Gastroschisis

ʻO Gastroschisis kahi kīnā hānau kahi o nā ʻōpū o ke keiki i waho o ke kino no ka puka o ka paia o ka ʻōpū.

Hānau ʻia nā pēpē me ka gastroschisis me kahi puka ma ka paia o ka ʻōpū. Pili pinepine ka ʻōpū o ke keiki (protrude) ma o ka lua.

Ua like ke ʻano me ke omphalocele. Eia naʻe kahi omphalocele, he kīnā hānau kahi e puka ai ka ʻōpū o ke pēpē a i ʻole nā ​​ʻōpū ʻē aʻe ma o ka puka ma ka wahi o ka ʻōpū a ua uhi ʻia me ka membrane. Me ka gastroschisis, ʻaʻohe ʻaʻohe membrane uhi.

Hoʻonui nā hemahema o ka paia ʻōpū i ka ulu ʻana o kahi pēpē i loko o ka ʻōpū o ka makuahine. I ka wā o ka hoʻomohala ʻana, ulu ka ʻōpū a me nā mea ʻē aʻe (akepaʻa, pūpū, ʻōpū, a me nā ovaries, ma waho o ke kino ma mua a hoʻi pinepine i loko. I nā pēpē me ka gastroschisis, noho nā ʻōpū (a i kekahi manawa ka ʻōpū) ma waho o ka paia o ka ʻōpū, me ka uhi ʻole o ka membrane iā lākou. ʻAʻole ʻike ʻia ke kumu kūpono o nā hemahema o ka paia ʻōpū.

ʻO nā makuahine me kēia aʻe e ʻoi aku ka nui o ka makaʻu i ka loaʻa ʻana o nā pēpē me gastroschisis.

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ʻAʻohe o nā pēpē me ka gastroschisis i nā kīnā hānau ʻē aʻe e pili ana.

ʻIke mau ʻia kahi gastroschisis i ka wā o kahi ultrasound prenatal. Hiki ke ʻike ʻia ke hānau ʻia ka pēpē. Aia he puka ma ka paia o ka ʻōpū. ʻO ka ʻōpū liʻiliʻi ma waho pinepine o ka ʻōpū kokoke i ka umbilical cord. ʻO nā ʻōnaehana ʻē aʻe e ʻike ʻia paha ka ʻōpū nui, ʻōpū, a i ʻole ka gallbladder.

ʻO ka maʻamau hoʻonāukiuki ʻia ka ʻōpū e ka hōʻike ʻana i ka wai amniotic.

Hoʻomaopopo pinepine nā ultrasound kani i ke keiki me gastroschisis ma mua o ka hānau ʻana, maʻamau e 20 mau pule o ka hāpai ʻana.

Inā loaʻa ka gastroschisis ma mua o ka hānau ʻana, pono i ka makuahine ke kiaʻi kūikawā ʻana e ʻike pono i ke olakino maikaʻi o kāna pēpē i hānau ʻole ʻia.

Hoʻopili ka mālama ʻana no ka gastroschisis i ka ʻoki kino. ʻO ka maʻamau o ka ʻōpū o ka ʻōpū he mea liʻiliʻi no ka ʻōpū e komo hou i ka wā hānau. No laila e humuhumu ʻia kahi ʻeke hei a puni nā palena o ka hemahema a huki ʻia nā kihi o ka kīnā. Kāhea ʻia ka ʻeke he silo. I loko o ʻelua pule aʻe a ʻelua paha, hoʻi ka ʻōpū i loko o ka ʻōpū o ka ʻōpū a hiki i ka hemahema ke pani ʻia.

Pono e mālama pono i ka mahana o ka pēpē, no ka mea, ʻo ka ʻōpū hūnā e ʻae i ka wela o ke kino e pakele. Ma muli o ke kaomi e pili ana i ka hoʻihoʻi ʻana i nā ʻōpū i ka ʻōpū, pono paha i ka pēpē ke kākoʻo e hanu me kahi ea. ʻO nā ʻano lapaʻau ʻē aʻe no ka pēpē me nā huaola a IV a me nā lāʻau ʻaloʻalo e pale ai i ka maʻi. ʻOiai ma hope o ka paʻa ʻana o ka hemahema, e hoʻomau ka meaʻai IV ʻoiai e hōʻike lohi i ka hānai ʻana i ka waiū.

