Fistula Ya Anal

Fistula ya anus — izwi kandi nka fistula-in-ano — ni umwobo uba hagati y'imbere y'umwanya w'inyuma (anus) n'uruhu rwo hanze rw'umwanya w'inyuma. Anus ni umwanya w'imitsi uri ku mpera y'umuyoboro w'igogorwa aho umusemburo usohoka mu mubiri.

Akenshi, fistula ya anus iterwa n'indwara ituruka mu gice cy'inyuma (glande anale). Iyo ndwara itera igisebe kibyimba (abcès) gisohora umusemburo ku giti cyacyo cyangwa kikavurwa hakoreshejwe ubuvuzi kugira ngo umusemburo usohoke ku ruhu rwo hafi y'umwanya w'inyuma. Uwo mwobo usohokamo umusemburo usigara ufunguye kandi uhuza igice cy'inyuma cyanduye cyangwa umuyoboro w'umwanya w'inyuma n'umwobo uri ku ruhu rwo hanze rw'umwanya w'inyuma.

Ubusanzwe, kubaga ni ngombwa mu kuvura fistula ya anus. Rimwe na rimwe, ubundi buryo butari ubuvuzi bushobora kuba amahitamo.

Ibimenyetso by'umuhogo w'inyuma bishobora kuba birimo:

• Umunwa ku ruhu rwo mu ibere
• Agasoko k'umutuku kandi kababara hafi y'umunwa w'umuhogo
• Umutobe w'ihehe, amaraso cyangwa umusemburo uva mu munwa w'umuhogo
• Kubabara mu kibuno no mu ibere, cyane cyane iyo wicaye cyangwa ugiye ku ntebe
• Umuriro

Ibiheri byinshi by'umushitsi biterwa n'ubwandu butangira mu gice cy'inyuma. Ubwandu butera igisebe kibyimba gisohora ubwayo cyangwa kikavurwa n'abaganga binyuze mu ruhu ruri hafi y'inyuma. Umushitsi ni umwobo uba munsi y'uruhu ku nzira yo gusohora. Uwo mwobo uhuza igice cy'inyuma cyangwa umwanya w'inyuma n'umwobo uri hanze ku ruhu ruri hafi y'inyuma.

Urukuta rw'imitsi ifunga umwanya w'inyuma rugufasha kugenzura uko umusemburo usohotse. Ibiheri by'umushitsi bigabanywa bitewe n'uko izi mitsi zifunga zibonekamo. Ubu bwoko bufasha umuganga kumenya uko avura.

Ibintu byongera ibyago byo kugira uburwayi bwa fistule y'umushitsi harimo:

• Ububyimba bwa purulent mu kibuno bwakize
• Indwara ya Crohn cyangwa izindi ndwara z'umwijima
• Gukomeretsa mu kibuno
• Imyanda mu kibuno
• Imyanya cyangwa imirasire yo kuvura kanseri y'umushitsi

Fistule y'umushitsi iba kenshi mu bantu bakuru bafite imyaka hafi 40 ariko ishobora kubaho no mu bantu bakiri bato, cyane cyane niba hari amateka y'indwara ya Crohn. Fistule y'umushitsi iba kenshi mu bagabo kurusha abagore.

Ndetse no mu gihe havuwe neza uburwayi bwa fistule y'umwanya w'inyuma, gusubira kugaragara kw'igisebe n'uburwayi bwa fistule y'umwanya w'inyuma bishoboka. Kubaga bishobora gutuma umuntu adashobora kubuza umusemburo kuva (kutagira ububasha bwo kwifata ku musambiro).

Kugira ngo hamenyekane uburwayi bwa fistule y'inyuma, umuganga wawe azakuganiraho ibimenyetso byawe, hanyuma akore isuzuma ngaruka mubuzima. Isuzumemo harimo kureba agace kari hafi no imbere y'inyuma yawe. Akanya gato k'inyuma ka fistule gasanzwe kaboneka ku ruhu ruri inyuma y'inyuma. Gushaka umwanya wo gutangira imbere muri canal y'inyuma biragoye. Kumenya inzira yose ya fistule y'inyuma ni ingenzi kugira ngo havurwe neza. Ibizamini byo kubona amashusho bimwe cyangwa byinshi muri ibi bikurikira bishobora gukoreshwa kugira ngo hamenyekane umwobo wa fistule: MRI ishobora gupima umwobo wa fistule kandi itange amashusho arambuye y'imitsi ya sphincter n'ibindi bice by'igice cyo hasi. Ultrasound ya endoscopic, ikoresha amajwi y'umuvuduko mwinshi, ishobora kumenya fistule, imitsi ya sphincter n'imiterere ibayikikuje. Fistulography ni X-ray ya fistule ikoresha ikintu cyinjijwe kugira ngo hamenyekane umwobo wa fistule y'inyuma. Isuzuma rikozwe munsi y'ibiyobyabwenge byo kubyara. Umuganga w'amara n'inyuma ashobora kugutegeka ibiyobyabwenge byo kubyara mu gihe cy'isuzuma rya fistule. Ibi bituma tureba neza umwobo wa fistule kandi bishobora kumenya ibibazo byose bishoboka. Ubundi buryo bwo kumenya aho fistule itangirira harimo: Ubuvumbure bwa fistule. Igikoresho cyakozwe cyane kugira ngo gishyirwe muri fistule gikoreshwa kugira ngo hamenyekane umwobo wa fistule. Anoscope. Endoscope ntoya ikoreshwa kugira ngo irebe canal y'inyuma. Sigmoidoscopy cyangwa colonoscopy byoroshye. Ibi bikorwa byo gusuzuma bifashisha endoscope gusuzuma umwijima munini (colon). Sigmoidoscopy ishobora gusuzuma igice cyo hasi cya colon (sigmoid colon). Colonoscopy, isuzumana uburebure bwa colon, ni ingenzi kugira ngo harebwe izindi ndwara, cyane cyane niba ulcerative colitis cyangwa Crohn's disease bikekwa. Igicuruzwa cyinjijwe. Ibi bishobora gufasha kubona aho fistule itangirira. Kwitaho muri Mayo Clinic Itsinda ryacu ryita ku barwayi b'inzobere za Mayo Clinic rishobora kugufasha mu bibazo byawe by'ubuzima bifitanye isano na fistule y'inyuma. Tangira hano

