Nutcracker esophagus inomirira sophageal spasm. Icho chiri munharaunda imwechete ye esophageal motility disorders sejackhammer esophagus uye kupararira kwepopugeal spasms. MuUnited States vanenge 1 mu100 000 vanhu vanoonekwa kuti vane chirwere chinonzi esophageal motility chirwere pagore, zvisinei, chiitiko chechokwadi chinofungidzirwa kuti chakakwirira zvikuru sezvo zvisinganzwisisiki seasid reflux.
Esophageal spasms inogona kuva yakawanda kuvanhu veCaucasian uye inoitika kakawanda kuvakadzi kupfuura varume. Iwe mukuru iwe unowanzoita kuti iwe uwane mararamiro emasikirwo.
Izvo zvinoratidzirwa zvinosanganisira nutcracker isophagus zvinosanganisira zvipingamupinyi zvepamusoro uye zvinyanyisa mumugwagwa unoitika nenzira yakarongeka. Kupisa kwemasimba emasimba kunokonzera kuti zvokudya zvive zvakasimba kana kuti zvigare munzvimbo. Ne nutcracker esophagus, zvisinei, nokuti masaisai achiri kuitika nenzira yakarongeka uye yakarongeka inowanzova nekutambudzika kwepfuva pane kunetseka kunomedza.
Hazvizivikanwi chaicho chinokonzera nutcracker esophagus. Dzimwe dzidziso ndeyokuti mamiriro acho akabatana zvikuru ne gastroesophageal reflux disorder (GERD) uye inogona kukonzerwa nayo. Imwe nyanzvi ndeyokuti inokonzerwa nehutano hwehutano, uye vamwe vanhu vanotenda kuti inokonzerwa nekusagadzikana kusingaoneki kwezvinhu zvinonzi acetylcholine.
Zviratidzo zveNutcracker Esophagus
Nutcracker esophagus inogona kukonzera kusanganiswa kwezvimwe kana zviratidzo zvose zvinotevera:
- kunetseka kumedza (dysphagia) iyo inowanikwa nezvose zvakasimba uye zvinodyiwa uye zvinogona kuitika dzimwe nguva chete
- chipfuva chepfu
- kudzokerazve kwezvokudya
- reflux
Izvo zvinoitawo kuti nutcracker isophagus ive yemaitiro (kwete kuita kuti zviratidzo zvionekwe).
Imwe tsvakurudzo inoratidza kuti vanhu vane nutcracker esophagus vanogona kuva nesophagus iyo inoshushikana uye yakaoma.
Zviratidzo zvevamwe kushungurudzika kwemaitiro (jackhammer esophagus uye kupararira kwepopugeal spasm) zvakafanana zvakafanana ne nutcracker esophagus zvakanyanya kuongororwa zvinofanira kuitwa kuti zviparadzanise pakati pezvinetso izvi.
Kuongorora Nutcracker Esophagus
Miedzo inotevera inogona kubatsira chiremba wako kuti aongorore nhengo ye nutcracker:
- A barium swallow is a test that involves in swallowing a substance called barium sulfate. Barium sulfate inoratidzika pa-x-rays kuitira kuti zvioneke nenzira yebhayoum sulfate kuburikidza nekugadzirisa chirwere. Mukuwedzera kune zvinyorwa zvisinganzwisisiki, iyi miedzo inogona kubatsira kuongororwa matambudziko akaita sekutambudzika kukumedza kana kuderedza demo. Iwe haufaniri kuva nemuedzo uyu kana uri weergoric kuBarium sulfate asi kazhinji kutaura, muedzo une runyoro rwekuchengeteka. Zvisinei, barium sulphate inozivikanwa kuti inokonzera kubatwa kuitira kuti iwe unganwe kunwa mvura yakawanda kana kushandisa pamusoro pekambisi yekugadzirisa pasi shure kwekuedzwa.
- A CT scan ingaratidza kuwedzera kwesophageal wall (inopfuura 3mm) kune vanhu vane nutcracker esophagus. Zvisinei, izvi zvinogonawo kuitika kune mamwe mamiriro ezvinhu kusanganisira chirwere chesophagus. Kana CT yako scan ichinyanya kukura kwesophageal rusvingo chiremba wako achada kurongedzazve kuedza kuti uone kuti iwe unorwara.
- High-frequency ultrasound inogona kubatsira mukusiyanisa pakati pe nutcracker esophagus, jackhammer esophagus, uye kupararira kwepopugeal spasm.
- Esophageal Manometry iyi yakanaka kwazvo yekuongorora zvirwere zvepopigeal uye zvinokonzera kurwadziwa kwepfungwa kusina mwoyo. Chiyero chinosanganisira kuiswa kwepini tsvina mumhino dzako, pasi pasi pako uye hoophagus uye mudumbu rako. Iyo tube inomanikidzwa uye inogona kuyera simba uye kushungurudzika kwemasisita zvipfeko mukati megumbo paunenge uchidya. Uyu muedzo unogona kukonzera kumwe kusagadzikana kunoshandiswa ne spray iyo inobata mukati memhino uye dzimwe nguva kumusoro kwehuro.
