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¡¾2332¡¿Reverse pumping

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    Reduction, people may hear this term most often from doctors in orthopedics, for example, joint reduction.  The doctor used manipulation to reset the dislocated joint.  The meaning of reset is easy to understand. In medicine, it means restoring the organ to its original normal state.

    In intussusception, the most straightforward and easiest way to think of to take out the encased intestines and restore them to their original state is for the doctor to put his hands in and straighten the folded intestines.  In this case, surgery will still be required.

    Duan Sanbao knew that what classmate Xie suggested was definitely not this surgery.  It¡¯s not that there are no conditions at the scene. The Emergency Department of Seoul Children¡¯s Hospital has an emergency operating room for emergency surgery, but there are no specialists.

    If the emergency doctor has the ability to cure the case, you are considered awesome. In fact, what the emergency doctor can usually do is to protect the child and wait as long as possible until the specialist arrives.  They are not pediatric general surgeons.

    Is there absolutely no solution without surgery?  As mentioned in many medical cases before, medicine and other engineering disciplines have similar results but different approaches.  No surgery is required, and the doctor's hands cannot go in to reposition the broken intestine. Instead, tools can be used to solve the problem following engineering principles.

    The intestine is an organ that looks a bit like a rubber tube.  In addition to using external force to pull out and integrate the discounted rubber tube, another method called inflating can usually be used to bulge the dented rubber items.

    At this point, you can try to pump air in the intestinal cavity in the opposite direction, and use the momentum of the gas to force the folded section that has been inserted into the recess to exit.  This method of resetting the intestines is clinically called an air enema.

    Because the intestinal peristalsis wave moves downward, most of the intestinal intussusception moves in line with the intestinal peristalsis wave, from the proximal end to the distal end.  When inflating, you have to do it in the opposite direction, from the far end.  To inject from the distal end, the outlet of the distal intestine of the human body is the anus of the human body, that is, air is injected into the intestine from the anal opening.

    Injecting air into the human body is a high-risk operation, and doctors must perform it under visual supervision.

    If you want to see the condition of the entire intestine after gas injection without laparotomy, it is definitely inappropriate to use B-ultrasound.  B-ultrasound can only perform partial observation.  The closest thing we can think of to this kind of real-time surgical monitoring is interventional surgery.

    Like interventional surgeries, real-time surgical monitoring can be achieved at any time using an X-ray fluoroscopy system.  Although barium meal fluoroscopy is more dangerous and eliminated in patients with intussusception.  Air enema is not like a barium meal. What is injected is not the indigestible barium but air, which has a relatively higher completeness coefficient.  To sum up, what Xie is referring to is the air enema reduction method under fluoroscopy.

    Classmate Wei spoke up again: "I know, Yingying is talking about using air enema."

    Classmate Xie Wanying thought: Every time classmate Wei responds to pediatrics, she quickly shows her special concern for them.  The classmates said that Wei's grades were average, and the only explanation was Wei's interest in pediatrics.  The question is why Mr. Wei denies it himself. Could it be that Mr. Wei denies that he likes pediatrics just to gain sway?

    "Don't you know about air enema?" Seeing that Duan Sanbao didn't respond, classmate Wei Shangquan questioned what had happened to this top student in the capital.

    The attending doctor is obviously concerned.  It is understandable that young doctors have many concerns. Young doctors have little experience and lack of confidence.  At present, the onset time of intussusception in this child is probably more than 48 hours, and it is too late for the elders in the family to discover the abnormality in the child.

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