I-fistula ingaba buhlungu, kodwa ngokuvamile ilashwa ngaphandle kokuhlinzwa
I-fistula ichazwa njengokuxhumeka okungavamile kwemizimba emibili yomzimba (njengengxenyana ne-vagin), noma njengokuxhunyaniswa komzimba emzimbeni (njengokwesikhumba esikhumbeni). Enye indlela i-fistula engase iyenze isuka ku- abscess -ephaketheni le-pus emzimbeni. I-abscess ingase ihlale igcwele izikhukhula zomzimba ezifana nesibalo noma umchamo, okuvimbela ukuphulukiswa.
Ekugcineni lidlulela esikhunjeni, esinye isidumbu, noma isitho, sakha i-fistula.
I-fistula ivame kakhulu kwisifo sikaCrohn kunokuba se-ulcerative colitis. Cishe amaphesenti angu-25 abantu abane-Crohn's disease akha i-fistula. Ama-fistula aphethwe ngokuhlinzwa noma ngokunakekelwa kwesilonda.
Izinhlobo
I-fistula ivame ukuvela endaweni ezungeze izitho zangasese kanye ne-anus (eyaziwa njenge-perineum). Izinhlobo ezine ze-fistula yizi:
- Ukungena ngaphakathi : Lolu hlobo lwe-fistula luvela emathunjini esikhumbeni. I-fistula engenazinambuzane ingaba yinkimbinkimbi yokuhlinzwa. Kungachazwa njengendlela ehambayo esuka emathunjini kuya endaweni yokuhlinzwa bese isikhumba.
- I-Enteroenteric noma i-Enterocolic : Lena fistula ehilela intumbu enkulu noma encane .
- Ukungena ngaphakathi : Lena fistula eya emkhathini.
- I-enterovesicular : Lolu hlobo lwe-fistula luya esikhwameni. Lezi fistula zingabangela ukutheleleka okuvamile kwamagciwane, noma ukuhamba kwegesi e-urethra ngesikhathi uchama.
Izimpawu
Izimpawu ze-fistula zingabandakanya ubuhlungu, umkhuhlane, ububele, ukushaya, futhi ngokuvamile uzizwe kabi. I-fistula ingase iphinde ibhidlize udoti noma ukukhishwa okungcolile. Lezi zimpawu ziyahlukahluka ngokugxila kwendawo ye-fistula.
Ukuxilongwa
I-fistula ivame ukutholakala ngokusebenzisa ukuhlolwa ngokomzimba, ukuskena kwe- computed tomography (CT) , futhi uma kudingeka, ezinye izivivinyo ezifana ne- barium enema , colonoscopy , sigmoidoscopy , endoscopy engenayo , noma i-fistulogram.
Ngesikhathi se-fistulogram, idayi ijojowe ku-fistula, futhi i-X-ray iyathathwa. Idayi isiza i-fistula ukuba ibonise kangcono kuma-X-rays. Idayi ifakwe engxenyeni ye-rectum, efana ne- enema , ye-fistula e-rectum. Idayi kufanele 'ibanjwe' ngaphakathi ngesikhathi senqubo. Njengoba i-fistula engaphandle komzimba, idayi ifakwa ekuvuleni nge-tube encane. Ama-X-ray azosuswa ezinhlangeni eziningana ezahlukene, ngakho-ke isiguli kungadingeka sishintshe izikhundla etafuleni le-X. Njenganoma yiluphi olunye uhlobo lwe-X-ray, kusasele kubalulekile.
Uma kucatshangwa ukuthi isiguli sinesifistula se-enterovesicular (isisindo), i-pyelogram (IVP), eminye uhlobo lwe-X-ray, ingenziwa. Ukulungiselela lokhu kuhlolwa kungabandakanya ukudla okunomsoco okucacile noma ukuzila ukudla, ngoba isitokisi ekoloni singavimbela umbono wesibindi. Idayi (i-contrast material) ifakwe egameni, kanti ama-X ambalwa athathwa.
Izinkinga ezingenzeka
I-fistula ingabangela izinkinga. Kwezinye izimo, i-fistula ingase ingaphilisi, futhi ingapheli. Ezinye izinkinga ezingase zibe khona zibandakanya amanzi e-fistula, i-sepsis, ne-perforation kanye ne-peritonitis. I-Sepsis yisifo esisongela impilo esibangelwa ukusabela komzimba ekutheleleni kwebhaktheriya.
Izimpawu ze-sepsis zihlanganisa ukuqubuka, umkhuhlane, ukubola, ukudideka, ukudangala, nokuphefumula okusheshayo nenhliziyo. I-Peritonitis ukuvuvukala noma ukutheleleka kwe-peritoneum, izicubu ezisendongeni elingaphakathi kwesisu elithinta izitho zangasese. Izimpawu ze-peritonitis zibandakanya ubuhlungu besisu nangesisa, imfiva, izikhukhula, izinhlungu ezihlangene, ukunxanxathela, nokuhlanza.
Ukwelapha
Ukwelashwa kwe-fistula kuyahlukahluka ngokuya endaweni kanye nobukhulu bezimpawu. Imithi yokwelashwa ihlanganisa i- Flagyl (i-antibiotic), i- 6-MP (i-immunosuppresant), noma imithi ethile yezinto eziphilayo (kubandakanya i- Remicade ne- Humira ).
Ukudla okungenakusihlwa kungahle kubekwe umfutho we-enterovaginal, enterocutaneous, ne-enterovesicular.
Ukudla okunomsoco kungukudla okunomsoco okuthathwa ngomlomo noma okunikezwa nge-tube yokudla. Lezi zindlela zokudla okunomsoco zithatha ukudla okuqinile futhi ziqukethe izakhi ezibalulekile. Ngaphandle kokudla okuqinile kukhona isiteji esingaphansi esidlula i-anus, esiza ukuphulukisa i-fistula futhi mhlawumbe isondelene.
Ama-fistula amaningi ngeke aphendule kunoma yimuphi wezokwelapha ezingenhla futhi uzodinga ukunakekelwa kanye / noma ukunakekelwa kwesilonda. Uma i-fistula ingxenyeni enempilo yamathumbu, ingasuswa ngaphandle kokuthatha noma iyiphi ingxenye yamathumbu. Uma i-fistula iyingxenye yesifo esibuhlungu kakhulu , kufanele kube nomthengisi.
Ukuthengiswa kungabangela ileostomy yesikhashana . Isitoreji sidluliselwa nge-ileostomy, sinika ingxenye yamathumbu isikhathi sokuphulukisa i-fistula. Lolu hlobo lokuhlinza luvame ukuqhutshwa kwi-frettula e-rectovaginal noma e-enterovesicular.
Isibikezelo
Indawo kanye nokuqina kwe-fistula kudlala indima enkulu ekunqumeni ukwelashwa. I-fistula iyisibonakaliso sesifo sofuba esibulalayo (IBD), futhi ngaphandle kokunakekelwa okufanele, singabangela izinkinga ezinkulu. Ukubona i-gastroenterologist njalo futhi ukuthatha imithi njengoba kunqunyiwe kubalulekile ekuphatheni nasekuvimbelweni kwezinkinga ze-IBD.
Imithombo:
UBuckmire M. "Abesilisa kanye neFistula Yandisa Ulwazi." I-American Society of Colon ne-Rectal Surgeons. Feb 2015.
Crohn's and Colitis Foundation of America. "Ukwelashwa kwe-Crohn's Disease & Ulcerative Colitis." CCFA 31 Aug 2010.