Air enema is a relatively safe method for reducing intussusception. It is widely used in clinical practice and is a mature technique. However, it has time requirements for the patient's condition. For example, myocardial infarction must be treated within a certain number of hours, otherwise the effect will be greatly reduced or even ineffective.
Specifically, statistics have been made on clinical cases. The data show that this method has the highest success rate within 24 hours of the onset of the disease, which can reach more than 90%. After 24 hours, there is a certain effect within 48 hours. After 48 hours, the folded part of the intestine is almost necrotic, and pumping air at this time will basically have no effect and surgery will be required. So Xie Wanying said that she must seize the last window of time within 48 hours.
The problem is that it has been nearly 48 hours now, the chance of intestinal necrosis is high, and the success rate of air enema is low. It would be a big risk to try this on the child again.
It is not to say that air enema is completely harmless. The most dangerous part of air enema is obvious. It is like inflating a rubber. If it cannot be inflated, you can only add gas and increase the air pressure. When the pressure increases, it is possible that the tube will burst inside the lumen. Necrotic intestines are difficult to inflate and the chance of bursting is higher. In the human body, bursting the intestines is intestinal perforation and massive bleeding in the abdominal cavity.
Well, the doctor knows about this terrible complication, how about turning the pressure down as much as possible. There is also a tricky complication waiting for you, intussusception.
Most laymen would find this unbelievable: You use this method to solve intussusception, so how could it cause intussusception?
The intestines are far more complex than a rubber tube. A rubber tube has only one layer of skin and is flat, but the intestines are not.
According to the branch histology in anatomy, the structure of the intestine can be divided into the mucosal layer, muscular layer and serosa. The most complex mucosal layer has a circular wrinkled wall structure, which is simply called wrinkled, and is a normal physiological phenomenon.
The wrinkles of the intestinal mucosa are a physiological structure that has evolved naturally in the human body in order to retain the time that food passes through the intestines, so that the intestines can properly absorb the nutrients in the food.
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Just imagine, if food slides through the intestines like in a smooth rubber tube, the food will pass through the intestines too quickly. It will be difficult for the human body to absorb the nutrients in the food and even water.
When clinically examining the digestive tract, if you pay attention to some of the examination reports, you can see the doctor's description of the intestinal folds. If there is a problem with the annular folds, it means that part of the reason for the patient's indigestion is here.
Due to the special physiological structure of the intestine, if the air cannot push back the invaginated intestine after entering the intestine, it may cause dysfunction of other intestinal segments and cause intussusception in other parts. The wrinkled walls of the intestine are another potential factor that causes intussusception.
In a word, as long as the probability of intestinal necrosis is high, it cannot be pushed out by pumping, not to mention curing, there will be many complications. The probability of intestinal necrosis is proportional to the onset time of the child.
It seems that the success rate of air enema for this child is not very high, and the doctor's focus must remain on complications. I am not a pediatric general surgery specialist, I have handled few cases, and I have no experience in dealing with such cases. I know there is this method, but I am not sure that I can solve the problems that arise during the treatment process, so I have no choice but to give up.
It is safer not to do it than to risk the child's life. If it is done and complications occur, it may be attributed to medical malpractice. Doctors dare not take this risk.
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