I-hernia yokuzalwa, eyaziwa nangokuthi i-hernia isisu, ngokuvamile ihlasela abantu abangaphezu kuka-50. Abantu abaningi abangamaphesenti angu-90 abanomunye ngeke babone izimpawu. Phakathi kwalabo abakwenzayo, ukuphuza, ukuphuza kwesisu, ukucasuka komlomo, ukugcoba, nokuphindaphinda kuvamile. Nakuba izimpawu ezifana nalezi zingaba zimbi, ngokuvamile azibi kakhulu. Njengoba kuthiwa, ngezikhathi ezingavamile, izinhlanzi ezinkulu zingakhula, zenze izinkinga ezinkulu futhi zidinga ukwelashwa okuphuthumayo.
Izimpawu Ezivamile
Ngokuvamile, ukunqunywa okuncane kwesisu akuyona into eyingozi futhi akumele kubangele ubuhlungu obuqondile noma buhlungu. Yeka ukuthi inhlama yokubeletha ingayenza kanjani ukushintsha izakhiwo nezinqubo ezigcina ukudla nama-acid lapho bekhona khona.
Isihluthulelo sale nkinga isakhiwo esibizwa ngokuthi i- sphincter esezansi ephansi (LES). Uma i-herniation yokubeletha ivela, ingashintsha isikhundla sale valve, ivumela okuqukethwe kwesisu ukuba kubuyele emuva ku-esophagus (eyaziwa njenge- reflux ). Okuhlobene, izimpawu zangaphakathi zingafaka:
- Ukuguquka kwenhliziyo
- Ukuphindaphinda
- Ukugcoba noma ukuhamba ngokushesha ngemva kokudla
- Inzwa ehlabayo emqaleni
- Umunwe omuncu noma obabayo emlonyeni
- Umoya omubi
Ngokuvamile, kuba kuphela uma i-hernia ikhula kakhulu ukuthi ingabonakalisa ngale ndlela. Uma i-LES ibuthakathaka ngisho nakakhulu, njengoba kungenzeka ngebudala, izimpawu ezihlobene zingaqhubeka zimbi nakakhulu.
Abantu abane-hernia yokubeletha cishe bayakwazi ukuhlakulela isifo se-reflux ye-gastroesophageal (GERD) , uhlobo oluhlala njalo lwe-reflux engaphazamisa izinga lokuphila.
Ukuphikelela kwezimpawu zeGERD kungabangela ukukhwehlela okungapheli, ubuhlungu besifuba, i-asthma, nokulimala okuqhubekayo ku-koqweqwe lwezinyo lakho.
Izinkinga
Ngokubanzi, kunezinhlobo ezimbili ze-hernia yokuzalwa: i-hernia yokulala ehambayo ne-hernia ephaophageal hernia. Ngenkathi i-hernia ehambayo iyona evame kakhulu, ibheka cishe amaphesenti angama-95 azo zonke izifo zokuxilonga, i-herneophageal hernia ingase ibe yingozi nakakhulu.
Ngomtholampilo wokulala olahlayo , ukuhlangana kwesisu nesisu (okubhekwa ngokuthi i-gastroesophageal junction) futhi ingxenye yesisu izohamba phakathi komgodi obizwa ngokuthi i-hiatus. Lesi yisikhala lapho i-esophagus idlula khona. Ubizwa ngokuthi "ukuhambisa" ngenxa yokuthi ingxenye yesisu ingasakaza ngaphakathi nangaphandle kwesikhumba esifubeni njengoba ugwinya.
With hernia paraesophageal , kuphela isisu siphumelela. Ngenkathi ama-hernias amaningi epulasophageal imane nje iqhubekela phambili ye-hernia ehambayo, ezinye zingase zivele ngokuzumayo uma kunesibuthakathaka esakhiweni esihlokweni.
Ngokungafani ne-hernia e-slider, i-hernia epharaophageal hernia ayifaki kalula kwi-hiatus. Esikhundleni salokho, ingaba ikhudlwana futhi iqhubekele phambili nakakhulu emgodini wesifuba njengoba isikhathi sihamba. Kulesi sigaba sokugcina ukuthi izinkinga zingase zibe yingozi futhi, ezimweni ezingavamile, ezisongela ukuphila.
Izinkinga zingase zibandakanye ukucindezelwa kokungalingani, ukuvinjelwa kwesisu, ukukhwabanisa, nesimo esivamile kakhulu esibizwa ngokuthi yisisu sangaphakathi.
Ukunciphisa okulinganayo
Ukucindezelwa kwesifo kungenzeka njengoba i-hernia icindezela ngokumelene nodonga lwe-tube yokudla. Uma lokhu kwenzeka, ukudla kungagxila esibhedlela, kubangele ubuhlungu besifuba ngemuva kokudla nokubunzima ukugwinya ( dysphagia ).
Ngenkathi ukucindezelwa kokuziqeda kungabhekwa njengesimo esiphuthumayo sezokwelapha, kungadinga imithi yokwehlisa noma ukuvimbela ukuwohloka kwezimpawu.
