Chapter 1343： 【1343】It is not easy for doctors to find lesions

Chapter 1343 [1343] It is not easy for doctors to find lesions

It is also simply called a gastric tube in clinical practice. The gastric tube is relatively short and easy to insert. The passage from the nose to the esophagus to the stomach is relatively smooth and not tortuous, and can usually be blindly inserted by a nurse.

Other catheters are more complicated. The nasoduodenal tube, nasojejunal tube, and jejunostomy tube are all inserted into the intestines. The twists and turns of the human intestines are like nine bends and eighteen bends. Blind insertion is very difficult. It is generally reserved by the surgeon during the surgical operation, or intubated under visual conditions through a gastroenterology endoscope.

For patients after gastrointestinal tract resection, it can be said that keeping this tube during surgery is based on the routine risk considerations of surgeons, and the possibility of anastomotic leakage in postoperative patients should be considered, which is called just in case.

Patients with anastomotic fistula cannot eat orally normally, and the food they eat will overflow through the fistula and cause infection in the body, so they must fast at the front end of the fistula. There is this feeding tube that reaches the bottom of the fistula, and enteral nutrition support can continue to be given to patients. For such patients, it is called the life tube. In the same way, now this patient has an anastomotic leakage after surgery, and the leakage failed to grow, resulting in the failure of the nasojejunal tube to be removed. At the same time, there is definitely no need for a jejunostomy.

We talked about anastomotic leakage earlier, and now we talk about anastomotic leakage, which is closely related to surgery, yes, so the word anastomotic is specially added in front of fistula. After all, fistulas may not only be caused by surgical operations, but are more common in patients with fistulas caused by their own diseases and trauma, such as **** fistulas and intestinal fistulas, which have nothing to do with surgery.

The anastomosis, as the name suggests, is the junction where the front and rear healthy tissues and organs are reconnected after surgical removal of the diseased part of the organ tissue. The surgical method is called anastomosis, and this junction is called an anastomosis.

It takes a precise understanding of these terms to understand where anastomotic leakage is usually hidden. To deal with anastomotic leakage, doctors must first find the fistula. The problem is that this fistula is not easy to find in the first place. It stands to reason that anastomotic leakage is related to surgery. The chief surgeon knows exactly where the anastomosis is performed, and the chief surgeon can find the fistula there. The chief surgeon can do this, but it needs to be re-operated, open or laparoscopy, all of which are more traumatic. Patients will not necessarily be able to tolerate such a surgical procedure again by lying on the operating table for extended periods of time. This patient just happened to be in poor health. The surgeon needs to think twice about the choice of operating on him again, so the first choice is not a surgical method to solve the fistula, so that the patient cannot get off the operating table.

Without surgery, the fistula can be found in the patient's digestive tract, using digestive endoscopy. Gastrointestinal endoscopy is not like surgery, which can open the intestines to find it. It can only rely on the limited field of view and limited auxiliary instruments in the digestive tract to find the fistula and block the fistula. Therefore, a master of internal medicine may be reflected in how to play digestive endoscope.

I have heard from Senior Sister Jiang for a long time, that Senior Brother Yu is an expert in digestive endoscopy. Xie Wanying and two classmates continued to listen to the conversation between Senior Brother Yu and Dr. Shao.

"I tried the titanium clip, but it didn't work?" Yu Xuexian asked.

"Yes, yes." Dr. Shao nodded.

"That must be the right one." After listening to it, Yu Xuexian pointed out the problem, that is, the big fistula was not found.

(end of this chapter)