After introducing the instrument and referring to interventional surgery, there are two steps that need to be completed before treating the child under fluoroscopy.
First, it is to determine whether the tube is properly inserted into the human body, whether the tube is fixed well, and whether the fixed air bag volume is too large or too small.
Doctor Yang skillfully manipulated the joystick to see through the child's anus. A bright ball appeared on the machine screen, indicating that the airbag had fully filled the anus.
The tube is not leaking and running, so it can be inflated. At this time, the inflated air is not for treatment. As with interventional surgery, it is necessary to first determine whether the preoperative diagnosis is correct before proceeding.
When performing inspection and diagnosis, the gas injection volume does not need to be large, as long as it is operated at the lowest insurance pressure value, generally 8kpa. This number was set by Dr. Yang and his team when debugging the machine in the inspection room. Now all we need to do is start the gas injection program remotely.
The gas whizzes into the child's intestines, which may burst the intestines.
Doctor Yang used the joystick to perform continuous X-rays of various parts. On the screen, one could see the distribution of the injected gas glowing as it gradually moved forward and diffused in the child's intestines.
As long as the fluoroscopy is done, 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 this operation can successfully achieve the goal.
The first step of diagnosis is to get the gas to the location of the lesion back to the cecum. Before that, the gas has to pass through a long section of the intestine as it moves forward. The human intestine is not as smooth as a tube, but has eighteen bends. The saying of eighteen bends is an exaggeration, but it is undeniable that there are some bends in the intestine that are difficult for gas to pass even under normal circumstances. The most famous of these physiological bends are the spleen flexure and the liver flexure.
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The splenic flexure is located in the upper left abdomen of the human body. It 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 bend is so difficult to turn that it is said that the biggest headache for colonoscopists during colonoscopy is getting the tube to pass smoothly through this place.
Occasionally, the excreta of the human body will get stuck in this place. In clinical practice, some patients feel pain under the left rib after meals or eating. They may have been diagnosed with gastritis and suspected pancreatitis for a long time, but the results were not cured. In fact, there is a problem with the splenic flexure. Excessive adhesion of the splenic flexure of the colon develops into benign stricture, which blocks gas and stool and makes the patient uncomfortable. This is called splenic flexure syndrome.
Back to the current child, the gas on the machine screen shows that it enters the anal canal, goes to the rectum, and then to the sigmoid colon. It passes through the descending colon and goes back to the transverse colon at the extremely difficult turn of the splenic flexure of the colon.
Doctor Yang's face gradually showed some seriousness. Injecting a small amount of gas now was just right to test how much pressure the bend of the intestine could withstand, so as to avoid the intestine from bursting here when increasing the gas volume.
The amount of gas distributed when passing through the splenic flexure of the child is relatively low, which shows that the gas encounters unusual resistance. Is it because of the intussusception in front that causes intestinal obstruction? Or is it because the child's physiological part is more curved? The doctor couldn't tell for a while. The key reminder to the doctor is that if the gas volume is increased later, there will be few options.
The next difficult hurdle after the splenic flexure is the hepatic flexure.
The hepatic flexure is the corner from the ascending colon to the transverse colon. The physiological structure is a 90-degree bend, and because it is located under the liver, it is called the hepatic flexure of the colon. After the hepatic flexure, the ascending colon is followed by the cecum, which is very close to the ileocecal region where intussusception occurs.
Doctor Yang picked up the intercom and spoke to the doctor in the examination room: "Doctor Duan, I'm afraid this won't work."
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