Ledd Syndrome: Iimpawu, Treatment

A kubuhlungu ezinxulumene ne indawo engaqhelekanga le duodenum, iimfama midgut, ekuthiwa syndrome Ledd. Ngokutsho koko imimiselo ukufumanisa ubukho emzimbeni kwesi sifo, yaye iindlela guided kunyango kuyo - kunye lo mbuzo siza kuphanda kweli nqaku.

Ledd syndrome

Le anomaly of ujikelezo isisu, oluthi luqokelelane ngexesha kuphuhliso ezingekazalwa (ngokuqhelekileyo 10-12 iiveki) kwaye ucinezelo le duodenum ukuya cecum volvulus le midgut, unalo igama ethile - Ledd syndrome.

ICD-10 - kucalulo eqhelekileyo ikhowudi yaphuhliswa WHO iSifo zonyango. Ngokuhambelana kunye nale Diseases Classification International uhlaziyo 10 Ledd syndrome ibhekisa izifo ngokwamalungu zokugaya (udidi XI). imeko yezifo akwenzeki rhoqo ngaphezu kunokwenzeka enye iintsana 500 kunye namakhwenkwe loo uphethwe izihlandlo ezibini kaninzi ngaphezu amantombazana.

Ngokuqhelekileyo, uxilongo lusekiwe kwiveki yokuqala yobomi isigulana kancinane, ngaphantsi kancinci - ngenyanga yokuqala yobomi. Ukwenza ukuxilongwa echanekileyo evela wabantwana kufuna amava kunye nolwazi olunzulu kunye sifo. Kulo mba, esi sifo akusoloko kubonakele ngexesha elifanelekileyo. Umqondiso ecaca izifo ngemihla yokuqala yobomi ngohlangothi inyongo.

Ngelishwa, le meko, ze isigulane kunye imeko isifo ezo mandundu naso ezihamba, ezifana:

• izintso hypoplastic okanye nemiphunga;
• nesifo sentliziyo;
• stenosis yemiphunga kunye nabanye.

Ledd syndrome abadala kunqabile kakhulu. emathunjini inokuba sisiphumo nokushukumisa cecum, kunye azikhuli kwi kwisisu. Ngamanye amaxesha ukubunjwa Ithemba ngezifo wavusa udonga sobuKristu esiswini. Not ubuncinane phakathi imiba echaphazela lokusekwa karhulumente sifo, kudlala nangezilonda ebubonisayo nesibuhlungu kumasebe okanye emathunjini.

Iimpawu zesi sifo

Ledd sifo ngo kuzalwa ngazo iimpawu ezingazinzanga. Ukongeza ukugabha kunye regurgitation of inyongo kwiintsana ebangela amaxesha iintlungu esiswini. Kwezinye iimeko, likakade zenzeka, okukhokelela etsolo emathunjini kunye ukonakala, ukuya collaptoid imeko yomntwana.

Iimpawu Jikelele syndrome:

• ubuhlungu paroxysmal;
• isitulo zezi-, flatulence;
• ukuphalaza;
• iindumbisa kummandla epigastric ;
• kwaziswa kwe osesiswini;
• Ngokucofa ayiboneleli ngolwazi epheleleyo malunga imeko yesigulane.

Ray isisu kubonisa inqanaba ezimbini ulwelo esiswini kunye duodenum, kananjalo imali encinane serhasi emathunjini. Ukuba ngexesha inkqubo esetyenzisiweyo barium sulfate, umphumo ibonisa zokwanda koko medium esiswini wazolula kunye duodenum. Thelekisa oku kunye ephambuka ngokulinganayo bahambisa emathunjini amancinci.

Ergography ngokuqhelekileyo utyhila nenkanuko yalo cecum sisibindi. Kodwa usebenzisa ngekhompyutha Itomography inversion yi midgut echazwe ngeenxa umthambo mesenteric.

picture clinical

Ledd syndrome - a ngezifo efuna ukungenelela yotyando. Njengoko kuchaziwe ngaphambili, iimpawu ezingazinzanga kwaye kuphindwa emva kwesithuba seentsuku ezininzi, iiveki okanye iminyaka.

Kwezinye iimeko, urhulumente sifo ukuba iyazibonakalisa ngayo iminyaka emininzi yaye nazimpawu. ngaloo ndlela abantwana bagula kulahlekelwa wokutya, kuba usesemva emva kuphuhliso ngokwasemzimbeni.

Ukongeza syndrome classical Ledd, ngakumbi ukwahlula iifom ezimbini:

1. Kwimeko yokuqala akukho inversion le midgut, kunye nendawo anomalous le cecum, leyo Oluma lo duodenum.
2. Kwimeko yesibini siye bodwa kuphela midgut volvulus.

