swori nawlavis da anusis atrezia

swori nawlavis da anusis atreziis

embriologia
• 4-6 kviris ganmavlobaSi kloaka TamaSobs mniSvnelovan rols
saSarde,sasqeso da saWmlis momnelebeli gzebis gayofaSi
• Kkloaka swrafad iyofa urogenitaluri Zgidis meSveobiT wina
urogenitalur da ukana nawlavis sinusad
• Kkloakas 2 nakecis SeerTebiT sruldeba saSarde da saWmlis
momelebeli sistemebis gayofa.
 swori nawlavis da anusis atrezia
• Ddaavadebis mizezia darRvevebi embriologiuri
ganviTarebis dros,Tumca zusti etiologia ucnobia
• 60%-Si gvxdeba vaJebSi
• 4500 axalSobilSi erTxel
 swori nawlavis da anusis atrezia
• pacientTa nawilSi dakavSirebulia VACTERL daavadebaTa
jgufTan,romelic moicavs xerxemlis,anusis,gulis,traqea-
saylapavis,Tirkmlis,kidurebis anomaliebs
 klinikuri gamovlineba
• Tu fizikuri daTvalierebis dros anomaliis diagnostika ar moxerxda,24
saaTis ganmavlobaSi axalSobils aReniSneba Seberiloba muclis areSi
da gauvaloba,ris Semdeg ufro safuZvliani gamokvleva Catardeba.
 klasifikacia
• WINGSPREAD-is klasifikacia,romelic atrezias “qveda,saSualo,zeda”
nawilebad hyofda,aRar gamoiyeneba
• amJamad klasificirdeba anatomiis mixedviT da gansxvavdeba
qalebsa da mamakacebSi
 reqtoperineuli fistula
• Ddaxuruli ukana xvreli,romelic dakavSirebulia perineumTan

• daxasiaTebulia SedarebiT kargi prognoziT,rogorc vaJebSi ise

gogonebSi
• vaJebs SesaZloa perineumis fistulis xvreli ar hqondeT,rac ganavlis
fistulaSi dagrovebas gamoiwvevs da SesaZloa mogvianebiT penisis
fuZeze gaixsnas
• Ddiagnozi inspeqciiT
 reqtoureTruli fistula
• gansakuTrebiT xSiria vaJebSi
• SesaZloa iyos qveda Sardsadenis(yvelaze xSiri),zeda
Sardsadenis(prostatuli) da Sardis buStis fistula
• xSirad qveda Sardsadenis fistulis dros,obstruqciis mosaxsneladb
kolostomia xdeba saWiro,romelic saSualebas aZlevs eqims
kolostografiis meSveobiT daadasturos anomalia
• Sardis buStis fistula gansakuTrebiT saSiSia,radgan Tan axlavs
sfinqteris ganuviTarebloba
 Ffistulis gareSe
• es anomalia orive sqesSi Tanabari sixSiriT gvxdeba,kargi prognozis
matarebelia da xSirad Tan axlavs 21-e qromosomis trisomias
• 24 saaTis ganmavlobaSi,gauvalobis SemTxvevaSi eqimi akeTebs
radiografiul kvlevas gverdiT proeqciaSi,romelic adasturebs diagnozs
 swori nawlavis atrezia
• swori nawlavis sanaTuri mTlianad daxSulia
• daxSobis proqsimalurad sanaTuria gadidebulia,xolo distalurad
Seviwroebuli
• saWiroebs qirurgiul Carevas pirveladi anastomozis Seqmnas
• Aam anomaliebis dros sfinqteruli kunTebis funqcia sruladaa
SenarCunebuli,Sesabamisad prognozic ukeTesia
 vestibuluri fistula
• Yyvelaze xSiri anomalia gogonebSi
• Ddiagnozi fizikuri gamokvleviT,sadac mcire xvreli Cans vestibulis
ukana nawilSi
• mkurnaloba kolostomiiT
 Mmudmivi kloaka
• Agvxdeba gogonebSi
• Aam anomaliis dros,ar xdeba saSarde,sasqeso da saWmlis
momnelebeli sistemis gancalkeveba da samive sistema erTiandeba
• Dukana xvrelis gauvaloba da mcire zomis sasqeso organoebi am
anomaliaze miuTiTebs
 diagnozi
• Danomalia kargad Cans fizikuri kvlevis dros
• saWiroa Sardis mekoniumze Semowmeba fistulis gamosaricxad
• Ddiagnozis dasadastureblad gamoiyeneba radiografiuli kvlevebi
 Ppacientis marTva
• pirvel 24 saaTSi pacients ar unda mieces sakvebi,unda gadaesxas
siTxeebi da antibiotikebi
• aseve saWiroa Catardes sxvadasxva radiografiuli kvlevebi fistulebis
gamosaricxad
• 24 saaTis Semdeg,Tu dadasturda perineuli fistula,SesaZlebelia
gakeTdes anoplastia kolostomiis gareSe
• sxva saxis fistulebis dros,saWiroa kolostomiis Catareba
 SesaZlo garTulebebi
• infeqcia
• daviwroeba
• gauvaloba