Yintoni iZenker's Diverticulum kwaye iphathwa njani?

Umxholo

• Amanqanaba
• Ziintoni iimpawu?
• Yintoni ebangela oku?
• Kufunyaniswa njani?
• 'Yima ubone'
• Unyango lotyando
• Iinkqubo ze-Endoscopic
• Utyando oluvulekileyo
• Zeziphi iingxaki?
• Imbonakalo

Yintoni i-diverticulum yeZenker?

I-Diverticulum ligama lonyango elibhekisa kwisakhiwo esingaqhelekanga, esinjengengxowa. I-Diverticula inokubumba phantse kuzo zonke iindawo zendlela yokugaya.

Xa ipokotho yenzeka kwindawo ekudibana kuyo umqala kunye nomqala, ibizwa ngokuba yiZenker's diverticulum. Ipharynx ifumaneka ngasemva komqala wakho, ngasemva kwempumlo nasemlonyeni.

I-diverticulum ye-Zenker ibonakala kwi-hypopharynx. Eli lelona candelo le-pharynx, apho lijoyina ityhubhu (umqala) ekhokelela kwisisu. I-diverticulum yeZenker ihlala ibonakala kwindawo eyaziwa ngokuba ngunxantathu kaKillian.

I-diverticulum yeZenker inqabile, ichaphazela phakathi kwabemi. Kuhlala kwenzeka kubantu abadala kunye nabadala, ngakumbi abantu abakwiminyaka yama-70 nama-80s. I-diverticulum yeZenker inqabile phakathi kwabantu abangaphantsi kweminyaka engama-40. Ichaphazela amadoda rhoqo kunabafazi.

Kukwabizwa ngokuba yi-pharyngoesophageal diverticulum, i-hypopharyngeal diverticulum, okanye ingxowa ye-pharyngeal.

Amanqanaba

Kukho iinkqubo ezahlukeneyo zokuhlela iZenker's diverticulum:

Ziintoni iimpawu?

Ubunzima bokuginya, okwaziwa ngokuba yi-dysphagia, lolona phawu luxhaphakileyo lweZenker's diverticulum. Kubonakala kuqikelelwa ukuba ngama-80 ukuya kuma-90 epesenti yabantu abane-diverticulum yeZenker.

Eminye imiqondiso kunye neempawu ze-diverticulum yeZenker zibandakanya:

• ukulungisa ukutya okanye amayeza omlomo
• umphefumlo ombi (halitosis)
• ilizwi elirhawuzelelayo
• ukukhohlela okungapheliyo
• ukuginya ulwelo okanye into etyiwayo "ezantsi kumbhobho ongalunganga" (umnqweno)
• uvakalelo lwesigaqa emqaleni wakho

Ukuba ishiywe inganyangwa, iimpawu zeZenker's diverticulum zinokuba mandundu ngokuhamba kwexesha.

Yintoni ebangela oku?

Ukuginya yinkqubo entsonkothileyo efuna ulungelelwaniso lwezihlunu emlonyeni, pharynx, kunye nomqala. Xa uginya, isihlunu setyhula esibizwa ngokuba yi-esophageal sphincter evulayo sivumela umcimbi wokutya ohlafunwayo ukuba udlule. Emva kokuginya, i-sphincter ephezulu yokuvala iyavala ukuthintela umoya ophefumlelweyo ukuba ungene kwisopha.

Ukuqulunqwa kwe-diverticulum yeZenker kuhambelana nokusebenza kakubi kwe-sphincter ephezulu. Xa i-sphincter ephezulu yokuvula ingavuli yonke indlela, ibeka uxinzelelo kwindawo yodonga lwepharynx. Olu xinzelelo lukhulu ngokuthe ngcembe lutyhala izicubu lwangaphandle, lubangela ukuba lwenze i-diverticulum.

Isifo se-reflux sesifo se-Gastroesophageal (GERD) kunye notshintsho olunxulumene nobudala ekwakhiweni kwezicubu kunye nethoni yezihlunu zikwacingelwa ukuba zidlala indima kule nkqubo.

Kufunyaniswa njani?

Thetha nogqirha wakho ukuba wena okanye umntu omkhathaleleyo uhlangabezana neempawu zeZenker's diverticulum.

I-diverticulum yeZenker ifunyaniswa kusetyenziswa uvavanyo olubizwa ngokuba ligwinya le-barium. Ukugwinya kwe-barium yi-X-ray ekhethekileyo ebalaselisa ngaphakathi komlomo wakho, i-pharynx, kunye ne-esophagus. I-barium swallow fluoroscopy ivumela ugqirha wakho ukuba abone ukuba uginya njani xa ushukuma.

Ngamanye amaxesha, ezinye iimeko zibakhona ecaleni kweZenker's diverticulum. Ugqirha wakho unokucebisa iimvavanyo ezongezelelweyo ukufumana okanye ukulawula ezinye iimeko. I-endoscopy ephezulu yinkqubo ebandakanya ukusebenzisa ubungakanani obuncinci, obuxhotyiswe ngekhamera ukujonga umqala kunye nomqala. I-Esophageal manometry luvavanyo olulinganisa uxinzelelo ngaphakathi kwe-esophagus.

'Yima ubone'

Amatyala athambileyo e-diversiculum yeZenker anokungafuneki unyango kwangoko. Ngokuxhomekeka kwiimpawu zakho kunye nobukhulu be-diverticulum, ugqirha wakho unokucebisa ukuba "ulinde uze ubone" indlela.

