Omphalocele

I-omphalocele sisiphene sokuzalwa apho amathumbu osana okanye amanye amalungu esisu angaphandle komzimba ngenxa yomngxunya kwindawo yesisu (inkaba). Amathumbu agqunywe kuphela ngumaleko omncinci weethishu kwaye ayabonakala ngokulula.

I-Omphalocele ithathwa njengesiphene sedonga esiswini (umngxunya eludongeni lwesisu). Amathumbu omntwana aqhele ukuphuma (aphume) emngxunyeni.

Imeko ijongeka ngokufana ne-gastroschisis. I-omphalocele sisiphene sokuzalwa apho amathumbu osana okanye amanye amalungu esisu aphuma emngxunyeni kwindawo yeqhosha lesisu kwaye agqunywe ngenwebu. Kwi-gastroschisis, akukho lwanwe lokugquma.

Iziphene zodonga lwesisu zikhula njengoko umntwana ekhula ngaphakathi kwisibeleko sikanina. Ngexesha lokukhula, amathumbu kunye namanye amalungu (isibindi, isinyi, isisu, ii-ovari okanye ii-testes) zikhula ngaphandle komzimba ekuqaleni kwaye zihlala zibuyela ngaphakathi. Kwiintsana ezine-omphalocele, amathumbu kunye namanye amalungu ahlala ngaphandle kodonga lwesisu, inwebu iyawagubungela. Oyena nobangela weziphene zodonga lwesisu awaziwa.

Iintsana ezine-omphalocele zihlala zinezinye iziphene zokuzalwa. Iziphene zibandakanya iingxaki zemfuza (ukungaqheleki kwe-chromosomal), ukuzalwa kwe-diaphragmatic hernia, kunye nentliziyo kunye neziphene. Ezi ngxaki zikwachaphazela imbonakalo ngokubanzi (prognosis) yempilo yomntwana kunye nokuphila.

I-omphalocele inokubonwa ngokucacileyo. Kungenxa yokuba imixholo esiswini iyanamathela ngaphandle (iphume ngaphandle) kwindawo yeqhosha lesisu.

Kukho ubungakanani obahlukeneyo bee-omphaloceles. Kwizincinci, kuphela ngamathumbu ahlala ngaphandle komzimba. Kwizinto ezinkulu, isibindi okanye amanye amalungu asenokuba ngaphandle ngokunjalo.

I-Ultrasound yaphambi kokubeleka ihlala ichonga iintsana nge-omphalocele ngaphambi kokuzalwa, zihlala ziiveki ezingama-20 zokukhulelwa.

Ukuvavanya kuhlala kungafuneki ukuba kufunyaniswe i-omphalocele. Nangona kunjalo, iintsana ezine-omphalocele kufuneka zivavanyelwe ezinye iingxaki ezihlala zihamba nayo. Oku kubandakanya i-ultrasound yezintso kunye nentliziyo, kunye novavanyo lwegazi lokuphazamiseka kwemfuzo, phakathi kolunye uvavanyo.

Ii-Omphaloceles ziyalungiswa ngoqhaqho, nangona kungekho rhoqo. Ingxowa ikhusela imixholo esiswini kwaye inokuvumela ixesha lezinye iingxaki ezinzulu (ezinje ngeziphene zentliziyo) ukuba zijongane nazo kuqala, ukuba kukho imfuneko.

Ukulungisa i-omphalocele, isingxobo sigutyungelwe ngento enemigca engenazintsholongwane, ethi ithungwe endaweni ukuze yenze into ebizwa ngokuba sisilo. Njengokuba umntwana ekhula ngokuhamba kwexesha, iziqulatho zesisu zityhalelwa esiswini.

Xa i-omphalocele inokuhlala ngokufanelekileyo ngaphakathi kwisisu, isisu siyasuswa kwaye isisu siyavalwa.

Ngenxa yoxinzelelo olubandakanyekayo ekubuyiseleni amathumbu esiswini, usana lusenokufuna inkxaso yokuphefumla ngomatshini wokuphefumla. Olunye unyango kunyana lubandakanya izakha-mzimba nge-IV kunye namayeza okuthintela usulelo. Nasemva kokuba isiphene sivaliwe, ukutya okunesondlo IV kuya kuqhubeka njengoko ukondla ubisi kufuneka kwenziwe kancinci.