Ngexesha kwezimilo (Ledd syndrome) kusenokuba etsolo kunye subacute (chronic). Kule fomu ezigulo ezondeleyo akukho kugqame iintlungu esiswini, ezifana nale, maxa wambi kukho ukugabha, ukungondleki. Yokunyhashwa esitulweni. imeko yomntwana uchazwa ngokwanelisayo. Ikholoni volvulus ingakhokeleli nokwaphulwa yonikezelo layo igazi. Ngemithambo emathunjini amancinci kuphela stasis igazi lwenzeka kwi phecana zesisu kukho utshintsho izidubuli.

Acute yangasese volvulus - isimo esibi ukuba kwimeko yokumpompoza ezimbi ezikhokelela necrosis okanye njengesilonda yethumbu.

Unyango lwe syndrome Ledd

Phucula isigulane iyonke chronic-relapsing ikhosi sifo yenza ukusetyenziswa arhente antispasmodic. Nangona kunjalo, lo ngumlinganiselo wexeshana kuphela. Inkqubo kuzo ukunyanga emathunjini isekhona uqhaqho. unyango zoqhaqho ezimbi (Ledd syndrome) iqulathe amanyathelo aliqela:

1. Ekuqaleni bayiyeka volvulus kunye kokuphazanyiswa.
2. Ngaphezu koko, amathumbu amancinane uba isisu kumasebe ekunene, ubukhulu - ekhohlo.
3. Ukuba ufuna ukulungisa ephambuka wamathumbu ngaphakathi peritoneum Parietal, wenze le ukuxhaphaza. Loo umlinganiselo kufuneka ukuba ogulayo okungaqhelekanga kwamathumbu motility.
4. Wenza i appendectomy.

Kwiminyaka yakutshanje, amayeza ngokubanzi kusetyenziswa iindlela laparoscopy loxilongo kunye nonyango lwe onaso. Loo mini-invasive iindlela zisebenza kakhulu. Noko ke, ngoncedo zoqhaqho ngendlela kwisifundo efanayo kwiingxaki ezithile ngenxa umqulu encinane kwisisu, kwakunye Ebubanzini encinane eludongeni esiswini ebantwaneni ngexesha kwiinyanga zokuqala zobomi. Ngamanye amaxesha kwixesha ekuqaleni postoperative, iingxaki kuvela:

• nokudumba;
• peritonitis;
• ukopha isisu;
• ileus.

Amathuba bachache ngokupheleleyo iya kuxhomekeka kwisiphumo yokusebenza. Ukuba nisindiswe yonke imimandla iphecana zesisu, uqikelelo ukwenzela inqanaba eliphezulu umgangatho wobomi sisihle. Ukuba, ke, kuye kwaba resection ebonakalayo isisu, ekhokelela onaso of "amathumbu elifutshane 'ogulayo iingxaki ngokudla kunye nokungondleki. Xa ezi ziphumo unyango ngotyando luyenziwa hospitalizations ezininzi ngeenjongo ngesondlo parenteral. Ngamanye amaxesha izigulane ezayo imisebenzi ngokuphindaphindiweyo. Ukuba ileus kujongwe nentsukaphi abanesigulo esinganyangekiyo, ukuba ukubuyisa i-ALS esibi.

ukulungiselela ipreoperative

Xa une lweentsana emathunjini (Ledd syndrome), ke wasiwa esibhedlele ngotyando, elawulwa tube nasogastric kwaye zinika imixholo rhoqo idreyini isisu. Ixesha elifunekayo ukwenza amanyathelo ipreoperative yamalungiselelo kuxhomekeke ebukhulwini kwimiqobo naso emathunjini.

Ukuba isigulane kurhanelwa volvulus namathumbu amancinci, enze amanyathelo diagnostic ilandelayo:

• uvavanyo igazi leqela kunye RH factor;
• uvavanyo igazi amanqanaba mpilo kunye hematocrit;
• uhlalutyo on coagulation igazi.

unyango kuhlinzwa kuyinto eyenziwa qho ngexesha likaxakeka, ukulungiselela ipreoperative ithabatha ubuninzi ngeyure enye. I yenziwa umntwana unyango iimela, hemostatics elawulwa, analgesics, maxa wambi umoya. Le catheter yaziswa emthanjeni engundoqo.

Kwimeko ileus eliphantsi ukulungiselela ipreoperative ingathatha ukuya kwiiyure ezingama-24. Ngeli xesha ke usana ndandiqhubeka ngenjongo ekuchongweni comorbidities kunokwenzeka. Ngaloo ndlela zisebenza sokuhambisa esiswini, iquka isixa izihlwele ezabelwe emiselweyo unyango iimela, elwa arhente hemostatic. ulawulo yokondla usana.

abantwana abaninzi kwixesha postoperative tirhisa umoya elide ngomatshini, leyo ungatsala ukuya kwiintsuku ezintlanu. unyango zintsholongwane usebenzisa amachiza asebenzayo ngokuchasene iintsholongwane anaerobic. Microecological status monitor ubuncinane kabini ngeveki. iiyure ezingamashumi amabini anesine emva kotyando ngamayeza ukuphucula motility isisu, kwakunye biologics.