Mafistula amatha kupweteka, koma nthawi zambiri amatha kuchiritsidwa popanda opaleshoni
Fistula imatanthawuza kukhala kugwirizana kosalimba kwa ziwalo ziwiri za thupi (monga rectum ndi umaliseche), kapena ngati kugwirizana kwa thupi kumatenda (monga khungu kwa khungu). Njira imodzi yomwe fistula imapangidwira ndi yochokera ku abscess -thumba la pus mu thupi. Kuchulukanso kungakhale kudzaza ndi madzi monga thupi kapena mkodzo, zomwe zimalepheretsa kuchiritsa.
Pamapeto pake amatha kupyola pakhungu, thupi lina, kapena chiwalo, kupanga fistula.
Mafistula ndi ofala kwambiri mu matenda a Crohn kuposa momwe amachitira matenda a zilonda zam'mimba. Pafupifupi 25 peresenti ya anthu omwe ali ndi matenda a Crohn amagwira fistula. Mafistula amachitidwa opaleshoni komanso opaleshoni.
Mitundu
Kawirikawiri fistula imapezeka m'dera lozungulira mawere ndi anus (wotchedwa perineum). Mitundu ina ya fistula ndi:
- Zowonongeka : Mtundu uwu wa fistula umachokera m'matumbo kupita pakhungu. Fistula yosakanikirana imakhala yovuta ya opaleshoni. Ikhoza kufotokozedwa ngati njira yomwe imayambira kuchokera m'mimba kupita ku malo opaleshoni ndiyeno khungu.
- Enteroenteric kapena Enterocolic : Iyi ndi fistula yomwe imakhudza matumbo akuluakulu kapena aang'ono .
- Enterovaginal : Ichi ndi fistula yomwe imapita kumaliseche.
- Enterovesicular : Mtundu uwu wa fistula umapita ku chikhodzodzo. Mafistulawa amachititsa kuti munthu asamangokhalira kuyamwa, kapena kuti mafuta amtundu wa chiberekero.
Zizindikiro
Zizindikiro za fistula zimaphatikizapo ululu, malungo, chifundo, kuyabwa, ndipo nthawi zambiri kumverera bwino. Fistula ingathenso kukhetsa pus kapena kukhutura kununkhira. Zizindikiro zimenezi zimasiyana malinga ndi kukula kwa fistula.
Kudziwa
Mafistula amapezeka mwa kugwiritsa ntchito kafukufuku wamthupi, computed tomography (CT) scan , ndipo, ngati pakufunikira, mayeso ena monga barium enema , colonoscopy , sigmoidoscopy , toposcopy, kapena fistulogram.
Pa fistulogalamu, utoto umayikidwa mu fistula, ndipo X-ray imatengedwa. Dye imathandiza fistula kusonyeza bwino pa X-rays. Dayi imalowetsedwa mu rectum, mofanana ndi enema , chifukwa cha fistula yomwe ili mu rectum. Dye iyenera 'kugwiriridwa' mkati mkati mwa njirayi. Ndi fistula yomwe ili kunja kwa thupi, utoto umayikidwa mu kutsegula ndi tiyi yaing'ono. X-ray idzatengedwa kuchokera maulendo angapo, kotero wodwala angasinthe malo pa tebulo la X-ray. Monga ndi mtundu uliwonse wa X-ray, otsalabe ndi ofunika.
Pamene akukayikira kuti wodwalayo ali ndi fistula yotchedwa enterovesicular (chikhodzodzo), pyelogram (IVP), yomwe imakhala ndi mtundu wina wa X-ray, ikhoza kuchitidwa. Kukonzekera kukayezetsa magazi kungaphatikizepo chakudya chodziwika bwino kapena kusala kudya, chifukwa chitseko mu khola chingalepheretse chikhodzodzo. Dayi (zosiyana) zimalowetsedwa mu mkono, ndipo ma X-ray angapo amatengedwa.
Zovuta Zomwe Zingatheke
Fistula ingayambitse mavuto. Nthawi zina, fistula sangathe kuchiza, ndipo imakhala yosasintha. Zina zomwe zingakhale zovuta zimaphatikizapo madzi a fistula, sepsis, ndi perforation ndi peritonitis. Sepsis ndi matenda owopsya omwe amabwera chifukwa cha thupi lanu poyambitsa matenda a bakiteriya.
Zizindikiro za sepsis zimaphatikizapo kuthamanga, malungo, kuzizira, kusokonezeka, kusokonezeka maganizo, kupuma mofulumira ndi mtima. Peritonitis ndi kutupa kapena matenda a peritoneum, minofu pamphuno wamkati mwa m'mimba yomwe imaphimba m'mimba. Zizindikiro za peritonitis zimapweteketsa m'mimba ndi chikondi, malungo, chiwombankhanga, ululu wamagulu, nseru, ndi kusanza.
Kuchiza
Mankhwala a fistula amasiyana malinga ndi malo awo ndi kuuma kwa zizindikiro. Mankhwalawa ndi Flagyl (antibiotic), 6-MP (immunosuppresant), kapena mankhwala enaake (kuphatikizapo Remicade ndi Huma ).
Zakudya zamakono zingaperekedwe kwa fistula.
Zakudya zamakono ndi zakudya zamadzi zomwe zimatengedwa pakamwa kapena kupatsidwa kudzera mu chubu. Zakudya zamadzimadzizi zimalowetsa chakudya cholimba ndipo zimakhala ndi zakudya zofunika kwambiri. Popanda chakudya cholimba palibenso chitsime chodutsa kupyolera mu anus, chomwe chimathandiza fistula kuchiza ndipo mwinamwake ngakhale pafupi.
Mafistula ambiri sangachitepo kanthu pa mankhwala alionse omwe atchulidwa pamwambawa ndipo adzafuna opaleshoni ndi / kapena chilonda. Ngati fistula ili m'kati mwa matumbo, ikhoza kuchotsedwa popanda kutenga gawo lililonse la m'matumbo. Ngati fistula ili m'thupi la matenda kwambiri, resection ikhoza kuchitidwa.
A resection angapangitse ileostomy yaifupi. Chophimba chimachotsedwa kudzera mu ileostomy, kupereka gawo la matumbo ndi nthawi ya fistula kuchiritsa. Kuchita opaleshoni imeneyi kumagwiritsidwa ntchito pafupipafupi kapena phokoso la ferotula.
Kuthamangitsani
Mmene fistula imakhalira komanso kulemera kwake zimakhudza kwambiri chithandizo. Fistula ndi chizindikiro cha matenda opatsirana kwambiri (IBD), ndipo popanda chisamaliro choyenera, chingayambitse mavuto aakulu. Kuwona gastroenterologist nthawi zonse ndi kumwa mankhwala monga momwe akufunira ndi kofunika kwa oyang'anira ndi kupewa mavuto a IBD.
Zotsatira:
Buckmire M. "Osowa ndi Fistula Akulitsa Zambiri." American Society of Colon ndi Rectal Surgeons. Feb 2015.
Crohn's ndi Colitis Foundation ya America. "Opaleshoni ya Matenda a Crohn & Ulcerative Colitis." CCFA 31 Aug 2010.