Transcolonic intussusception bowel resection

Surgical treatment of intussusception by colonic intussusception. Intussusception refers to a disease caused by the insertion of a proximal intestinal tube into the distal lumen. It is one of the common acute abdomen diseases in pediatric surgery. Most infants and young children within 1 year of age, especially those with 4 to 10 months of age, have the highest incidence. The incidence is significantly reduced by less than 4 months and greater than 2 years of age. The majority of infant intussusceptions are not accompanied by organic lesions, and only about 2% to 5% are caused by organic lesions. The disease has a high incidence in the spring and may be associated with upper respiratory tract infections and lymph node virus infections. Sudden changes in feeding methods and diet patterns may also be one of the causes of the disease. In organic lesions, Michael's diverticulum, polyps, intestinal duplication and tumors can be seen as the starting point for inducing the intussusception. After the intubation occurs in the intestine, the intestinal wall is generally folded into 3 layers. In a few cases, when the ileum is inserted into the ileum and then inserted into the colon, it can be folded into 5 layers, so it is easy to cause blood vessels in the intestine, which can occur in the early stage. The necrosis of the intestine tube is inserted into the intestine, and the intestine tube is pushed forward with the peristalsis of the intestine, causing the intestinal lumen to be compressed and formed an obstruction. Due to the compression of the sheath tube, the intestinal mesenteric blood supply gradually becomes obstructed. First, the venous return is limited, the intestinal vascular stagnation is bleeding, and the intestinal tube pressure is continuously increased until the arterial supply is interrupted, and the intestinal tube is necrotic and perforated. However, because it is enclosed in the sheath, there are few signs of peritonitis. The common intussusception is the return-knot type, followed by the back-return-knot type, and the small intussusception is less common. Treatment of diseases: pediatric intussusception intussusception Indication The colonic intussusception is only suitable for invasive intussusception, and the intestine is necrotic. The forced extrusion may lead to injury of the sheath. Preoperative preparation Children without dehydration and acidosis can be treated with open venous access, placement of nasogastric tube and early surgery. In case of dehydration, acidosis or shock, short-term fluid replacement, blood transfusion and anti-shock treatment are required. The operation was performed immediately after the above positive treatment. Antibiotics should be given before surgery. Surgical procedure 1. Put the invertible tube that cannot be repaired outside the incision, and protect the abdominal cavity with a saline gauze pad. Make a circle of interstitial muscle suture at the junction of the insertion part and the sheath. Then, the ascending colon is cut longitudinally on the colonic band close to the mass, and the necrotic intestine is taken out. 2. The necrotic intestine is cut at the base of the nesting portion. A 3-0 or 4-0 gut or absorbable suture is sutured continuously or intermittently through the two layers of the intestinal wall. 3. A latex tube with a side hole was placed in the ileum through the anastomosis, and the other end was taken out from the cecum as a temporary decompression, and then the colon wall incision was sutured with a 2-0 silk suture, and the muscle layer was additionally applied. Stitching. Rinse the abdominal cavity, and the drainage tube in the cecum is taken out from the abdominal wall. The layers of the abdominal wall incision were sutured layer by layer. complication 1. Intussusception recurrence. 2. The abdominal incision is split. 3. Infection. 4. Intestinal adhesions and adhesive intestinal obstruction. 5. Enteral necrosis and perforation.