Loaʻa ka manawa kūpono i ka pēpē e ola hou inā ʻaʻohe pilikia ʻē aʻe a inā lawa ka nui o ka ʻōpū o ka ʻōpū. Hiki i kahi ʻōpū ʻōpū liʻiliʻi loa ke hopena i nā pilikia e pono ai i nā ʻoki hou aʻe.

Pono e hoʻolālā i nā hoʻolālā no ka lawe pono ʻana a me ka hoʻokele koke ʻana i ka pilikia ma hope o ka hānau ʻana. Lawe ʻia ka pēpē i kahi kikowaena olakino e mākaukau i ka hoʻoponopono ʻana i nā hemahema o ka paia ʻōpū. E ʻoi aku paha ka maikaʻi o nā pēpē inā ʻaʻole pono lākou e lawe i kahi kikowaena ʻē aʻe no ka mālama hou.

Ma muli o ka hopena o ka wai amniotic, ʻaʻole e hana maʻamau nā ʻōpū o nā pēpē ma hope o ka hoʻihoʻi ʻia ʻana o nā mea i loko o ka lua o ka ʻōpū. Pono nā pēpē me ka gastroschisis i ka manawa no ko lākou ʻōpū e ola a maʻa i ka lawe ʻana i ka hānai.

ʻO kahi helu liʻiliʻi o nā pēpē me gastroschisis (ma kahi o 10-20%) hiki i ka atresia ʻōpū (nā ʻāpana o nā ʻōpū i ulu ʻole i loko o ka ʻōpū). Koi aku kēia mau pēpē i kahi ʻoki hou e hoʻomaha ai i ka ālai.

Hiki ke hoʻonui i ke kaomi mai nā ʻōpū o kahi ʻōpū i hiki ke hoʻoliʻiliʻi i ke kahe o ke koko i nā ʻōpū a me nā puʻupaʻa. Hiki iā ia ke lilo i mea paʻakikī i ka pēpē e hoʻonui i nā ake māmā, e hiki ai i nā pilikia hanu.

ʻO kekahi pilikia hiki ke make ʻo bowros make nekrosis. Kū kēia i ka make ʻana o ke kino o ka ʻōpū ma muli o ke kahe o ke kahe o ke koko a i ʻole ka maʻi. Hiki ke hoʻemi ʻia kēia makaʻu i nā pēpē i loaʻa ka waiū umauma ma mua o ka hoʻopili.

ʻIke ʻia kēia ʻano i ka wā hānau a e ʻike ʻia i ka haukapila i ka wā hānau inā ʻaʻole i ʻike ʻia ma nā hōʻike ultrasound fetal maʻamau i ka wā hāpai. Inā ua hānau ʻoe ma ka home a loaʻa paha kāu pēpē i kēia kīnā, e kāhea koke i ka helu kūloko kūloko (e like me 911).

Kuhi ʻia kēia pilikia a mālama ʻia i ka haukapila i ka wā hānau. Ma hope o ka hoʻi ʻana i ka home, e kāhea i kāu kahu mālama inā loaʻa i kāu pēpē kekahi o kēia mau ʻōuli.

• Hoʻoemi i ka neʻe ʻana o ka ʻōpū
• Nā pilikia hānai
• Fiva
• ʻO ka luaʻi ʻōmaʻomaʻo ʻōmaʻomaʻo ʻōmaʻomaʻo paha
• Kahi ʻōpū pehu
• ʻO ka luaʻi (ʻokoʻa ma mua o ka kuha ʻana o ka pēpē maʻamau)
• Hoʻololi i nā ʻano hana Worrisome

Hānau hānau - gastroschisis; Kīnā o ka paia ʻōpū - pēpē; Kīnā o ka paia ʻōpū - neonate; Hapa kīnā o ka ʻōpū - hānau hou

• Hernia opu hernia (gastroschisis)
• Hoʻoponopono Gastroschisis - moʻo
• Silo

Nā hemahema Islam S. Congenital abdomen: gastroschisis a me omphalocele. I: Holcomb GW, Murphy P, St. Peter SD, eds. ʻO Holcomb a me Ashcraft's Pediatric Surgery. ʻEpekema 7 Piladelapia, PA: Elsevier; 2020: chap 48.

ʻO Walther AE, ʻo Nathan JD. Nā hemahema o ka paia ʻōpū hānau hou. I: Wyllie R, Hyams JS, Kay M, hua pā. Pediatric Gastrointestinal a me ka maʻi maʻi. 5th lā. Piladelapia, PA: Elsevier; 2016: chap 58.