I-Hatalia yaseHiatal eboshiwe
Ukuboshwa kuvela lapho ingxenye ye-herniated yesisu iboshelwe ngesikhathi se-hiatus. Kwezinye izimo, izimpawu zokuboshwa zingase zibe ezingapheli kepha zinganciphisi (ikakhulukazi ukuzwa kwengcindezi esifubeni njengoba ukudla kudlula ngendlela ephezulu yokugaya). Kwezinye, kungabangela ukuvimbela noma ukuvimbela ukujikeleza kwegazi. Ukuthunjwa ngokwabo akuyona into ephuthumayo yezokwelapha ngaphandle kokuba kube khona ukuvimbela okukhulu.
Volvulus
I-Volvulus iyigama elisetshenziselwa ukuchaza lapho isisu sesisu sishintsha ama-degree angaphezu kuka-180, okubangela ukuvinjelwa okukhulu kwesisu.
Izimpawu zingabandakanya i-dysphagia, ubuhlungu besifuba ngemuva kokudla, ukugcoba nokuhlanza.
Uma izimpawu zivunyelwe ukuba zithuthuke, zingabangela ubuhlungu obukhulu besisu nokukhunjulwa, ukuhlanza okuholela ekutheni kungabonakali, futhi ukuphuma kwesisu (ngenxa yokwanda kwegazi okungavamile). I-volvulus ephawulekayo yezimpawu ngokuvamile ivela kubantu abangaphezu kweminyaka engu-50 futhi kubhekwa njengesimo esiphuthumayo sezokwelapha ngezingozi ezingamaphesenti angu-30 kuya kwangu-50 ezokufa.
Ukumisa
I-Strangulation ichaza ukusika igazi ekudleni, ngenxa ye-volvulus noma ukuboshwa. Lokhu, futhi, kubhekwa njengesidingo esiphuthumayo sezokwelapha njengoba ukuvinjelwa kungabangela ukushona kwe-cell ngokushesha (necrosis) nokulimala komzimba.
Izimpawu zihlanganisa ubuhlungu obuhlungu ngokuzumayo, obukhali; umkhuhlane; ukukhathala; ukuvula; ukuhlanza; ukuhluleka ukudlula igesi; ukuqotshwa; ukufudumala noma ubomvu phezu kwe-herniation; isilinganiso senhliziyo esisheshayo; kanye nezitshalo ezigazini noma ezilindile (ngenxa yokuphuma kwamathumbu emathunjini). Uma kungelashwa ngokushesha, ukucabangela kungaholela ekuguleni , ukushaqeka nokufa.
Isisu se-Intrathoracic
Isisu esisemtholampilo yisimo esingavamile lapho isisu singena khona emgodini wesifuba. Ngokusobala, akuwona wonke amacala abangela izimpawu. Izimpawu ezivame kakhulu ukuphefumula ( dyspnea ) kanye nokuzwa okugcwele kwesibindi nokucindezela. Ezinye izimpawu zingabandakanya ukuhlanza, ukubuyisela emuva, ukuxoshwa kwamathumbu, nokuphaphaza kwamathumbu (okubangelwa lapho ukudla kukhishwa emaphashini).
Igebe elikhulayo lokuzala lingabangela ezinye izitho ukuba zishaye emgodini wesifuba, kuhlanganise ne-pancreas, isibindi, noma ikholoni. Ukuhlinzeka ngezindlela eziwukuphela kokulungisa lesi sixazululo esingavamile kodwa esibi kakhulu.
Nini Ukubona Udokotela
Iningi lama-hernias angama-hiatal angaphathwa kalula ngemithi yokwelapha, ukulahlekelwa isisindo, nokulungiswa kokudla kwakho. Ama-hernias ama-hiatal ngokuvamile akudingeki ukuba alawulwe ngokwemithi ngaphandle uma izimpawu ziphikelela noma ziba nzima.
Uma kuthiwa, kufanele ubone uma udokotela uma izimpawu zakho zingaphumeleli naphezu kokwelashwa. Kwezinye izimo, izidakamizwa ezinamandla zemithi kanye nokunye ukungenelela kungadingeka.
Ngakolunye uhlangothi, kufanele ufune ukunakekelwa kwezempilo ngokushesha uma izimpawu ze-reflux zihambisana ne-fever ephezulu (ngaphezu kuka-100.4 degrees), ubuhlungu obukhulu besifuba, isisindo senhliziyo esisheshayo, ukubukeka okungenakukhiqiza, noma izitshalo ezigazini. Lezi zingase zibe izibonakaliso zenkinga enkulu yokuphila engozini.
> Imithombo:
> Polomsky, M .; UJones, C .; Sepesi, B. et al. "Ingabe ukulungiswa komzimba kufanele kukhuthazwe?" J Ukuhlinzwa Kwesisu Kuyeka J Soc Surg Aliment Tract. 2010; 14 (2): 203-10. I-DOI: 10.1007 / s11605-009-1106.
> Roman, S. "Ukuxilongwa nokuphathwa kwe-hiatus hernia." BMJ. 2014; 349: g6154. I-DOI: 10.1136 / bmj.g6154.
> Shukla, R .; I-Mandal, K .; Maltra, S. et al. "I-gastric volvulus ene-necrosis ye-gastric ephelele futhi ephelele." J Indian Assoc Pediatr Surg . 2014; 19 (1): 49-51. I-DOI: 10.4103 / 0971-9261.125968.
> Society of American Gastrointestinal and Endoscopic Doctors (SAGES). "Imihlahlandlela yokuphathwa kweHernia yamaHiatal." Los Angeles, California; ukukhipha ngo-Ephreli 2013.