Ma muli o ka huli ʻana o ka "manamana lima lima" o kahi ʻāpana o ka ʻōpū, hōʻailona ʻia ka intussusception e ka ʻeha ʻōpū. He kumu ia o ka ulia pōpilikia a me ke kaʻi ʻana i nā keiki liʻiliʻi, no ka mea, hiki iā ia ke ala i ka ʻōpū. I nā keiki ʻōpio a me nā mākua, hiki iā ia ke lawe i kahi ʻano maʻi a hōʻailona i ka hiki ʻana mai o kahi polyp a i ʻole kahi maʻi maʻi maʻi.

Definition

Hana ʻia ka intussusception (a i ʻole intussusception) i ka wā e huli ai kekahi ʻāpana o ka ʻōpū e like me ka mīkina lima a komo i loko o ka ʻāpana ʻōpū i lalo koke. Ma hope o kēia "telescoping", ʻo nā ʻaʻahu hoʻoheheʻe i hoʻokumu ʻia i ka paia o ka ʻāpana digestive e hui pū kekahi me kekahi, e hana ana i kahi ʻōwili invagination me ke poʻo a me ka ʻāʻī.

Hiki i ka intussusception ke hoʻopilikia i kēlā me kēia pae o ka ʻōpū ʻōpū. Eia naʻe, ʻeiwa o ka ʻumi, aia ia ma ke alahaka o ka ileum (ka ʻāpana hope o ka ʻōpū liʻiliʻi) a me ke kolonā.

ʻO ke ʻano maʻamau ʻo ia ka intussusception acute o ke pēpē, hiki ke alakaʻi koke i ke keakea a me ka hoʻopau ʻana i ke koko (ischemia), me ka pilikia o ka necrosis intestinal a i ʻole ka perforation.

I nā keiki ʻōpio a me nā mākua, aia nā ʻano intussusception ʻaʻole piha, mau a holomua paha.

Nā kumu

ʻO ka intussusception idiopathic acute, me ka ʻole o ke kumu i ʻike ʻia, hiki ke loaʻa i nā keiki liʻiliʻi olakino, akā i loko o kahi pōʻaiapili o ka maʻi viral a i ʻole ka maʻi ENT me ka hoʻoilo hoʻoilo i hoʻoulu ai i ka mumū o nā lymph nodes o ka ʻōpū.

Hoʻopili ʻia ka intussusception lua me ka loaʻa ʻana o kahi lesion ma ka paia o ka ʻōpū: kahi polyp nui, kahi maʻi maʻi maʻi, kahi diverticulum Merckel inflamed, a pēlā aku.

• rheumatoid purpura,
• lymphoma,
• ka maʻi hemolytic uremic,
• cystic fibrosis…

ʻO ka intussusception ma hope o ka hana ʻana he hoʻopiʻi ia o kekahi mau ʻoki ʻōpū.

PalekanaEND_LINK

Hoʻokumu ʻia ka maʻi ma muli o ke kiʻi kiʻi olakino. 

ʻO ka ultrasound abdominal ka hoʻokolokolo koho.

ʻO ka barium enema, kahi hōʻike x-ray o ke kolonā i hana ʻia ma hope o ka hoʻokomo ʻana i ka anal o kahi mea hoʻohālikelike (barium), ʻo ia ka maʻamau gula. ʻO nā enemas hydrostatic (ma ka hoʻokomo ʻana i ka solution barium a i ʻole saline) a i ʻole pneumatic (ma ka insufflation o ka ea) ma lalo o ka mana radiological ke hoʻohana ʻia nei e hōʻoia i ka maʻi. Loaʻa i kēia mau hoʻokolohua ka ʻae ʻana i ka manawa like i ka mālama mua ʻana i ka intussusception ma o ka hoʻolaha ʻana i ka hoʻololi ʻana o ka ʻāpana invaginated ma lalo o ke kaomi o ka enema.

Pili ka poʻe

Hoʻopilikia nui ʻia ka intussusception i nā keiki ma lalo o 2 mau makahiki o ka makahiki, me ka piʻi nui ʻana o nā pēpē mai 4 a 9 mau mahina. ʻOi aku ka pālua o nā keikikāne ma mua o nā kaikamahine. 

