Matenda a Hirschsprung

Matenda a Hirschsprung ndi kutsekeka kwa m'matumbo akulu. Zimachitika chifukwa cha kusayenda bwino kwa minofu m'matumbo. Ndi chikhalidwe chobadwa nacho, chomwe chimatanthauza kuti chimakhalapo kuyambira chibadwire.

Kutsekeka kwa minofu m'matumbo kumathandizira zakudya zopukutidwa ndi zakumwa zimadutsa m'matumbo. Izi zimatchedwa peristalsis. Mitsempha pakati pa minofu imayambitsa kupindika.

Mu matenda a Hirschsprung, misempha imasowa kuchokera mbali ya matumbo. Madera opanda mitsempha imeneyi sangathe kupititsa patsogolo zinthu. Izi zimayambitsa kutseka. Zamkatimu zimakhazikika kuseri kwa kutsekeka. Zotsatira zake zimakhala zotupa ndi m'mimba.

Matenda a Hirschsprung amayambitsa pafupifupi 25% yamatumbo onse obadwa kumene m'mimba. Zimachitika maulendo asanu mwa amuna kuposa akazi. Matenda a Hirschsprung nthawi zina amalumikizidwa ndi zovuta zina zobadwa nazo kapena zobadwa nazo, monga Down syndrome.

Zizindikiro zomwe zimatha kupezeka mwa ana obadwa kumene ndi makanda ndizo:

• Zovuta ndimayendedwe amatumbo
• Kulephera kupititsa meconium atangobadwa kumene
• Kulephera kupititsa chopondapo choyamba mkati mwa maola 24 mpaka 48 mutabadwa
• Zojambula zosawerengeka koma zophulika
• Jaundice
• Kudya moperewera
• Kulemera kolemera
• Kusanza
• Kutsekula m'madzi (mwa mwana wakhanda)

Zizindikiro mwa ana okulirapo:

• Kudzimbidwa komwe kumangowonjezereka pang'onopang'ono
• Zochita zachimbudzi
• Kusowa zakudya m'thupi
• Kukula pang'onopang'ono
• Mimba yotupa

Matenda ovuta mwina sangapezeke mpaka mwana atakula.

Pakati pa kuyezetsa thupi, wothandizira zaumoyo amatha kumva malupu m'mimba yotupa. Kuyezetsa magazi kumatha kuwonetsa kulimba kwaminyewa yama minofu.

Mayeso omwe amagwiritsidwa ntchito kuthandizira kuzindikira matenda a Hirschsprung atha kukhala:

• X-ray m'mimba
• Man manometry (buluni imakhuta mu rectum kuti muyese kupanikizika m'deralo)
• Enema wa Barium
• Zolemba zenizeni

Njira yotchedwa serial rectal irrigation imathandizira kuthana ndi kuthamanga kwa (decompress) matumbo.

Gawo lachilendo la colon liyenera kutengedwa pogwiritsa ntchito opaleshoni. Nthawi zambiri, rectum komanso gawo losazolowereka la colon limachotsedwa. Gawo labwino la m'matumbo limatsitsidwa ndikumangirizidwa ku anus.

Nthawi zina izi zitha kuchitika kamodzi. Komabe, nthawi zambiri zimachitika m'magawo awiri. Colostomy imachitika koyamba. Gawo lina la njirayi limachitika pambuyo pake mchaka choyamba cha mwana.

Zizindikiro zimasintha kapena zimatha mwa ana ambiri atachitidwa opaleshoni. Chiwerengero chochepa cha ana atha kudzimbidwa kapena kuthana ndi zovuta (chimbudzi). Ana omwe amachiritsidwa msanga kapena omwe ali ndi gawo lalifupi lamatumbo omwe amakhala nawo amakhala ndi zotsatira zabwino.

Zovuta zingaphatikizepo:

• Kutupa ndi matenda amatumbo (enterocolitis) amatha kuchitika asanachite opareshoni, ndipo nthawi zina mzaka 1 mpaka 2 zoyambirira pambuyo pake. Zizindikiro zimakhala zovuta, kuphatikizapo kutupa pamimba, kutsekula m'madzi kwam'madzi, ulesi, komanso kusadya bwino.
• Kuwonongeka kapena kutuluka kwa matumbo.
• Matenda amafupikitsidwe, vuto lomwe limatha kubweretsa kuperewera kwa zakudya m'thupi komanso kuchepa kwa madzi m'thupi.

Itanani yemwe amakupatsani mwana ngati:

• Mwana wanu amakhala ndi matenda a Hirschsprung
• Mwana wanu ali ndi ululu wam'mimba kapena zisonyezo zina zatsopano atalandira chithandizo cha matendawa

Megacolon wobadwa nawo

Bass LM, Wershil BK. Anatomy, histology, embryology, ndi zolakwika pakukula kwamatumbo ang'ono ndi akulu. Mu: Feldman M, Friedman LS, Brandt LJ, olemba. Sleisenger ndi Fordtran's Mimba ndi Matenda a Chiwindi: Pathophysiology / Diagnosis / Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016: chap 98.

Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM. Matenda a motility ndi matenda a Hirschsprung. Mu: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, olemba. Nelson Textbook of Pediatrics. Wolemba 21. Philadelphia, PA: Elsevier; 2020: chap 358.