Chotupa chodziwika bwino, chomwe chimadziwikanso ndi chiberekero cha m'mimba, kaŵirikaŵiri chimakhudza anthu opitirira 50. Ambiri mwa anthu 90 peresenti ali ndi mmodzi sadzakhala ndi zizindikiro. Pakati pa iwo amene amachititsa kupweteka, kupweteka kwa m'mimba, kupweteka kwa mmimba, kumangirira, ndi kubwezeretsa nthawi zambiri. Ngakhale kuti zizindikiro ngati izi zingakhale zopweteka, nthawi zambiri sizowopsa. Pomwe zikunenedwa, pa nthawi zochepa, ziphuphu zazikulu zingathe kukulirakulira, zomwe zimayambitsa mavuto akuluakulu omwe amafunikira chithandizo chamwadzidzidzi.
Zizindikiro Zowonjezereka
Kawirikawiri, kuchepa kwake kwa m'mimba sikumangokhala kovulaza ndipo sikungathe kuchititsa ululu uliwonse kapena kupweteka. Kodi chizoloŵezi chotha msinkhu chikhoza kuchita ndi kusintha machitidwe ndi njira zomwe zimasunga chakudya ndi zizindikiro zawo.
Chinsinsi cha vuto ili ndi dongosolo lotchedwa low esophageal sphincter (LES). Mimba yamatenda ikatha, imatha kusintha malo a valveyi, zomwe zimapangitsa kuti m'mimba zikhazikike m'mimba (yotchedwa reflux ). Zizindikiro zofanana, zowonjezera zingaphatikizepo:
- Kuthamangitsani
- Kubwereza
- Kuwombera kapena kumangomaliza kudya pang'ono
- Kumverera kozizira kummero
- Kulawa kowawa kapena kowawa pakamwa
- Mpweya woipa
Kawirikawiri, ndi pokhapokha ngati hernia ikukula kwambiri kuti iwonetsere motere. Ngati LES imafooketsa kwambiri, monga momwe zingakhalire ndi ukalamba, zizindikiro zokhudzana nazo zikhoza kupitirirabe.
Anthu omwe ali ndi vuto lachiberekero amatha kukhala ndi matenda a reflux a gastroesophageal (GERD) , mtundu wamakono wa reflux umene ungasokoneze umoyo wa moyo.
Kulimbikira kwa zizindikiro za GER kungayambitse chifuwa chachikulu, kupweteka pachifuwa, mphumu, ndi kuwonongeka kwazitsulo kwa dzino lanu.
Mavuto
Mwachidule, pali mitundu iwiri ya chithokomiro cholera: chilakolako cholera chokhachokha ndi chosowa chapasophageal. Ngakhale nthenda yotsekemera ndi yofala kwambiri, yowerengera pafupifupi 95 peresenti ya matenda onse, chithandizo cha paraesophageal chikhoza kukhala choopsa kwambiri kwa awiriwa.
Ndi nthendayi yowonongeka , mapangidwe a mimba ndi m'mimba (omwe amatchedwa kugonana kwa gastroesophageal) ndipo gawo la mimba lidzayenda kupyola mu dzenje, lotchedwa hiatus. Iyi ndiyo malo omwe mimba imadutsa. Icho chimatchedwa "kutayira" chifukwa mbali ya mimba ya mimba imatha kulowa mkati ndi kunja kwa chifuwa pamene mukumeza.
Ndi nthenda ya pharaopophageal , mimba yokha imadutsa. Ngakhale kuti mitsempha yambiri yamagazi imangokhala pang'onopang'ono, zina zimatha kuchitika mwadzidzidzi ngati pali zofooka zapangidwe.
Mosiyana ndi nthenda yotsekemera, phokoso la paraesophageal silimangoyenda mosavuta komanso kunja kwa hiatus. M'malo mwake, ikhoza kukula pang'onopang'ono komanso kupitirira mpaka m'kati mwa chifuwa. Ndi pamapeto otsiriza kuti mavutowa angakhale ovuta ndipo, nthawi zambiri, amaopseza moyo.
Mavuto angaphatikizepo kupanikizika kochepa, kutsekemera kwapakhosi, kusokoneza, ndi chikhalidwe chosadziwika kwambiri chodziwika kuti chiwalo cha m'mimba.
Kusokonezeka kwa Esophageal
Kupweteka kwa mimba kungatheke ngati nthata imayendetsa pakhoma la chubu. Izi zikachitika, chakudya chimatha kumangirira, kumapweteka pamtima mukatha kudya komanso kuvutika kukumeza ( dysphagia ).
Ngakhale kuti vutoli silikudziwika ngati lachipatala, limadalira mankhwala kuti achepetse kapena kuchepetsa kuwonjezereka kwa zizindikiro.
Hernia Hatalia omwe anamangidwa
Kutsekera kumachitika pamene gawo la herniated la m'mimba limasweka pa hiatus. Nthawi zina, zizindikiro za kumangidwa zingakhale zochepa koma zochepa (makamaka kumverera kwa chifuwa ngati chakudya chimadutsa pamtunda wapamwamba). Kwa ena, zikhoza kusokoneza kapena kuchepetsa kuyendetsa magazi. Kulowa m'ndende sizowopsa mwachipatala pokhapokha chitetezo choopsa chikuchitika.
