Common diseases in pediatric surgery: intestinal gas

Common diseases in pediatric surgery: intestinal gas

Intestinal gas is one of the common diseases in pediatric surgery. Do you know what intestinal gas is? The following is the knowledge about intestinal qi that I brought to you. Welcome to reading.

1. What is "intestinal gas"? How is it formed?

Inguinal indirect hernia is the most common disease in pediatric surgery. In pediatric surgery, intestinal gas is equivalent to a cold in pediatric internal medicine. Boys are more common than girls.

When the baby is still in the womb (because boys are more common, take men as an example), the testicles of a male baby are not in its uterus-scrotum, but grow under the kidneys in the stomach. With the development of the embryo, the testis needs to descend slowly. It pushes away the fascia and muscles of the abdominal wall, thus forming the scrotum. The testis stays outside the stomach, avoiding the relatively high temperature in the abdominal cavity. From this, you can imagine a worker opening a tunnel on the abdominal wall, which is called "inguinal canal" in medicine. This tunnel is bound to have two openings, one is called the inner ring opening in the stomach and the other is called the outer ring opening in the abdominal wall. The tunnel connects the sheath process of scrotum and abdominal cavity. When the baby is quiet, that is, the stomach is not hard and the abdominal pressure is not high, then the intestine will not be squeezed. But when the baby is always crying or running, or when he is sick, frequent coughing will increase the abdominal pressure. At this time, the intestine will squeeze down through the inguinal canal and enter the scrotum. Two things will happen at this time. 1 When the abdominal pressure disappears, the intestine can return to the abdominal cavity along the inguinal canal. If the intestine cannot return to the abdominal cavity at this time, but is stuck in the scrotum, incarcerated indirect inguinal hernia will be formed. Because long-term oppression of the intestine will lead to the interruption of blood supply to the intestine and lead to intestinal necrosis, incarcerated indirect inguinal hernia is an emergency in pediatric surgery.

2. What do you think?

If you have intestinal gas, you can only choose surgery. Theoretically, babies under 1 year-old have the possibility of intestinal gas self-healing. However, in clinical work, we often see children under 1 year-old, often accompanied by parents' anxiety in the middle of the night, and more mothers come to surgery in tears and ask for manual reduction. But because I missed the time window of manual reduction, I had to choose emergency surgery. This has caused parents who have never faced surgery to be more anxious and at a loss. Surgery in such a passive situation is a test for doctors, parents and babies. Therefore, in the case of a healthy baby, surgery should be performed as soon as possible. With the development and accumulation of pediatric surgery and anesthesia in recent 50 years, the appropriate age for surgery can be advanced to 6 months, and even 3 months for some infants.

So how is the operation done?

The traditional surgical method is that the surgeon makes an incision in the inguinal region, finds the hernia sac, cuts it open, and wraps two bandages around him with silk thread, which is equivalent to sealing the pocket. Then suture the incision and other layers of tissue, and the operation is completed.

In recent years, laparoscopic high ligation of hernia sac has been widely used, and most of them can be ligated by percutaneous puncture under the supervision of single-hole laparoscopy of umbilical fossa. It has the advantages of safe operation, short time, quick recovery and no scar left. At the same time, it can explore whether the contralateral hernia sac is closed and can be treated surgically.

3. What effect does anesthesia have on children's growth and development?

First of all, anesthesia is indispensable and necessary for surgery. From the child's point of view, we can avoid the bad memories of childhood (I believe that parents of China after 1980s and 1990s have bad memories of being beaten by their parents when they were children). From the doctor's point of view, it can provide good surgical conditions (crying children can't have surgery).

Many parents are concerned about whether the baby under 1 year old will have an impact on growth and intelligence after receiving narcotic drugs. There is absolutely no need to worry. 1. Millions of children receive anesthesia and surgery every year. Decades of use show that its safety is similar to that of adults. 2. In 2007, the US Food and Drug Administration (FDA) Advisory Committee concluded that "based on the existing evidence, there is no need to change the status quo of clinical anesthesia"; 20 13 experts believe that "even if anesthesia has a little impact on the nervous system, changing the existing anesthesia technology or not doing anesthesia at all will cause greater damage to the nervous system".

4. Recurrence and complications?

With the development of surgical technology, the recurrence rate of indirect hernia has been lower than 65438 0%. But please note that the recurrence rate is not zero, and it is not impossible to relapse. But very low, very low. After recurrence, surgery is still the only option.

So as a parent, how should we avoid recurrence? The common clinical reason is 1. Constipation; 2. Chronic cough; 3. It was caused by strenuous exercise within 1-3 months after operation. Knowing the reason, it is easy to avoid recurrence. Children with a secret history of defecation must eat more vegetables and fruits, drink more water, keep their stools unobstructed, and use kaiselu when necessary. If your child coughs, especially cough variant asthma, you must go to a regular asthma specialist. For older children, strenuous exercise should be avoided before 1 month after operation (this is also the favorable side of hernia treatment for 6 months).

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