- Esophagogastroduodenoscopy (EGD) inzira isingagoni kunyatsoongorora nhengo ye nutcracker asi inogona kubatsira pakuronga zvimwe zvinetso zvakafanana zvakadai sehutano hwekuzvarwa kana GERD.
Kurapa kweNutcracker Esophagus
Iwe uye chiremba wako angasarudza kushandisa zvimwe zvezvirapa zvinotevera kuti ubatsire kutarisa zviratidzo zve nutcracker esophagus.
Mishonga yakawanda inoshandiswa kurapa chirwere ichi uye inosanganisira calcium channel blockers, nitrates, uye phosphodiesterase inhibitors. Injections ye botulinum inxin kumusoro kwecheperegeal sphincter inogona kuderedza zviratidzo nekudzivisa kusunungurwa kweacetylcholine. Proton pump inhibitors inogona kubatsira kubvisa zviratidzo zvine chokuita neAxy reflux. Imwe yemishonga inobatsira zvikuru yekusangana kwemaitiro etility kusanganisira nutcracker isophagus is tricyclic vanodzvinyirira.
Balloon dilation ye-esophagus inzira inotambanudza hupamhi hwesophagus uye inokwanisa kuderedza zviratidzo zve nutcracker esophagus. Nzira yacho inowanzoitwa pamusana pekudzivirira kwepasi uye pasi pedheti. Iwe uchagamuchira mirayiridzo yakakosha pamusoro pekusadya uye kunwa kweimwe nguva nguva yako isati yasvika. Ngozi dzebhouni kuwedzera dzinosanganisira migumisiro kana kuti zvinokonzerwa nemararamiro kune anesthesia mhando yemishonga inoshandiswa kana kuti kazhinji isingaenzaniswi.
Mumamiriro ezvinhu akaipisisa asina kumbobvuma zvakanaka kune dzimwe kurapwa, chirongwa chinonzi chirongwa chinonzi myotomy chinogona kubvumirwa. Nzira iyi inonziwo Heller myotomy kana kuti inophageal myotomy uye inowanzoshandiswa kurapa achalasia asi inogona kushandiswa kubata chirongwa che nutcracker pamwe chete. Iyo inoshandiswa senzira yekupedzisira nokuti pane dzimwe nguva iyo yakanyatsoita kuti maitiro emisumbu anokonzerwa ne nutcracker isophagus kuti iwedzere kuipa.
Nzira yacho inogona kuitwa laparoscopically kana senzira yakasununguka asi nzira yaparparcopic inobatanidza nehuwandu hwehuwandu uye nguva shoma yekudzorera. Kushongedzwa kuduku kunowanikwa pamusoro pebhatani badzi uye ipapo kunze kwemavara emutsetse wakagadzirwa kunobatsira kudzivirira kuti vasabvumirana. Kuwedzerwa, kuderedza mishonga pakusangana kwegastroesophageal kunokonzera kuti sphincter iri pakati pemudumbu uye inophagus igare yakasununguka.
Njodzi dzinobatanidzwa muhutachiona hwe myotomy dzinosanganisira kukanganisa kune nhengo dzakapoteredza dzinosanganisira spleen, chiropa, kana mudumbu pamwe nekupora-opera utachiona. Sezvakaita chero nzira ipi zvayo yokuvhiya, kunewo mukana wekutengesa kwehutano kana yemigumisiro yeanesthesia. Sezvambotaurwa pamusoro apo pachinoshandiswa kubata chirongwa che nutcracker pane ngozi yokuti zviratidzo zvichanyanya kuipa. Kunyangwe kana zviratidzo zvinopera mushure memakore emakore zvinokwanisika kuti zvinobudirira zvemuitiro uyu zvinowedzera.
Mukuwedzera kune mishonga inotsanangurwa tsanangudzo inoratidza kuti nutcracker isophagus inoratidzika kuva nani pane zvayo mumakore mashomanana.
> Sources:
> Barium Swallow. emedicinehealth. Yakaperedzwa June 25, 2015. https://www.emedicinehealth.com/barium_swallow/article_em.htm#what_is_a_barium_swallow
> Esophageal manometry. Medline Plus. https://medlineplus.gov/ency/article/003884.htm
> Esophageal Spasm. Medscape. https://emedicine.medscape.com/article/174975-overview
> Heller Myotomy for Achalasia. Washington University School of Medicine muSt. Louis Cardiothoracic Surgery. http://cardiothoracicsurgery.wustl.edu/en/Thoracic/Benign-Esophageal-Disease/Heller-Myotomy-for-Achalasia