifo seBoerhaave

• Inkqubo yokwetyisa
• Inkqubo yokugaya ukutya

UMaxwell R, uReynolds JK. Ulawulo lwe-perforation yokuqina. Ku: UCameron JL, uCameron AM, ii-eds. Unyango lwangoku lonyango. Umhla we-12. IPhiladelphia, PA: Elsevier; Ngo-2017: 73-78.

URaja AS. Umonzakalo weToracic. Ku: Iindonga RM, iHockberger RS, iGausche-Hill M, ii-eds. Unyango lukaRosen oluNgxamisekileyo: iikhonsepthi kunye nokuziqhelanisa neklinikhi. Umhla we-9. IPhiladelphia, PA: Elsevier; I-2018: isahluko 38.