Ukutshintsha indlela otya ngayo ngamanye amaxesha kunokunceda ukuphucula iimpawu. Zama ukutya ukutya okuncinci kwindawo enye, ukuhlafuna ngokucokisekileyo kunye nokusela phakathi kokulunywa.

Unyango lotyando

Ukumodareyitha ukuya kumatyala amabi e-Zenker's diverticulum kuhlala kufuna utyando. Kukho iindlela ezimbalwa zotyando. Ugqirha wakho unokukunceda uqonde ukuba loluphi ukhetho olulungele wena.

Iinkqubo ze-Endoscopic

Ngexesha le-endoscopy, ugqirha ufaka isixhobo esibhityileyo esifana netyhubhu ekuthiwa yi-endoscope emlonyeni wakho. I-endoscope ixhotyiswe ngokukhanya kunye nekhamera. Ingasetyenziselwa ukwenza ukusikeka eludongeni okwahlula i-diverticulum kumngxunya we-esophagus.

Ii-Endoscopies zeZenker's diverticulum zinokuba ngqongqo okanye ziguquguquke. I-endoscopy engqongqo isebenzisa i-endoscope engapheliyo kwaye ifuna i-anesthesia ngokubanzi. Ii-endoscopy eziqinileyo zifuna ukongezwa kwentamo.

Ngenxa yomngcipheko weengxaki, le nkqubo ayikhuthazwa kubantu abane:

• i-diverticulum encinci
• ubunzima bomzimba obuphezulu
• kunzima ukwandisa intamo yabo

I-endoscopy eguquguqukayo isebenzisa i-endoscope egobekayo kwaye inokwenziwa ngaphandle kwe-anesthetic ngokubanzi. Olona khetho lincinci lokungenelela lungenayo ukunyanga iZenker's diverticulum. Ngokuqhelekileyo yinkqubo yokugula ngaphandle ebeka umngcipheko omncinci weengxaki.

Nangona ii-endoscopies eziguqukayo zinokunciphisa iimpawu zeZenker's diverticulum, amaqondo okuphindaphinda anokuphakama. Iinkqubo ezininzi ze-endoscopy eziguqukayo zinokusetyenziselwa ukujongana neempawu eziphindaphindayo.

Utyando oluvulekileyo

Xa i-endoscopy ingenakwenzeka okanye i-diverticulum inkulu, utyando oluvulekileyo lukhetho olulandelayo. Utyando lweZenker's diverticulum lwenziwa phantsi kwe-anesthetic ngokubanzi.

Ugqirha uya kwenza intambo encinci entanyeni yakho ukuze enze i-diverticulectomy. Oku kubandakanya ukwahlula i-diverticulum eludongeni lwakho lokuopha. Kwezinye iimeko, ugqirha wenza i-diverticulopexy okanye i-inversion diverticular. Ezi nkqubo zibandakanya ukutshintsha indawo ye-diverticulum kunye nokuyithunga endaweni yayo.

Utyando oluvulekileyo lunenqanaba eliphezulu lempumelelo, kwaye iimpawu akunakulindeleka ukuba ziphinde zivele kwixesha elide. Nangona kunjalo, kufuna ukuhlala esibhedlele kweentsuku ezininzi kwaye ngamanye amaxesha, ukubuyela esibhedlele ukususa imithungo. Kuya kufuneka usebenzise ityhubhu yokondla iveki okanye nangaphezulu ukulandela inkqubo. Ugqirha wakho unokucebisa ukuba ulandele ukutya okhethekileyo ngelixa uphilisa.

Zeziphi iingxaki?

Ukuba ishiywe inganyangwa, i-diverticulum yeZenker inokunyusa ubungakanani, yenza ukuba iimpawu zakho zibe mandundu. Ixesha elingaphezulu, iimpawu ezinzima ezifana nobunzima bokuginya kunye nokuphinda ubenokwenza kube nzima ukuhlala usempilweni. Unokufumana ukungondleki.

Ukuphefumla luphawu lweZenker's diverticulum. Kwenzeka xa uphefumlela ngaphakathi ukutya okanye enye into kwimiphunga endaweni yokukuginya kwi-esophagus. Iingxaki zomnqweno zibandakanya i-aspiration pneumonia, usulelo olwenzeka xa ukutya, amathe, okanye enye into ibambeke kwimiphunga yakho.

Ezinye iingxaki ezinqabileyo ze-diverticulum yeZenker zibandakanya:

• isithintelo sokuqina (ukukrwitsha)
• ukuphuma kwegazi (ukopha)
• ukukhubazeka kwentambo yelizwi
• squamous cell carcinoma
• fistula

Phantse i-10 ukuya kwi-30 yepesenti yabantu abafumana utyando oluvulekileyo lweZenker's diverticulum yamava obunzima. Iingxaki ezinokubakho zibandakanya:

• ukukrala kwemiphunga
• imastastinitis
• Umonakalo wemithambo (ukukhubazeka)
• ukuphuma kwegazi (ukopha)
• ukubunjwa kwefistula
• usulelo
• stenosis

Thetha nogqirha wakho malunga nemingcipheko yotyando oluvulekileyo lweZenker's diverticulum.

Imbonakalo

I-diverticulum yeZenker yimeko enqabileyo echaphazela abantu abadala. Kwenzeka xa ingxowa yeefom zethishu apho ipharynx ihlangana khona nomqala.

Iifom ezinobulali zeZenker's diverticulum zisenokungafuneki unyango. Unyango lweentlobo ezimodareyithayo nezomeleleyo zeZenker's diverticulum zihlala zibandakanya utyando.

Umbono wexesha elide weZenker's diverticulum ulungile. Ngonyango, uninzi lwabantu lubona ukuphucuka kweempawu.