I want to take the child's life.
In children with congenital anal atresia, both high, medium and low anal atresia have external anal sphincter, there is no difference and it is well developed. It is equivalent to saying that it is not important but its development is good. The important internal anal sphincter is exactly the opposite. The higher the anal atresia, the worse the development of the internal anal sphincter or even absence.
Doctors are smart women, but they are most afraid of making a meal without rice. This has been said many times in the article.
Among congenital diseases in children, it is a common problem to live without rice, because most of the deformities in children with such deformities are due to underdevelopment of organs. For example, the esophageal atresia we talked about last time, which has the worst classification, can only be replaced by other organs in the human body to replace the missing esophagus.
Faced with this kind of child, the doctor can only search desperately in the child's body, trying to find the residual tissue of the internal anal sphincter. For example, if the end part of the rectum and cecum is thickened, it may be the internal anal sphincter tissue, which can be brought to the doctor. use.
This is exactly what pena surgery does, using the well-developed external anal sphincter and the remaining part of the internal rectal sphincter to form a new anus. It is accurately called posterior sagittal anoplasty. The direction of the scalpel is the same as the direction of the sphincter, which can avoid damage to the sphincter to the greatest extent, which is the highlight of this surgery.
It can be seen from here that pena surgery is a traditional surgery and not a new technology laparoscopy. Families would definitely prefer laparoscopy, which is less harmful to the human body. Regarding this issue, we have talked about this issue in the general surgery department. This kind of low-median rectal and anal surgery is difficult to operate with laparoscopy and there is no advantage. Therefore, laparoscopy is more used for high-level anal atresia.
The first step, as Teacher Wu asked, is to determine what position it is.
Since Teacher Wu went to notify the operating room, it is conceivable that it is basically impossible to be in a low position. There is usually a fistula at the lower level that allows defecation, so there is no need to rush into surgery. After all, if the life of such a young child is not in danger, the operation itself is too risky.
Students cannot use the teacher's behavior to answer the teacher's questions, otherwise the teacher will look down upon them.
To accurately determine the location of anal atresia, the most economical solution is to use a plain abdominal radiograph. If the child's condition permits, it is more accurate to take an inverted abdominal
Today, this child only had a simple abdominal radiograph. Several students gathered around the radiograph on the light board to carefully identify it.
This time it was Classmate Pan’s turn to answer this question: “This is the blind end of the inflated rectum, and this side may be the pubococcygeal muscle. The two are relatively close to each other and should be in the middle.” After saying this, Classmate Pan Let’s look at the other two students first: Do you agree with my opinion?
"This visual inspection is a bit difficult. Is it more than two centimeters?" Lin Hao helped classmate Pan look at it with his eyes, intending to use his eyes as a measuring stick to measure the distance between the rectum and anus. The textbook says that generally speaking, a height below two centimeters is a low position, and a height above two centimeters is a mid-to-high position.
It is difficult to judge the mid-high and low positions by taking local X-rays of this area.
The difficulty is. Classmate Xie added: "It also depends on the child's weight and size."
Some seem to be smaller than two centimeters, which should be considered a low position. The child with the problem is less than a month old and small. Relatively speaking, if the distance is smaller than two centimeters, it is actually a large distance, which is a high position.
It’s not surprising to have such less than accurate results.
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