aseptic bowel decompression

The purpose of intestinal decompression is to eliminate the accumulation of gas in the intestine, eliminate the expansion of the intestine, improve the exposure, and facilitate the operation; at the same time, eliminate the toxic substances in the intestinal cavity, reduce the symptoms of poisoning, and help the recovery of the disease. Intestinal decompression is less common in the clinical decompression of the intestines, and is often a part of the operation of intestinal obstruction. Treatment of diseases: balloon swelling of the intestine Indication 1. In the case of intestinal obstruction, the intestinal swell is severe, the effect is revealed, and it is impossible to perform exploration or surgical operation. 2. There are many toxic gases and liquids in the intestinal lumen, which will cause severe symptoms of poisoning after absorption. Surgical procedure After entering the abdominal cavity, the following ways can be taken according to the condition: 1. With the necrotic intestine segment resection: If the intestinal obstruction has been removed, the intestinal content can be squeezed into the intestine segment to be resected, and the end of the intestine tube to be resected with a straight hemostatic clamp is used. The intestinal clamp clamps the intestinal tube at a distance of 3 to 5 cm from the margin, and the intestine is removed by a straight hemostat at both ends, and the intestine is wrapped with a disinfectant towel or removed by a basin. Absorb the contents of the broken end and wipe it with a "small fish" gauze, then use 2% red mercury solution to swab, disinfect the broken intestinal mucosa, and then anastomosis of the intestine. 2. The intestinal content is squeezed into the colon: if the intestinal obstruction is low, the cause is not necrotic after the cause is removed, and the intestinal content is mainly accumulated in the ileum, which can be squeezed into the colon to be discharged from the anus. 3. Intestinal incision decompression: first move the lower part of the inflated intestine to the outside of the incision edge, put two large gauze pads between the intestine and the abdominal wall, close to the skin side pad dry gauze, and the intestine side pad warm saline gauze to avoid cutting the intestine The incision is contaminated during decompression. The instruments used for the operation should also be strictly separated from other surgical instruments. On the side wall of the mesentery that proposes the intestinal fistula, the site of the intestine wall is selected, and the No. 1 or No. 4 silk thread is used as a purse-string suture, and the intestine wall is cut with a sharp-edged knife at the center of the purse, and a thick trocar is inserted. The cannula (or catheter No. 14-14) attracts and discharges gases and fluids from the intestines. The assistant can gently squeeze the intestinal tube on the upper and lower sides of the decompression port to discharge the contents of the intestine as much as possible. When squeezing, the right hand finger and the middle finger can be used to clamp the intestine tube, and the distal part is gently squeezed to the cannula to suck out. At this time, the other end of the intestine should be controlled to prevent the intestinal content from being pushed into the upper part by the lower part. Or its not enough to squeeze from the bottom. During the extrusion, the proposed intestinal fistula should not be slipped back into the abdominal cavity, and the assistant should also pay attention not to contaminate the abdominal cavity or damage the serosa of the intestinal wall. If the contents of the intestines have large solid foods, the decompression method is often unsatisfactory. The casing or the catheter is often blocked by food. Only one needle can be sewed on the opposite side of the purse string and placed under the intestines. Pull out the catheter after bending the plate or small basin, and directly let the contents of the intestines flow into the tray so that the intestinal lumen is drained as much as possible. After the end of the decompression, the purse string was tightened, and the muscle layer was intermittently sutured. The intestinal wall around the decompression port was disinfected with red mercury or 1:1000. After removing the contaminated instruments and gauze pads, continue the operation.

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