This Doctor is Great

a patient comes,

Zhou Mo quickly picked up the pen and paper and left the duty room.

"Huh!"

Zhou Mo went out to take a look and saw that the patient was very special.

1 year old baby!

"Wow wow~~~~"

Weeping in pain, his face turned purple from crying.

Cries resounded throughout the East Ward.

The baby's mother was holding the baby, tears dripping, while the father was busy going through the admission procedures.

Zhou Mo ran over quickly: "Hello, I'm your doctor, what's wrong with the baby now?"

The mother hugged the baby tightly and cried, "I don't know either. After feeding Niu Niu rice at noon today, Niu Niu started to cry for some reason. She cried for a long time and seemed to be in pain..."

Zhou Mo: "How many times have you cried? How long have you cried each time?"

Mom: "Niu Niu has cried several times since noon... every time for more than ten minutes, she used to be very obedient and never cried when she hugged her. Now she can't even hug her..."

Zhou Mo breathed a sigh of relief. Fortunately, these parents belong to the kind that can communicate and speak fluently.

Zhou Mo: "Go, go to the ward..."

It was the first time for Zhou Mo to pick up such a young patient, so he was a little nervous.

Ask while walking: "Is there any time not to cry? How long will you not cry?"

Mom: "Niu Niu cries for ten minutes each time, then quiets down for ten minutes, and then cries for ten minutes... Is my baby eating something wrong? Why does it hurt so much?"

Zhou Mo shook his head: "Eating something wrong, it should be gastroenteritis, and logically speaking, there will be no such paroxysmal pains at intervals of more than ten minutes."

"Did you come from the emergency department or the outpatient department?"

"Emergency."

"Did the emergency department diagnose the baby?"

"Yes, I called a few doctors in the emergency department for consultation, and finally there was a B-ultrasound result... What about intussusception."

intussusception?

Zhou Mo was taken aback for a moment.

Life is impermanent, the large intestine wraps the small intestine?

The so-called intussusception is actually a "telescope-style big trap and small circle", and the small intestine enters the ileocecal part.

(Big guy, last picture?)

However, starting at noon, it was clearly acute.

Zhou Mo hurriedly said: "Show me the results of the B-ultrasound."

Mom cried, "At my husband's place."

Zhou Mo: "Wait here for a while, I'll get it..."

He quickly walked out of the ward and went to the nurse's station.

At this moment, Teacher Zhang Luojia also came over: "What's the condition of the patient?"

Zhou Mo: "The consultation in the emergency department is for intussusception. I'll go get the B-ultrasound results."

Soon, Zhou Mo got the B-ultrasound result from her husband.

Two pictures.

——One is a cross-sectional view: it is the sign of "concentric circles\

,"——One is the longitudinal section: it is the "sleeve" sign.

——B ultrasound teacher: consider intussusception, see blood flow signal

Obviously, there is no doubt about it.

It's definitely intussusception.

Zhou Mo handed the B-ultrasound results to Teacher Zhang Luojia: "Teacher, it's intussusception. It appeared at noon. It's been 3 hours now. It must be acute intussusception. It needs to be smoothed out as soon as possible... "

Teacher Zhang Luojia took a look: "Okay, I will contact the doctor now."

Intussusception in children is usually primary. In acute cases, it may be caused by food, problems in the ileocecal itself, intestinal spasm, etc...

While waiting for the doctor to come over, Zhou Mo looked at the results of other examinations.

There is a routine blood test showing leukocytosis.

There is no problem with liver function and kidney function.

"Ugh~~~"

At this moment, the crying baby suddenly vomited out.

"Ah~~Niu Niu, what's wrong with you?" Mom was worried all of a sudden, ignoring the dirty vomit, hugging and crying.

Zhou Mo comforted: "It's okay, intussusception, vomiting is a normal symptom."

The mother cried: "Doctor, will my baby... woo woo woo~~~~"

Zhou Mo sweated wildly, and quickly comforted him: "There should be no major problems, and a doctor will come to deal with this intussusception soon..."

But obviously this kind of comfort is of no use.

Mom is still so nervous.

Zhou Mo: "I'll give the baby a checkup to see how his body is doing now, how is it?"

Mom hurriedly said: "Doctor, I'm sorry to trouble you, hurry up and check me up..."

Zhou Mo checked it out and breathed a sigh of relief.

The baby, apart from being pale and restless, was well nourished.

In other words, the condition is not serious.

Severe acute intussusception (long time, increased inflammation, necrosis), the baby will have dehydration, electrolyte imbalance, listlessness, lethargy, unresponsiveness... and other symptoms.

More serious is peritonitis, toxic shock. (Talk about these two later)

Zhou Mo breathed a sigh of relief and comforted: "The situation is fine, you can rest assured and wait for the doctor to come..."

Mom: "Really? That's great, woo woo woo~~~~"

After a minute or two,

The baby stopped crying and began to quiet down.

Mom breathed a sigh of relief: "Look, doctor, Niu Niu's behavior is like this, for a while crying manically, and for a while being quiet..."

Zhou Mo explained: "This is a characteristic of intussusception, paroxysmal crying, because there is a certain time interval for intestinal peristalsis, when the intestinal peristalsis pushes the intussusception forward, the mesentery is pulled, and the bowel Severe pain caused by strong contraction of the intussusception sheath, when the peristaltic wave passes, the child becomes quiet."

Mother:"?????"

Did not understand.

(Pretty boy reader: "I understand!!")

Zhou Mo smiled and said: "This kind of distress shows that the baby's health is not bad... because once the intussusception is serious, it will be combined with intestinal necrosis and peritonitis, and the baby at that time will be depressed and unresponsive... how good it is now Ah, although he cried a lot, he is in good spirits..."

"Huh? Really?"

Mom was surprised.

Can you still understand it this way?

But I have to say, after being told by Zhou Mo, she immediately felt relieved a lot!

At this time, the husband finished the formalities and came over quickly.

Zhou Mo: "The doctor will come later, and if there is no problem after seeing it, he will take the baby for an intussusception reduction... The specific method is: "air enema to reset intussusception". "

To put it simply, it is to use a machine "colon gas injection machine" and anal cannula.

Inflate.

Gas passes through: anus - rectum - colon, cecum (ileocecal) - small intestine...

A large amount of gas accumulates in the ileocecal area, and the pressure increases. The caliber of the small intestine is too small, and the deflation is too slow. A large amount of gas cannot be vented, and the intussusception can be pushed away by huge pressure.

(Note: This method is only suitable for those under the age of 2, and the success rate is relatively high. But for those over the age of 2, or even adults, most of the intussusception is secondary (other causes), so this method is not very good. Then look at it as surgery, not gastroenterology)

...

Tread Tread~~~

Soon, a middle-aged doctor and teacher Zhang Luojia walked in quickly.

After an introduction,

The middle-aged doctor began to examine the baby.

The first is palpation, touching the baby's upper right abdomen and lower right abdomen.

Then disinfected and put on gloves, after applying lubricant, touched the baby's anus, and soon 'taken out' the bloody stool like jam.

Jam-like bloody stool is an important diagnostic symptom of intussusception.

confirmed!

Yes - intussusception! !

.