Toshewa UPJ

Toshewar mahadar Ureteropelvic (UPJ) toshewa ce a daidai inda ɓangaren koda yake manne da ɗayan bututun zuwa mafitsara (ureters). Wannan yana toshe hanyoyin fitar fitsari daga koda.

Cushewar UPJ galibi yana faruwa ne a cikin yara. Yana faruwa sau da yawa yayin da jariri ke girma a cikin mahaifar. Wannan ana kiran sa yanayin haihuwa (yanzu daga haihuwa).

Ana haifar da toshewar lokacin da akwai:

• Auntataccen yanki tsakanin mafitsara da ɓangaren koda wanda ake kira da ƙodar ƙodar ƙugu
• Jirgin jini mara kyau wanda ke tsallaka mafitsara

A sakamakon haka, fitsari na taruwa tare da lalata koda.

A cikin manyan yara da manya, matsalar na iya kasancewa saboda tabon fata, kamuwa da cuta, jiyya ta farko don toshewa, ko duwatsun koda.

Toshewar UPJ shine mafi yawan dalilin toshewar fitsari ga yara. Yanzu ana samun shi sosai kafin haihuwa tare da gwajin duban dan tayi. A wasu lokuta, yanayin ba zai iya bayyana ba sai bayan haihuwa. Ana iya buƙatar aikin tiyata a farkon rayuwa idan matsalar ta yi tsanani. Yawancin lokaci, ba a buƙatar tiyata har sai daga baya. Wasu lokuta ba sa buƙatar tiyata kwata-kwata.

Babu alamun bayyanar cututtuka. Lokacin da bayyanar cututtuka ta faru, zasu iya haɗawa da:

• Ciwo na baya ko na gefe musamman lokacin shan mayuka masu sha kamar su barasa ko maganin kafeyin
• Fitsarin jini (hematuria)
• Ciki a cikin ciki (na ciki)
• Ciwon koda
• Rashin girma ga jarirai (gazawar bunƙasa)
• Cututtukan fitsari, yawanci tare da zazzaɓi
• Amai

Wani duban dan tayi yayin daukar ciki na iya nuna matsalolin koda a cikin jaririn da ke ciki.

Gwajin bayan haihuwa na iya haɗawa da:

• BUN
• Yarda da halittar
• CT dubawa
• Wutan lantarki
• IVP - wanda ba a saba amfani da shi ba
• CT urogram - bincika duka kodan da fitsarin tare da bambancin IV
• Binciken nukiliya na kodan
• Cystourethrogram mai ɓoye
• Duban dan tayi

Yin aikin tiyata don gyara toshewar yana ba da izinin fitsari ya gudana yadda ya kamata. Mafi yawan lokuta, ana yin tiyata a buɗe (mai cin zali) a cikin jarirai. Mayila a yi wa manya aiki tare da hanyoyin da ba su da haɗari. Waɗannan hanyoyin sun haɗa da ƙananan ƙananan tiyata fiye da buɗe tiyata, kuma na iya haɗawa da:

• Endoscopic (retrograde) fasaha baya buƙatar yankan tiyata akan fata. Madadin haka, ana sanya karamin kayan aiki a cikin fitsarin da mafitsara da kuma cikin fitsarin da cutar ta shafa. Wannan yana bawa likita damar bude toshewa daga ciki.
• Fercutaneous (antegrade) dabara ta haɗa da ƙaramin yanki da aka yanke a gefen jiki tsakanin haƙarƙari da ƙugu.
• Pyeloplasty yana cire kyallen tabo daga yankin da aka toshe kuma ya sake haɗa ɓangaren lafiyayyen koda zuwa lafiyayyen ureter.

An kuma yi amfani da laparoscopy don magance toshewar UPJ a cikin yara da manya waɗanda ba su sami nasara ba tare da sauran hanyoyin.

Ana iya sanya wani bututu da ake kira stent don magudanar fitsari daga koda har sai tiyatar ta warke. Hakanan za'a iya buƙatar bututun nephrostomy, wanda aka sanya shi a gefen jiki don fitar da fitsari, na ɗan gajeren lokaci bayan tiyatar. Wannan nau'in bututun ana iya amfani dashi don magance mummunan kamuwa da cuta kafin ayi tiyata.

Ganowa da magance matsalar da wuri na iya taimakawa wajen hana lalacewar koda nan gaba. Rikicin UPJ da aka gano kafin haihuwa ko farkon bayan haihuwa na iya inganta da kansa.

Yawancin yara suna da kyau kuma basu da matsaloli na dogon lokaci. Lalacewa mai tsanani na iya faruwa a cikin mutanen da aka gano daga baya a rayuwa.

Sakamakon lokaci mai tsawo yana da kyau tare da jiyya na yanzu. Pyeloplasty yana da mafi kyawun nasarar dogon lokaci.

Idan ba a kula da shi ba, toshewar UPJ na iya haifar da asarar koda na har abada (gazawar koda).

Dutse na koda ko kamuwa da cuta na iya faruwa a cikin koda da abin ya shafa, koda bayan magani.

Kira mai ba da sabis na kiwon lafiya idan jaririnku yana da:

• Fitsarin jini
• Zazzaɓi
• Wani dunkule a cikin ciki
• Alamar ciwon baya ko ciwo a gefen hannu (yanki zuwa gaɓɓukan jiki tsakanin haƙarƙari da ƙashin ƙugu)

Toshewar mahadar Ureteropelvic; UP mahada toshewa; Tushewar mahadar ureteropelvic

• Ciwon jikin koda

Dattijo JS. Tushewar fitsari. A cikin: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Littafin koyar da ilimin yara. 21st ed. Philadelphia, PA: Elsevier; 2020: babi 555.

Frøkiaer J. Maganin hana fitsari. A cikin: Skorecki K, Chertow GM, Marsden PA, Taal MW, Yu ASL, eds. Brenner da Rector na Koda. 10 ed. Philadelphia, PA: Elsevier; 2016: babi na 38.

Meldrum KK. Pathophysiology na toshewar hanyoyin fitsari. A cikin: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier; 2016: babi na 48.

Nakada SY, Mafi kyawun SL. Gudanar da toshewar hanyoyin fitsari na sama. A cikin: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier; 2016: babi na 49.

Stephany HA, Ost MC. Rashin lafiyar Urologic. A cikin: Zitelli BJ, McIntire SC, Nowalk AJ, eds. Zitelli da Davis 'Atlas na Ciwon Lafiyar Jiki na Yara. 7th ed. Philadelphia, PA: Elsevier; 2018: babi na 15.