ʻAtopage atresia

ʻO ka esophageal atresia kahi maʻi digestive kahi e ulu pono ʻole ai ka esophagus. ʻO ka esophagus ka paipu e lawe maʻamau i ka meaʻai mai ka waha a i ka ʻōpū.

ʻO Esophageal atresia (EA) kahi kīnā pili. Kuhi kēia ma mua o ka hānau ʻana. Nui a hewahewa nā ʻano. I ka hapanui o nā hihia, hoʻopau ka ʻāʻī luna a ʻaʻole hoʻopili me ka esophagus lalo a me ka ʻōpū.

ʻO ka hapa nui o nā pēpē me EA i kekahi kīnā i kapa ʻia tracheoesophageal fistula (TEF). He pilina maʻamau kēia ma waena o ka esophagus a me ka windpipe (trachea).

Eia hou, ʻo nā pēpē me EA / TEF pinepine ka tracheomalacia. ʻO kēia kahi nāwaliwali a me nā floppiness o nā paia o ka puhi ʻōlani, kahi e hiki ai ke kani ke kani kiʻekiʻe a kani paha.

ʻO kekahi pēpē me EA / TEF kekahi kīnā ʻē aʻe pū kekahi, ʻo nā maʻi kīnā ʻole o ka naʻau.

Pākuʻi ʻia paha nā ʻōuli o EA:

• ʻO ka waihoʻoluʻu Bluish i ka ʻili (cyanosis) me ka hoʻāʻo ʻana e hānai
• ʻO Coughing, gagging, a ʻāʻā me ka hoʻāʻo ʻana e hānai
• Drooling
• ʻAi hānai maikaʻi ʻole

Ma mua o ka hānau ʻana, hōʻike paha ka ultrasound a ka makuahine i ka nui o ka wai amniotic. Hiki i kēia ke lilo i hōʻailona o EA a i ʻole blockage ʻē aʻe o ka pēpē digestive o ka pēpē.

ʻIke pinepine ʻia ka maʻi ma hope koke iho o ka hānau ʻana ke hoʻāʻo ka pēpē e hānai a laila hemo, ʻāʻā, a uliuli polū. Inā manaʻo ʻia ʻo EA, e hoʻāʻo ka mea mālama ola e lawe i kahi paipu hānai liʻiliʻi ma o ka waha o ka pēpē a ihu paha i loko o ka ʻōpū. Inā hiki ʻole i ka ʻōmele hānai ke hele a hiki i ka ʻōpū, e ʻike ʻia ka pēpē me EA.

Hana ʻia kahi x-ray a hōʻike i kekahi o kēia mau mea:

• ʻO kahi ʻeke piha piha i ka ea i ka esophagus.
• Air i loko o ka ʻōpū a me ka ʻōpū.
• E ʻike ʻia kahi ʻōmole hānai i ʻōwili ʻia i ka esophagus o luna inā i hoʻokomo ʻia ma mua o ka x-ray.

He ulia pōpilikia ʻo EA. ʻO ke ʻoki kino e hoʻoponopono ai i ka esophagus e hana ʻia ma ka wā hikiwawe ma hope o ka hānau ʻana i mea e hōʻino ʻole ʻole ai nā māmā a hiki ke hānai ʻia ka pēpē.

Ma mua o ke ʻoki ʻana, ʻaʻole hānai ʻia ka pēpē e ka waha a pono i ka meaʻai intravenous (IV). Mālama ʻia e pale i ka huakaʻi o nā huna hanu i loko o nā akemāmā.

Hāʻawi kahi hōʻailona mua i kahi manawa kūpono o kahi hopena maikaʻi.

Hiki i ke pēpē ke hanu i ka lawai a me nā wai ʻē aʻe i loko o nā akemāmā, e hoʻoulu ai i ka pulumonia aspiration, ʻāʻā, a me ka make paha.

Hiki i nā pilikia ʻē aʻe ke:

• Nā pilikia hānai
• ʻO Reflux (ka lawe pinepine ʻana o ka meaʻai mai ka ʻōpū) ma hope o ke kahakaha ʻana
• Pahu (paʻa) o ka esophagus ma muli o ka scarring mai ʻoki kino

Hoʻopilikia paha ka prematurity i ke ʻano. E like me ka mea i ʻōlelo ʻia ma luna, aia nō kekahi hemahema i nā wahi ʻē aʻe o ke kino.

Kuhi pinepine ʻia kēia maʻi ma hope koke o ka hānau ʻana.

Kāhea koke i ka mea hāʻawi i kāu pēpē inā luaʻi pinepine ka pēpē ma hope o ka hānai ʻana, a i ʻole inā hoʻomōhala ka pēpē i nā pilikia hanu.

ʻO Madanick R, Orlando RC. ʻO Anatomy, histology, embryology, a me nā anomalies ulu o ka esophagus. I: Feldman M, Friedman LS, Brandt LJ, eds. ʻO Sleisenger a me Fordtran's Gastrointestinal a me ka maʻi Liver: Pathophysiology / Diagnosis / Management. 10 o ka lā. Piladelapia, PA: Elsevier Saunders; 2016: chap 42.

ʻO Rothenberg SS. Esophageal atresia a me tracheoesophageal fistula malformations. I: Holcomb GW, Murphy JP, St. Peter SD, eds. ʻO Holcomb a me Ashcraft's Pediatric Surgery. ʻEpekema 7 Piladelapia, PA: Elsevier Saunders; 2020: chap 27.

ʻO Wolf RB. ʻO ke kiʻi ʻōpū. I: Resnik R, Lockwood CJ, Moore TR, Greene MF, Copel JA, Silver RM, eds. ʻO Medicine a Maternal-Fetal a Creasy a me Resnik: Nā Manaʻo a me ka Hoʻomeheu. 8th ed. Piladelapia, PA: Elsevier Saunders; 2019: chap 26.