Returning to ’90s, She Became Famous in Major Surgical Fields

   Chapter 2331 [2331] Appropriate means of inspection

  Before taking medical measures, it is necessary to make a clear diagnosis in a non-rescue situation.

  If intussusception is suspected and selected for auxiliary examination, barium meal is usually taught in previous textbooks.

   This is because at that time there was a shortage of b-ultrasound machines and CT machines, and only X-ray machines had abundant resources.

   Advances in medical technology allow doctors to have more choices, thereby eliminating those inappropriate examination methods.

  For example, barium meal is actually very inappropriate, because intussusception causes intestinal obstruction. If you give barium meal again, it will only aggravate intestinal obstruction.

  ct has radiation, and b is the first choice for fast and convenient.

  There is a b-ultrasound room in the emergency department of Seoul. It's the fastest way to carry the child over there.

   Several people came to the b ultrasound room with their children. Since the child was in a hurry, I explained it to the other children and parents in the queue, and went straight to the front for the check.

   There are four typical symptoms of intussusception. One is the paroxysmal abdominal pain manifested as the child crying and then quiet. The second is vomiting, which this child has. The third is jam-like stool with **** mucous membranes, which this patient did not have. The fourth is a sausage-like mass, there is.

   There are only two of the four symptoms, which can only be called preliminary suspicion, and instrument-assisted examination is necessary. Like vomiting and sausage-like lumps are signs of intestinal obstruction, not necessarily due to intussusception. For example, another common clinical child disease ascariasis. Ascaris clumps can also cause intestinal obstruction, but the age of onset is generally older in older children, but it is true that this disease usually does not have **** stools. If the doctor's hand touches the lump, the surface of the roundworm group is cord-like. That is to say, depending on the feeling of the doctor's hand, each doctor feels different, it is like Schrödinger's cat and can't tell.

  B-ultrasound examination is much more intuitive. According to the principle of intussusception, b-ultrasound can detect the phenomenon of a large ring and a small ring, which is called the concentric circle sign.

   The clinician stood around and followed the b-ultrasound doctor. Two hypoechoic clumps appeared on the instrument screen, with a hyperechoic band in the middle.

   "It should be intussusception." The doctor's b-ultrasound knows a lot about this disease.

   Just in case, scan the child's appendix. Acute appendicitis is also a very common and easily overlooked acute abdomen in infants and young children. The appendix is ​​attached to the cecum, so it is close to the location of the onset of the disease, so it is necessary to distinguish it.

   After scanning the appendix of the child, there is no problem. If you want to be more cautious, you can do CT again. CT is more time-consuming, and there is no need to add CT if there are relatively clear inspection results.

  A great doctor can save money for patients and their families.

   Now the focus is on the next medical strategy.

  Intussusception, if severe intestinal necrosis is caused, an operation should be performed immediately, and the dead part of the intestine will be cut off for enteroenteric anastomosis. Inform the emergency nurse to call and call the pediatric general surgeon of the inpatient department to come down to see the child, so that a decision can be made.

   Today happens to be the first day for the employees to return to the hospital collectively, which is the busiest time for everyone. Many surgeries that were delayed by the holidays were scheduled to be done in a hurry, and the surgeries the day before were filled to the brim. It is said that all pediatric general surgeons have gone to the operating room, and it will take some time to notify the doctor that they have come down from the operating room.

   Until the inpatient department comes down to pick up the patient, the doctor in charge continues to be the emergency doctor.

   Seeing that the child's condition was getting worse, Xie Wanying suggested, "Let's hurry up and try to reset the child, Dr. Duan."

   Thank you for your support! ! ! Good night dears~

   (end of this chapter)

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