Congenital intestinal stenosis

　　It is generally believed to be due to developmental disorders during the rechannelization stage of the intestinal tract in the embryonic period; some people believe it is due to circulatory disorders in the fetal intestinal tract, which hinders its normal development. Intestinal stenosis is most common in membranous stenosis, with mild cases only being a narrow ring. Short-segment stenosis is rare.

　　Congenital intestinal stenosis often complicates with other malformations. Most patients have satisfactory outcomes, and after a relatively short period of recovery, they can normally breastfeed, gain weight, and their growth and development can reach the level of normal children of the same age.

　　A small number of patients may experience stenosis at the surgical anastomosis site, with varying degrees of vomiting after surgery, weight loss, or even weight gain; prolonged duration of symptoms may lead to chronic dehydration and electrolyte imbalance; severely affecting growth and development, and patients who are ineffective after conservative treatment may need to undergo surgery again for resection of the original anastomosis site and reanastomosis. In actual clinical practice, it is not uncommon to see cases of multiple surgeries and multiple anastomoses.

　　The timing of vomiting and the degree of abdominal distension in children with congenital intestinal stenosis and the degree of stenosis vary, and can manifest as chronic incomplete intestinal obstruction. Severe congenital intestinal stenosis has similar symptoms to congenital intestinal atresia. The clinical manifestations are typical symptoms of intestinal obstruction, with vomiting, abdominal distension, and abnormal passage of meconium appearing after birth. The timing and severity of symptoms are directly related to the location of the atresia. Frequent vomiting can lead to dehydration and aspiration pneumonia. Prolonged delay in treatment will inevitably cause intestinal perforation, peritonitis, and sepsis, leading to rapid deterioration of the condition and ultimately death.

　　Pre-marital physical examination plays a positive role in preventing birth defects, the extent of which depends on the items and content of the examination. It mainly includes serological tests (such as hepatitis B virus, syphilis spirochete, HIV), reproductive system examinations (such as screening for cervical inflammation), general physical examinations (such as blood pressure, electrocardiogram), and inquiries about family medical history and personal medical history, and doing genetic disease counseling work.

　　Pregnant women should try to avoid harmful factors including staying away from smoke, alcohol, drugs, radiation, pesticides, noise, volatile harmful gases, and toxic heavy metals. During the prenatal care process of pregnancy, systematic screening for birth defects is required, including regular ultrasound examinations, serological screenings, and, if necessary, chromosome testing, in order to adopt practical and feasible diagnostic and treatment measures.

　　Intestinal stenosis is a congenital developmental anomaly of the intestine and is one of the common causes of neonatal intestinal obstruction. The occurrence site is most common in the jejunum and ileum, followed by the duodenum, and the colon is the least common. Then, what kind of laboratory tests are needed for congenital intestinal stenosis? The following experts introduce the laboratory tests that should be done for congenital intestinal stenosis:

　　1. Abdominal X-ray upright film:Routine examination can preliminarily judge the location of the atresia, the severity of the lesion, and the possible prognosis.

　　2. Gastrointestinal contrast examination:Examinations that may cause radiation injury are still widely used in small and medium-sized cities and non-specialty hospitals with relatively lower medical levels. Contrast examination can clearly diagnose the location of the lesion and is of great significance for related differential diagnosis. It should be used when necessary.

　　3. Abdominal ultrasound examination:Ultrasound examination has developed rapidly in recent years and has partially or even completely replaced the diagnostic functions of traditional large auxiliary instruments such as contrast and tomography. The ultrasound examination method is simple, the equipment requirements are low, the objectivity is strong, and it is harmless to the body. However, it requires that ultrasound doctors have rich clinical experience and certain surgical anatomical professional skills, which cannot be achieved by non-specialty hospitals and ultrasound doctors who have received extremely professional training.

　　During the fasting period of congenital intestinal stenosis patients, water, electrolytes, and intravenous hyperalimentation are administered intravenously every day. Generally, oral intake can be resumed after 7 to 14 days after surgery, when the intestinal function is restored. The initial intake is 5 to 10 ml each time, every 2 hours, and if the child does not vomit, the feeding amount can be gradually increased. After 4 to 5 days of feeding, it is generally possible to resume normal feeding. It is advisable to consume light food and pay attention to dietary regularity.

　　Severe congenital intestinal stenosis has similar manifestations to congenital intestinal atresia. After the diagnosis of congenital intestinal stenosis, it is necessary to correct the disorder of water and electrolytes and the imbalance of acid-base balance. The best effect of congenital intestinal stenosis is to perform intestinal end-to-end anastomosis after resection of the stenotic intestinal segment.