How to judge the baby's intestinal malformation

Parents are usually very nervous about their newborn babies, but since babies are not yet able to express their physical discomfort, parents must pay more attention to their baby's emotional changes. If they find any abnormalities, they must go to the hospital for examination. If the baby has a poor appetite, it is very likely that there is a problem with the intestines. In fact, many babies now have intestinal malformations after birth.

1. The course of vascular diseases varies in length, most are longer, and some may last for decades.

2. Bleeding occurs in various ways, including acute massive bleeding, repeated intermittent bleeding, and chronic minor bleeding.

3. Most bleeding is self-limited or can be temporarily stopped by hemostatic drugs, blood transfusion, etc., and hemoglobin can also return to normal.

4. There are almost no positive symptoms and signs when there is no bleeding.

1. Selective intestinal angiography Since 1960, selective or highly selective angiography has been the main means of diagnosing this disease, with a diagnostic rate of 75% to 90%. Vascular malformations in angiography can be divided into three types: Type I is arteriovenous anastomosis or submucosal vascular dysplasia; Type II is vascular hamartoma; Type III is hemorrhagic telangiectasia (if caused by genetic factors, it is called hereditary hemorrhagic telangiectasia, also known as Osler-Weber-Rendu syndrome). The main signs after angiography are:

(1) Abnormally increased vascular plexus with disordered structure.

(2) Spider-like dilation and tortuosity of peripheral blood vessels.

(3) During the arterial phase, the veins develop early, showing a "double track" sign, indicating the presence of an arteriovenous shunt.

(4) During the bleeding period, contrast agent can be seen overflowing and accumulating in the intestinal cavity.

(5) The venous phase shows that the veins in the intestinal wall on the mesenteric margin side are dilated and tortuous.

2. Endoscopic examination After 1970, with the development of endoscopy and the improvement of operator skills, electronic gastroscopy, small intestine endoscopy, colonoscopy and other endoscopic examinations have become the preferred methods for diagnosing vascular malformations. In recent years, the positive rate of capsule endoscopy for the diagnosis of small intestinal vascular malformations can reach more than 90%. However, vascular malformations can be divided into the following under endoscopy:

(1) Localized type (Type I): Localized vascular dilatation with clear boundaries from the surrounding normal mucosa, including regional vascular dilatation (Ia) and spider nevus-like vascular dilatation (Ib).

(2) Diffuse type (Type II): Vascular dilation is diffuse, wide-ranging, bright red in color, and has a vague boundary with normal mucosa.

(3) Hemangioma-like type (type III): It appears as a purple-red or gray-blue mass, slightly raised on the mucosal surface, and clearly demarcated from the surrounding normal mucosa.

3. Radionuclide imaging using 99mTc-red blood cells for radionuclide scanning is more sensitive in the localization of active bleeding caused by intestinal vascular malformations, but it cannot make a qualitative diagnosis and can only be used as an auxiliary method for angiography and endoscopic diagnosis.

3. Surgical exploration has a dual role in diagnosis and treatment of intestinal vascular malformation bleeding. It is suggested that patients under 50 years old with recurrent bleeding should undergo surgery as early as possible. Intraoperative endoscopy and/or intraoperative angiography can be used to help find the lesion.