After introducing the instruments and referring to the interventional surgery, there are two steps that need to be done before treating the child under fluoroscopy.
The first is to determine whether the tube has entered the human body in place, whether the tube is fixed well, and whether the amount of the fixed air bag is too large or too small.
Dr. Yang skillfully used the operating rod to see through the child's anus. A bright small ball appeared on the screen of the machine, indicating that the air bag had fully filled the anus.
If the tube is not leaking or running, you can inject gas. The gas injection at this time is not for treatment. Like interventional surgery, you must first determine whether the preoperative diagnosis is correct before proceeding.
When performing examination and diagnosis, the gas injection volume does not need to be large. It only needs to be operated at the lowest insurance pressure value, which is usually 8kpa. Dr. Yang and the others have set this number before debugging the machine in the examination room. Now they only need to start the gas injection program remotely.
The gas whizzes into the child's intestines without blowing or exploding the intestines.
Dr. Yang used the joystick to complete the continuous fluoroscopy of each part. On the screen, you can see the distribution map of the injected gas and the shiny objects gradually moving forward and spreading in the child's intestines.
As long as it is seen clearly, it can be said that all operations are carried out in an orderly manner under the control of the doctor. The next question is whether the operation can successfully achieve the goal.
The first step in diagnosis is to inject the gas into the ileocecum where the lesion is located. Before that, the gas has to pass through a long intestine as it advances through the intestinal tube. The human intestine is not as smooth as a tube.
The curvature is like eighteen bends. The term eighteen bends is an exaggeration. It is undeniable that there are some bends in the intestines where it is difficult for gas and liquid to pass even under normal circumstances. The most famous of these physiological bends are the splenic flexure and hepatic flexure.
The splenic flexure is located in the left upper abdomen of the human body and is the corner from the transverse colon to the descending colon. Because it is located near the spleen, it is called the splenic flexure of the colon.
This section of the bend is very difficult to turn. It is said that when performing a colonoscopy operation, the colonoscopy doctor has the most headache in letting the tube pass through this place smoothly.
Occasionally, the body's own excrement and stool will get stuck in this place. Clinically, some patients have pain under the left rib after meals or eating. It may be that they have been diagnosed with gastritis and suspected pancreatitis for a long time, but the result is not cured. In fact, there is a problem with the splenic flexure.
.Excessive adhesion of the splenic flexure of the colon develops into a benign stricture, which blocks gas and stool and makes the patient uncomfortable. This is called splenic flexure syndrome.
Returning to the current child, the gas on the machine screen shows that it enters from the anal canal to the rectum and then to the sigmoid colon. After passing through the descending colon, it has to go retrograde from the splenic flexure of the colon, which is a very difficult turn, to the transverse colon.
Dr. Yang gradually showed a serious look on his face. The small amount of air injected now is just enough to test the pressure that the intestinal bend here can withstand, so as to avoid exploding the intestine here when the air volume is increased.
The amount of gas distributed when the gas passes through the splenic flexure of the child is relatively low, which shows that the resistance encountered by the gas is extraordinary. Is it because of the intestinal obstruction caused by the intussusception in the front? Or is the child's physiological part of this place relatively flexed? The doctor is at a loss.
To be clear. An important reminder to the doctor is that if the air volume is increased later, there will be very few options.
The difficulty after the splenic flexure is the hepatic flexure.
The hepatic flexure is the corner from the ascending colon to the transverse colon. Its physiological structure reaches a 90-degree angle. It is called the hepatic flexure of the colon because it is located under the liver. After the hepatic flexure, the ascending colon is immediately connected to the cecum, where the intussusception occurs.
The blind part is very close.
Dr. Yang picked up the intercom and spoke to the doctor in the examination room: "Dr. Duan, I'm afraid it's not possible."
