Omphalocele

Omphalocele ndi chilema chobadwira momwe matumbo a mwana wakhanda kapena ziwalo zina zam'mimba zili kunja kwa thupi chifukwa cha bowo m'dera lamimba (mchombo). Matumbo amatsekedwa ndi kanyama kakang'ono ndipo amatha kuwoneka mosavuta.

Omphalocele amawonedwa ngati cholakwika cham'mimba (dzenje pakhoma). Matumbo a mwana nthawi zambiri amatuluka (kutuluka) kudzera pabowo.

Chikhalidwe chikuwoneka chofanana ndi gastroschisis. Omphalocele ndi chilema chobadwa momwe m'matumbo mwa khanda kapena ziwalo zina zam'mimba zimatuluka kudzera mu dzenje lam'mimba ndipo zimakutidwa ndi nembanemba. Mu gastroschisis, palibe chotchinga chophimba.

Kupindika kwa khoma m'mimba kumakula pamene mwana amakula m'mimba mwa mayi. Pakukula, matumbo ndi ziwalo zina (chiwindi, chikhodzodzo, m'mimba, ndi thumba losunga mazira kapena ma testes) zimatulukira kunja kwa thupi poyamba ndipo nthawi zambiri zimabwerera mkati. Kwa makanda omwe ali ndi omphalocele, matumbo ndi ziwalo zina zimatsalira kunja kwa khoma la m'mimba, ndikutsegula. Zomwe zimayambitsa zolakwika zam'mimba sizikudziwika.

Makanda omwe ali ndi omphalocele nthawi zambiri amakhala ndi zovuta zina zobadwa. Zolakwitsa zimaphatikizaponso mavuto amtundu (chromosomal sali bwino), kobadwa nako diaphragmatic hernia, mtima ndi impso. Mavutowa amakhudzanso mawonekedwe (malingaliro) a thanzi la mwana ndi moyo wake.

Omphalocele amatha kuwona bwino. Izi ndichifukwa choti zomwe zili m'mimba zimatuluka (zimatuluka) kudera lam'mimba.

Pali mitundu yosiyanasiyana ya ma omphaloceles. Pazing'ono, matumbo okha ndiwo amakhala kunja kwa thupi. Kukula kwake, chiwindi kapena ziwalo zina zimatha kukhala panja.

Ma ultrasound omwe amakhala asanabadwe nthawi zambiri amadziwika kuti ana omwe ali ndi omphalocele asanabadwe, nthawi zambiri pamasabata 20 obadwa.

Kuyesa nthawi zambiri sikofunikira kuti mupeze omphalocele. Komabe, makanda omwe ali ndi omphalocele ayenera kuyesedwa pamavuto ena omwe nthawi zambiri amapita nawo. Izi zikuphatikiza ma ultrasound a impso ndi mtima, komanso kuyezetsa magazi pamavuto amtunduwu, pakati pamayeso ena.

Omphaloceles amakonzedwa ndi opareshoni, ngakhale sizikhala choncho nthawi yomweyo. Thumba limateteza zomwe zili m'mimba ndipo limatha kupatsa nthawi mavuto ena akulu (monga kupindika kwa mtima) kuti athane nawo koyamba, ngati kuli kofunikira.

Pofuna kukonza omphalocele, chikwamacho chimakutidwa ndi thumba lopanda kanthu, lomwe limasokedwa m'malo kuti lipange chomwe chimatchedwa silo. Mwana akamakula pakapita nthawi, zomwe zili m'mimba zimakankhidwira m'mimba.

Omphalocele ikamakwanira bwino m'mimba, silo imachotsedwa ndipo mimba imatsekedwa.

Chifukwa cha kukakamizidwa kubwezera matumbo m'mimba, mwana angafunike kuthandizidwa kuti apume ndi mpweya wabwino. Njira zina zochizira khanda zimaphatikizira michere ya IV komanso maantibayotiki kupewa matenda. Ngakhale chilepheretsocho chitatsekedwa, zakudya za IV zidzapitilirabe popeza kuyamwa mkaka kuyenera kuyambitsidwa pang'onopang'ono.

Nthawi zina, omphalocele amakhala wokulirapo kotero kuti sangayikidwe kumbuyo m'mimba mwa khanda. Khungu lozungulira omphalocele limakula ndipo pamapeto pake limakwirira omphalocele. Minofu yam'mimba ndi khungu zimatha kukonzedwa mwanayo atakula kuti apangidwe bwino.

Kuchira kwathunthu kumayembekezereka pambuyo pochitidwa opaleshoni ya omphalocele. Komabe, ma omphaloceles nthawi zambiri amapezeka ndi zovuta zina zobadwa. Momwe mwana amachitila bwino zimadalira zina zomwe mwanayo ali nazo.

Ngati omphalocele amadziwika asanabadwe, mayi amayenera kuyang'aniridwa mosamala kuti mwana wosabadwa akhale wathanzi.

Ndondomeko ziyenera kupangidwa pobereka mosamala ndikuwongolera msanga vutoli atabadwa. Mwanayo ayenera kuperekedwa kuchipatala chomwe ndi luso lokonza zolakwika zam'mimba. Ana atha kuchita bwino ngati sakufunika kupita nawo kumalo ena kukalandira chithandizo china.

Makolo ayenera kulingalira za kuyesa mwana, ndipo mwina abale, pamavuto ena amtundu womwe amakhudzana ndi vutoli.

Kuwonjezeka kwa kuthamanga kuchokera m'mimba kolakwika kumatha kuchepetsa kuthamanga kwa magazi m'matumbo ndi impso. Zingapangitsenso kuti zikhale zovuta kuti mwana akweze mapapu, zomwe zimabweretsa mavuto kupuma.

Vuto lina ndikufa kwamatumbo (necrosis). Izi zimachitika minofu yamatumbo ikafa chifukwa chotsika magazi kapena matenda, chiopsezo chimatha kuchepetsedwa mwa makanda omwe amalandila mkaka wa amayi osati mkaka.

Matendawa amawonekera pobadwa ndipo amawonekera kuchipatala pakubereka ngati sanawonekere pamayeso azowoneka a fetus nthawi yapakati. Ngati mwaberekera kunyumba ndipo mwana wanu akuwoneka kuti ali ndi vuto ili, itanani nambala yadzidzidzi yakomweko (monga 911) nthawi yomweyo.

Vutoli limapezeka ndikukonzedwa mchipatala pakubadwa. Mukabwerera kunyumba, itanani wothandizira zaumoyo wanu ngati mwana wanu ali ndi izi:

• Kuchepetsa matumbo
• Mavuto akudya
• Malungo
• Masanzi obiriwira obiriwira kapena achikasu
• Malo otupa amimba
• Kusanza (mosiyana ndi kulavuliridwa kwa mwana)
• Kusintha kwamakhalidwe oyipa

Chibadwa chobadwira - omphalocele; M'mimba khoma chilema - khanda; M'mimba khoma chilema - akhanda; M'mimba khoma chilema - wakhanda

• Omwana omphalocele
• Kukonza omphalocele - mndandanda
• Silo

Islam S. Kubadwa kwam'mimba zolakwika: gastroschisis ndi omphalocele. Mu: Holcomb GW, Murphy P, St. Peter SD, eds. Opaleshoni ya Ana ya Holcomb ndi Ashcraft. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2020: chap 48.

Walther AE, Nathan JD. Khanda lobadwa m'mimba lobadwa kumene. Mu: Wyllie R, Hyams JS, Kay M, olemba., Eds. Matenda a m'mimba ndi Matenda a Chiwindi. 5th ed. Philadelphia, PA: Elsevier; 2016: chap 58.