ʻO Gastrointestinal Fistula

Anter

• Nā ʻano GIF
• 1. Fistula ʻōpū
• 2. Fistula keu
• 3. ʻO fistula waho
• 4. Pākuʻi paʻakikī
• Nā Kumu o kahi GIF
• Nā pilikia ʻoki kino
• Hoʻonohonoho GIF kūlohelohe
• Trauma
• Nā ʻōuli a me nā pilikia o kahi GIF
• I ka manawa e ʻike ai i ke kauka
• ʻO ka hoʻāʻo a me ka hōʻailona
• Ka mālama ʻana i kahi GIF
• Nānā wā lōʻihi

He aha ka fistula gastrointestinal?

ʻO ka gastristestinal fistula (GIF) kahi wehe kīnā ʻole i kāu wahi digestive e hiki ai i nā wai ʻōpū ke komo i loko o ka pale o kou ʻōpū a i ʻole nā ​​ʻōpū. Hiki i kēia ke hopena i ka maʻi i ke kulu ʻana o kēia mau wai i kou ʻili a i ʻole nā ​​mea ʻē aʻe.

Hana ʻia ʻo GIF ma hope o ke kaha ʻōpū o ka ʻōpū, ʻo ia ka ʻoki o loko o kou ʻōpū. ʻO ka poʻe me nā pilikia kūpilikiʻi mau me ka makaʻu nui i ka hoʻomohala ʻana i kahi fistula.

Nā ʻano GIF

ʻEhā ʻano nui o nā GIF:

1. Fistula ʻōpū

I loko o ka fistula ʻōpū, kahe ka wai o ka ʻōpū mai kekahi ʻaoʻao o ka ʻōpū a i kahi ʻē aʻe kahi e pili ai nā pā. ʻIke ʻia kēia ma ke ʻano he "gut-to-gut" fistula.

2. Fistula keu

Hana ʻia kēia ʻano fistula ke kahe mai ka wai o ke ʻōpū mai kou ʻōpū i kāu mau mea ʻē aʻe, e like me kou ʻōpū, nā māmā, a me nā ʻōnaehana vascular.

3. ʻO fistula waho

I loko o kahi fistula kūwaho, e kahe ana ka wai kōpū ma loko o ka ʻili. ʻIke ʻia ia ma ke ʻano he "ciste fistula."

4. Pākuʻi paʻakikī

ʻO kahi fistula paʻakikī kahi e hiki mai i nā mea ʻoi aku ma mua o hoʻokahi.

Nā Kumu o kahi GIF

Nui nā kumu like ʻole o GIF. Pākuʻi ʻia lākou:

Nā pilikia ʻoki kino

Ma kahi o 85 a 90 pākēneka o nā GIF e hoʻomōhala ana ma hope o ka ʻōpū o ka ʻōpū. E hoʻolālā paha ʻoe i kahi fistula inā loaʻa iā ʻoe:

• maʻi ʻaʻai
• ka hoʻomaʻamaʻa radiation i kou ʻōpū
• he keakea opu
• pilikia pilikia suture
• pilikia pilikia kahua paʻa
• he abscess
• he maʻi maʻi
• kahi hematoma, a i ʻole ke koko i lalo o kou ʻili
• he tumo
• hana maikaʻi ʻole

Hoʻonohonoho GIF kūlohelohe

Hana ʻia kahi GIF me ke kumu ʻole i ʻike ʻia ma kahi o 15 a 25 pakeneka o nā hihia. Kāhea ʻia kēia mea he hoʻokumu wale.

Hiki i nā maʻi ʻōpala ke hoʻoulu, e like me ka maʻi o Crohn, ke hana i nā GIF. ʻO ka poʻe a pau me ka maʻi o Crohn e hoʻomohala i kahi fistula i kekahi manawa i ko lākou ola. ʻO nā maʻi bowel, e like me diverticulitis, a me ka lawa ʻole o ke kīpē (lawa ʻole ke kahe o ke koko) kekahi kumu ʻē aʻe.

Trauma

ʻO ka hōʻeha kino, e like me ka pū kī a i nā ʻeha pahi e komo i loko o ka ʻōpū, hiki ke hoʻokumu i kahi GIF e ulu. Kākaʻikahi kēia.

Nā ʻōuli a me nā pilikia o kahi GIF

E ʻokoʻa kāu mau ʻōuli ke hilinaʻi inā loaʻa iā ʻoe kahi fistula o loko a i waho paha.

Hoʻokumu nā fistula kūwaho i waho o ka ʻili. Hele pū lākou me nā ʻōuli ʻē aʻe, e like me:

• abdominal eha
• keakea i ka ʻōpū ʻeha
• fiva
• helu kiʻekiʻe keʻokeʻo o ke koko

ʻO ka poʻe i loaʻa nā fistula o loko e ʻike paha:

• pāhoehoe
• hoʻokahe kahe
• kahi maʻi koko a sepsis paha
• maikaʻi ʻole ka lawe ʻana i nā meaʻai a me ka pohō kaumaha
• hoʻomake wai
• ke kaumaha o ka maʻi kumu

ʻO ka paʻakikī koʻikoʻi o GIF ka sepsis, kahi pilikia olakino kahi e pane ai ke kino i nā bacteria. Hiki i kēia ʻano ke alakaʻi i ke kahe o ke koko haʻahaʻa, weliweli a me ka make.

