This Doctor is Great

a patient comes,

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

"what!"

Zhou Mo went out and saw that the patient was very special.

1 year old baby!

"Wow wow~~~~"

Crying in pain, her face turned purple from crying.

Cries resounded throughout the Eastern Ward.

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

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

The mother hugged the baby tightly and cried, "I don't know. After I fed Niu Niu rice at noon today, I don't know why Niu Niu began to cry, crying for a long time, it seemed to be very painful..."

Zhou Mo: "How many times did you cry? How long did you cry each time?"

Mother: "Niuniu has cried several times since noon... Every time I cry for ten minutes, I used to be very good. I didn't cry when I hugged it, but now I can't hug it..."

Zhou Mo breathed a sigh of relief. Fortunately, this parent belongs to the kind who can communicate and speak fluently.

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

It was the first time for Zhou Mo to receive such a small patient, so he was a little nervous.

As he walked, he asked, "Is there a time when you don't cry? How long do you not cry?"

Mom: "Niuniu cried for ten minutes each time, then quieted down for ten minutes, and then cried for ten minutes... Did my baby eat the wrong thing? Why does it hurt so much?"

Zhou Mo shook his head: "Eating the wrong thing, it should be gastroenteritis. Logically speaking, it won't be this kind of paroxysmal pain every ten minutes."

"Did you come from the emergency room or the outpatient clinic?"

"Emergency."

"Does the emergency department diagnose the baby?"

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

intussusception?

Zhou Mo was stunned for a moment.

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

The so-called intussusception is actually a 'telescope-style big snare and a small loop', where the small intestine enters the ileocecal region.

(Big guy last picture?)

However, starting at noon, obviously this is acute.

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

Mom cried, "At my husband's."

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

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

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

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

Very cross, Zhou Mo got the B-ultrasound results from her husband.

two pictures.

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

- One is a longitudinal section: it is the "sleeve" sign.

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

Obviously, there is no need to doubt it.

It's definitely intussusception.

Zhou Mo handed the B-ultrasound results to Teacher Zhang Luojia: "Teacher, it is intussusception, which appeared at noon, and it has been 3 hours now, it must be acute intussusception, and it needs to be sorted out as soon as possible... "

Teacher Zhang Luojia glanced: "Okay, I will contact the doctor now."

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

While waiting for the doctor to come, Zhou Mo looked at other test results.

There is a blood routine, leukocytosis.

Liver and kidney function are fine.

"Yuck~~~"

At this moment, the crying baby suddenly spit out.

"Ah~~ Niuniu, what's the matter with you?" Mom was so worried, she didn't care about the dirty vomit, she hugged and cried.

Zhou Mo reassured: "It's okay, intussusception and vomiting are normal symptoms."

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

Zhou Mo was sweating wildly, and quickly comforted: "There shouldn't be a big problem, a doctor will come to deal with this intussusception soon..."

But apparently this consolation is useless.

Mom is still so nervous.

Zhou Mo: "I'll check the baby to see how he is doing now. How about it?"

Mom said quickly: "Doctor, please, please help me check Niuniu..."

Zhou Mo checked it 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 symptoms such as dehydration, electrolyte imbalance, lethargy, lethargy, unresponsiveness, etc.

More serious point is peritonitis, toxic shock. (More on these two later)

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

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

After a minute or two,

The baby stopped crying, and then began to quiet down.

Mom breathed a sigh of relief: "Look, doctor, Niuniu's behavior is like this, a period of frantic crying, a period of quiet..."

Zhou Mo explained: "This is a feature of intussusception, paroxysmal crying, because peristalsis has a certain time interval, when peristalsis pushes the intussusception forward, the mesentery is pulled, and the intestines are pulled forward. Severe pain caused by strong contractions of the intussusception sheath, and when the peristaltic wave passes, the child becomes quiet."

Mother:"?????"

Did not understand.

(Beautiful readers: "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. At that time, the baby will be sluggish and have a low response... How good is it now? Ah, although he cried a lot, he was still in good spirits..."

"Huh? Really?"

Mom was surprised.

Can you understand that?

But I have to say that after Zhou Mo said this, she was relieved a lot!

At this time, the husband finished the formalities and hurried over.

Zhou Mo: "There will be a doctor who will come over later, and there will be no problem, and I will take the baby to do an intussusception reset... The specific method is: "air enema resets the intussusception." "

Simply put, it is to use a machine 'colon insufflation machine' to intubate the anus.

Inflate.

The gas passes through: **** - **** - colon, cecum (ileocecal) - small intestine...

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

(Note: This method ~www.readwn.com~ is only suitable for people under 2 years old, and the success rate is relatively high. But more than 2 years old, even adults, most of the intussusception is secondary (other causes), so this The method is not very good, then it is regarded as surgery, not gastroenterology)

...

step, step, step~~~

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

After some introduction,

The middle-aged doctor began to examine the baby.

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

Then sterilized, put on gloves, applied lubricant, touched the baby's anus, and quickly "pulled out" the jam-like **** stool.

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

confirmed!

Yes - intussusception! !

.