Hirschsprung chirwere

Hirschsprung chirwere kuvharika kwematumbo makuru. Izvo zvinoitika nekuda kwekufamba kwakashata kwemhasuru muura. Icho chiitiko chekuzvarwa, zvinoreva kuti chiripo kubva pakuberekwa.

Tsinga dzemhasuru mumatumbu dzinobatsira chikafu chakagayiwa uye zvinwiwa zvinofamba zvichidzika neura. Izvi zvinonzi peristalsis. Tsinga pakati pemitsara yemhasuru dzinokonzeresa kupunzika.

Muchirwere cheHirschsprung, tsinga dzinoshayikwa kubva muchikamu chemuura. Nzvimbo dzisina tsinga idzi hadzigone kusundira zvinhu kuburikidza. Izvi zvinokonzera kuvhara. Zvemukati zvemukati zvinovaka kuseri kwekuvharika. Ura uye dumbu rinozvimba semhedzisiro.

Hirschsprung chirwere chinokonzeresa ingangoita 25% yeese achangozvarwa ura. Inoitika ka5 kazhinji kazhinji muvanhurume kupfuura muvakadzi. Hirschsprung chirwere dzimwe nguva chinobatanidzwa kune mamwe akagarwa nhaka kana mamiriro ekuberekwa, senge Down syndrome.

Zviratidzo zvinogona kunge zviripo muvacheche nevacheche zvinosanganisira:

• Dambudziko nekufamba kwematumbo
• Kukundikana kupfuudza meconium nguva pfupi mushure mekuzvarwa
• Kukundikana kupfuudza chituru chekutanga mukati maawa makumi maviri nemana kusvika makumi mana mushure mekuzvarwa
• Kazhinji asi zvituru zvinoputika
• Jaundice
• Kudya zvisina tsarukano
• Kurera huremu kuwedzera
• Kusvipa
• Manyoka emvura (mumucheche)

Zviratidzo muvana vakura:

• Kuzvimbirwa kunowedzera kuwedzera
• Kusanzwisisana
• Kushaya zvokudya zvinovaka muviri
• Kunonoka kukura
• Dumbu rakazvimba

Mhosva dzakashata dzinogona kunge dzisina kuongororwa kusvikira mwana akura.

Munguva yekuongorora kwepanyama, mupi wezvehutano anogona kukwanisa kunzwa zvishwe zvemukati mudumbu rakazvimba. Iyo rectal bvunzo inogona kuburitsa yakasimba mhasuru toni mune iyo rectal mhasuru.

Miedzo inoshandiswa kubatsira kuongorora Hirschsprung chirwere inogona kusanganisira:

• Abdominal x-ray
• Anal manometry (chibharumu chakazara mukati meye rectum kuyera kumanikidza munzvimbo)
• Barium enema
• Rectal biopsy

Maitiro anonzi serial rectal kudiridza anobatsira kubvisa kumanikidza mu (decompress) ura.

Chikamu chisina kujairika chekoloni chinofanira kutorwa kunze nekuvhiyiwa. Kazhinji, iyo rectum uye isina kujairika chikamu chekoloni inobviswa. Chikamu chine hutano chekoloni ipapo chinodhonzwa pasi ndokunamirwa kune anus.

Dzimwe nguva izvi zvinogona kuitwa mune kumwe kushanda. Zvisinei, inowanzoitwa muzvikamu zviviri. Colostomy inoitwa kutanga. Chimwe chikamu chemaitiro chinoitwa gare gare mugore rekutanga remwana rehupenyu.

Zviratidzo zvinovandudza kana kuenda muvana vazhinji mushure mekuvhiyiwa. Chiverengero chidiki chevana vanogona kuve nekuzvimbirwa kana matambudziko ekudzora zvituru (fecal incontinence). Vana vanorapwa nekukurumidza kana vane chikamu chipfupi chemuviri vanobatanidzwa vane mhedzisiro iri nani.

Zvinetso zvinogona kusanganisira:

• Kuzvimba uye hutachiona hwematumbo (enterocolitis) zvinogona kuitika usati wavhiyiwa, uye dzimwe nguva panguva yekutanga 1 kusvika 2 makore mushure. Zviratidzo zvakakomba, zvinosanganisira kuzvimba kwedumbu, manyoka emvura anonhuwa-akasviba, kuneta, uye kusadya zvakanaka.
• Kuora kana kutsemuka kweura.
• Ipfupi ura chirwere, mamiriro anogona kutungamira mukushomeka uye kushaya mvura mumuviri.

Fonera mupi wemwana wako kana:

• Mwana wako anovandudza zviratidzo zvechirwere cheHirschsprung
• Mwana wako anorwadziwa mudumbu kana zvimwe zviratidzo zvitsva mushure mekurapwa mamiriro aya

Kuberekwa megacolon

Bass LM, Wershil BK. Anatomy, histology, embryology, uye kusimudzira kusagadzikana kweiyo diki uye hombe ura. Muna: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger uye Fordtran's Gastrointestinal uye Chirwere Chirwere: Pathophysiology / Diagnosis / Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016: chits. 98.

Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM. Motility kusagadzikana uye Hirschsprung chirwere. Mune: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Chinyorwa chePediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020: chitsiko 358.