Umuti wo kuvura uburwayi bwa fistule y'inyuma uterwa n'aho fistule iherereye, uburyo igoye ndetse n'icyayiteye. Intego ni ugukira burundu fistule y'inyuma kugira ngo hirindwe kongera kugaruka no kurinda imitsi y'umuvuduko. Gukomeretsa iyi mitsi bishobora gutera kudakora neza kw'umubiri. Nubwo kubaga bisanzwe bikenewe, rimwe na rimwe uburyo budakoresha kubaga bushobora kuba amahitamo.

Uburyo bwo kubaga burimo:

• Fistulotomi. Umuganga ubabaga aca umwenge wo imbere wa fistule, akakuraho kandi agakuraho umwanda, hanyuma agapfundikira umwobo kandi awuboshe. Kugira ngo avure fistule ikomeye, umuganga ashobora gukenera gukuraho igice cy'umwobo. Fistulotomi ishobora gukorwa mu byiciro bibiri niba igice kinini cy'imitsi y'umuvuduko kigomba guca cyangwa niba umwobo wose utaboneka.
• Igisenge cyateye imbere cya rectum. Umuganga akora igisenge kuva ku rukuta rwa rectum mbere yo gukuraho umwenge wo imbere wa fistule. Icyo gisenge hanyuma kikoreshwa mu gupfundikira igikomere. Ubu buryo bushobora kugabanya umubare w'imitsi y'umuvuduko ica.
• Guhambira inzira ya fistule intersphincteric (LIFT). LIFT ni ubuvuzi bukorwa mu byiciro bibiri ku bwandu bukomeye cyangwa bufite ubujyakuzimu. LIFT iha umuganga ubabaga uburyo bwo kugera kuri fistule hagati y'imitsi y'umuvuduko no kwirinda kuyica. Ubudodo bwa siliki cyangwa ubwo mu mpira (seton) burabanza gushyirwa mu mwobo wa fistule, bugatuma bwaguka buhoro buhoro. Nyuma y'ibyumweru bike, umuganga akuraho umwanda kandi afunga umwenge wo imbere wa fistule.

Uburyo budakoresha kubaga burimo:

• Gushyira seton. Umuganga ashyira seton muri fistule kugira ngo afashe gukuraho ubwandu. Ibi bituma umwobo ukora. Ubu buryo bushobora guhuzwa no kubaga.
• Itonde ry'umusemburo wa fibrin na collagen. Umuganga atunganya umwobo kandi aboshe umwenge wo imbere. Itonde ryihariye rikozwe mu mubiri wa fibre (fibrin) hanyuma rirasutswe mu mwenge wo hanze wa fistule. Umuyoboro wa fistule y'inyuma ushobora kandi gufungwa n'igice cy'umusemburo wa collagen hanyuma ugafumbwa.
• Imiti. Imiti ishobora kuba igice cy'ubuvuzi niba indwara ya Crohn ari yo yateye fistule y'inyuma.

Mu gihe cy'uburwayi bukomeye bwa fistule y'inyuma, uburyo bwo kubaga bugoye cyane bushobora gusabwa, harimo:

• Ostomy na stoma. Umuganga akora umwenge w'agateganyo mu nda kugira ngo atandukanye amabyo ava mu muyoboro w'inyuma. Imfubyi ziteranywa mu gipfunsi ku nda. Ubu buryo buha agace k'inyuma umwanya wo gukira.
• Igisenge cy'imitsi. Mu burwayi bukomeye cyane bwa fistule y'inyuma, umwobo ushobora kuzura n'umubiri w'imitsi muzima ukomoka ku gice cy'amaguru, labia cyangwa ikibuno.