The second child is coming
It was supposed to be something that filled the whole family with joy
And Ms. Xu, 32 years old in Hangzhou
But his life hung by a thread because of this
At 27 weeks of gestation
Ms. Xu's body suddenly became abnormal
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Severe abdominal pain→ pain to the point that I can't straighten my back
There was also severe nausea and vomiting
Difficulty with bowel movements
Ms. Xu thought it was caused by pregnancy, and after a blood test and abdominal ultrasound at the maternity hospital, the results showed that everything was normal, but Ms. Xu's symptoms became more and more serious.
So, Ms. Xu's family, who were very anxious, came to the Second Hospital of Zhejiang University for help.
(Network picture)
Protecting the fetus CT scan is not possible
Diagnosis is even more difficult
Gastrointestinal surgery received
Deputy Chief Physician Jin Xiaoli
After inquiring about Ms. Xu's situation in detail
There were preliminary doubts in my mind
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Ms. Xu's first child was delivered by cesarean section
Adhesive intestinal obstruction due to caesarean section is suspected
Or Ms. Xu because of pregnancy
Uterine compression during pregnancy leads to intestinal obstruction
(Network picture)
To find out the cause of Ms. Xu's intestinal obstruction, a CT scan is required, but CT can affect the fetus in the womb. Therefore, CT scans cannot be done at this time, which makes it difficult for doctors to make further definitive diagnoses.
After consulting and evaluating the obstetricians, Dr. Jin decided to carry out conservative symptomatic treatment, including fasting, gastrointestinal decompression, and fluid rehydration, to improve Ms. Xu's nausea, vomiting, abdominal pain and other uncomfortable symptoms.
In order to better ensure the nutrition supply of Ms. Xu and the fetus, the doctor also specially formulated a personalized parenteral nutrition plan. After one week of meticulous treatment and nursing, Ms. Xu's symptoms have been alleviated, her eating and bowel movements have gradually returned to normal, and she has recovered and been discharged from the hospital.
Symptoms recurred one month after discharge
Before being discharged from the hospital, Dr. Jin explained to Ms. Xu: "The cause of intestinal obstruction is not yet clear, and it is very likely to have another attack after discharge. ”
One month later, Ms. Xu suffered from unbearable abdominal pain, nausea and vomiting again, and was sent to the Second Hospital of Zhejiang University for gastrointestinal surgery. The symptoms are milder than the last time, but considering that the pregnancy is 33 weeks and the fetus has more pressure on the intestines, it is particularly important to improve Ms. Xu's symptoms.
The Department of Gastrointestinal Surgery, Obstetrics, and Nutrition conducted a joint consultation again, and after assessing the condition of the fetus, Ms. Xu's condition was effectively controlled through conservative treatment.
Use cesarean section to explore the cause of intestinal obstruction
Soon after the 37th week of Ms. Xu's pregnancy, the doctor decided to perform an exploratory laparotomy at the same time as the emergency cesarean section to determine the cause of the intestinal obstruction.
The operation went smoothly, Ms. Xu not only gave birth to a girl weighing 5 pounds and 4 taels, but the gastrointestinal surgeon also found multiple polyp-like masses in the distal small intestine near the end of the small intestine.
It was the polyp at the end of Ms. Xu's small intestine that caused the small intestine to be squeezed into the large intestine during intestinal peristalsis, resulting in the syndrome of "large intestine encapsulating small intestine". The culprit of Ms. Xu's repeated intestinal obstructions has finally been found!
After 3 hours of hard work, the operation was successfully completed and the mother and daughter were safe.
10 days after the operation, Ms. Xu gradually resumed her diet, recovered smoothly, and was happily discharged from the hospital with her new family members.
Chen Jian, director of the Department of Gastrointestinal Surgery of the Second Hospital of Zhejiang University, said that intussusception is very rare in gastrointestinal surgery, and it is more common in children under 2 years old. Intussusception in adults is generally caused by polyps, tumors, intestinal ascariasis, etc. in the intestine, just like this patient, Ms. Xu, who had intussusception because of polyps at the end of the small intestine. From the point of view of disease, there is a possibility of malignant transformation of small intestinal polyps, and the usual symptoms are not obvious. If Ms. Xu did not seek medical attention because she was pregnant or had symptoms, once the polyp became malignant, the consequences would be unimaginable.
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Source: Newsroom Comprehensive Second Hospital of Zhejiang University
This article is edited by small door ears