UPJ isithintelo

Ureteropelvic junction (UPJ) isithintelo kukuvaleka kwindawo apho inxalenye yezintso incamathele kwenye yeetyhubhu kwisinyi (ureters). Oku kuthintela ukuphuma komchamo kwizintso.

Ukuthintelwa kwe-UPJ ikakhulu kwenzeka ebantwaneni. Ihlala isenzeka xa umntwana esakhula esibelekweni. Oku kubizwa ngokuba yimeko yokuzalwa (ekhoyo ukususela ekuzalweni).

Ukuvaleka kubangelwa xa kukho:

• Ukunciphisa indawo phakathi kwe-ureter kunye nenxalenye yezintso ezibizwa ngokuba yi-renal pelvis
• Isitya segazi esingaqhelekanga esiwela i-ureter

Ngenxa yoko, umchamo uyakha kwaye wonakalise izintso.

Kubantwana abadala nakubantu abadala, ingxaki inokubangelwa kukuqina kwesikhumba, usulelo, unyango lwangaphambi kwexesha lokuthintela, okanye amatye ezintso.

Ukuthintelwa kwe-UPJ sesona sizathu siphambili sokuvaleka komchamo ebantwaneni. Ngoku ifunyenwe ngaphambi kokuzalwa kunye novavanyo lwe-ultrasound. Kwezinye iimeko, le meko ayinakubonakala kude kube semva kokuzalwa. Utyando lunokufuneka kwasekuqaleni ebomini ukuba ingxaki inzima. Uninzi lwexesha, utyando aludingeki kude kube kamva. Ezinye iimeko azidingi kuqhaqho.

Kungangabikho mpawu. Xa iimpawu zivela, zingabandakanya:

• Intlungu ebuyayo okanye yeplani ngakumbi xa usebenzisa i-diuretics enje ngotywala okanye icaffeine
• Umchamo wegazi (hematuria)
• Isigaxa esiswini (esiswini)
• Usulelo lwezintso
• Ukukhula kakubi kubantwana (ukusilela ukukhula)
• Usulelo lwe-Urinary tract, ngokuqhelekileyo kunye nomkhuhlane
• Ukuhlanza

I-ultrasound ngexesha lokukhulelwa ingabonisa iingxaki zezintso kumntwana ongekazalwa.

Uvavanyo emva kokuzalwa lunokubandakanya:

• BUN
• Ukucoca creatinine
• Ukuskena i-CT
• Ii-Electrolyte
• IVP-isetyenziswa ngokungaqhelekanga
• I-CT urogram-ukuskena zombini izintso kunye ne-ureters ngokuchaseneyo kwe-IV
• Ukuskena kwenyukliya kwizintso
• Ukuhamba ngecystourethrogram
• I-Ultrasound

Utyando ukulungisa ukubhloka kuvumela umchamo ukuba uqukuqele ngesiqhelo. Uninzi lwexesha, utyando oluvulekileyo (olungenelelayo) lwenziwa kwiintsana. Abantu abadala banokunyangwa ngeenkqubo ezingangenisi kangako. Ezi nkqubo zibandakanya ukusika okuncinci kakhulu kunotyando oluvulekileyo, kwaye kunokubandakanya:

• Inkqubo ye-Endoscopic (retrograde) ayifuni ukusikwa kotyando kulusu. Endaweni yoko, isixhobo esincinci sibekwe kwi-urethra nakwisinyi nakwindawo yokuchopha echaphazelekayo. Oku kuvumela ugqirha ukuba avule ukuvaleka ngaphakathi.
• Inkqubo ye-Percutaneous (antegrade) ibandakanya ukusikwa okuncinci kwicala lomzimba phakathi kweembambo kunye nomlenze.
• I-Pyeloplasty isusa izicwili ezibomvu kwindawo evaliweyo kwaye iphinde inxibelelanise indawo esempilweni yezintso kwi-ureter esempilweni.

I-Laparoscopy ikwasetyenziselwa ukunyanga ukuphazamiseka kwe-UPJ ebantwaneni nakubantu abadala abangakhange baphumelele ngezinye iinkqubo.

Umbhobho obizwa ngokuba yi-stent unokufakwa ukukhupha umchamo kwizintso kude kube lunyango luphilisa. Ityhubhu ye-nephrostomy, ebekwe ecaleni lomzimba ukucoca umchamo, inokufuneka okwexeshana emva kotyando. Olu hlobo lwetyhubhu lusenokusetyenziselwa ukunyanga usulelo olubi ngaphambi koqhaqho.

Ukuchonga kunye nokunyanga ingxaki kwangoko kunokunceda ukuthintela ukonzakala kwezintso kwixa elizayo. Ukuthintelwa kwe-UPJ kufunyaniswe ngaphambi kokuzalwa okanye kwangoko emva kokuzalwa kunokuziphucula ngokwakho.

Uninzi lwabantwana luqhuba kakuhle kwaye alunangxaki zexesha elide. Umonakalo omkhulu unokwenzeka kubantu abafunyaniswa sele bekhulile.

Iziphumo zexesha elide zilungile kunyango lwangoku. IPyeloplasty yeyona mpumelelo yexesha elide.

Ukuba ayinyangwa, ukuphazamiseka kwe-UPJ kunokukhokelela ekuphulukaneni ngokusisigxina nomsebenzi wezintso (ukusilela kwezintso).

Amatye eentso okanye usulelo lunokwenzeka kwizintso ezichaphazelekayo, kwanasemva konyango.

Fowunela umboneleli wezempilo ukuba usana lwakho:

• Umchamo wegazi
• Ifiva
• Isigaxa esiswini
• Izibonakaliso zentlungu yangemva okanye intlungu emacaleni (indawo eya kumacala omzimba phakathi kweembambo kunye ne-pelvis)

Ureteropelvic junction ukuphazamiseka; Ukuphambuka kokuhlangana; Uthintelo lwendibano ye-ureteropelvic

• I-anatomy yezintso

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UFrøkiaer J. Uthintelo lomjelo womchamo. Ku: Skorecki K, Chertow GM, Marsden PA, Taal MW, Yu ASL, ii-eds. Brenner kunye noMphathi weZintso. Ngomhla we-10. IPhiladelphia, PA: Elsevier; 2016: isahluko 38.

IMeldrum KK. I-Pathophysiology yokuthintela umchamo. Ku: Wein AJ, Kavoussi LR, Partin AW, Peters CA, ii-eds. UCampbell-Walsh Urology. Ngomhla we-11. IPhiladelphia, PA: Elsevier; 2016: isahl 48.

I-Nakada SY, eyona SL. Ulawulo lokuphazamiseka kwendlela ephezulu yomchamo. Ku: Wein AJ, Kavoussi LR, Partin AW, Peters CA, ii-eds. UCampbell-Walsh Urology. Ngomhla we-11. IPhiladelphia, PA: Elsevier; 2016: isahluko 49.

UStephany HA, Ost MC. Iingxaki zomchamo. Ku: Zitelli BJ, McIntire SC, Nowalk AJ, ii-eds. UZitelli no-Davis ’Atlas of Pediatric Physical Diagnosis. Umhla wesi-7. IPhiladelphia, PA: Elsevier; I-2018: isahluko 15.