Chapter 2338 【2338】Far More than That

Doctor Yang's words fell to the ground.

Student Wei was the first to stare: what? no? Why not?

How can it suddenly not work? If not, the child will be taken to the operating room for surgery.

What do you say, classmate Xie?

We must first listen to what experienced Dr. Yang has to say.

The schematic diagram of the pathological anatomy of intussusception is as follows. As mentioned earlier, intussusception is when the head of one section of intestine is folded into the inner diameter of another section of intestine. According to this, the structure of intussusception can be divided into:

The outer layer is the outer tube called the sheath, which is the outer diameter of the inserted intestine, and the head of the sheath is the neck, like a bag with the folded intestine inside. The middle layer is the middle tube, the part where the folded intestinal segment enters the neck of the person, and the front end here is called the head of the intussusception. The innermost layer is the inner tube, and the intestines have to be folded back after being folded into the opposite pocket.

According to the intussusception, intussusception can be divided into several types: jejunum-in-jejunum, ileum-in-ileum, ileum-in-caecum, ileum-in-colon, colon-in-colon, and so on.

The most common one is the ileum with cecum in this child today.

Do you think the ileum is discounted into the cecum? no. The mechanism of intussusception has been said that intestinal dysfunction leads to unhealthy movement of the intestinal tube. Until this unhealthy movement is corrected, the bowel will continue to move and may wiggle more violently in an attempt to break free after an intussusception occurs.

The intestines want to live or not to die, which is the body's self-protection mechanism.

The problem is that the intestines are not like the hands and feet of a human being. They can't move wherever the brain tells them to move, and they move around as if they have no brains. What is the result of your own turmoil, like a drowning person who doesn't know how to survive, the result of turbulent movement is nothing, the more violent you move, the faster you sink, the faster you die.

Same as intussusception. The turbulent intestines make the intussusception head unable to withdraw by itself, and the intestines will continue to move forward, which means that the intussusception may become deeper and deeper. The outside of the intestine is the mesentery, and the deeper the sleeve is, the more the mesentery is pulled into the interlayer between the outer and middle cylinders and between the middle and inner cylinders. In addition to the mesentery that binds the intestines, there are important structures such as blood vessels that nourish the intestines. After the sleeve is deep, the blood vessels are stuck in the middle layer, and the intestines without nutrient supply have a higher probability of necrosis.

According to the principle mentioned above, during the b-ultrasound examination, the doctor specifically asked the b-ultrasound doctor to scan the appendix again. One is fear of appendicitis. The second is that the surgeon is afraid of inserting the appendix together.

This situation is not uncommon in clinical practice. These body parts are close to each other. After the ileum sleeves 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 carried into the colon together.

Do you think this situation is difficult just thinking about it?

Under fluoroscopy, the insufflated gas comes to the sleeve of the diagnostic site. When gas enters the inner and outer tubes, a cup-shaped image can appear, which is a unique X-ray sign of intussusception. If too many things are turned in, the gas will permeate the messy intestinal tube, and the overall appearance will look like a light ball with a sense of indistinct layering.

Dr. Yang is now observing the condition of the patient's bowel from a perspective view, and it does not seem to be the original cup-shaped or clamp-shaped.

Pliers-shaped, as you can imagine from the name, the inserted intestinal structure is relatively layered and clear like the cup-shaped, and the depth of the sleeve may be deeper like a pair of pliers.