Esophageal kupera

Kuzvimba esophageal kupomba igomba mune yegurokuro. Iyo esophagus ndiyo chubhu chikafu chinopfuura kuburikidza ichienda kubva pamuromo kuenda mudumbu.

Zviri mukati medu zvinogona kupfuura munzvimbo yakapoterera muchipfuva (mediastinum), kana paine buri mugurokuro. Izvi zvinowanzo guma nehutachiona hwe mediastinum (mediastinitis).

Chikonzero chakajairika che esophageal perforation kukuvara panguva yekurapwa. Nekudaro, kushandiswa kwezviridzwa zvinosanduka kwakaita kuti dambudziko iri riwanikwe.

Iyo sophagus inogona zvakare kuputirwa semhedzisiro ye:

• Bundu
• Gastric Reflux ine ulceration
• Kuvhiya kwakapfuura pane yegurokuro
• Kumedza chinhu chekunze kana makemikari anokonzeresa, akadai seanochenesa dzimba, mabhatiri e diski, uye bhatiri acid
• Kushungurudzika kana kukuvara kuchifuva uye kugurokuro
• Kurutsa zvine chisimba (Boerhaave syndrome)

Zvishoma zvikonzero zvinozivikanwa zvinosanganisira kukuvara kunzvimbo yegurokuro (kushungurudzika kwakashata) uye kukuvara kune iyo esophagus panguva yekuvhiya kweimwe nhengo padyo nesophagus.

Chiratidzo chikuru marwadzo apo dambudziko rinotanga kuitika.

Kupfachukira pakati kana kudzika kwakawanda chikamu cheyophagus kunogona kukonzera:

• Kumedza matambudziko
• Kurwadziwa pachifuva
• Matambudziko ekufema

Mutapi wako wezvehutano achatsvaga:

• Kukurumidza kufema.
• Kupindwa nechando.
• Kuderera kweropa.
• Kukurumidza kurova kwemoyo.
• Kurwadziwa kwemutsipa kana kuomarara uye mabhuru emhepo ari pasi peganda kana iko kuzora kuri muchikamu chepamusoro cheziso.

Iwe unogona kunge uine chest x-ray yekutsvaga:

• Mhepo munyama nyoro dzechifuva.
• Fluid yakabuda kubva mudumbu kuenda munzvimbo yakatenderedza mapapu.
• Mapapu akadonha. X-ray inotorwa mushure mekunwa dhayi isiri-inokuvadza inogona kubatsira kuona nzvimbo yekuzorwa.

Iwe unogona zvakare kuve nechipfuva CT scan kuti utsvage bundu muchipfuva kana kenza yesophageal.

Ungangoda kuvhiyiwa. Kuvhiya kunoenderana nenzvimbo uye saizi yekuzorwa. Kana kuvhiya kuchidikanwa, zvinonyanya kuitwa mukati maawa makumi maviri nemana.

Kurapa kunogona kusanganisira:

• Mvura inopihwa kuburikidza netsinga (IV)
• IV mishonga inodzivirira kana yekurapa hutachiona
• Kudhonza kwemvura yakatenderedza mapapu nechubhu yechipfuva
• Mediastinoscopy kubvisa fluid yakaunganidzwa munzvimbo irikuseri kwebhonzo rechipfuva uye pakati pemapapu (mediastinum)

Stent inogona kuiswa mudumbu kana paine shoma chete yemvura yakabuda. Izvi zvinogona kubatsira kudzivirira kuvhiyiwa.

Kupfachukira mudenga repamusoro (mutsipa nharaunda) chikamu cheyophagus kunogona kupora pachako kana ukasadya kana kunwa kwenguva yakati rebei. Mune ino kesi, iwe uchazoda dumbu rekudyisa chubhu kana imwe nzira yekuwana zvinovaka muviri.

Kuvhiya kunowanzo kudikanwa kugadzirisa pendi mukati kana pakati pezvikamu zvegurokuro. Iyo inodonha inogona kurapwa nekureruka kugadzirisa kana nekubvisa iyo esophagus, zvichienderana nehukuru hwechinetso.

Mamiriro acho anogona kufambira mberi kusvika mukuvhunduka, kunyangwe rufu, kana ikasarapwa.

Maonero akanaka kana dambudziko rikawanikwa mukati maawa makumi maviri nemana zvichiitika. Vanhu vazhinji vanopona kana kuvhiya kwaitwa mukati maawa makumi maviri nemana. Kupona kwehuwandu kunodzika kana iwe ukamira kwenguva yakareba.

Zvinetso zvinogona kusanganisira:

• Kukuvadza zvachose kune esophagus (kudzikira kana kuomesa)
• Kusvikira kugadzirwa mukati nekukomberedza esophagus
• Utachiona mukati uye mukati memapapu

Udza mupi wako ipapo ipapo kana iwe ukaita dambudziko kana iwe watove muchipatara.

Enda kuimba yekukurumidzira kana kufonera 911 kana:

• Iwe uchangobva kuvhiyiwa kana chubhu yakaiswa mudumbu uye une kurwadziwa pachipfuva, matambudziko ekumedza kana kufema.
• Iwe une chimwe chikonzero chekufungidzira kuti unogona kunge uine esophageal perforation.

Uku kukuvara, kunyangwe zvisingawanzoitika, zvakaoma kudzivirira.

Kukanganiswa kwegurokuro; Boerhaave chirwere

• Kugaya chirongwa
• Digestive system nhengo

Maxwell R, Reynolds JK. Iwo manejimendi eesophageal perforation. Mune: Cameron JL, Cameron AM, eds. Parizvino Kuvhiya Therapy. 12th ed. Philadelphia, PA: Elsevier; 2017: 73-78.

Raja AS. Kunetseka kukuru. Mune: Masvingo RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts uye Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018: chitsiko 38.