ʻO ka intussusception i nā keiki ma luna o 3-4 mau makahiki a ma nā pākeke he mea maʻalahi loa.

Nā mea pilikino

ʻO nā malformations congenital o ka gastrointestinal tract he predisposition paha.

Ua hōʻoia ʻia e kekahi mau noiʻi ʻana i kahi piʻi liʻiliʻi o ka pilikia o ka intussusception ma hope o ka hoʻokomo ʻia ʻana o kahi kano e kūʻē i nā maʻi rotavirus (Rotarix). Loaʻa kēia pilikia i loko o 7 mau lā ma hope o ka loaʻa ʻana o ke kano mua o ke kano.

I nā kamaliʻi, ʻeha ʻeha ʻeha loa, ʻo ka hoʻomaka koke ʻana, hōʻike ʻia e ka hopu ʻana i kekahi mau minuke. Haikea loa, uē ke keiki, uē, huhū… Hoʻokaʻawale ʻia i ka hoʻomaka ʻana e nā manawa o 15 a 20 mau minuke, ʻoi aku ka nui o ka hoʻouka ʻana. I loko o nā lulls, ʻike ʻia ke keiki me ka mālie a i ʻole ke kūlou a me ka hopohopo.

ʻIke koke ʻia ka luaʻi. Hōʻole ka pēpē i ka hānai ʻana, a ʻike ʻia ke koko i kekahi manawa i loko o ka waihona, e like me ka "gooseberry jelly" (ua hui ʻia ke koko me ka ʻōpū o ka ʻōpū). ʻO ka mea hope loa, ʻo ka hoʻōki ʻana i ka hele ʻana o ka ʻōpū e hoʻāla ai i ke keʻakeʻa o ka ʻōpū.

I nā keiki ʻoi aʻe a me nā mākua, ʻo nā hōʻailona ka nui o ke keʻakeʻa ʻana o ka ʻōpū, me ka ʻeha o ka ʻōpū a me ka hoʻopau ʻana o ka pehu a me ke kinoea.

I kekahi manawa, lilo ka pathology i mea maʻamau: intussusception, incomplete, hiki ke hoʻihoʻi iā ia iho a hōʻike ʻia ka ʻeha iā ia iho i nā episodes.

ʻO ka intussusception acute i nā pēpē he pilikia pediatric. He koʻikoʻi a make paha inā haʻalele ʻole ʻia ma muli o ka pilikia o ke keakea ʻana o ka ʻōpū a me ka necrosis, loaʻa ka prognosis maikaʻi loa ke mālama pono ʻia, me ka haʻahaʻa haʻahaʻa o ka hoʻi hou ʻana.

Kākoʻo honua

Pono e hoʻoponopono ʻia ka ʻeha pēpē a me ka pilikia o ka dehydration.

ʻEnema lāʻau lapaʻau

ʻEiwa mau manawa mai ka ʻumi, pneumatic a me hydrostatic enemas (e ʻike i ka ʻike) ua lawa ia e hoʻihoʻi i ka ʻāpana invaginated i kahi. ʻO ka hoʻi ʻana i ka home a me ka hoʻomaka ʻana o ka ʻai ʻana he wikiwiki loa.

ʻoki kino

I ka hopena o ka maʻi lohi, ka hemahema o ka enema a i ʻole contraindication (nā hōʻailona o ka huhū o ka peritoneum, a me nā mea ʻē aʻe).

Hiki ke hoemi lima o ka intussusception i kekahi manawa, ma ka hooikaika hope ana i ka opu a hiki i ka nalo ana o ka sausage.

Hiki ke hana ʻia ka ʻoki ʻoki ʻana o ka ʻāpana invaginated e ka laparotomy (ka hana maʻamau o ka ʻōpū o ka ʻōpū) a i ʻole ma ka laparoscopy (ke ʻoki hōʻemi liʻiliʻi i alakaʻi ʻia e ka endoscopy).

I ka hihia o ka intussusception i ke kula kiʻekiʻe i ka maʻi maʻi, pono e wehe ʻia kēia. Akā naʻe, ʻaʻole ia he pilikia i nā manawa a pau.