Imedian arcuate ligament syndrome (MALS)

Imedian arcuate ligament syndrome (MALS)

By Uhlaziyo lweMedia; Ukuhlaziywa ngu-Varixcare.cz. Igqityelwe ukuvuselelwa ngo-Disemba 4, 2020.

Ushwankathelo

Umxholo ovela kwikliniki yaseMayo

I-median arcuate ligament syndrome (i-MALS) yenzeka xa ibhanti ebunjiweyo ye-arc kwindawo yesifuba (i-median arcuate ligament) icinezela, okanye imigibe, umthambo onika igazi kumalungu akwisisu sakho esingasentla (umthambo we-celiac).

Indawo ye-median arcuate ligament kunye ne-celiac artery iyahluka kancinci ukusuka komnye umntu ukuya komnye. Ngokwesiqhelo, i-ligament ibaleka inqanawa yegazi enkulu emzimbeni (aorta) kwaye ihleli ngaphezulu komthambo we-celiac ngaphandle kokubangela iingxaki. Kodwa ngamanye amaxesha i-ligament okanye i-artery inokuba ingekho ndawo, ibangele i-MALS. I-ligament inokubeka uxinzelelo kwinethiwekhi ye-nerves ejikeleze i-celiac artery (celiac plexus).



I-MALS inokwenzeka nakubani na, nkqu nakubantwana. Amanye amagama eMALS ngala:

  • Ukucinezelwa kwemithambo yeCeliac
  • Celiac axis syndrome
  • Isifo seDunbar

Unyango lubandakanya utyando ukukhupha (i-decompress) i-ligament kunye nokubuyisela ukuphuma kwegazi kwimithambo.

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Iimpawu

Rhoqo, uxinzelelo lomthambo we-celiac awubangeli zimpawu.

Nangona kunjalo, abo bane-MALS banokuba neentlungu zesisu zexesha elide (ezingapheliyo). Iimpawu kunye neempawu ze-MALS zibandakanya:

ngaphaya kwepenicillin yekhawuntari
  • Ubuhlungu kwindawo ephezulu yesisu esisemgangathweni, enokuthi ihambe xa uncike phambili
  • Intlungu yesisu emva kokutya, ukwenza umthambo okanye ukutshintsha komzimba
  • Uloyiko lokutya ukutya ngenxa yeentlungu, ezikhokelela ekulahlekelweni kwesisindo esibalulekileyo- zihlala zikhulu kuneepawundi ezingama-20 (9.1 kilograms)
  • Ukuqhawula
  • Isicaphucaphu nokugabha
  • Urhudo

Ugqirha wakho unokuva isandi esingaqhelekanga esibizwa ngokuba yi-bruit xa umamele indawo yakho ephezulu yesisu nge-stethoscope. Isandi senzeka xa umthambo wegazi uvalekile okanye unciphile.

Nini ukubona ugqirha

Zininzi izizathu ezibangela iintlungu zesisu. Ukuba unentlungu esiswini eqhubekayo ngaphandle kononophelo lwasekhaya, tsalela ugqirha wakho. Uya kudinga uvavanyo olupheleleyo lomzimba kunye neemvavanyo ukumisela unobangela othile.

Ukuba isisu sakho sinzima kwaye umsebenzi okanye intshukumo iyenza mandundu, tsalela ugqirha kwangoko. Funa uncedo lwangoko lwezonyango ukuba isisu sakho sivela kunye nezinye malunga neempawu, kubandakanya:

  • Izitulo zegazi
  • Ifiva
  • Isihlunu kunye nokuhlanza okungapheliyo
  • Ukuthantamisa okukhulu xa uchukumisa indawo yesisu sakho
  • Ukudumba kwendawo esiswini
  • Ukuluhlaza kwesikhumba okanye abamhlophe bamehlo (i-jaundice)

Ngamanye amaxesha iintlungu eziphezulu zesisu zinokudideka kunye nesifuba. Fumana uncedo olungxamisekileyo okanye utsalele umnxeba ku-911 ukuba unesifuba okanye iintlungu zesisu kunye okanye ngaphandle kwezi mpawu zilandelayo, ezinokuthi zibonakalise isifo sentliziyo.

