A 4-year-old child with periodic complaints of abdominal pain came to a polyclinic and was referred for an abdomen ultrasound scan. On ultrasound in the right upper quadrant of the abdomen, a target sign was visualized, intestinal intussusception was suspected, and hospitalization was recommended. The clinicians had doubts - the abdomen is soft, the diagnosis was not confirmed in the admission department of a Moscow hospital. The parents were unhappy that the ultrasound scared them. From a conversation with a surgeon who did not confirm the diagnosis, his "logic" became clear to me. Intussusception corrected by air irrigoscopy is considered as intussusception (the diagnosis is confirmed!), but intussusception corrected by water during an enema is not intussusception, but incorrect peristalsis (the diagnosis has not confirmed!)! Some kind of rock-paper-scissors game, and if the air conquers the water, and the enema verifies the ultrasound, then maybe we should not buy the ultrasound scanners and should have an enemas ... three times a day after meals? Here's what, for example, write on the website of the Mayo Clinic, respected by all of us - "Treatment options for intussusception may include: A water soluble contrast or air enema...". So the respected Mayo Clinic recognizes the enema as a treatment for intussusception, but in our country prefer to tune patients into an unreasonable conflict with a more competent doctor ... external link |