Congenital Insufficiency of Intestinal Rotation Rehabilitation

Congenital intestinal insufficiency includes various lesions caused by incomplete rotation of the midgut from the early return of the embryo to the body cavity. Such as duodenal compression, midgut torsion, superior mesenteric artery compression syndrome, or the former two coexist. Clinical manifestations of high intestinal obstruction. Treatment of diseases: colon torsion volvulus and intestinal torsion syndrome Indication All children with clinical diagnosis of congenital regurgitation causing intestinal obstruction should be treated surgically. Preoperative preparation 1. Keep warm and intramuscularly inject vitamin E to prevent neonatal scleredema. 2. Gastric decompression. 3. Wash and dry the skin with warm soapy water. The newborn baby's fingers can be wiped off with liquid paraffin. 4. If the umbilical cord of the sick child has not fallen off, it can be properly wrapped after disinfection with 1:1000 benzalkonium or thiomersal. 5. Apply antibiotics to prevent infection. 6. Transfusion, infusion, correction of water and electrolyte imbalance. Surgical procedure 1. Position: supine position. 2. Incision: right middle transabdominal rectus incision. 3. Exposure of the intestine: After entering the abdominal cavity, the small intestine that is twisted and dilated can be seen, congested or blue-purple, and the right colon, cecum, and appendix cannot be seen in the surgical field. All small intestines were incised, turned upwards and properly protected. It can be found that the mesenteric root is stalk-like. Most of the small intestine is centered on the mesenteric root, suspended in the abdominal cavity, twisted in the clockwise direction, and some can be twisted. Up to 2 to 3 laps; sometimes there is a terminal ileum or cecum, ascending colon entangled in the tortuous mesenteric root. 4. Intestinal torsion reduction: The surgeon will rotate the small intestine in a counterclockwise direction by hand to reset the small intestine obstruction, and the color of the small intestine will quickly change from blue-purple to normal reddish color. 5. Cut the peritoneal cord and relieve the duodenal obstruction: After the intestinal torsion is reset, the duodenal bulb and descending part are examined. Push the small intestine to the left, you can see the incomplete cecum, appendix and ascending colon in the right upper abdomen or mid-upper abdomen, and the peritoneal cord from the lateral edge of the cecum and ascending colon can be seen, crossing and pressing the duodenum The descending part stops at the lower edge of the liver, the gallbladder and the right abdominal wall, causing obstruction and dilatation of the duodenum lower than above. Cut the peritoneal cord to relieve the pressure on the descending part of the duodenum. After the peritoneal cord is completely cut, the duodenum is completely free, located on the right side of the abdominal cavity. The cecum and ascending colon are located on the left side of the abdominal cavity (the so-called small intestine and colon fetus), and the operation is achieved. 6. Closing the abdomen: layering and suturing the layers of the abdominal wall.

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.