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¡¾2337¡¿Intestinal twists and turns

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    After introducing the instruments, refer to the interventional surgery. Now there are two steps that need to be done before treating the child under fluoroscopy.

    First, it is to determine whether the tube has entered the human body in place, whether the tube is fixed well, and whether the amount of the fixed air bag is too large or too small.

    Dr. Yang skillfully used the operating rod to see through the anus of the child.  The bright little blob appears on the screen of the machine, indicating that the air bag has fully filled the anus.

    The tube is not leaking or running, so it¡¯s time to inject gas.  The gas injection at this time is not for treatment first. Like interventional surgical procedures, 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, usually 8kpa.  Dr. Yang and the others had set this number before debugging the machine in the examination room. Now they only need to remotely start the gas injection process.

    The gas whizzes into the child's intestines without blowing up the intestines.

    Dr. Yang uses the operating lever to complete continuous fluoroscopy of each part.  On the screen, you can see the distribution map of the injected gas and the glowing objects gradually advancing and spreading in the child's intestines.

    As long as you look through it, you can say 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 in diagnosis is to inject gas into the ileocecum where the lesion is located.  Before this, the gas had to pass through a long section of intestine as it progressed through the intestines.  The human intestine is not as smooth as a tube, it is as winding as eighteen bends.  The idea of ??eighteen bends is an exaggeration. It is undeniable that there are some bends in the intestines that are difficult for gas and liquid to pass through even under normal circumstances.  The most famous of these physiological curvatures are the splenic flexure and hepatic flexure.

    The splenic flexure is located in the left upper abdomen of the human body and 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.

    It is said that this section of the bend is very difficult to turn. It is said that when performing a colonoscopy operation, colonoscopy doctors have the most headache to let the tube pass through this place smoothly.

    Occasionally, the body's own excrement and stool will get stuck in this place.  Clinically, some patients experience pain under the left rib after meals or after eating. They may have been diagnosed with gastritis for a long time and suspected pancreatitis, but the result was not cured. In fact, there is a problem with the splenic flexure.  Excessive adhesion of the splenic flexure of the colon develops into a benign stricture, which blocks gas and stool and makes the patient uncomfortable, which is called splenic flexure syndrome.

    Back to the current child, the gas on the machine screen shows that it enters from the anal canal to the rectum and then to the sigmoid colon. After passing through the descending colon, it has to go retrograde from the splenic flexure of the colon, a very difficult turning, to the transverse colon.

    Dr. Yang gradually showed a serious aura on his face. The small amount of air injected now is just enough to test how much pressure the intestinal bend can withstand, so as to avoid exploding the intestine here when the air volume is increased.

    The amount of gas distributed when the gas passes through the splenic flexure of the child is relatively low, which shows that the resistance encountered by the gas is extraordinary.  Is it caused by intestinal intussusception in the front?  Or is this child's physiological part more flexed?  The doctor couldn't explain clearly for a while.  An important reminder to doctors is that there will be very few options if the air volume is increased later.

    The difficulty after splenic flexure is hepatic flexure.

    The hepatic flexure is the corner from the ascending colon to the transverse colon. The physiological structure reaches a 90-degree angle. Because it is located under the liver, it is called the hepatic flexure of the colon.  After the hepatic flexure, the ascending colon is immediately followed by the cecum, which is very close to the ileocecal part where intussusception occurs.

    Dr. Yang picked up the intercom and spoke to the doctor in the examination room: "Dr. Duan, I'm afraid it's not possible."

    ©¤©¤©¤©¤©¤Digression©¤©¤©¤©¤©¤

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