Beibei
, who was born at the end of January this year, was a 33-week premature infant
weighing only 1.56kg.
was diagnosed with
abdominal mass and neonatal intestinal obstruction
right after birth and was in critical condition.
was rushed to Henan Provincial Children's Hospital. Neonatal Surgery
Emergency laparotomy was performed on the same day
Director of Neonatal Surgery Wang Xianliang and attending physician Chen Li discovered during the operation that the mass in Beibei's abdominal cavity turned out to be necrotic and adherent intestinal tube. In order to save Beibei To save Beibei's life, the director removed 30cm of necrotic small intestine, preserved about 55cm of intestinal tube as much as possible, and performed an ileostomy for Beibei.
Under normal circumstances, food passes through the stomach, duodenum, enters , jejunum, , ileum, , then enters , colon, , rectum, and finally forms feces and is excreted through the anus.
Due to the serious contamination of Beibei's abdominal cavity and extremely poor general condition, he could not tolerate a one-stage enterotomy and enterostomy. In order to solve the problem of defecation after Beibei's operation, an ileostomy was required. The end of the ileum was cut off through surgery and the The broken end is raised through the abdominal wall to form an artificial stoma. Later, defecation will be directly discharged from the body through the abdominal wall stoma. The stoma can be restored after the patient recovers well.
Beibei is temporarily out of danger, and this is only the first step in the long journey of Beibei's rebirth. After surgery, due to insufficient absorption area of the remaining intestine and diarrhea, Beibei gradually developed symptoms of malnutrition, electrolyte imbalance, dehydration, and failure to gain weight, such as short bowel syndrome, requiring long-term intravenous nutrition. life.
The neonatal surgery team developed a personalized plan based on Beibei’s condition, and clearly gave parenteral nutrition combined with enteral nutrition support treatment.
Under the careful treatment of deputy chief physician Li Xiaoyong and the careful care of all the nursing staff of the neonatal surgery department, Beibei is very successful and her weight is gradually increasing.
When the amount of milk was increased to 15ml every two hours
Beibei suddenly became worse at feeding
The stool began to become thinner
Beibei developed milk intolerance
In order to allow the intestines to fully rest
Beibei started again After a new round of fasting
one week later
Beibei's stool condition gradually improved
and started eating again
html For more than 13 months
Li Xiaoyong came to Beibei's bedside during ward rounds every day
to guide parents on correct feeding
daily Monitor weight
According to Beibei's eating status and stool condition
Finely adjust the amount of enteral and enteral nutrition
Finally
Beibei is out of danger
Symptoms such as blood in the stool and diarrhea gradually improved
Eating well
The weight also slowly increased to 4.11kg
21, Wang Xianliang and Li Xiaoyong performed enterostomy reduction surgery on Beibei. The operation went smoothly and Beibei started breastfeeding a week later.
Now Beibei has completely weaned off parenteral nutrition and his weight has increased to 5kg. He can rely on his own food to meet his own growth and development needs. Although her weight is still behind that of babies of the same age, as long as she continues to follow up and feeds actively, Beibei will definitely be able to catch up with babies of the same age in the future.
Wang Xianliang introduced that short bowel syndrome is a syndrome caused by small intestinal absorption capacity being limited due to removal of most of the small intestine, exclusion or congenital short intestine, which cannot meet the needs of normal growth and development of children, thus leading to nutrient absorption disorders .
The main clinical manifestations of short bowel syndrome are severe diarrhea, dehydration, malabsorption, nutrient deficiency, metabolic disorders and progressive malnutrition. For infants and young children, these will affect their growth and development, and even be life-threatening.
The most common cause of pediatric short bowel syndrome is neonatal necrotizing enterocolitis, followed by midgut volvulus caused by intestinal malrotation, then multiple intestinal atresia, and intestinal necrosis caused by various causes , inflammatory bowel disease is also the cause of short bowel syndrome.
The treatment of short bowel syndrome is a difficult problem worldwide. Many children cannot survive without parenteral nutrition and eventually die from parenteral nutrition-related complications. However, because the intestinal development and compensatory capabilities of newborns are stronger than those of adults, many newborns have a better prognosis.
Basic principles of general treatment
Supply adequate nutrition to achieve normal growth and development.
promotes compensation of the remaining intestine. Compensation of the remaining small intestine means that after leaving parenteral nutrition, its ability to digest and absorb nutrients in the intestine can ensure the normal growth of children and maintain water and electrolyte balance.
Avoid complications after intestinal resection ( intestinal obstruction , intestinal adhesions , etc.) and complications of long-term application of parenteral nutrition (liver function damage, etc.).
The treatment of short bowel syndrome requires the cooperation of multiple departments, and Beibei's recovery is also inseparable from the hospital's multidisciplinary assistance in diagnosis and treatment.
Now, Beibei has been discharged from the hospital smoothly. Her parents were very happy and sent a banner to the department.
In recent years, neonatal surgery has successfully cured many children with short bowel syndrome, bringing hope to many families.
Although short bowel syndrome is clinically difficult, parents must not be discouraged and give up if they encounter it. Children’s vitality is the most tenacious. As long as you persist, miracles may happen.
