Ukubonakaliswa kwemitholampilo
Iningi (95%) leziguli ezine-appendicitis zinempawu ezilandelayo:
• ubuhlungu - ukusabalalisa kokuqala, bese kuthiwa indawo;
• ukulahlekelwa ukudla.
Noma kunjalo, cishe cishe isigamu seziguli, izibonakaliso "ezijwayelekile" zokufaka i-appendicitis zingalingisa ezinye izifo ezimbi zomzimba wesisu. Ezinganeni ezincane nasebekhulile, ngokuvamile kuvame ukuba nezimpawu ezingenakuqhathaniswa ezikhulayo ezinyathelweni ezilandelayo zenqubo yokugulisa umzimba, okwenyusa ingozi yezinkinga. Isihlomelo sivame ukutholakala esigabeni esingaphansi kwesiguli sesisu, esinqumayo ukutholakala kobuhlungu ekufakweni kwesisu. Uma isithasiselo sitholakala ngemuva kwe-cecum noma emgodini we-pelvic, ubuhlungu buvele buvele uma kuhlolwa i-rectum. Ngokuphambene nalokho, ngesikhathi sokukhulelwa, ukufuduka kwesithasiselo sesithasiselo ngesibindi esithintekayo phezulu siphenduka endaweni ephakeme yobuhlungu.
Izimpawu Zokuqala ze-Appendicitis
• Ukubonakala kobuhlungu esiswini esingenhla noma inkaba, kuhambisane nesicefe, ukuhlanza nokulahlekelwa ukudla.
• Ukufuduka kokuncipha kwezinhlungu kuya kwesisindo esincane esifanele esiswini (kuze kube sekupheleni kukaMcBurney), ubuhlungu obuningi ngokucindezela kwi-peritoneum nokubuthakathaka okubukhali
ukucindezelwa (uphawu lweShchetkin-Blumberg).
• Ukucindezeleka kwemizimba yegciwane lesiguli ngesikhathi sokulunywa noma ukukhwehlela.
• Umkhuhlane omncane: ukushisa komzimba ku-37.7-38.3 ° C.
• Ukwanda okungcolile kwenani lama-leukocyte egazini (i-leukocytosis).
Ukuxilongwa ngokuvamile kwenziwa ngokusekelwe emlandweni kanye nezibonakaliso zomtholampilo zesifo. Isithombe esivamile se-appendicitis esiphuthumayo siphuthuma kakhulu, ngokuvamile esingaphansi kwamahora angu-24. Izimpawu zakhe zigcina ngaphezu kwamahora angu-48, akunakwenzeka ukuthi ukutholakala kwesibalo se-appendicitis. Izivivinyo ezicacile ukuqinisekisa ukuthi ukufakwa kwe-appendicitis akukhona, ukuhlolwa okwengeziwe kusetshenziselwa ukungabaza ekuxilongweni.
Izindlela zokucwaninga
• Ukuhlola i-laboratory kanye nobuchwepheshe bokubona izithombe kusetshenziselwa ukukhipha ezinye izimbangela zobuhlungu obukhulu kunokuba kuqinisekiswe ukufakwa kwe-appendicitis.
• I-laparoscopy - ukuhlolwa kwesigxobo esiswini ngokusebenzisa isisindo sokugcina ngekhamera yevidiyo.
• I-ultrasonography ivame ukusiza ekuxilongweni okuhlukile kokuhlukunyezwa kanye nokukhubazeka kwegazi (isib. Ukuvuvukala kwezitho zomzimba).