  • Uxinzelelo, ukugcwala okanye ukuqina esifubeni sakho
  • Ukutyumza okanye ukuqaqambisa iintlungu ezisasazeka emhlathini, entanyeni, emagxeni, nakwenye ingalo zombini
  • Intlungu ehlala ngaphezulu kwemizuzu embalwa okanye iba mandundu ngomsebenzi
  • Ukubila okubandayo
  • Ukuba nesiyezi okanye ubuthathaka
  • Isihlunu okanye ukugabha
  • Ukuqhawukelwa ngumphefumlo

Oonobangela

Oogqirha abaqinisekanga ukuba yintoni ebangela i-median arcuate ligament syndrome. Unobangela kunye nokuchongwa kwe-MALS ibingumbandela wempikiswano. Iimpawu kunye neempawu zinokubangelwa kukusilela kokuhamba kwegazi nge-celiac artery, okanye uxinzelelo kwimithambo-luvo (ye-neurological) ye-celiac ganglion ebangela iintlungu.

Imiba yomngcipheko

Ngenxa yokuba unobangela we-MALS awuqondwa kakuhle, imeko yomngcipheko wesifo ayicacanga. I-MALS ibonakele ebantwaneni, nakumawele, oko kunokuthetha ukuba imfuza idlala indima.

Abanye abantu baye bakhula i-MALS emva kotyando lwe-pancreatic kunye nokwenzakala okungalunganga kwindawo ephezulu yesisu.

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Iingxaki

Iingxaki ze-MALS zibandakanya iintlungu zexesha elide, ngakumbi emva kokutya, ezinokubangela uloyiko lokutya kunye nokwehla kobunzima. Intlungu kunye noxinzelelo olunxulumene noko okanye uxinzelelo lunokuchaphazela kakhulu umgangatho wobomi bakho. Ngenxa yokuba iimpawu ze-MALS zinokungacacanga kwaye zilingise ezinye iimeko, kungathatha ixesha ukufumana uxilongo oluchanekileyo.

Uxilongo

Akukho vavanyo oluthile lokufumanisa i-MALS. Ugqirha wakho uya kukuvavanya ngononophelo kwaye akubuze malunga neempawu zakho kunye nembali yezempilo. Uvavanyo lomzimba luhlala luqhelekileyo kubantu abane-MALS. Uvavanyo lwegazi kunye nokuvavanya ukunceda ugqirha wakho akhuphe ezinye izizathu zentlungu yesisu.

Uvavanyo olusetyenziselwa ukukhuphela ngaphandle ezinye iimeko kunye nokuchonga i-MALS inokubandakanya:

  • Uvavanyo lwegazi. Uvavanyo lwegazi olupheleleyo lwenziwa ukukhangela iingxaki kwisibindi sakho, ipancreas, izintso kunye namanye amalungu omzimba. Inani elipheleleyo leeseli zegazi libonisa inqanaba lakho leeseli ezimhlophe ezibomvu zegazi. Ukubalwa kwamaseli egazi amhlophe aphezulu kunokuthetha ukuba unosulelo.
  • I-Ultrasound yesisu sakho. Olu vavanyo lungashukumiyo lusebenzisa amaza esandi aphindaphindiweyo ukumisela indlela igazi elihamba ngayo kwimithambo yegazi lakho. Ingabonisa ukuba umthambo we-celiac ucinezelwe, ngakumbi xa uphefumla ngaphakathi nangaphandle ngokunzulu.
  • Endoscopy ephezulu. Le nkqubo, ekwabizwa ngokuba yi-esophagogastroduodenoscopy (EGD), yenziwa ukujonga umqala, isisu kunye nenxalenye ephezulu yamathumbu amancinci (duodenum). Ngexesha le-EGD, ugqirha ngobumnene ukhokela ityhubhu ende, eguqukayo kunye nekhamera esiphelweni (endoscope) ezantsi emqaleni emva kokufakwa kwamayeza e-numbing. Ukuba kuyimfuneko, ugqirha unokuthatha iisampulu zethishu (i-biopsy) ngexesha lale nkqubo.
  • Izifundo zokukhupha isisu. Ukucinezelwa komthambo we-celiac kunokucothisa isantya sokukhupha isisu. Izifundo zokukhupha isisu zenziwe ukufumanisa ukuba isisu sakho sikhupha ngokukhawuleza kangakanani imixholo yaso. Ukucotha okanye ukulibaziseka kokukhupha isisu kunokubakho kwezinye iimeko zonyango.
  • Imagnetic resonance imaging (MRI). I-MRI isebenzisa iimagnethi ezinamandla kunye namaza erediyo ukuvelisa imifanekiso eneenkcukacha ngendawo yomzimba efundwayo. Ngamanye amaxesha, idayi ifakwe kwisitya segazi ukubonisa ngokucacileyo ukuba igazi lihamba njani kwimithambo yakho kunye nemithambo (i-magnetic resonance angiogram).
  • I-tomography ekhompyuter (i-CT) yesisu. I-CT isebenzisa i-X-ray ukwenza imifanekiso ye-3D yendawo yomzimba evavanyiweyo. Iskena se-CT esiswini sinokubonisa ukuba umthambo we-celiac uncitshisiwe okanye uvalekile. Ukuba ukuxilongwa akukacaci emva kokuba kwenziwe ezinye iimvavanyo zokucinga, ugqirha unokufaka idayi kwisitya segazi ukuqaqambisa ukuhamba kwegazi kwimithambo yakho kunye nemithambo (CT angiogram).

