Ledd Syndrome: Bayyanar cututtuka, Jiyya

A m yanayin hade da wani mahaukaci matsayi na duodenum, makãho da mai midgut, kira ciwo Ledd. Bisa ga abin da sharudda ƙayyade gaban a jikin wannan cuta, da kuma abin da hanyoyin da ake shiryar da a cikin ta magani - tare da wannan tambaya za mu bincika a wannan labarin.

Ledd ciwo

A anomaly na hanji juyawa, wanda aka kafa a lokacin fetal ci gaba (yawanci 10-12 makonni) da kuma shi ne mai matsawa na duodenum da cecum volvulus na midgut, yana da wani sunan - Ledd ciwo.

ICD-10 - da na kowa rarrabuwa na coding likita diagnoses ci gaba da WHO. A daidai da wannan International Nau'in Cututtuka 10th bita Ledd ciwo yana nufin cututtuka na narkewa kamar gabobin (aji XI). Pathological yanayin ba ya faruwa more sau da yawa fiye da a daya hali ta 500 jarirai da kuma yara maza da irin wannan ganewar asali ne biyu sau fiye da sau da yawa fiye da 'yan mata.

Yawanci, da ganewar asali da aka kafa a cikin makon farko na rayuwa kadan haƙuri, kadan kasa - a watan farko na rayuwa. Domin gudanar da wani daidai ganewar asali daga wani pediatrician bukatar kwarewa da kuma m saba da cutar. A wannan batun, cutar ba a ko da yaushe gano a dace hanya. A mafi bayyananne alamar cuta a farkon zamanin na rayuwa ne amai bile.

Abin baƙin ciki, mai tsanani daga cikin haƙuri da irin wannan cuta da yanayin da za a iya aggravated rakiyar nakasar, kamar:

• hypoplastic kodan ko huhu.
• cututtukan zuciya.
• na huhu stenosis da sauransu.

Ledd ciwo a manya ne musamman rare. Hanji toshewa iya zama sakamakon da motsi na da cecum, kuma adhesions a cikin kogon ciki. Wani lokacin samuwar hernia Pathology tsokani agara na ciki bango. Ba kalla a cikin abubuwan da shafi samuwar cutar a jihar, wasa benign kuma m marurai na daban-daban sassan na wani hanji.

Bayyanar cututtuka da cutar

Ledd ciwo a jarirai iya tabbatar da cututtuka m. Bugu da kari ga amai da regurgitation na bile a jarirai lokaci-lokaci sa jin zafi a ciki. A wasu lokuta, komowan cutar faruwa, abu don m hanji toshewa tare da tabarbarewar, har zuwa yaro ta yanayin collaptoid.

Janar cututtuka na ciwo:

• paroxysmal zafi.
• jinkiri stool, flatulence.
• amai.
• kumburi daga cikin epigastric yankin .
• karyata daga cikin ƙananan ciki.
• palpation ba samar da cikakken bayanai game da haƙuri da yanayin.

Radiography ciki nuna biyu ruwa matakin a ciki da kuma duodenum, kuma ma a kananan adadin gas a cikin hanji. Idan a lokacin hanya amfani barium sulfate, sakamakon ya nuna jari na bambanci matsakaici a miƙa ciki da kuma duodenum. Bambanci da wannan tare da ko'ina rarraba madaukai na kananan hanji.

Ergography yawanci bayyana kam na cecum da hanta. Amma yin amfani da lissafta tomography inversion ne a tsare midgut kusa mesenteric jijiya.

asibiti hoto

Ledd ciwo - a Pathology cewa bukatar nan da nan m baki. Kamar yadda aka ambata a baya, da cututtuka su ne m, kuma za a iya maimaita a kan jinkiri na kwanaki da dama, makonni ko ma shekaru.

A wasu lokuta, da cutar a jihar da aka ba yin kanta ji har shekaru da yawa da suke asymptomatic. Yara kamar haka fama da asarar ci, ana lagging a baya a jiki ci gaba.

Bugu da kari ga gargajiya ciwo Ledd, kara bambanta biyu siffofin:

1. A cikin farko idan akwai wani inversion na midgut, da kuma wani anomalous wuri na cecum, wanda compresses da duodenum.
2. A karo na biyu idan mun kawai ware midgut volvulus.

