Ukuxoshwa okuncane kwezingane ezincane

Okubalulekile kwalokhu kuhlushwa kwe-esophagus kubangelwa izici ezithile zekhanda lakhe elimangalisa. Njengengxenyana ebulalayo, i-esophagus ngaphandle ihlala ubude obuvamile, kodwa ingxenye engezansi yayo ingaphakathi ne-gastric epithelium. Ngakho-ke, isigaba se-distal se-oophagus isisu ngokuqhubekayo nokuqhubeka kwesisu, ngakho-ke, isisindo sifushane.


Esikhathini seminyaka eminingi, kwakungavumelaniseki ezincwadini ezithathwe esikhathini esiyinkimbinkimbi yesikhashana njengengqondo yokuzimela emele. Umnikelo omkhulu kunayo yonke i-etiology, i-pathogenesis, idatha ye-clinico-morphological, ukuxilongwa nokwelashwa kwesifo esincane sokuzalwa esenziwa nguBarret (1959). Lesi sifo sichazwa ezincwadini ngaphansi kwamagama ahlukene: brachiozophagus, isisu esifubeni, ukungenwa kwesisu, isisu esifubeni esiswini.

Ukubonakala kokuvuthwa kwesikhashana kuchazwa ukwephulwa komgudu wokugaya ukudla esikhathini sokuqala se-embryonic, lapho i-epopular yayinomphetho we-epithelium. Ukushintshwa kwalesi sihloko se-epithelium, okuqala nge-third-party yesigameko, kuphazanyiswa, ngenxa yalokho ingxenye engezansi yayo ihlanganiswe ne-gastric epithelium. Ngakho-ke kukhona i-dystopia ye-mucosa esiswini engxenyeni engezansi ye-esophagus (ene-cardia indawo evamile).

Ukuqinisekiswa kwalokhu kucatshangelwa ukuthi i-supra-diaphragmatic ingxenye yalokho okuthiwa isisu esingenakulinganiswa, ngaphandle kwebhande elimangcwabeni, lenziwa njengesisindo futhi singenasembozo se-serous. Esigabeni esifanayo, izingxenyana zomzimba zomzimba ezihamba phambili nezingxenyeni eside, izici ze-esophagus, zihlukaniswa, futhi ukuhlinzeka ngegazi kwenziwa, njengokujwayelekile, kusuka e-aorta.

Izimpawu zomtholampilo

Isifo esifushane sokubeletha sihambisane, njengokubusa, nge-reflux ye-gastroesophageal, eyinkimbinkimbi yi-esophagitis kanye nokuqala kwe-stenosis ye-peptic esophageal stenosis.

Isifo esincane sokuzalwa esivela kubantwana sibonakala ezinganeni zeminyaka yokuqala emithathu yokuphila, ngoba bane-reflux syndrome ezinzile. Ku-anamnesis, iziguli ezinjalo zivame ukuhlanza njalo ngemva kokuzalwa. Ngokuvamile kunezibonakaliso zezifo zokuphefumula ezivamile: i-bronchitis, i-pneumonia (ngamacala angu-30%). Esikhathini esizayo, ukubonakaliswa kwemitholampilo kuxhomeke ekubunjweni kwesimo se-stenosis yesibili. Uma i-stenosis ingabonakali, uphawu oluyinhloko ukuhlanza nokuqukethwe kwesisu. Ukuvuthwa kukhathazeka ngokukhala, ngesimo esingenqamuzana somzimba, nangenkinga encane yomzimba eyenza ukwanda komfutho we-intra-kwesisu. Ukuhlanza kwegazi kutholakala emhlanzweni; ikhofi yokuhlanza njalo. Ngokunciphisa okwesikhashana isifo ngenxa ye-peptic ulcerative anopharyngitis, izimpawu zokuphulwa kwesithiyo sokuvimbela izidakamizwa zikhona: i-dysphagia, ukuhlanza kokudla.

