Apendik Wanita Hamil

BAGI wanita hamil, kesakitan pada bahagian perut boleh terjadi akibat pelbagai sebab. Selain perubahan fizikal pada bahagian abdomen yang menyebabkan ketidakselesaan, kesakitan lain seperti sakit pada bahagian bawah pusat sebelah kanan perut mungkin petanda bahawa anda menghidap apendik.

Kes apendik dalam kalangan wanita hamil agak jarang didengar, namun kebarangkalian untuk menghidapnya sama seperti individu yang tidak mengandung.

Menjelaskan lebih lanjut keadaan ini, Perunding Pembedahan Am dari Hospital Pakar KPJ Kajang, Dr. Ahmad Sudirman Mohd. Salleh berkata, ramai pesakit apendik tidak mempunyai simptom-simptom klasik seperti muntah, loya, hilang selera, demam, cirit mahupun kesakitan di abdomen bahagian bawah sebelah kanan.

Simptom apendik yang dinyatakan ini biasanya tidak dapat dikesan terhadap pesakit apendik daripada golongan kanak-kanak, individu obes, warga emas dan termasuk wanita mengandung.

“Kedudukan apendik adalah di belakang usus (retrocaecal) yang menyebabkannya sukar dikesan pada peringkat awal.

“Kumpulan seperti kanak-kanak, warga emas, mereka yang obes dan wanita mengandung yang menghidap penyakit apendik sering lambat dikesan dan biasanya apabila dapat dikesan ia sudah berada di tahap yang boleh dikatakan agak komplikasi.

“Dalam kalangan wanita mengandung, apendik akut ini memang sesuatu yang normal, sama seperti yang boleh dihidapi wanita yang tidak mengandung. Cuma cabarannya ialah untuk mengesan keadaan apendik, kerana pembesaran uterus sekali gus mengalih kedudukan apendik dari tempat asalnya.

“Apendik dalam kalangan wanita hamil ini boleh mendatangkan bahaya kepada ibu dan bayi dalam kandungan apabila apendik mula bernanah, pecah dan menimbulkan komplikasi yang lain pula,” ujarnya yang ditemui di kliniknya di hospital KPJ Kajang, Selangor, baru-baru ini.

Menurut Dr. Ahmad Sudirman, adalah amat perlu bagi individu mengenali dengan sebenarnya apa yang dimaksudkan dengan penyakit apendik.

“Apendik akut berbentuk seperti ‘cacing kecil’ bersaiz 5 hingga 8 sentimeter yang mana keadaan fizikalnya sedikit terkeluar dari caecum, iaitu pertembungan antara usus besar dan usus kecil.

“Dalam istilah perubatan, apendik tidak memiliki fungsi tertentu seperti kebanyakan organ lain, jadi apabila apendik dibuang, ia tidak akan memberi kemudaratan kepada keadaan kesihatan seseorang individu tersebut,” jelasnya.

Menurut beliau lagi, apendik akut ini boleh menjadi lebih teruk apabila berlakunya keradangan di bahagian tersebut.

Katanya, apendik akut memang amat jarang berlaku kepada kanak-kanak bawah umur dua tahun, sebaliknya kes ini lebih kerap berlaku dalam kalangan mereka yang berusia 10 hingga 30 tahun dengan peratusan yang sama untuk lelaki dan juga perempuan.

Mengesan apendik

Beliau berkata, kira-kira dua pertiga daripada kes apendik akut terjadi apabila kerosakan berlaku di bahagian lumen atau dinding apendik disebabkan oleh najis yang keras, jangkitan parasit, limpa nod yang membesar atau mungkin juga disebabkan tumor.

“Apendik menjadi bengkak, dijangkiti dan akhirnya dipenuhi dengan nanah. Ketika di peringkat ini apendik memerlukan pemerhatian khusus dan rawatan segera. Dikhuatiri komplikasi akan berlaku sekiranya rawatan dilengahkan atau mendapat rawatan yang salah.

“Maka sebab itu pengesanan yang betul memang perlu dilakukan. Pertamanya, doktor akan menemu bual pesakit dengan mengenal pasti sejarah kesakitan dan pengesanan klinikal.

“Ujian darah juga akan dilakukan untuk mengira kiraan jumlah sel darah putih yang tinggal akibat jangkitan. Sebanyak 70 hingga 80 peratus pesakit apendik dapat dikesan menerusi ujian darah ini,” ujarnya.

Selain ujian darah dan pemeriksaan klinikal, doktor turut akan menguji air kencing kerana kebanyakan wanita mengandung lebih terdedah kepada jangkitan salur kencing.

Pengesanan ultra bunyi juga boleh membantu mengesan simptom lain seperti kehadiran batu karang, sista ovari, kandungan luar rahim atau mungkin juga penyakit lain berkaitan usus.

“Ujian ultra bunyi boleh dikatakan berjaya mengesan 60 hingga 70 peratus penyakit apendik. Walaupun pengesanan menerusi pengimejan resonan magnetik atau MRI dikatakan sangat berkesan hingga 90 peratus, ia tidak begitu dicadangkan kerana kesan radiasi kepada pesakit tersebut,” jelasnya.

Komplikasi dan rawatan apendik akut

Dr. Ahmad Sudirman berkata, komplikasi yang sangat serius adalah apabila apendik menjadi pecah. Kandungan dalam usus dan organisma yang membawa jangkitan akan menyerang kawasan abdomen.

Ini akan menyebabkan jangkitan pada lapisan yang meliputi kawasan pencernaan. Apabila apendik pecah, jangkitan kuman dalam darah boleh berlaku dan ini boleh berakhir dengan kegagalan organ utama seperti buah pinggang, paru-paru dan hati untuk berfungsi.

Pembedahaan adalah rawatan terbaik untuk pesakit radang apendik. Pesakit memerlukan pembedahan bagi membuang apendik (appendectomy) yang hanya melibatkan torehan yang kecil pada abdomen. Rawatan tersebut memberikan pemulihan yang segera dan bekas pembedahan yang sedikit.

Jika apendik pesakit telah pecah dan jangkitan yang sudah merebak atau bengkak bernanah, pesakit akan dibedah dengan torehan yang besar supaya pakar bedah dapat membersihkan bahagian abdomen. Pesakit akan diberi antibiotik melalui salur darah dan ditahan di wad sehingga sihat.

“Jika simptom yang dialami sudah melewati lima hari atau lebih, selalunya doktor akan memberi antibiotik untuk mengurangkan radang yang dialami dan jangkitan pada bahagian sekitar apendik.

“Ia selalunya akan menjadi bengkak dan bernanah. Melalui cara ini (antibiotik), bengkak akan dikuranglan terlebih dahulu dan nanah akan dikeluarkan melalui kulit. Jika cara tersebut berjaya, pembedahan membuang apendik biasannya dilakukan dua bulan selepas itu,” ujarnya. – Noor Fazrina Kamal

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