nlwxpearo
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 Posted: Fri 23:13, 18 Mar 2011 Post subject: Small intussusception in children after abdominal |
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,[link widoczny dla zalogowanych]
Small intussusception in children after abdominal surgery (report of 7 cases)
Cases; youngest 1O months,[link widoczny dla zalogowanych], maximum 9 years, mean age 2.8 years. Among them, Hirschsprung's disease after 3 cases of acute appendicitis in 2 cases after resection of creeping tail. Choledochal cyst excision Rou ~ y anastomosis, 1 cupboard, duodenal stenosis after a fall. Site of intussusception in the jejunum in 4 cases, 3 cases = 1.2II Fou ileum bed-side performance are in the abdomen after 7 2 ~ 5d paroxysmal abdominal pain of different degrees (or cry illustrates), abdominal distension and vomiting. Decompression is invalid. 1 ~ 3d after a different amount of yellow mucous, blood does not appear they were not jam-like palpable abdominal mass, with hyperthyroidism or bowel sounds heard over the water and gas acoustic, x ray films were prompted abdominal standing position of organic maple obstruction. Line B ultrasonic examination in 4 cases. There were no intussusception. 1.3 Results 7 cases were confirmed after the second operation after a small intussusception, in which air back to the 4 cases of type 3 inverted back and forth. 7 backward manual reduction of intussusception patients, there was no intestinal necrosis. 2 to discuss the reasons for the formation of 2.1 intussusception has been reported is not entirely clear, both can occur after abdominal surgery in a small number of + can also occur in non-abdominal surgery. The split abdominal surgery induce autonomic nervous shock after retroperitoneal main port of intussusception. Hirschsprung's radical resection of congenital choledochal cyst Roux-y anastomosis were stimulated peritoneal and pelvic nerves, sympathetic and cut directly disrupt sympathetic, causing its dysfunction, bowel movements can not be normal. Hirschsprung's disease a longer operation time (average hospital 3 ~ 4h). As a long exposure time intestine and colon + free ligaments stretch intestinal loop, the removal of bowel disease, injury and pollution are likely to occur, leading to intestinal leakage, edema, thickening and spasm of normal bowel peristalsis to pass. Intraoperative anesthesia, infection, and postoperative fever, water-electrolyte and acid-base balance disorders,[link widoczny dla zalogowanych], such as low potassium and so can lead to intestinal disorders, prolonged gastrointestinal decompression after abdominal surgery and so may be related to the occurrence of intussusception United States. Misdiagnosis of intussusception after 2.2 (1) Small intussusception generally do not affect blood circulation, can be expressed as incomplete obstruction, coupled with the high site of obstruction, bowel obstruction distal fecal residue, often mistaken for a resumption of bowel function Bad or early adhesion. The group 2 patients after appendectomy. 2d to adhesions after surgery, patients diagnosed as small intussusception. (2) incision in the abdominal pain caused by intussusception cover. (3), abdominal distension caused by tension + so palpable abdominal mass is unclear. And often treated conservatively. (4) is a rare abdominal complication of intussusception after small, easy to lose sight of the recovery of preoperative diagnosis. Intussusception of the small group of seven cabinet occurred 1 week after surgery,[link widoczny dla zalogowanych], the longest only to intestinal obstruction and 9d after laparotomy. There are varying the amount of yellow mucous, so there was no jam-like and difficult to consider the disease. 2.3 The early diagnosis of intussusception after Adams should be emphasized that early diagnosis of small intussusception. When the early postoperative paroxysmal abdominal pain (or cry illustrates), abdominal distension, vomiting, gastrointestinal reservoir pressure is invalid, or a transient post-operative bowel function was improved, again about 1 week out of Li obstructive symptoms, x ray abdomen erect position slice suggest obstruction, should take into account the possibility of intussusception. Required abdominal surgery and intestinal obstruction in early Shuangxing differentiated, which is more common in the abdominal cavity pollution is serious, severe infection of appendicitis excision of the primary B-ultrasound diagnosis of intussusception is higher, then consider the line B- examination, ultrasound examination of the group B 4 down. There were no intussusception. The diagnosis of air enema for intussusception diagnosis and treatment of small black are helpless. Abdominal x-ray examination showed small bowel obstruction, no special diagnostic value. 2.4 Early diagnosis and preventive measures to prevent serious complications of surgery is the key. In order to reduce the incidence of intussusception after surgery is important to emphasize: (1) abdominal surgery should be noted that the operation time as short as possible to reduce the intestinal exposure (2) reduced retroperitoneal and pelvic nerve plexus of the interference; (3) reduce unnecessary intestinal stretch and squeeze t (4) strengthen anti-infection after surgery,[link widoczny dla zalogowanych], attention to maintain water and electrolyte and acid-base balance, and promote early resumption of intestinal function.
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