As soon as Dr. Yang said this.
Wei was the first to stare: What? No? Why is it not possible?
How could it suddenly fail? If it fails, the child will have to be taken to the operating room for surgery.
What does Xie say?
First, listen to what the experienced Dr. Yang says.
The pathological anatomical structure diagram 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 inserted intestine. The head of the sheath is the neck, like a bag with the folded intestine inside. The middle layer is the middle tube, where the folded intestine enters the neck. The front end here is called the head of the intussusception. The innermost layer is the inner tube, where the folded intestine must be folded back after being inserted into the opposite pocket.
According to the intestinal segments that are intussuscepted, intussusception can be divided into several types: jejunum within jejunum, ileum within ileum, ileum within cecum, ileum within colon, colon within colon, etc.
The most common one is the ileum invaginate cecum in the child we are seeing today.
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Do you think that the ileum is broken into the cecum and that's it? No. The mechanism of intussusception says that intestinal dysfunction leads to unhealthy intestinal movement. Before this unhealthy movement is corrected, the intestines will continue to move, and may swing more violently after intussusception in an attempt to break free.
The intestines want to live, not 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 in any direction as told by the brain. The swinging motion is like a random movement without a brain. What is the result of random movement? It is like a drowning person who does not know how to survive. The result of random movement is sinking into the sea. The harder it moves, the faster it sinks and the sooner it dies.
It's the same as intussusception. The moving intestines prevent the intussusception head from withdrawing by itself, so the intestines will continue to move forward, which is equivalent to getting deeper and deeper. The outside of the intestines is the mesentery. The deeper the intussusception, the more mesentery is pulled into the interlayer between the outer tube and the middle tube, and between the middle tube and the inner tube. In addition to tying up the intestines, the mesentery contains important structures such as blood vessels to nourish the intestines. When the intussusception is deep, the blood vessels are stuck in the middle layer, and the intestines without nutrition supply are more likely to necrotize.
According to the above principle, when doing ultrasound examination, the doctor specifically asks the ultrasound doctor to scan the appendix again. One reason is to avoid appendicitis. The other reason is that the surgeon is afraid of inserting the appendix together.
This situation is not uncommon in clinical practice. These parts of the human body are close to each other. After the ileum is intussuscepted to the cecum, the ileocecal valve becomes the head of the intussusception, carrying the end of the ileum into the ascending colon, and the cecum and part of the appendix are turned into the colon together.
Just thinking about it makes you feel that this situation is very tricky.
Under fluoroscopy, the injected gas reaches the cuff at the diagnostic site. The gas entering the inner and outer tubes can present a cup-shaped image, which is a unique X-ray sign of intussusception. If too much stuff is turned in, the gas will diffuse in the chaotic intestinal tube, and the overall appearance will look like a light ball with a little difficulty in distinguishing the layers.
Doctor Yang is now observing the child's intestinal condition under fluoroscopy, and it does not appear to be the initial cup-shaped or clamp-shaped shape.
As the name suggests, the inserted intestinal structure is relatively clear and layered, just like the cup-shaped one, and the depth of the insertion may be deeper, like a pair of pliers.
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