gastrostomy repair

Abdominal fissure deformity is used for surgical treatment of umbilical abdominal bulging. Due to the developmental defect of the anterior abdominal wall of the fetus, some organs protrude from the base of the umbilical cord, and the surface has a transparent capsule membrane composed of peritoneum and amniotic membrane, and there is no skin covering. At birth, the capsule is thin, moist and transparent, and gradually becomes dry, turbid, and easily broken after several hours. Umbilical bulge varies in size. The bulging organs are most common in the small intestine, and the liver and transverse colon can also swell, and other organs bulge very little. The gastroschisis may be formed by the rupture of the physiological umbilical hernia sac during the embryo. There is a fissure-like defect on the right side of the umbilicus, no sac, and the intestine is thickened and shortened. The repair of the abdominal fissure is often performed in an emergency after a short period of preoperative preparation. If possible, it is best to fix it in one installment. If the first-stage repair is difficult, consider a second-stage repair or stage repair. Treatment of diseases: abdominal fissure Indication Abdominal fissure deformity is suitable for visceral exposure in children with abdominal fissure. Contraindications Birth or weight less than 2kg, with a variety of other severe malformations, late onset, local capsule rupture infection or systemic conditions can not tolerate surgery. Preoperative preparation 1. Keep warm and oxygen. This disease is more common in premature infants. It is necessary to prevent scleredema. 2. Set the nasogastric tube decompression. 3. Local protection should be given in the delivery room to prevent rupture and infection. 4. Prophylactic antibiotics. 5. Nutritional support to establish venous access. 6. Systematic examination, including chest X-rays of the abdomen, to exclude other severe malformations and umbilical bulge - Exomphalose-Macroglossia-Gigantism, or Beckwith with visceral hypertrophy and hypoglycemia - Wiedeman syndrome. 7. Surgery should be carried out within 4 to 6 hours after birth, generally no more than 24 hours. Due to the emptiness of the digestive tract in the early operation, the organ is also beneficial, and the capsule has not been ruptured, and the infection is less. Surgical procedure Incision The upper and lower edges of the skin along the abdominal fissure are enlarged. 2. Expand the volume of the abdominal cavity After opening the abdomen, in order to enlarge the volume of the abdominal cavity, it is beneficial to retract the organs outside the abdominal cavity, and it is necessary to extend into the abdominal cavity with fingers to expand vigorously up and down. 3. Still visceral The inclusion of more intestinal contents in the intestines that are removed is an important factor causing difficulties in repayment. At this point, the contents of the intestine can be squeezed by hand. If it is a small intestine, the contents of the intestine should be squeezed into the stomach and then sucked out through the stomach tube; if there is more content in the colon, the contents of the intestine should be squeezed to the anus and excreted. After the above treatment, the organ can be returned to the abdominal cavity. complication Difficulty breathing The swelled viscera also incorporates a relatively small abdominal cavity volume to form an increase in abdominal pressure, causing the diaphragm to move up, causing difficulty in breathing, cyanosis, and severe respiratory failure. 2. Heart rate is too fast The heart rate is as high as 180 to 200/min. Mainly due to respiratory disorders, hypoxia and inferior vena cava blood return disorders, severe cases can occur circulatory failure. 3. Abdominal distension, intestinal obstruction Changes in gastrointestinal position, excessive compression, or adhesion can cause intestinal obstruction, severe cases of intestinal narrowing, perforation. 4. Lower extremity edema Mostly caused by compression of the inferior vena cava.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.