Meconium ileus syndrome

　　1. Necrosis of the intestinal wall is common in intestinal obstruction, with clinical manifestations of intermittent abdominal pain around the umbilicus and vomiting. There may be a history of intestinal worms or vomiting worms.

　　2. Intestinal perforation refers to the process in which the intestinal wall lesions penetrate the intestinal wall, causing the intestinal contents to overflow into the peritoneal cavity. It is one of the serious complications of many intestinal diseases, causing severe diffuse peritonitis, mainly manifested as severe abdominal pain, bloating, peritonitis, and other symptoms and signs. Severe cases can lead to shock and death.

　　3. Peritonitis is a severe surgical disease commonly caused by bacterial infection, chemical irritation, or injury. Most are secondary peritonitis, originating from organ infection in the peritoneal cavity, such as necrotic perforation, trauma, etc.

　　Mostly female, more common in adolescents, presenting with upper abdominal pain, bloating, nausea, vomiting. Due to the valve-like action of wool stones, the amount of vomiting is generally not large, and the vomitus may contain bile, but if the obstruction is at the pylorus, it does not contain bile. A few may be accompanied by diarrhea and gastrointestinal bleeding. On physical examination, a mass can often be palpated in the upper abdomen. If there are symptoms and signs of diffuse peritonitis due to necrosis and perforation of the gastrointestinal wall, there may be symptoms and signs of diffuse peritonitis.

　　Pay attention to the diet of pica and psychiatric patients. The characteristics of pica:

　　1. At the beginning of the disease, there is poor digestion, followed by the emergence of pica, such as eating wood pieces, stones, bricks, rags, grass, etc.

　　2. When swallowing sharp objects, there may be drooling and bleeding from the mouth due to injury to the oral cavity. In severe cases, esophageal, gastric, and intestinal perforation may occur. Some may swallow plastic sheets or strips, peach kernels, coal blocks, etc., which can cause intestinal obstruction or intussusception. Affected dogs often become emaciated due to malnutrition and have coarse and rough fur.

　　3. Diagnosis is made through palpation and X-ray examination.

　　Gastroscopy and X-ray examination. Gastroscopy can directly observe the actual condition of the examined area, and can further clarify the diagnosis by performing pathological biopsy and cytological examination on suspicious lesion sites. It is the preferred examination method for upper gastrointestinal tract lesions. X-ray examination has a wide application in the diagnosis of anorectal surgical diseases and is one of the most effective means for early detection, early diagnosis, and differential diagnosis of certain diseases in clinical practice.

　　Dietary precautions:

　　1. The diet for intestinal obstruction should be light, nutritious, and liquid, such as congee, lotus root starch, egg flower soup, vegetable soup, noodle slices, etc.; do not eat indigestible,刺激性, fibrous, greasy, bloating, and fishy foods, such as beef, mutton, chili, scallions, beef soup, chicken soup, milk, soybeans, broad beans, potatoes, sweet potatoes, spinach, celery, Chinese cabbage, chives, coriander, bamboo shoots, etc.

　　2. Fast until the intestinal sounds return, anal exhaust, give half-quantity semi-liquid food, and instruct patients not to overeat, change to semi-liquid diet after three days, and eat soft food after ten days postoperatively; the diet for intestinal obstruction should avoid eating after a full meal and doing vigorous exercise to prevent the occurrence of intestinal torsion, and do not overeat and drink.

　　This condition requires surgical treatment due to the long gallstones, which are usually difficult to remove. Multiple incisions are needed, and if there is intestinal necrosis, intestinal resection should be performed. Intraoperative precautions:

　　1. In obese patients, there is an excessive amount of mesenteric fatty tissue, which is not easy to see the mesenteric vessels. The mesentery can be lifted and exposed to light to see the course of the vessels. In addition, when separating and ligating mesenteric vessels, the serosal layer of the mesentery can be incised first, the fatty tissue separated, and the vessels exposed before ligation and transection to avoid knot shedding or vessel retraction after ligation, causing bleeding.

　　2. When separating and ligating mesenteric vessels, pay attention to the distribution of the vascular arches, and the closer to the mesenteric root, the more attention should be paid to prevent mistakenly ligating too many mesenteric vessels, causing large segments of the intestinal tract to become ischemic. The mesentery at the end of the intestinal tract should also not be separated too much, generally within 1.0 cm of the cut end, otherwise it may affect the blood supply to the anastomotic site and lead to anastomotic necrosis after surgery.

　　3. If there is arterial bleeding at the cut end of the intestinal tract, it indicates good blood supply. If the cut end turns purple or only has venous bleeding, with purple-black blood, it indicates poor blood supply, which is not suitable for anastomosis. It is necessary to resect a segment of the intestinal tract to ensure good blood supply before performing anastomosis.

　　4. It is not advisable to use electrocoagulation to stop bleeding at the cut ends excessively to avoid excessive tissue damage. Generally, a No. 1 silk thread is used to tie the bleeding points. It is not necessary to tie the bleeding points if there is only a small amount of bleeding to avoid leaving too many knots: after the full-thickness suture is completed, the oozing blood will stop spontaneously.