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NEONATOLOGY: MANAGEMENT, PROCEDURES, ON-CALL PROBLEMS, DISEASES, AND DRUGS - part 9

Nguyên nhân chính xác của tắc nghẽn có thể không được biết đến cho đến khi mở bụng được thực hiện. A. bụng x-ray nghiên cứu. Trong tắc nghẽn tá tràng hoàn toàn, x-ray pathognomonic tìm kiếm là một "bong bóng đôi." Hai bộ sưu tập khí lớn, một trong dạ dày và phần đầu tiên của tá tràng, là lucencies duy nhất trong đường ruột. | with or without the complication of midgut volvulus. V. Diagnosis. The exact cause of the obstruction may not be known until a laparotomy is performed. A. Abdominal x-ray study. In complete duodenal obstruction the pathognomonic x-ray finding is a double bubble. Two large gas collections one in the stomach and the other in the first portion of duodenum are the only lucencies in the GI tract. B. Radiologic contrast studies 1. Partial obstructions will probably require an upper GI series to identify the site of difficulty. 2. Malrotation. It is important to eliminate malrotation as a possibility because its complication midgut volvulus is a true surgical emergency. This is best done by an upper GI series identifying a transverse portion of the duodenum leading to a fixed ligament of Treitz or by barium enema localizing the cecum to its normal right lower quadrant position. VI. Management A. Duodenal atresia or annular pancreas. In cases of atresia or annular pancreas gastric suction will control vomiting and allow elective surgical correction. B. Malrotation mandates immediate surgical intervention because the viability of the intestine from the duodenum to the transverse colon may be at risk from midgut volvulus. Proximal Intestinal Obstruction I. Definition. Proximal intestinal obstruction is obstruction of the jejunum. II. Pathophysiology. Jejunal obstruction typically results from atresia of that segment of the bowel usually caused by a vascular accident in utero. III. Clinical presentation. Infants with jejunal obstruction usually have bilious vomiting associated with minimal abdominal distention because few loops of intestine are involved in the obstructive process. IV. Diagnosis. A plain abdominal x-ray study reveals only a few dilated small bowel loops with no gas distally. V. Management. Surgical correction is required. Distal Intestinal Obstruction I. Definition. The term distal intestinal obstruction denotes partial or complete obstruction of the distal .