Volvulus
Volvulus ndi mawu omwe amagwiritsidwa ntchito kufotokoza pamene mimba ya mimba imapotoza madigiri oposa 180, zomwe zimayambitsa chipsinjo chachikulu cha mimba.
Zizindikiro zingakhale monga dysphagia, kupweteka pachifuwa mutadya, kumeta, ndi kusanza.
Ngati zizindikiro zimaloledwa kupita patsogolo, zimayambitsa kupweteka kwa m'mimba komanso kusokonezeka, kusanza kumabweretsa kuwonetsa kosakwanira, komanso kutuluka kwa m'mimba (chifukwa cha kuwonjezeka kwa magazi). Zizindikiro zoopsa za volvulus kawirikawiri zimapezeka mwa anthu oposa zaka 50 ndipo zimaonedwa kuti ndizochitika mwamsanga mwachipatala ndipo ndi 30 peresenti mpaka 50 peresenti ya imfa.
Kusokoneza
Kukonzekera kumatanthauzira kuchotsa magazi m'mimba, mwina chifukwa cha volvulus kapena kutsekeredwa m'ndende. Izi, nazonso, zimaonedwa kuti ndizochitika mwadzidzidzi ngati matendawa amatha kupha imfa yambiri (necrosis) ndi kuwonongeka kwa thupi.
Zizindikiro zimaphatikizapo kupweteka kwadzidzidzi kwapachifuwa; malungo; kutopa; kukhetsa; kusanza; kusowa kudutsa gasi; kudzimbidwa; kutentha kapena redness pa herniation; kuthamanga kwa mtima; ndi mitsempha yamagazi kapena yamala (chifukwa cha m'mimba mwazi). Ngati sichikuchiritsidwa mwamsanga, kulongosola kungayambitse kugwedezeka, kukhumudwa, ndi imfa.
Mimba ya Intrathoracic
Mimba ya m'mimba ndi yachilendo yomwe mimba imalowa m'kati mwa chifuwa. Zovuta, sizinthu zonse zomwe zimayambitsa zizindikiro. Zizindikiro zofala kwambiri ndi mpweya wochepa ( dyspnea ) ndi kumverera kwa chifuwa chokwanira ndi kukakamizidwa. Zizindikiro zina zimaphatikizapo kusanza, retching, dysphagia, m'mimba m'magazi, ndi aspiration chibayo (zomwe zimachitika pamene chakudya chimakwera m'mapapo).
Mphuno yowonjezera yowonongeka ingayambitse ziwalo zina kulowa mu chifuwa, kuphatikizapo kapisa, chiwindi, kapena colon. Opaleshoni mwa njira yokhayo yothetsera vutoli koma lovuta.
Nthawi Yomwe Muwone Dokotala
Matenda ambiri omwe amatha kusamalidwa akhoza kuthandizidwa mosavuta ndi mankhwala owonjezera, kulemera kwake, ndi kusintha kwa zakudya zanu. Hiatal hernias kawirikawiri sangafunikire kuti azitha kuchipatala pokhapokha ngati zizindikiro zikupitirira kapena zikuipiraipira.
Pomwe zikunenedwa, muyenera kuwona ngati dokotala ngati zizindikiro zanu zikulephera kusintha ngakhale mukuchiritsidwa. Nthawi zina, mankhwala osokoneza bongo amphamvu ndi zina zowonjezera zingafunike.
Komabe, muyenera kufufuza chithandizo chamankhwala mwamsanga ngati zizindikiro za reflux zimaphatikizapo kutentha thupi (madigiri oposa 100.4), kupweteka kwa chifuwa chachikulu, kuthamanga kwa mtima pamtima, kuchepa kosapindulitsa, kapena kupha magazi. Izi zikhoza kukhala zizindikiro zowopsya komanso zoopsa zowopsya.
> Zotsatira:
> Polomsky, M ;; Jones, C .; Sepesi, B. et al. "Kodi kukonzekera kukonzekera m'mimba mwakuthupi kuyenera kulimbikitsidwa? 2010; 14 (2): 203-10. DOI: 10.1007 / s11605-009-1106.
> Roman, S. "Kuzindikira ndi kusamalira chikhalidwe cha hiatus." BMJ. 2014; 349: g6154. DOI: 10.1136 / bmj.g6154.
> Shukla, R .; Mandal, K .; Maltra, S. et al. "Gastric volvulus ali ndi nthenda yeniyeni yeniyeni yeniyeni." J Indian Assoc Pediatr Surg . 2014; 19 (1): 49-51. DOI: 10.4103 / 0971-9261.125968.
> Bungwe la Amayi Am'mimba a American and Endoscopic Opaleshoni (SAGES). "Malangizo Othandizira Kulamulira kwa Hernia ya Hiatal." Los Angeles, California; yakutuluka mu April 2013.