Reduction is a term most often heard by doctors in orthopedics. For example, a dislocated joint is reduced by a doctor using manipulation to reduce it. The meaning of reduction is easy to understand. In medicine, it means restoring an organ to its original normal state.
In intussusception, the most straightforward and easiest way to get the intestines out and restore them to their original state is for the doctor to reach in and straighten the folded intestines. This still requires surgery.
Duan Sanbao knew that what Xie suggested was definitely not this surgery. It was not that there were no conditions on site. The emergency department of the Capital Children's Hospital had an emergency operating room for emergency surgery, but there were no specialist doctors.
If the emergency doctor is able to cure the case, then he is awesome. In fact, what the emergency doctor can do is to protect the child as long as possible until the specialist arrives. They are not pediatric general surgeons who can perform any surgery.
Is there no way out without surgery? Many medical cases have mentioned that medicine and other engineering disciplines have similarities and differences. Without surgery, the doctor's hands do not have to go in to fix the broken intestines, but tools can be used to follow engineering principles to solve the problem.
The intestine is a bit like a rubber tube. In addition to using external force to pull out the folded rubber tube, another method called inflating is often used to make the concave rubber objects bulge.
In this regard, you can try to reversely pump air into the intestinal cavity, and use the force of the gas to force the folded section that is inserted into the concave part to withdraw. This method of resetting the intestine is called air enema in clinical practice.
Because the peristaltic wave of the intestine moves downward, most of the intussusception moves in line with the peristaltic wave of the intestine, from the proximal end to the distal end. When pumping air, you have to do it the other way around, from the distal end. To pump air from the distal end, the outlet of the distal intestine of the human body is the anus of the human body, that is, inject air into the intestinal tract from the anus.
Injecting air into the human body is a high-risk operation and doctors must perform it under visual monitoring.
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If you want to see the whole intestine after gas injection without opening the abdomen, B-ultrasound is definitely not suitable. B-ultrasound can only be used for local observation. We can think of the closest real-time surgical monitoring method to this method, yes, it is interventional surgery.
Like interventional surgery, an X-ray fluoroscopy system is used to monitor the surgery in real time at any time. Although barium meal fluoroscopy is relatively dangerous for patients with intussusception, it is eliminated. Unlike barium meal, air enema does not inject indigestible barium but air, which has a higher safety coefficient. In summary, what Mr. Xie refers to is the air enema reduction method under fluoroscopy.
Student Wei spoke up again: "I know, Yingying is talking about using air enema."
Xie Wanying thought: Wei's quick response to pediatrics showed that she was particularly interested in it. Classmates said that Wei's grades were average, and the only explanation was that Wei was interested in pediatrics. The question was why did Wei deny it himself? Could it be that Wei denied that he liked pediatrics in order to divert attention?
"Don't you know about air enema?" Seeing that Duan Sanbao didn't respond, Wei Shangquan questioned what this Guodu academic master was doing.
The attending physician was obviously worried. It is understandable that young doctors have many concerns. Young doctors have little experience and are not confident. At present, the intussusception of this child may have occurred for more than 48 hours, and the elders in the family discovered the abnormality of the child too late.
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