Hirschsprung ọrịa

Hirschsprung ọrịa na-ezo aka a malformation nke ekpe ọkara nke colon. Ọ e ji enweghị ganglion mkpụrụ ndụ na submucosal na intramuscular plexus. Hirschsprung ọrịa n'akparamagwa ụmụ ke ruru nke 1: 5000 ikpe. Na-eto eto, ọ na-na ole obere ugboro ugboro. Boys na-ata ahụhụ ugboro ise karịa ụmụ agbọghọ. N'ihi na nke a enweghị nchịkwa ọnọdụ ji ezinụlọ nketa. Mgbe ụfọdụ, ọrịa na-ejikọta ya na ọdịdị nke Down syndrome. Na okenye Hirschsprung ọrịa na-adị mgbe ọnọdụ orunótu na anorectal mpaghara. Na oké ikpe, ọ nwere ike na-agbasa na distal obere eriri afọ.

Na pathogenesis nke ọrịa na-arụ ọrụ dị mkpa na-enweghị mmetụta nke parasympathetic nkewa nke ụjọ usoro. The N'ihi nke a ọnọdụ bụ oge esịtidem sphincter ntụrụndụ ikensi, nke na-eduga a na-adịgide adịgide Mbelata ke spastic, mgbochi nke peristalsis, na mmụba nke hypertrophy. Clinically ọrịa na-egosipụta a ọnọdụ na a maara dị ka megacolon.

Hirschsprung ọrịa nwere ike ime na a ụgwọ atụrụ, decompensated subcompensated na udi. Ogo-enweghị nchịkwa na ọnọdụ na-adabere na anglionarnogo òkè ogologo. Decompensated ụdị na gosipụtara oké mgbaàmà nke ileus.

E ji mara atụmatụ nke ọrịa na-ufiop mgbu, bloating, ụzụ afo, afọ ntachi. Igbu oge nke oche nwere a-adịghị ala ala N'ezie (na ụfọdụ ruo a ọnwa). Bloating bụkwa a mgbe nile mma nke ọrịa, bụ arọ na nwere ike ime ka ike na-eku ume nwa. Bloating-anọgide na ọbụna mgbe a bowel ije na-enyemaka nke enemas. Esi na ya pụta nwere ike na-akpọ onye ahụ nke na-ufiop mgbu. Isi mgbaàmà nke ọrịa na-mmasị ọgbụgbọ, vomiting, adịghị ike, agụụ arịa ọrịa. Nsogbu nke a enweghị nchịkwa ọnọdụ bụ anaemia, deformation nke akara angles. Ọnụnọ nke mbufụt, mmerụ ahụ, goiter nwere ike inye ịrị elu persistent afọ ọsịsa na-eme ka ike ọgwụgwụ, collaptoid ala.

Diagnosis Hirschsprung ọrịa amalite na a visual nnyocha. Omume ya na-abawanye na afo ruru ka mgbe nile ọzịza, peristaltic contractions nke emetụta eriri afọ, oké stool. Na-agbanwe agbanwe mkpi nke gbasara ike sphincter kpebisiri ike site digital nyochaa. Fluoroscopy ziri ezi na-enye a pụtara ezi pụta. Akara mgbanwe nsia ụkpụrụ n'ihi ọnụnọ nke ịrịba ichekwa, haruru na-eme ka ihe mgbochi. Na ọzọ instrumental ụzọ na-eji maka nchoputa nke enweghị nchịkwa ọnọdụ ndị colonoscopy, barium enema. Nke ikpeazụ a na-eji na-ekpebi ókè na orunótu nke constriction n'obosara suprastenoticheskoy colon ebe.

Iji nyochaa nchoputa na-eji transanal biopsy. Mbenata neuronal ganglia intermuscular plexus bụ a mma na-egosi Hirschsprung ọrịa. N'oge na-arụ ọrụ, usoro a na-enyere aka na-ekpebi na ọkwa nke resection.

Ọgwụgwọ nke ọrịa na-adabere na ogo ya N'ezie. Ụgwọ atụrụ forms ike iwepụ site mgbanwe ụzọ nke ọgwụ, na ndị ọzọ na-achọ ngwa ngwa ịwa ahụ aka, bụ nke a wetara kolonostomy, wepụ aganglionarnoy ebe, decompensated, overextension eriri afọ nke nnukwu. Enwe mgbe ekenịmde ọgwụgwọ na-abịa na-anọ percent.