Izingane ezineminyaka engaphezu kweyisishiyagalombili zikhononda ngobuhlungu obubangelwa i-sternum, ukuvela kwayo okumele kube yi-todisagia ne-ulcerative esophagitis. Ngokuvamile, izingane zizama ukuphuza i-pishchuk. Ngenxa yokuphuma kwegazi emlonyeni we-dystopic, njengoba kuboniswa ukuhlanganiswa kwegazi emasimini okuhlanza kanye nokuphendula kahle kwegazi elingenalutho emanzini, i-anemia iqala. I-anemic syndrome ibonakala ku-1/3 yeziguli. Izingane ezinesifo esincane sokuzalwa esiswini ngemuva kokuthuthukiswa ngokomzimba.

Ukuze uthole ukuxilongwa kwesifo esincane sokuzalwa, ukuhlolwa kwe-X-ray kuyasetshenziswa, ngosizo lwalo, okokuqala, reflux yesisu itholakala. Esikhundleni seTelverelenburg, isiguli sokuthi u-reflux osondelene kakhulu nesifo sokuphefumula uzimisele ukuphonsa into ehlukile ye-ovary engxenyeni. Ingxenye yokuhlukanisa ye-esophagus, njengombuso, ivuliwe phansi ngendlela ye-funnel noma insimbi. Izithombe ze-X emgqeni we-distal zibonisa ukubopha kwe-longitudinal, isici sekhanda lesisu. Ukuhamba kwesifo ngesikhathi sokuhlolwa kwesiguli esimweni sokuma kuhambelana. Nge-stenosis yesibili, ubuciko bomphakathi ohlukehlukeneyo buvinjelwe, futhi ukucindezelwa kwesiguli kunqunywe ngaphezu kwe-constriction. Isithombe se-radiological ne-deformation esifundeni sokuqinela nokugcinwa ngokweqile kwendwangu kudinga ukuhlukaniswa kusukela emkhakheni wokuvulwa kwe-diaphragm kanye ne-diverticula ye-esophagus.

Isetshenziswa kabanzi ekuxilongweni kwe-esophagofibroscopy. Uphawu olubaluleke kunazo zonke lwe-endoscopic lungumgudu ophezulu we-mucosal lining of the esophagus in the mucosa esiswini, i.s. ngenhla ukubonakala kwesigxobo se-diaphragmatic. Uma kungekho stenosis e-distal esophagus, i-catarrhal noma i-ulcerative fibrinous isophagitis kwenzeka. Ngokuthuthukiswa kwe-stenosis, njengomthetho, itholakala emngceleni wendwangu yamangcwaba yesisu nesisu.

Ngokuqondene neqiniso lokuthi ezigulini ezinesifo esincane sokubeletha zihlala njalo zinezindawo zokuhlaziya i-reflux ye-gastroesophageal, inani elithile lokuxilonga line-pH-metry ye-intraepithelial.

Izakhamuzi kanye nezinsana zihlinzekwa ngokuhlukana ngokuhlukile nge-pyenicle stenosis, pilorospasm, ukuhlaziywa kwesifo se-diaphragm, i-chalasia, i-stenoses evulekile futhi etholakalayo ye-distal esophagus.

Ukwelapha

Ukwelashwa kuvamise ukuhlinzeka, okuhloswe ekuqedeni i-reflux ye-gastroesophageal. Ukuhlinzekwa kwe-antireflux kunokwethenjelwa kakhulu ukusebenza kuka-NN Kanshin ekuguqulweni kwe-YF Isakova et al., Ngokusekelwe ku-gastroplication ye-valve. Uma kwenzeka ukuthi i-peptic stenosis ivuke kancane , ukuhlinzekwa kwe-antireflux kuhlanganiswa nokufakwa kwe-gastrostomy. Esikhathini esizayo, igxilwe yi-bougie.

Ngokombono odokotela abacubungula ukuthi isifo esincane sokuzalwa esingenasiphazamiso sesisu, kubalulekile ukuqhuba ukwelashwa okuhlala isikhathi eside ekubalweni kwesisu esisondelene (njengoba ingane iqala).

Imithi yokwelapha ihlinzekela indawo ephakeme njalo engxenyeni engenhla yesiqu, ukudla njalo kwengane ezinxenyeni ezincane zokudla okulinganayo. Ukuziphatha kubuye kube nokwelashwa okujwayelekile nokuvuselela.

Ukukhula!