Ngenxa yokuguqulwa "komunwe wegilavu" wengxenye yamathumbu, i-intussusception ibonakala ngobuhlungu besisu obunobudlova. Kuyimbangela yezimo eziphuthumayo zezokwelapha nezokuhlinzwa ezinganeni ezincane, njengoba kungaholela ekuvinjweni kwamathumbu. Ezinganeni ezindala nakubantu abadala, kungathatha ifomu elingapheli futhi kubonise ukuba khona kwe-polyp noma isisu esibi.

Incazelo

I-Intussusception (noma i-intussusception) kwenzeka lapho ingxenye yamathumbu iphenduka njengegilavu ​​futhi ingena ngaphakathi kwengxenye yamathumbu ngokushesha phansi komfula. Ngemva kwalokhu “i-telescoping”, izigqoko zokugaya ukudla ezakha udonga lomgudu wokugaya ukudla ziyahlangana, zenze umqulu wokuhlasela ohlanganisa ikhanda nentamo.

I-Intussusception ingathinta noma yiliphi izinga lomzila wamathumbu. Nokho, izikhathi eziyisishiyagalolunye kweziyishumi, itholakala empambanweni ye-ileum (ingxenye yokugcina yamathumbu amancane) kanye nekholoni.

Ifomu elivame kakhulu i-acute intussusception yosana, okungase kuholele ngokushesha ekuvinjweni nasekuphazamisekeni kokunikezwa kwegazi (ischemia), ngengozi ye-necrosis yamathumbu noma ukubhobozwa.

Ezinganeni ezindala nakubantu abadala, kunezinhlobo ezingaphelele, ezingapheli noma eziqhubekayo ze-intussusception.

Izimbangela

I-acute idiopathic intussusception, ngaphandle kwesizathu esihlonziwe, ngokuvamile ivela ezinganeni ezincane ezinempilo, kodwa esimweni sokutheleleka ngegciwane noma i-ENT nge-recrudescence yasebusika ebangele ukuvuvukala kwama-lymph nodes esiswini.

I-intussusception yesibili ixhunyaniswe nokuba khona kwesilonda odongeni lwamathumbu: i-polyp enkulu, isimila esiyingozi, i-Merckel's diverticulum evuvukele, njll. Izifo ezivamile eziningi nazo zingase zihileleke:

• i-rheumatoid purpura,
• i-lymphoma,
• i-hemolytic uremic syndrome,
• i-cystic fibrosis…

I-postoperative intussusception iyinkinga yokuhlinzwa okuthile kwesisu.

kwesifo

Ukuxilongwa kusekelwe ezithombeni zezokwelapha. 

I-ultrasound yesisu manje isiyisivivinyo sokuzikhethela.

I-barium enema, ukuhlolwa kwe-x-reyi kwekholoni okwenziwa ngemva kokujova indunu ye-extratant medium (i-barium), yake yaba indinganiso yegolide. I-Hydrostatic enemas (ngomjovo wesisombululo se-barium noma usawoti) noma i-pneumatic (ngokuhoxiswa komoya) ngaphansi kokulawulwa kwe-radiological manje isetshenziselwa ukuqinisekisa ukuxilongwa. Lezi zivivinyo zinenzuzo yokuvumela ngesikhathi esifanayo ukwelashwa kwangaphambi kwesikhathi kwe-intussusception ngokukhuthaza ukushintshwa kwengxenye ehlaselwe ngaphansi kwengcindezi ye-enema.

Abantu abathintekayo

I-acute intussusception ihlasela ikakhulukazi izingane ezingaphansi kweminyaka emi-2 ubudala, nemvamisa ephezulu kakhulu ezinsaneni ezinezinyanga ezi-4 kuye kweziyi-9. Abafana bathinteka ngokuphindwe kabili kunamantombazane. 

I-Intussusception ezinganeni ezingaphezu kweminyaka engu-3-4 futhi nakubantu abadala ingavamile kakhulu.

Izici zengozi

Ukukhubazeka kokuzalwa kwepheshana lesisu kungase kube i-predisposition.

Ukwenyuka okuncane kwengozi yokungenwa yisisu kulandela umjovo wokugomela izifo ze-rotavirus (i-Rotarix) kuqinisekiswe ucwaningo oluningi. Le ngozi yenzeka ikakhulukazi ezinsukwini eziyi-7 zokuthola umthamo wokuqala womgomo.

Ezinsaneni, ubuhlungu besisu obunodlame kakhulu, obuvela kungazelelwe, bubonakaliswa ukuquleka okungapheli okuthatha imizuzu embalwa. Iphaphatheke kakhulu, ingane iyakhala, ikhala, iyacasuka… Ihlukaniswa ekuqaleni ngezikhathi zemizuzu eyi-15 kuya kwengama-20, ukuhlaselwa kuyanda. Ngokululaza, ingane ingase ibonakale izolile noma ngokuphambene iguqe futhi ikhathazeke.

Ukuhlanza kuvela ngokushesha. Umntwana uyenqaba ukudla, futhi ngezinye izikhathi igazi litholakala esitokisini, esibukeka "njenge-gooseberry jelly" (igazi lixutshwe nolwelwesi lwamathumbu). Ekugcineni, ukumisa ukuhamba kwamathumbu kubangela ukuvinjelwa kwamathumbu.

Ezinganeni ezindadlana nakubantu abadala, izimpawu ngokuyinhloko yilezo zokuvaleka kwamathumbu, nobuhlungu besisu nokunqamuka kwendle negesi.

Ngezinye izikhathi i-pathology iba engapheli: intussusception, engaphelele, kungenzeka ukuthi ihlehlise ngokwayo futhi ubuhlungu buzibonakalisa ngeziqephu.

I-acute intussusception ezinsaneni iyisimo esiphuthumayo sezingane. Ebucayi noma ebulalayo uma ishiywe ingalashwa ngenxa yengozi yokuvinjwa kwamathumbu kanye ne-necrosis, ine-prognosis enhle kakhulu uma ilawulwa kahle, nengozi ephansi kakhulu yokuphindeka.

Ukuxhaswa komhlaba wonke

Ubuhlungu bezinsana kanye nengozi yokuphelelwa amanzi emzimbeni kufanele kubhekwane nayo.

I-enema yokwelapha

Izikhathi eziyisishiyagalolunye kweziyishumi, i-pneumatic ne-hydrostatic enemas (bona ukuxilongwa) kwanele ukubuyisela ingxenye ehlaselwe endaweni. Ukubuyela ekhaya nokuqala kabusha ukudla kuyashesha kakhulu.

ukuhlinzwa

Uma kwenzeka ukuxilongwa sekwephuzile, ukwehluleka kwe-enema noma ukuphikisana (izimpawu zokucasuka kwe-peritoneum, njll.), ukungenelela kokuhlinzwa kuyadingeka.

Ukwehliswa mathupha kwe-intussusception ngezinye izikhathi kungenzeka, ngokufaka ingcindezi emuva emathunjini kuze kube yilapho isoseji liyanyamalala.

Ukuhlinzwa kabusha kwengxenye engenelwe kungenziwa nge-laparotomy (ukuhlinzwa kwesisu esivulekile kwakudala) noma nge-laparoscopy (ukuhlinzwa okungenavaza okuncane okuholwa yi-endoscopy).

Uma kwenzeka i-intussusception yesibili ku-tumor, lokhu kufanele futhi kususwe. Nokho, akusona isimo esiphuthumayo ngaso sonke isikhathi.