Fistulas inogona kurwadza, asi inowanzorapwa pasina kuvhiyiwa
Fistula inorondedzerwa sekubatana kusina kukodzera kwemuviri miviri (zvakadai se rectum nemudzimai), kana sekubatana kwemuviri wechipfu ganda (zvakadai sehutachi reganda). Imwe nzira iyo fistula inogona kuumba inobva kubasa -muhomwe yepus mumuviri. Ivhavha inogona kunge ichizadza nguva dzose nemuviri wemvura yakadai sedonho kana urini, iyo inodzivisa kuporesa.
Pakupedzisira inoputika kusvika kune ganda, imwe muviri, mutezo, kana nhengo, kusika fistula.
Fistulas inowanzozivikanwa muhosha yaCrohn kupfuura iyo iri muchirwere cheplitis. Inenge 25 muzana yevanhu vane Crohn's disease vanoita fistulas. Fistulas inowanzorapwa nekuvhiyiwa kana nekuvaravara kwevanga.
Aina
Fistulas inowanzoitika munharaunda yakapoteredza nhengo dzepabonde uye anus (inozivikanwa se perineum). Mhando ina ye fistula ndeyi:
- Inocutaneous : Iyi fistula inobva mumatumbo kusvika paganda. Imwe fistula inosangana nayo inogona kunge iri dambudziko rekuvhiyiwa. Inogona kurondedzerwa semugwagwa unofambira kubva mumatumbo kuenda kunzvimbo yekuvhiya uye zvakare kuganda.
- Enteroenteric kana Enterocolic : Uyu fistula unosanganisira mumukati mukuru kana muduku .
- Inovaginal : Uyu fistula unoenda kumudzimai.
- Enterovesicular : Mhando iyi ye fistula inoenda kumubhedha. Iyi fistura inogona kuita kuti nguva dzose urinary tract infections, kana kupera kwegesi kubva muurwere panguva yekuzorora.
Zviratidzo
Zviratidzo zveFistura zvinogona kusanganisira kurwadziwa, fivha, unyoro, kuchenesa, uye kazhinji kunzwa zvisina kunaka. Izvo fistula inogonawo kubvisa pus kana kusvina kunhuwirira. Zviratidzo izvi zvinosiyana zvichienderana nekuoma uye nzvimbo ye fistula.
Kuziva
Fistulas inowanzoongororwa kuburikidza nekushandiswa kwekuongorora kwepanyama, computed tomography (CT) scan , uye, kana zvichidiwa, mamwe mimwe miedzo yakadai saabrium enema , colonoscopy , sigmoidoscopy , upper endoscopy , kana fistulogram.
Munguva ye fistulogram, dhayi inopindwa mu fistula, uye X-rays inotorwa. Dhayi inobatsira fistula kuratidzira zviri nani pa-X-rays. Dhayi iri kuiswa mukati re rectum, yakafanana neenema , yefistula iri mu rectum. Dhayi inofanira 'kubatwa' mukati mukati mekuita. Ne fistula iyo iri kunze kwemuviri, dae inoiswa muvheti nekidiki duku. X-rays ichabviswa kubva pamakumbo akasiyana-siyana, saka murwere angada kuchinja nzvimbo pa-X-ray tafura. Sezvimwe chero ipi zvayo yemhando ye X-ray, zvakasara zvichiri kukosha.
Kana zvichifungidzirwa kuti murwere ane enterovesicular (bladder) fistula, chirwere chepyelogram (intravenous pyelogram (IVP), chimwe chinyorwa che X-ray, chinogona kuitwa. Kugadzirira chiyero ichi kunogona kusanganisira zvakajeka mvura yekudya kana kutsanya, nokuti chigaro chiri mumakoloni chinogona kudzivisa maonero echando. Dhayi (musiyano wezvinyorwa) inorohwa muhuni, uye huwandu X-ray inotorwa.
Zvimwe Zvimwe Zvinetso
Fistula inogona kukonzera zvinetso. Mune zvimwe zviitiko, fistulas haigone kuporesa, uye inogara isingaperi. Zvimwe zvinogona kuita zvinetso zvinosanganisira fistula mvura, sepsis, uye perforation. Sepsis chirwere chinopisa upenyu chinokonzerwa nemhinduro yemuviri kune utachiona hwehutachiona.
Zviratidzo zvechiputi zvinosanganisira kuputika, fever, chills, kuvhiringidzika, kuora mwoyo, nekufema nekukurumidza nekushaya moyo. Peritonitis chirwere kana kutapurika kwe peritoneum, maronda pamuviri wemukati mukati mukati memukati unofukidza nhengo dzemimba. Zviratidzo zvePeritonitis zvinosanganisira kurwadziwa kwepamuviri uye unyoro, fever, chills, marwadzo akabatana, kushungurudza, uye kurutsa.
Mishonga
Mishonga ye fistula inokera zvichienderana nekunzvimbo uye kukwirira kwezviratidzo. Zvirwere zvokurapa zvinosanganisira Flagyl (an antibiotic), 6-MP (an immunosuppresant), kana mamwe maitiro ekurapa (kusanganisira Remicade uye Humira ).
Chikafu chekudya chinogona kurongerwa kune zvinonzi enterovaginal, enterocutaneous, uye enterovesicular fistulas.
Chikafu chekudya chinokonzerwa nemvura chinotorwa nemuromo kana kuti chinopiwa kuburikidza nehutano hwekudya. Izvi zvinokonzerwa nehuwandu hwemvura zvinotsiva zvokudya zvakasimba uye zvine mishonga inokosha. Pasina zvokudya zvakasimba pane chiduku chiduku chinopfuura nenyuchi, iyo inobatsira fistula kurapa uye zvichida kunyange pedyo.
Vazhinji fistulas havazopinduri kune chero ipi zvayo pamusoro pemishonga uye inoda kuvhiyiwa uye / kana kukuvara kwevanga. Kana fistula iri mune chikamu chine utano hwemukati, inogona kubviswa pasina kutora chero chikamu chemukati. Kana fistula iri mune chikamu chikuru chechirwere, rection ingatofanira kuitwa.
A resection ingaguma neoostomy yenguva pfupi. Chifukidzo chinodururwa kuburikidza ne ileostomy, ichipa chikamu chemukati ne nguva ye fistula yekuporesa. Mhando iyi yekuvhiya inowanzoitwa pane rectovaginal kana enterovesicular fistulas.
Prognosis
Nzvimbo uye kuoma kwe fistula inobatsira zvikuru pakugadzirisa kurapa. Fistula chiratidzo chekudzivirira chirwere chinokonzera chirwere (IBD), uye pasina kutarisirwa kwakakodzera, kunogona kutungamirira kumatambudziko akakomba. Kuona gastroenterologist nguva dzose uye kutora mishonga sezvinorayirwa kunokosha kune vatungamiri uye kudzivirira kwezvinetso zveBD.
Sources:
Buckmire M. "Kusagadzikana uye Fistula Kuwedzera Mashoko." The American Society of Colon uye Rectal Surgeons. Feb 2015.
Crohn's uye Colitis Foundation yeAmerica. "Kuvhiya kwaCrohn's Disease & Ulcerative Colitis." CCFA 31 Aug 2010.