Umthambo weMesenteric ischemia

Umthambo weMesenteric ischemia wenzeka xa kukho ukuhla okanye ukuvaleka kwemithambo enye okanye engaphezulu kwezi zintathu zinikezela ngamathumbu amancinci kunye amakhulu. Ezi zibizwa ngokuba yimithambo ye-mesenteric.

Imithambo ehambisa igazi emathunjini ibaleka ngokuthe ngqo ukusuka kwi-aorta. I-aorta yeyona nto ibalulekileyo isuka entliziyweni.

Ukuqina kwemithambo kwenzeka xa amanqatha, icholesterol, kunye nezinye izinto zakha ezindongeni zemithambo. Oku kuxhaphake kakhulu kubantu abatshayayo nakubantu abanexinzelelo lwegazi okanye icholesterol ephezulu yegazi.

Oku kunciphisa imithambo yegazi kwaye kunciphisa ukuhamba kwegazi kumathumbu. Njengalo lonke ilungu lomzimba, igazi lizisa ioksijini emathunjini. Xa unikezelo lweoksijini luyehla, iimpawu zinokwenzeka.

Ukunikezelwa kwegazi emathunjini kunokuvalwa ngequbuliso ngegazi (embolus). Amahlwili ahlala evela entliziyweni okanye kwi-aorta. Ezi zihlwili zibonakala ngokuxhaphakileyo kubantu abanesingqisho sentliziyo esingaqhelekanga.

Iimpawu ezibangelwa kukuqina kancinci kwemithambo ye-mesenteric ibandakanya:

• Intlungu zesisu emva kokutya
• Urhudo

Iimpawu ze-artery ischemia yequbuliso (etsolo) ye-mesenteric ngenxa yegazi elijikelezayo liquka:

• Ngequbuliso iintlungu zesisu okanye ukudumba
• Urhudo
• Ukuhlanza
• Ifiva
• Isicaphucaphu

Xa iimpawu ziqala ngesiquphe okanye ziba nzima, uvavanyo lwegazi lunokubonisa ukwanda kwenani leeseli ezimhlophe kunye notshintsho kwinqanaba leasidi yegazi. Kunokubakho ukopha kwiphecana le-GI.

I-Doppler ultrasound okanye i-CT angiogram scan ingabonisa iingxaki kwimithambo yegazi nakwisisu.

I-angiogram ye-mesenteric luvavanyo olubandakanya ukujoba idayi ekhethekileyo kwigazi lakho ukuqaqambisa imithambo yamathumbu. Emva koko ii-ray-ray zithathwa kuloo ndawo. Oku kunokubonisa indawo ekucinywa kuyo umthambo.

Xa ukuhanjiswa kwegazi kuthintelwe kwinxalenye yesihlunu sentliziyo, umsipha uya kufa. Oku kubizwa ngokuba sisifo sentliziyo. Uhlobo olufanayo lokulimala lunokwenzeka nakweyiphi na indawo yamathumbu.

Xa ukunikezelwa kwegazi kunqunyulwa ngequbuliso ligazi, kungxamiseko. Unyango lunokubandakanya amayeza anyibilikisa amahlwili egazi kunye nokuvula imithambo.

Ukuba unempawu ngenxa yokuqina kwemithambo ye-mesenteric, kukho izinto onokuzenza ukulawula ingxaki:

• Yeka ukutshaya. Ukutshaya kunciphisa imithambo. Oku kunciphisa amandla egazi ukuphatha ioksijini kwaye kwandisa umngcipheko wokwenza amahlwili (i-thrombi kunye ne-emboli).
• Qinisekisa ukuba uxinzelelo lwegazi luphantsi kolawulo.
• Ukuba utyebe kakhulu, nciphisa ubunzima bakho.
• Ukuba icholesterol yakho iphezulu, yitya ukutya okune-cholesterol esezantsi kunye nokutya okunamafutha asezantsi.
• Jonga eswekile yegazi lakho ukuba unesifo seswekile, kwaye usigcine phantsi kolawulo.

