Ukuxilongwa Nokuphathwa KweDuodenal Atresia
I-Duodenal atresia yi-defect yokuzalwa yesimiso sokugaya noma esiswini (GI) esenzeka njalo njalo ezinsaneni ezine- Down syndrome . Endaweni ephakathi kuka-5 amaphesenti kanye namaphesenti angu-7 ezinsana ezine-Down syndrome zizozalwa nge-duodenal atresia, uma kuqhathaniswa nezingane eziyi-1 kuphela ezingu-10 000 ezingenayo i-Down syndrome.
Akekho owazi kahle ukuthi kungani lokhu kwenzeka, kodwa kwaziwa ukuthi kwenzeka ekuqaleni kokukhula kokubeletha komntwana, ngaphambi kokubeletha kwamasonto ayishumi nanye.
Qinisekisa ukuthi uma ingane yakho ine-atodsia ye-duodenal, akukho lutho olwenzile ukulibangela noma olwenzile ukulivimbela. Izinsana eziningi ezinale nkinga zihamba kahle ngemva kokuhlinzwa.
Kuyini i-Duodenal Atresia?
I-Duodenal atresia yisimo lapho ingxenye yesiguli esincane (i-duodenum) engenzi kahle. I-duodenum iyisakhiwo esincane se-tube-like evumela ukuthi izinto ezigaya zisuke esiswini zingene emathunjini amancane. Ngezinye izikhathi, i-duodenum ayifaki kahle futhi ivaliwe (duodenal atresia) noma encane kakhulu kunejwayelekile (i-duodenal stenosis).
Ukuxilongwa kwangaphambi kokubeletha kweDuodenal Atresia
I-Duodenal atresia ivame ukuxilongwa ngesikhathi sokukhulelwa ngesikhathi se-ultrasound. Uma kunjalo, kunethuba elingama-30% lokuthi ingane izoba ne-Down syndrome. Ngesinye isikhathi, izindlela eziwukuphela kokuxilonga i-Down syndrome ku-trimester yesibili noma yesithathu yi-amniocentesis noma ukuhlolwa kwe-PUBS (isampuli segazi esisodwa).
I-ultrasound izobonisa lokho okubizwa ngokuthi "isibonakaliso kabili". Uphawu lwesibhakabhaka kabili lubangelwa uketshezi oluthe xaxa ku-duodenum nesisu, okubangela ukuba bavuke. Njengoba zitholakala eduze komunye nomunye futhi zihlukaniswe ukuvula okuncane okuyiziyingi, lezi zakhiwo ezimbili zifana ne "bubble kabili" noma amabhubhu amabili eceleni, uma ibhekwa nge-ultrasound.
I-Duodenal atresia ingatholwa yi-ultrasound esikhathini esingamaviki angu-18 ukuya kwangu-20 okukhulelwa, kodwa ngokuvamile ibonakala emva kwamasonto angu-24. Esinye isibonakaliso se-duodenal atresia ekukhulelwe yi-amniotic fluid ngokweqile. Isikali somama wesisu somzimba singase senyuke ngenxa yoketshezi ngokweqile esiswini. Lokhu ngokuvamile akwenzeki kuze kube ngemva kwamasonto angu-24.
Ukuxilongwa kweDuodenal Atresia ngesikhathi sokuzalwa
Amacala amaningi e-duodenal atresia atholakala ngesikhathi sokukhulelwa noma ngokushesha emva kokuzalwa.
Uma ingane yakho itholakale ngesikhathi ukhulelwe, uzothunyelwa ku-perinatologist (isazi sezinambuzane esibhekana nokukhulelwa okuphezulu) ukuze uxoxe ngokulawula konke okukhulelwe kwakho. Ungathunyelwa futhi kumeluleki wezakhi zofuzo, ukuxoxa ngokukhetha kokuhlolwa kokubeletha, kanye nodokotela ohlinzayo wezingane, ukuxoxa ngokulungiswa kokuhlinzwa kwalenkinga ngemuva kokuzalwa.
Izinsana ezine-atresia ye-duodenal zingase zibe nalezi zimpawu ezilandelayo, ezingabangela ukuxilongwa:
- Ukuguqa kwesisu esiswini
- Ukuhlanza ngokweqile, ngaphandle kokudla noma ukuhlanza okuluhlaza (bile)
- Ukuntuleka kokuchama
- Ukunyakaza okungekho emathunjini ngemuva kwezitembu ezimbalwa zokuqala ze-meconium
Uma sekutholakala ukuthi ukuxilongwa kwe-duodenal atresia , udokotela uzoyala i-x-ray yesisu.
Uma ukuxilongwa kuyi-duodenal atresia, i-x-ray izobonisa umoya esiswini nasengxenyeni yokuqala ye-duodenum, kodwa akukho moya ngemuva kwalokho okubonisa ukuvinjelwa.
Ukwelashwa kweDuodenal Atresia
Ukwelashwa okuphela kwe-duodenal atresia kuhlinzwa, okuvame kwenziwa ngemuva nje kokuzalwa. Ngaphambi kokuhlinzwa, i-nasogastric (NG) tube izofakwa kwisisu somntwana ukukhipha uketshezi oludlulayo nomoya oqoqiwe, futhi umntwana uzothola i-IV ukuze athole uketshezi oluzovimbela ukungcola. Udokotela wezingane kanye nodokotela ohlinzayo uzoxoxa nge-prognosis nezingane zakho ngaphambi kokuhlinzwa.
Izinsana ezinezinye izinkinga zokuzalwa noma ezinye izimo ezingezansi zingahle zenze kanye nezinsana ezine-duodenal atresia kuphela. Izinsana eziningi zenza kahle kakhulu emva kokuhlinzwa futhi zilulame ngokuphelele kule nsalela yokuzalwa.
Imithombo:
UCassidy, uSuzanne B., Allanson, uJudith E., (2001) Ukuphathwa kwe-Genetic Syndromes. I-1st ed. ENew York, NY; 2001.
Karrer, F., Duodenal Atresia, Emedicine , 2009
U-Newberger, D., Down Syndrome: Ukuhlolwa Kwengane Yokubeletha Nokuhlolwa Kwengane. I-American Family Physician. 2001.