Isifo seHirschsprung

Isifo seHirschsprung kukuvaleka kwamathumbu amakhulu. Kwenzeka ngenxa yokungahambi kakuhle kwemisipha emathunjini. Yimeko yokuzalwa, oko kuthetha ukuba ikho kwasekuzalweni.

Ukuncipha kwemisipha emathunjini kunceda ukutya okutyetyisiweyo kunye nolwelo luhamba emathunjini. Oku kubizwa ngokuba yi-peristalsis. Imithambo phakathi kwamanqanaba emisipha ibangela ukucutha.

Kwisifo iHirschsprung, imithambo-luvo ilahlekile kwinxalenye yamathumbu. Iindawo ezingenayo le mithambo-luvo azinakutyhala izinto. Oku kubangela ukucinywa. Iziqulatho zangaphakathi zakha emva kokuvaleka. Isisu kunye nokudumba kwesisu ngenxa yoko.

Isifo seHirschsprung sibangela malunga neepesenti ezingama-25 zazo zonke izithintelo zamathumbu ezisanda kuzalwa. Kwenzeka izihlandlo ezi-5 rhoqo kumadoda kunabafazi. Isifo se-Hirschsprung ngamanye amaxesha sinxulunyaniswa nezinye izinto ezizuzwe njengelifa okanye isifo sokuzalwa, njenge-Down syndrome.

Iimpawu ezinokubakho kwiintsana kunye neentsana zibandakanya:

• Ubunzima ngokuhamba kwamathumbu
• Ukusilela ukudlula kwi-meconium kwakamsinya emva kokuzalwa
• Ukusilela ukugqitha isitulo sokuqala ngaphakathi kweeyure ezingama-24 ukuya kuma-48 emva kokuzalwa
• Izitulo ezinqabileyo kodwa ezinokudubula
• I-jaundice
• Ukutya okungalunganga
• Ukutyeba ubunzima
• Ukuhlanza
• Urhudo lwamanzi (kwimveku)

Iimpawu kubantwana abadala:

• Ukuqunjelwa okuya kusiba kubi
• Impembelelo yelindle
• Ukungondleki
• Ukukhula kancinci
• Isisu esidumbileyo

Amatyala amabi anokungafunyanwa ade abe mdala umntwana.

Ngexesha lovavanyo lomzimba, umboneleli wokhathalelo lwempilo unokukwazi ukuziva iilophu zesisu esidumbileyo. Uvavanyo lwe-rectal lunokutyhila ithoni yemisipha eqinileyo kwimisipha ye-rectal.

Uvavanyo olusetyenziselwa ukufumanisa isifo se-Hirschsprung sinokubandakanya:

• X-ray esiswini
• I-anal manometry (ibhaluni ifakwe kwi-rectum ukulinganisa uxinzelelo kwindawo)
• I-enema yeBarium
• I-biopsy ebonakalayo

Inkqubo ebizwa ngokuba yi-serial rectal irrigation inceda ukunciphisa uxinzelelo kwi (decompress) emathunjini.

Icandelo elingaqhelekanga lekholoni kufuneka lithathelwe ngaphandle kotyando. Ngokuqhelekileyo, i-rectum kunye nengxenye engaqhelekanga yekholoni isuswe. Inxalenye esempilweni yekolon iyatsalwa ibotshelelwe kwi-anus.

Ngamanye amaxesha oku kunokwenziwa kwintsebenzo enye. Nangona kunjalo, ihlala isenziwa kwiindawo ezimbini. I-colostomy yenziwa kuqala. Elinye icandelo lenkqubo lwenziwa kamva kunyaka wokuqala wokuzalwa komntwana.

Iimpawu ziphucula okanye zihamba kuninzi lwabantwana emva kotyando. Inani elincinci labantwana linokuba nokuqunjelwa okanye iingxaki zokulawula ilindle (ukungabinakho ukungcola). Abantwana abafumana unyango kwangethuba okanye abanecandelo elifutshane lamathumbu abandakanyekayo baneziphumo ezingcono.

Iingxaki zinokubandakanya:

• Ukudumba kunye nosulelo lwamathumbu (i-enterocolitis) inokwenzeka ngaphambi kotyando, kwaye ngamanye amaxesha kunyaka wokuqala ukuya kwiminyaka emi-2 emva koko. Iimpawu ziqatha, kubandakanya ukudumba kwesisu, urhudo olunamanzi olunukayo, ukonqena, kunye nokungondleki kakuhle.
• Ukugqobhoza okanye ukuqhekeka kwamathumbu.
• Isifo esifutshane samathumbu, imeko enokubangela ukungondleki kunye nokuphelelwa ngamanzi emzimbeni.

Fowunela umnikezeli womntwana wakho ukuba:

• Umntwana wakho uvelisa iimpawu zesifo seHirschsprung
• Umntwana wakho uneentlungu esiswini okanye ezinye iimpawu emva kokunyangwa ngale meko

Megacolon ezelwe

IBass LM, iWershil BK. I-Anatomy, i-histology, i-embryology, kunye nokukhula okungahambelaniyo kwethumbu elincinci nelikhulu. Ku: UFeldman M, uFriedman LS, uBrandt LJ, ii-eds. Sleisenger kunye neFordtran's Amathumbu kunye nezifo zesibindi: iPathophysiology / Diagnosis / Management. Ngomhla we-10. IPhiladelphia, PA: Elsevier Saunders; Ngo-2016: isahluko 98.

IKliegman RM, iSt Geme JW, iBlum NJ, i-Shah SS, iTasker RC, uWilson KM. Ukuphazamiseka kwemotility kunye nesifo seHirschsprung. Ku: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, ii-eds. Incwadi kaNelson yeNcwadi yePediatrics. Umhla wama-21. IPhiladelphia, PA: Elsevier; 2020: isahluko 358.