Unokwenziwa kungenziwa ukuba ingxaki inzima.

• Isithintelo siyasuswa kwaye imithambo ibuye yaxhuma kwi-aorta. Ukudlula ecaleni kokuvalelwa yenye inkqubo. Ngokuqhelekileyo kwenziwa ngeplastiki ye-graft.
• Ukufakwa kwe-stent. I-stent inokusetyenziswa njengenye indlela yotyando ukuze kwandiswe ukucinywa komthambo okanye ukuhambisa amayeza ngqo kwindawo echaphazelekayo. Le yindlela entsha kwaye kufuneka yenziwe kuphela ngabanikezeli bonyango abanamava. Isiphumo sihlala singcono ngokuhlinzwa.
• Ngamaxesha athile, inxenye yamathumbu akho iya kufuneka isuswe.

Imbonakalo ye-mesenteric ischemia elungileyo emva kotyando oluyimpumelelo. Nangona kunjalo, kubalulekile ukwenza iinguqu kwindlela yokuphila ukunqanda ukuqina kweemithambo ekubeni kubi.

Abantu abanzima kwimithambo ebonelela ngamathumbu bahlala beneengxaki ezifanayo kwimithambo yegazi ebonelela ngentliziyo, ingqondo, izintso, okanye imilenze.

Abantu abane-acent mesenteric ischemia bahlala besenza kakubi kuba iinxalenye zamathumbu zisenokufa ngaphambi kokuba kwenziwe utyando. Oku kunokuba yingozi. Nangona kunjalo, ngoxilongo olukhawulezileyo kunye nonyango, i-acent mesenteric ischemia inokunyangwa ngempumelelo.

Ukufa kwamathambo ngenxa yokunqongophala kokuhamba kwegazi (infarction) emathunjini yeyona ngxaki inkulu ye-mesenteric artery ischemia. Utyando lunokufuneka ukuze kususwe isahlulo esifileyo.

Fowunela umnikezeli wakho ukuba unayo:

• Utshintsho kwimikhwa yamathumbu
• Ifiva
• Isicaphucaphu
• Iintlungu ezinzima zesisu
• Ukuhlanza

Olu tshintsho lulandelayo lweendlela zokuphila lunokunciphisa umngcipheko wokunciphisa imithambo:

• Yenza umthambo rhoqo.
• Landela ukutya okusempilweni.
• Fumana unyango lwesingqisho sentliziyo.
• Gcina i-cholesterol yakho yegazi kunye noshukela wegazi phantsi kolawulo.
• Yeka ukutshaya.

Isifo seMesenteric semithambo; Ischemic colitis; Ischemic wamathumbu - mesenteric; Amathumbu afileyo - mesenteric; Amathumbu afileyo - mesenteric; I-atherosclerosis - umthambo we-mesenteric; Ukuqaqanjelwa kwemithambo-umthambo we-mesenteric

• Umthambo weMesenteric ischemia kunye ne-infarction

I-Holscher CM, iReifsnyder T. Acute mesenteric ischemia. Ku: ICameron AM, uCameron JL, ii-eds. Unyango lwangoku lonyango. Umhla we-13. IPhiladelphia, PA: Elsevier; Ngo-2020: 1057-1061.

IKahi CJ. Izifo zeVascular zephecana lesisu. Ku: IGoldman L, iSchafer AI, ii-eds. Amayeza eGoldman-Cecil. Ngomhla wama-26. IPhiladelphia, PA: Elsevier; 2020: isahl. 134.

Jonga i-RC, iShermerhorn ML. Isifo seMesenteric isifo: i-epidemiology, i-pathophysiology, kunye novavanyo lweklinikhi. Ku: Sidawy AN, Perler BA, ii-eds. Utshintsho lukaRutherford lweeVascular and Therapy ze-Endovascular Therapy. Umhla we-9. IPhiladelphia, PA: Elsevier; I-2019: isahluko 131.