Student Wei was the first to stare: What? It doesn’t work? Why doesn’t it work?
How could it suddenly stop working? If not, the child would have to be taken to the operating room for surgery.
What did classmate Xie say?
You should first listen to what experienced Dr. Yang has to say.
The schematic diagram of the pathological anatomy of intussusception is as follows. As mentioned before, intussusception is when the head of one section of intestine is folded into the inner diameter of another section of intestine. The structure of intussusception can be divided into:
The outer layer is the outer tube, which is called the sheath, which is the outer diameter of the intestine being inserted. The head of the sheath is the neck opening, which is like the mouth of a bag holding the folded intestines inside. The middle layer is the middle tube, where the folded intestine segments enter the neck opening.
Part, 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 intestinal segment of intussusception, intussusception can be divided into various types: jejunum within jejunum, ileum within ileum, ileum within cecum, ileum within colon, colon within colon, etc.
The most common one is the ileum-caecum in this child today.
Do you think that everything is over after the ileum is folded into the cecum? No. The mechanism of intussusception is that intestinal dysfunction leads to unhealthy movements of the intestines. Until this unhealthy movement is corrected, the intestines will continue to move, and may
Because after intussusception occurs, the patient swings more violently in an attempt to break free.
The intestines want to live rather than die. This is the body's self-protection mechanism.
The problem is that the intestines are not like human hands and feet. They cannot move wherever the brain tells them to move. The swinging motion is like a random movement without a brain. What is the result of the random movement? It is like a drowning person.
If you don't know how to survive and move around, you will end up sinking into the sea. The harder you move, the faster you will sink and the faster you will die.
It’s the same as intussusception. The turbulent intestines prevent the head of the intussusception from retracting on its own. The intestines will continue to move forward, which means that the intussusception may become deeper and deeper. The outside of the intestines is the mesentery. The deeper the intussusception, the more the mesentery is pulled in.
The more interlayers there are between the outer tube and the middle tube and between the middle tube and the inner tube. In addition to tying the intestines, the mesentery also has important structures such as blood vessels to nourish the intestines. After the sleeve is deep, the blood vessels are stuck in the middle layer and there is no nutritional supply.
The greater the chance of intestinal necrosis.
According to the principle mentioned above, during the B-ultrasound examination, the doctor specifically asked the B-ultrasound doctor to scan the appendix again. First, he was afraid of appendicitis. Second, the surgeon was afraid of inserting a piece of the appendix.
This situation is not uncommon in clinical practice. These human body parts are close to each other. After the ileum is encased in the cecum, the ileocecal valve becomes the head of the intussusception, bringing the end of the ileum into the ascending colon, and the cecum and part of the appendix are brought together.
Turn it into the colon.
Just thinking about it makes you think this situation is very difficult.
Under fluoroscopy, the injected air reaches the head of the diagnostic site. The air entering the inner and outer tubes can show a cup-shaped image, which is a unique X-ray sign of intussusception. If too much is turned in, the gas will
It spreads in the chaotic mess of the intestinal tract, and overall it looks like a ball of light, with a somewhat unclear sense of layering.
Dr. Yang now observes the condition of the child's intestines under fluoroscopy. It does not appear to be cup-shaped or pincer-shaped at first.
Clamp-shaped, as you can imagine from the name, the structure of the inserted intestinal tube is relatively clear and layered like the cup mouth shape, and the depth of the inserted intestine may be deeper like a pair of pliers.