A lokacin Pathology (Ledd ciwo) na iya zama m, kuma subacute (na kullum). A kullum form akwai ba su furta zafi a ciki, kamar colic, wani lokacin akwai amai, ciwon tamowa. A take hakkin a kujera. The yaro ta yanayin da aka bayyana a matsayin mai gamsarwa. Ciwon volvulus ba ya haifar da wani warwarewarsu ta jini wadata. A cikin kananan hanji jijiyoyinmu kawai jini stasis auku a cikin gastrointestinal fili akwai amsawa canje-canje.

M hanji volvulus - mai tsanani yanayin da cewa a cikin hali na fi karfinsu kwarara manyan zuwa necrosis ko gangrene na hanji.

Jiyya na ciwo Ledd

Inganta harkokin haƙuri da kullum-relapsing cuta Hakika sa da yin amfani da antispasmodic jamiái. Duk da haka, wannan shi ne kawai ta wucin gadi gwargwado. Babban hanya da magani daga hanji toshewa ne har yanzu tiyata. M magani daga pathologies (Ledd ciwo) kunshi dama matakai:

1. Da farko shafe volvulus kuma mai shãmakacẽwa.
2. Bugu da ari, kananan hanji yana da wani ciki a dama sassan, m - hagu.
3. Idan kana bukatar gyara da hanji madaukai a cikin parietal peritoneum, yin wannan magudi. Irin wannan ma'auni ne da ake bukata idan haƙuri yana da mahaukaci hanji motility.
4. Yi wani appendectomy.

A cikin 'yan shekaru, magani yadu amfani laparoscopic hanyoyin bincike da kuma lura da ciwo. Irin wannan mini-cin zali dabaru ne sosai tasiri. Duk da haka, m baki a irin wannan hanya batun wasu matsaloli saboda da karamin girma daga cikin kogon ciki, kazalika da kananan kauri daga cikin ciki bango a yara a lokacin farko da watanni na rayuwa. Wani lokaci a farkon postoperative zamani, da rikitarwa bayyana:

• sepsis.
• peritonitis.
• hanji zub da jini;
• ileus.

A chances wani cikakken maida zai dogara ne a kan sakamakon da aiki. Idan ajiye duk yankuna na gastrointestinal fili, da untuk babban matakin ingancin rayuwa shi ne m. Idan, duk da haka, akwai lokatan gagarumin hanji resection, manyan ga ciwo na "short Gut" haƙuri yana da matsaloli tare da cin da tamowa. Lokacin da wadannan sakamakon m magani aka yi mahara asibiti domin dalilai na parenteral abinci mai gina jiki. Wani lokaci marasa lafiya suna zuwa maimaita aiki. Idan ileus raya kan bango na cystic fibrosis, warke wani unfavorable hangen nesa.

preoperative shiri

Da zarar kamu kamar yadda neonatal hanji toshewa (Ledd ciwo), shi ne canjawa wuri zuwa wani m asibiti, gudanar nasogastric tube da kuma samar da wani m magudana ciki abinda ke ciki. A lokacin da ake bukata don yin preoperative shiri matakan dogara da tsananin nakasar da hanji mai shãmakacẽwa.

Idan wani haƙuri ana zargin kananan hanji volvulus, yi da wadannan bincike matakan:

• wani jini gwajin ga kungiyar da kuma RH factor.
• wani jini gwajin ga matakan haemoglobin da hematocrit.
• bincike a kan jini coagulation.

M magani aka yi a kan gaggawa akai, preoperative shiri daukan a kalla sa'a daya. The yaro kwashe jiko far, an gudanar hemostatics, analgesics, wani lokacin samun iska. A catheter aka gabatar a cikin wani tsakiyar jannayẽnsa.

A cikin hali na low ileus preoperative shiri iya daukar har zuwa 24 hours. A wannan lokaci jariri kara nazari tare da wani ra'ayi da zai yiwu ganewa na comorbidities. Kamar wancan aiki na ciki da magudanun ruwa, hada da adadin kasaftawa talakawa wajabta jiko far, maganin rigakafi da kuma hemostatic jamiái. jariri ciyar mulki.

Mai yara a cikin postoperative zamani ciyar shafe tsawon inji iska, wanda zai iya wuce har zuwa kwanaki biyar. Kwayoyin far amfani da kwayoyi aiki da anaerobic kwayoyin. Microecological matsayi duba a kalla sau biyu a mako. Ashirin da hudu bayan tiyata da magani don inganta hanji motility, kazalika da biologics.