Unyango

Utyando kuphela kwendlela yokhetho yeMALS. Inkqubo eqhelekileyo ibizwa ngokuba yi-median arcuate ligament release, okanye i-median arcuate ligament decompression. Ihlala yenziwe njengotyando oluvulekileyo kodwa ngamanye amaxesha inokwenziwa njengenyathelo elincinci lokuhlasela (laparoscopic okanye robotic).

Ngelixa uphantsi kwe-anesthesia ngokubanzi, ugqirha wohlulahlula i-median arcuate ligament kunye nenethiwekhi yeentsholongwane kwindawo yesisu (celiac plexus). Ukwenza njalo kubonelela ngakumbi kwigumbi lomthambo, ukubuyisela ukuhamba kwegazi kunye nokunciphisa uxinzelelo kwimithambo-luvo.

Abanye abantu abane-MALS banokufuna utyando oluvulekileyo ukulungisa okanye ukubuyisela umthambo we-celiac ovaliweyo kunye nokubuyisela ngokupheleleyo ukuhamba kwegazi (i-revascularization).

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Ukuba une-MALS yokukhululwa kotyando, uhlala esibhedlele kangangeentsuku ezimbini ukuya kwezintathu. Uzakufuna i-ultrasound malunga nenyanga emva kotyando ukuqinisekisa ukuba ukuhamba kwegazi nge-celiac artery kubuyiselwe ngokupheleleyo. Izifundo ezininzi zibonise ukuba utyando lokukhupha i-median arcuate ligament lukhuselekile, nakubantwana abane-MALS. Ihlala ikhokelela ekukhululekeni kwentlungu kwangoko kwaye iphucula umgangatho wobomi bomntu.

Indlela yokuphila kunye namayeza asekhaya

Intlungu noxinzelelo zihlala zenzeka kumjikelo. Ubuhlungu bunokukwenza uzive uxinezelekile, kwaye uxinzelelo lunokwenza iintlungu zibe mandundu. Iintlungu ze-MALS zinokwenza kube nzima ukutya, ukwenza umthambo, ukulala nokwenza imisebenzi yemihla ngemihla. Iindlela zokuphumla, ezinje ngokuphefumla nzulu kunye nokucamngca, zinokunciphisa iintlungu kwaye zikonyuse impilo yakho yengqondo.

Ukujongana nenkxaso

Ukuhlala ne-MALS kunokukwenza uzive ukhathazekile, unxunguphalo okanye uxinzelelo. Umceli mngeni wokufumana uxilongo oluchanekileyo- kunye nokuba novavanyo oluninzi lwezonyango- kunokuba nzima. Ukwabelana ngeengcinga zakho kunye neemvakalelo zakho nabanye abanamava afanayo kunokuba luncedo. Iqela lenkxaso linokubonelela ngenkxaso yeemvakalelo kwaye likuncede ufunde malunga nezakhono ezitsha zokulwa. Isiseko seSizwe seMALS sibonelela ngolwazi nonxibelelwano kubantu abane-median arcuate ligament syndrome. Okanye, buza ugqirha wakho, iklinikhi okanye isibhedlele ukuba bangacebisa iqela lenkxaso kwindawo yakho.