Ngamanye amaxesha, i-omphalocele inkulu kakhulu kangangokuba ayinakubekwa ngaphakathi esiswini sosana. Ulusu olujikeleze i-omphalocele luyakhula kwaye ekugqibeleni ligquma i-omphalocele. Izihlunu zesisu nolusu zinokulungiswa xa umntwana emdala kwisiphumo esingcono sezithambiso.

Ukubuyiselwa okupheleleyo kulindelwe emva kotyando lwe-omphalocele. Nangona kunjalo, ii-omphaloceles zihlala zenzeka nezinye iziphene zokuzalwa. Indlela aqhuba kakuhle ngayo umntwana ixhomekeke ekubeni zeziphi ezinye iimeko anazo umntwana.

Ukuba i-omphalocele ichongiwe ngaphambi kokuzalwa, umama kufuneka abekwe iliso elibukhali ukuqinisekisa ukuba usana olungekazalwa luhlala lusempilweni.

Kufuneka kwenziwe izicwangciso zokuhanjiswa ngononophelo kunye nokulawulwa kwangoko kwengxaki emva kokuzalwa. Usana kufuneka luziswe kwiziko lonyango elinobuchule ekulungiseni iziphene zodonga lwesisu. Iintsana kunokwenzeka ukuba zenze ngcono ukuba akukho mfuneko yokuba zisiwe kwelinye iziko ukuze zifumane unyango olungaphezulu.

Abazali kufuneka bakuthathele ingqalelo ukuvavanya umntwana, kwaye mhlawumbi namalungu osapho, kwezinye iingxaki zemfuza ezinxulumene nale meko.

Uxinzelelo olonyukayo oluvela kwindawo engalunganga yesisu lunokunciphisa ukuhamba kwegazi ukuya emathunjini nasezintso. Inokwenza nokuba kube nzima emntwaneni ukwandisa imiphunga, kukhokelela kwiingxaki zokuphefumla.

Enye ingxaki kukufa kwamathumbu (necrosis). Oku kwenzeka xa izicubu zamathumbu zisifa ngenxa yokuhamba kwegazi okuphantsi okanye usulelo Umngcipheko unokuncitshiswa kwiintsana ezifumana ubisi lomama endaweni yobisi olungumgubo.

Le meko ibonakala ekuzalweni kwaye iya kufunyanwa esibhedlele xa kuziswa ukuba ibingakhange ibonwe kwiimviwo zesiqhelo ze-fetal ultrasound ngexesha lokukhulelwa. Ukuba ubelekele ekhaya kwaye umntwana wakho ubonakala enale ngxaki, tsalela umnxeba kwindawo yongxamiseko yendawo (enje nge-911) kwangoko.

Le ngxaki ifunyaniswa kwaye ilungiswa esibhedlele ngexesha lokuzalwa. Emva kokubuyela ekhaya, biza umboneleli wakho wezempilo ukuba umntwana wakho uvelisa naziphi na kwezi mpawu:

• Ukwehla kwamathumbu
• Iingxaki zokondla
• Ifiva
• Umhlanzo oluhlaza okanye otyheli
• Indawo yesisu edumbileyo
• Ukuphalaza (ngokwahlukileyo kunesiqhelo sokutshica umntwana)
• Utshintsho kwindlela yokuziphatha

Isiphene sokuzalwa - i-omphalocele; Isiphene eludongeni lwesisu - usana; Isiphene sodonga lwesisu - umntwana osandul 'ukuzalwa; Isiphene sodonga lwesisu - usana olusandul 'ukuzalwa

• Omphalocele wosana
• Ukulungiswa kwe-Omphalocele-uthotho
• Isililo

I-Islam S. Iziphako zodonga lwesisu esiswini: i-gastroschisis kunye ne-omphalocele. Ku: Holcomb GW, Murphy P, St. Peter SD, ii-eds. Uqhaqho lwabantwana lweHolcomb kunye neAshcraft. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2020: isahluko 48.

UWalther AE, uNathan JD. Usana olusanda kuzalwa oluneziphene. Ku: Wyllie R, Hyams JS, Kay M, ii-eds. Izifo zesisu esiswini kunye nezifo zesibindi. Umhla we-5. IPhiladelphia, PA: Elsevier; 2016: isahluko 58.