Udokotela onolwazi uyakwazi ukuhlola ukufakwa kwesisindo kuphela ngesisekelo somlando kanye nomtholampilo wesifo, kodwa ngesikhathi sokusebenza kwe-15% ukuthola i-appendicitis ephawulekayo kuyatholakala ukuthi imbangela "yesisu esiswini" kwakuyisinye isifo, noma akukho ukugula okuphilayo okutholakala nhlobo. Ukwehluleka ukunikeza ukunakekelwa okufanelekile kwe-appendicitis enzima kubhekene nezinkinga ezibucayi, ngakho-ke lapho kwenzeka khona izinkinga, odokotela abahlinzayo bayathinteka ekuhlinzekeni. Ukuvimbela (ukuvinjelwa) kwe-appendix lumen kuholela ekunyuseni komfutho kulo futhi kulimaze ulwelwesi olunamanzi. Ngaphansi kwalezi zimo, amabhaktheriya ahlala emathunjini awela kalula odongeni lwesithasiselo futhi abangela ukuvuvukala. Ngenxa yokuqoqwa kwesikhanyiso se-appendectomy ye-mucus, ingcindezi ngaphakathi ngaphakathi yanda ngokugxila kancane kancane kwemithambo yegazi. Ngokuthuthukiswa kwesibhamu, ukudilizwa kwedonga lokudubula kungenzeka.
Izimbangela ezivamile
Kukholelwa ukuthi imbangela eyinhloko ye-appendicitis i-ulceration ye-mucosa, mhlawumbe ngenxa yokungenwa yi-Yersinia microbe. Ukwakhiwa kwesithasiselo kuvame ukubangelwa yi-coprolitis (ukuxubana kwemifino ezungeze izitshalo zezitshalo). Ezinye izizathu zihlanganisa:
• ama-parasite emathumbu;
• Izicubu;
• i-edema yamathambo lymphatic emdongeni wamathumbu emithonjeni yegciwane.
Izimpawu zomtholampilo ekuqhubekeni okukhulu kwe-appendicitis ngokushesha kakhulu. Uma ixilongwa ngokushesha, le nqubo ingaphula udonga lwenqubo ngokuphuma kokuqukethwe kwayo kwisigxobo esiswini (i-perforation).
Imiphumela
• Ngokuhlwithwa okusheshayo kwesithasiselo, isithombe senqubo yokuvuvukala ejwayelekile emzimbeni wesisu (peritonitis) iqala, okungenzeka kube nemiphumela ebulalayo.
• Ngokuqhubeka kancane, kungenzeka ukumboza isayithi le-perforation nge-site enkulu yegland ngokubunjwa kwe-abscess.
Ukuhlukunyezwa
• I-appendicitis enhle ibhekisela ezifweni ezivame kakhulu ebuntwaneni nasebudala; izibalo phakathi kwabantu ziphakeme kunabesifazane (isilinganiso 3: 2).
• I-appendicitis encane encane ibonakala lapho isencane kanye nokuguga, ngenengozi eyengeziwe yokubhekana nezinkinga ezihlukahlukene.
• Ngokuvamile, izibalo ze-appendicitis emhlabeni ziyancipha. Isizathu esiqondile salokhu asiyazi, kepha izinga eliphansi kakhulu lokukhubazeka emazweni asathuthuka (ikakhulukazi kwezinye izindawo zase-Asia) lisikisela ukuthi kunomthelela ongakwenza wokudla okunomsoco.
Indlela kuphela yokwelapha i-appendicitis enamandla ukukhipha ukwelashwa kwe-appendectomy (i-anendectomy). Namuhla, ukusebenza okuvela ku-laparoscopic kufinyeleleke.
Ukubuya okusheshayo
Ngemva kokuhlinzwa, iziguli ngokuvamile zilulame ngokushesha. Ingozi yokusabalalisa ukutheleleka iyancishiswa ngokulawulwa kwemithi yama-antibiotics. Uma kukhona i-abscess, kufanele igwetshwe. I-lesion enkulu ehilela i-cecum noma i-small fetop loop idinga ukususwa konke okuqukethwe kwe-abscess okulandelwa ukufakwa kwe-ileostomy (ukususwa kwesibindi somathumbu omncane esiqongweni sesikhumba).
Izinyathelo zokuvimbela
Ngesikhathi sokuhlinzwa, isigxobo esiswini nesisu sitholwe ngokucophelela ukuze kutholakale izifo. Isibonelo, udokotela ohlinzayo angathola ukuthi i-anomaly engavamile - okuthiwa i-Meckel diverticulum (insalela encane yedonga lomathumbu omncane). Ngisho uma kungekho izimpawu zokuvuvukala, kubalulekile ukususa ukuze kuvikelwe izinkinga ezingenzeka.