I ka manawa e ʻike ai i ke kauka

Kāhea aku i kāu kauka inā ʻike ʻoe i kekahi o kēia mau ʻōuli ma hope o ke kahakaha ʻana:

• kahi hoʻololi nui i kāu mau ʻōpū
• ʻōpū nui loa
• kahe o ke kahe mai kahi hāmama i loko o kou ʻōpū a i ʻole kokoke i kou anus
• ʻeha ʻeha o ka ʻōpū

ʻO ka hoʻāʻo a me ka hōʻailona

E nānā mua kāu kauka i kāu mōʻaukala a me kāu mōʻaukala a e nānā i kāu mau hōʻailona o kēia manawa. Holo paha lākou i nā hoʻokolohua koko e kōkua i ke koho ʻana i kahi GIF.

E nānā pinepine kēia mau ho'āʻo koko i kāu mau electrolytes serum a me ke kūlana nutritional, kahi ana o kāu pae o albumin a me pre-albumin. ʻO kēia nā protein āpau i koʻikoʻi i ka hōʻeha ʻana i ka ʻeha.

Inā kūwaho ka fistula, hiki i ka hoʻokuʻu ke hoʻouna ʻia i kahi hale hana no ka loiloi. Hana ʻia kahi fistulogram e ka hoʻopili ʻana i ka pena ʻokoʻa i loko o ka wehe o kou ʻili a lawe i nā kukuna X.

ʻOi aku ka paʻakikī ke loaʻa ʻana o nā fistula o loko. E holo paha kāu kauka i kēia mau hoʻokolohua:

• ʻO kahi endoscopy o luna a me lalo e pili ana i ka hoʻohana ʻana o kahi Tube lahilahi, maʻalahi me kahi kāmela i hoʻopili ʻia. Hoʻohana ʻia kēia e ʻike i nā pilikia i hiki i kāu digestive a i ʻole gastrointestinal tract. Kāhea ʻia ke kāmela ʻo endoscope.
• Hiki ke hoʻohana ʻia ka radiography ʻōpū o luna a me lalo me ka waena waena. Hiki i kēia ke hoʻopili i kahi barium e ale inā manaʻo kāu kauka he ʻōpū a i ʻole fistula ʻōpū kou. Hiki ke hoʻohana ʻia kahi barium enema inā manaʻo kāu kauka he fistula kolone kāu.
• Hiki ke hoʻohana ʻia kahi ultrasound a i ʻole CT scan e ʻike i nā fistula ʻōpū a i ʻole nā ​​wahi i hūnā ʻia.
• Hoʻopili kahi fistulogram i ka pena ʻana i kahi kala ʻokoʻa i ka wehe o kou ʻili i kahi fistula waho a laila lawe i nā kiʻi X-ray.

No kahi fistula e pili ana i nā kahe nui o kou ake a i ʻole pancreas, hiki i kāu kauka ke kauoha i kahi hoʻokolohua kiʻi kūikawā i kapa ʻia he magnetic resonance cholangiopancreatography.

Ka mālama ʻana i kahi GIF

E nānā pono kāu kauka i kāu fistula e hoʻoholo i ka likelike o ka pani ʻana iā ia iho.

Hoʻokaʻawale ʻia nā fistula ma muli o ka nui o ka wai o ke gastric e kolo ana ma o ka wehe. Hana nā fistula puka haʻahaʻa ma lalo o 200 milliliter (mL) o ka wai ʻōpū i kēlā me kēia lā. Hana nā fistula kiʻekiʻe ma kahi o 500 mL i kēlā me kēia lā.

Kū kekahi mau ʻano fistula iā lākou iho ke:

• kaohi kou maʻi
• ʻoluʻolu kou kino i ka nui o ka momona
• maikaʻi kou olakino holoʻokoʻa
• ʻo kahi liʻiliʻi wale nō o ka wai kōpū e hiki mai ana ma ka wehe

E kau ka lāʻau i ka mālama ʻana iā ʻoe i ka meaʻai a me ka pale ʻana i ka maʻi ʻeha inā manaʻo ʻoe kauka e pani paha kāu fistula iā ia iho.

Hiki i nā mālama ke hoʻopili:

• hoʻopiha hou ʻana i kāu wai
• ke hoʻoponopono nei i kāu electrolytes serum
• normalizing i kahi waikawa a me ke kaulike kumu
• e hoʻemi ana i ka hopena o ka wai mai kāu fistula
• ka mālama ʻana i ka maʻi a me ka pale ʻana i nā sepsis
• ka pale ʻana i kou ʻili a me ka mālama ʻana i ka ʻeha mau ʻana

Hiki i ka mālama ʻana i GIF ke hala i mau pule a i ʻole mau mahina.Hiki i kāu kauka ke koi aku i ka pani ʻana i kāu fistula inā ʻaʻole ʻoe i hoʻomaikaʻi ma hope o ʻekolu a ʻeono paha mahina o ka mālama ʻana.

Nānā wā lōʻihi

Pani ʻo Fistula iā lākou iho ma kahi o 25 pākēneka o ka manawa me ka ʻole o ke kaha ʻana i ka poʻe i olakino ʻole a ke hana ʻia nā wai liʻiliʻi o ka gastric.

Hoʻomohala pinepine ka GIF ma hope o ke ʻōpū o ka ʻōpū a i ʻole he hopena o nā maʻi digestive mau. E kamaʻilio me kāu kauka e pili ana i kāu mau pilikia a pehea e ʻike ai i nā ʻōuli o kahi fistula e ulu nei.