Clinical factors of neonatal digestive tract malformation

The care and feeding of newborns are issues that every parent should pay attention to, because the physical condition of newborns is relatively fragile, and they may be adversely affected invisibly if they are not careful. The most common problem among newborns is gastrointestinal malformations. When this phenomenon occurs, parents often feel at a loss. So here we will analyze the clinical disease factors of neonatal gastrointestinal malformations.

1. Diseases with dyspnea, choking, and cyanosis as the main clinical manifestations

1. Congenital esophageal atresia: Most cases are type III, i.e. the proximal esophagus is blind and accompanied by esophageal tracheal fistula. It is a representative surgical disease in the neonatal period that requires emergency treatment. In the past, the mortality rate was quite high. However, with the development of perinatal medicine and neonatal surgery, the mortality rate has been declining year by year. It has dropped to below 10% abroad and the cure rate in China has reached about 70-90%. The key to success lies in early diagnosis, as most patients have a history of polyhydramnios or asphyxia after birth, and aspiration pneumonia after birth. The severity of pneumonia is an important factor affecting prognosis. Any newborn who foams at the mouth, drools, chokes, coughs, has shortness of breath, cyanosis, and has difficulty breathing after being fed water or sucking milk, and whose symptoms improve after oral secretions are suctioned out, should be considered as having this disease, and a nasogastric feeding tube can be tried. If the tube is blocked or folded back from the mouth, the tube can be adjusted to the blind end, a chest X-ray can be taken, and iodized oil can be injected through the tube for contrast imaging to confirm the diagnosis. After the diagnosis is confirmed, active preoperative preparation should be made and primary anastomosis should be performed.

2. Hiatal hernia: This disease is characterized by a huge defect in the diaphragm, which allows the abdominal organs to enter the chest cavity, and is accompanied by lung hypoplasia and pulmonary hypertension. Therefore, the baby dies shortly after birth due to dyspnea and hypoxemia. In recent years, the mortality rate has dropped significantly after the adoption of artificial membrane lung (EcMI) abroad. In mild cases, shortness of breath or mild cyanosis may occur when feeding or crying, but the symptoms will be relieved when the chest is elevated or the baby is in the side-lying position. Pneumonia is a common complication. X-ray fluoroscopy shows many translucent areas or alveolar shadows in the chest cavity. The lung is collapsed and the mediastinum is displaced toward the healthy side. Barium meal radiography can reveal the stomach and intestines entering the chest cavity and confirm the diagnosis. Treatment should be open-chest hernia reduction and diaphragm repair.

3. Hiatal hernia: This disease occurs when part or all of the stomach enters the chest cavity through the enlarged esophageal hiatus. Most of the sick children will spit up or vomit milk after drinking milk, and in severe cases, they will vomit brown or coffee-colored substances. The diagnosis is mainly based on X-rays. Chest X-rays can show gastric bubbles in the chest cavity, and further barium meal fluoroscopy can confirm the diagnosis. When the condition is serious, hernia reduction and hiatal hernia repair should be performed promptly. For mild cases, conservative treatment can be used first, and surgical treatment can be performed if there is no improvement.

Parents certainly hope that their newborns can grow up healthy and happy without any illness or disaster. However, they are prone to various diseases in the various processes of their growth. Therefore, the key is that parents should learn more about and master these common sense. Only by paying attention to the recognition and understanding of these common sense can they truly protect the health and happiness of newborns.