Ukulungiselela idinga

Ukuba ucinga ukuba unentlungu yesisu engapheliyo, okanye ucinga ukuba unokuba ne-median arcuate ligament syndrome, kubalulekile ukuba wenze idinga nogqirha wakho. Ukuba i-median arcuate ligament syndrome ifunyenwe kwangoko, unyango lunokusebenza ngakumbi.

Isiphumo secala benzoate

Ukuqeshwa kukagqirha kunokuba mfutshane, kwaye kuhlala kuninzi ekuxoxwa ngako. Ke licebo elihle ukuba uzilungiselele ngokufanelekileyo ukuqeshwa kwakho. Ukubhala uluhlu lwakho lwemibuzo okanye ukuxhalaba ngenye yeendlela ezininzi ongayithatha ukuze ulungele ukutyelela ugqirha wakho.

Into onokuyenza

  • Yazi nakuphi na ukuthintelwa kwangaphambili. Xa usenza idinga, qiniseka ukuba ubuza ukuba ikhona into ekufuneka uyenzile kwangaphambili, njengokungaseli okanye ungatyi nantoni na iiyure ezimbalwa. Kuya kufuneka wenze oku ukuba ugqirha wakho uyalela uvavanyo lwegazi okanye lokucinga.
  • Bhala phantsi zonke iimpawu zakho, kubandakanya nayiphi na into enokubonakala ingadibani ne-median arcuate ligament syndrome.
  • Bhala phantsi ulwazi oluphambili lomntu, kubandakanya nayiphi na imbali yosapho yesifo sentliziyo, ukubetha, uxinzelelo lwegazi, amahlwili egazi, kunye naluphi na uxinzelelo oluphambili okanye utshintsho lobomi kutshanje.
  • Dwelisa onke amayeza, iivithamini okanye izongezo ozithathayo ngoku okanye ozithathileyo kutshanje.
  • Yiza nelungu losapho okanye umhlobo kunye nawe, ukuba kuyenzeka. Ngamanye amaxesha kunokuba nzima ukuqonda kwaye ukhumbule lonke ulwazi olufunyenweyo ngexesha lokuqeshwa. Umntu ohamba nawe unokukhumbula into oyiphosileyo okanye oyilibeleyo.
  • Bhala phantsi imibuzo ukubuza ugqirha wakho.

Dwelisa imibuzo yakho ukusukela kokona kubalulekileyo ukuya kokungabalulekanga, ukuba ixesha liphelile. Kwi-median arcuate ligament syndrome, eminye imibuzo esisiseko yokubuza ugqirha ibandakanya:

  • Yintoni enokubangela iimpawu okanye imeko yam?
  • Zeziphi ezinye izinto ezinokubangela iimpawu okanye imeko yam?
  • Zeziphi iintlobo zovavanyo endiza kuzifuna?
  • Loluphi olona nyango lufanelekileyo?
  • Leliphi inqanaba elifanelekileyo lomsebenzi womzimba?
  • Zeziphi ezinye iindlela ocinga ngazo?
  • Ndinezinye iimeko zempilo. Ndingabalawula njani ngokugqibeleleyo kunye?
  • Ngaba kukho nayiphi na imiqobo ekufuneka ndiyilandele?
  • Ngaba zikhona iincwadana ezinemifanekiso okanye enye into eprintiweyo endinokuya nayo ekhaya? Zeziphi iwebhusayithi oncomela ukuba uzindwendwele?

Unganqikazi ukubuza ugqirha wakho imibuzo eyongezelelweyo ngexesha lokuqeshwa kwakho.

Yintoni onokuyilindela kugqirha wakho

Ugqirha wakho unokukubuza imibuzo emininzi. Ukulungela ukubaphendula kunokonga ixesha lokuya kuyo nayiphi na inkxalabo ofuna ukuchitha ixesha elininzi kuyo. Ugqirha wakho angabuza:

  • Uqale nini ukuba neempawu?
  • Ngaba uhlala unempawu okanye ngaba bayahamba?
  • Zibuhlungu kangakanani iintlungu zakho?
  • Yintoni, ukuba kukho nantoni na, ebonakala izenza ngcono iimpawu zakho?
  • Yintoni, ukuba kukho nantoni na, eyenza iimpawu zakho zibe zibi?

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