Chapter 2338： 【2338】More than that

Chapter 2338 [2338] Much more than that

Dr. Yang's words came to the fore.

Wei was the first to stare: What? no? Why not?

How can you suddenly fail? If not, the child will be taken to the operating room for surgery.

What did Xie say?

Let's hear what the experienced Dr. Yang has to say.

The schematic diagram of the pathological anatomy of    intussusception is as follows. As mentioned earlier, intussusception is when the head of a section of intestines is folded into the inner diameter of another section of intestines. The structure of intussusception can be divided into:

The outer layer is the outer tube called the sheath, which is the outer diameter of the intestines to be inserted. The head of the sheath is the neck, like a bag with the intestines folded inside. The middle layer is the middle tube, and the part of the discounted intestine that enters the neck of the family. The front end here is called the head of the intussusception. The innermost layer is the inner tube. After the intestines are folded and inserted into the opposite pocket, they must be folded back.

According to the intussusception segment, intussusception can be divided into various types: jejunal insufflation jejunum, ileal insufflation ileum, ileal insufflation cecum, ileal insufflation colon, colonic insufflation colon and so on.

Which is the most common, is the ileo-sleeve cecum in this patient today.

Do you think it happened after the ileum was broken into the cecum? no. The mechanism of intussusception said that intestinal dysfunction leads to unhealthy movement of the intestinal tract. Until this unhealthy movement is corrected, the bowels will continue to move and may wobble more violently in an attempt to break free after intussusception occurs.

The intestines do not want to die, this is the body's self-protection mechanism.

The problem is that the intestines are not like the hands and feet of a human being. They can't move where the brain tells them to move. The swinging motion is like a brainless movement of their own. What is the result of one's own disturbance? It's like a drowning person who doesn't know how to survive. The result of disturbance is that the stone sinks into the sea.

is the same as intussusception. If the moving intestines make the intussusception head unable to withdraw by itself, the intestines will continue to move forward, which is equivalent to the possibility of deeper and deeper intussusception. Outside the intestines is the mesentery, and the deeper the sheath, the more the mesentery is pulled into the interlayer between the outer and middle tubes and between the middle and inner tubes. In addition to tying the intestines, the mesentery has important structures such as blood vessels that nourish the intestines. After the sleeve is deep, the blood vessels are stuck in the middle layer, and the probability of necrosis of the intestine without nutrient supply is greater.

According to the principle mentioned above, during the b-ultrasound examination, the doctor specially instructed the b-ultrasound doctor to scan the appendix again. One is the fear of appendicitis. The second is that the surgeon is afraid of putting the appendix in it.

This condition is not uncommon in clinical practice. These body parts are close to each other. After the ileo-cecal invagination, the ileocecal valve becomes the intussusceptible head, carrying the distal end of the ileum into the ascending colon, and the cecum and part of the appendix are brought into the colon together.

Do you think this situation is difficult just thinking about it?

Under fluoroscopy, the injected gas comes to the cannula at the diagnosis site. The gas entering the inner and outer barrels can present a cup-shaped image, which is a unique x-ray sign of intussusception. If there are too many things turned in, the gas will diffuse in the chaotic intestinal tube, and it will look like a light group in general, which is a bit unclear.

Dr. Yang is now observing the condition of the child’s bowel under fluoroscopy, and it seems that it is neither cup-shaped nor clamp-shaped at first.

The forceps shape, as you can imagine from the name, the structure of the intestinal tube inserted is relatively clear in layers like the cup mouth shape, and the depth of the sleeve may be deeper like a pair of forceps.

(end of this chapter)