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Chapter 2255: 【2255】Not easy to find



   In the thoughts of family members, it is often heard that there are pregnant women who find out that the fetus has something wrong with the prenatal examination, and the doctor recommends an abortion. The prenatal examination should completely find out the unhealthy fetus.

This is the reason for Dr. Peng's sad sigh. When I go out and talk to the family of the patient about this, it is estimated that there will be a lot of quarrel. The patient's father had previously questioned the negligence of their medical staff.

   It is expected that the family will not only complain that the obstetrician did not check the fetus to be sick in advance, but also that the neonatologist took 20 hours to realize that my child was sick.

   Dr. Wang's mood is not much better than Dr. Peng's, but when the doctor needs to admit the actual situation: "The child's disease is not easy to detect."

   "Is this esophageal atresia?" Dr. Peng asked his colleagues.

   The common tracheal fistula in neonatology is not bronchopleural fistula, but a relatively rare disease called esophageal atresia.

   The "big belly" of the child is actually pneumoperitoneum, the abdominal distension caused by the gas entering the gastrointestinal tract.

   Where does this gas in the gastrointestinal tract come from?

  The amount of gas inhaled into the human digestive tract in the normal population is small enough to cause bloating. The gas inhaled by the human body mainly travels through the nose and goes to the lungs for gas exchange.

  Some of the abnormal clinical conditions are caused by the anatomical differences between the patient's human body structure and the normal human body. If the gas does not take the normal route to the lungs, but goes to the digestive tract in an abnormal route, it may cause pneumoperitoneum.

  The abnormal path is the fistula Xie said. A fistula formed between the child's trachea and digestive tract, and air that should have been inhaled into the child's lungs escaped into the digestive tract. In human anatomy, the digestive tract organ next to the trachea is the esophagus, where abnormal fistulas are most likely to occur. The same is true, called esophagotracheal fistula.

  Esophagotracheal fistula can be said to be a symptom of a result, and the cause can be trauma, infection, etc. In the neonatology department, doctors should pay attention to checking whether it is a congenital disease.

   For a young child with a good score at birth, the likelihood of factors such as trauma and external infection is indeed lower, and the likelihood of congenital causes is higher. Among the esophagotracheal fistulas caused by neonatal congenital diseases, congenital esophageal atresia is the most common cause that Dr. Peng said.

   Dr. Peng continued: "If the esophagus is blocked, you should not be able to breastfeed."

  The spearhead points to the fact that no abnormality was found in breastfeeding in the neonatal department before?

  Esophageal atresia, as the name suggests, is the closure of the esophagus, that is, the esophagus as the digestive tract has one end terminated. To put it more generally, the image point is more specific, the esophagus is like the terminal port of the tap water pipe and is not connected to the upper pool (stomach). If part of the body of a child with this disease is cut open, it can be clearly seen that the esophagus and the stomach are not connected, and the esophagus is closed by itself. The digestive tract that was supposed to be unobstructed was left empty for a while in this place.

   So strange, why does the esophagus close on its own? It is said that the disease is congenital, which means that it is caused by the poor development of the fetus in the mother's body. Then trace back the various causes of the child's congenital diseases. There are many factors. It may be that the mother encountered a polluted environment during pregnancy, or the chromosomal abnormality of the father and mother may cause the child to develop abnormally. Waiting for these reasons, it is difficult for the time being medically to investigate the specific investigation.

   (end of this chapter)


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