New Jiangsu·China Jiangsu Net News (Reporter Sun Jun, Intern, Reporter Gu Yanwu, Correspondent Zhang Aixuan) Shanshan is 6 years old this year. Half a year ago, she had a routine blood test in the hospital because of a cold. , only half of the normal value for children (hemoglobin ≥120g/L). “At that time, the child’s face was bad. We thought it was the cause of the illness, but we didn’t expect it to be anemia,” the parents recalled. Therefore, Shanshan was treated with iron deficiency anemia and supplemented with iron as prescribed by the doctor. However, Shanshan’s hemoglobin rose after each iron supplementation, and fell again after a few days, and it continued for more than half a year.
At the beginning of March this year, Shanshan went to the Gastroenterology Department of Nanjing Children’s Hospital. Zhang Zhihua, the deputy chief physician, said: “The effect of iron supplementation for half a year is not good, and there must be other primary diseases. Find out.” Later, during the detailed examination, Zhang Zhihua found that Shanshan had occasional mucus and bloody stools. “Blood in the stool + anemia, it is likely to be intestinal polyps.” Later, colonoscopy showed that there was a huge polyp of 3-4 cm in the transverse colon of Shanshan, which completely blocked the field of view of the colonoscopy. Zhang Zhihua introduced that intestinal polyps in 6-year-old children are usually less than 2.5 cm. Giant polyps like this are very rare, and because the location of polyps is high in the colon, colonoscopy is difficult to remove, so it needs to be removed by laparoscopic surgery.
On March 9, Huang Lei, chief physician of the General Surgery Department of the hospital, performed laparoscopic polypectomy for Shanshan. “In the past, such operations required incision of the abdomen, which was very traumatic; later, conventional laparoscopic surgery was to make three ‘holes’ in the abdomen, one for laparoscope, and two for surgical instruments. This time, we used three channels. For single-port laparoscopy (Triport), only a hole of about 2 cm can be opened on the navel, and there is almost no obvious wound after surgery.” Huang Lei said, “Under the laparoscopy, we can see that the polyp is very large, The entire intestinal lumen was blocked, and it was ‘buried’ in the intestinal wall in an irregular lobulated shape, with no obvious roots.” During the operation, Huang Lei peeled off the polyp from the intestinal tract little by little under the laparoscope to avoid injuring the intestinal wall. In the end, the polyp that was surgically removed was about 4 centimeters in diameter, about the size of a “pigeon’s egg”. After the operation, Shanshan’s hemoglobin and various indicators quickly returned to normal.
Zhang Zhihua said: “This kind of juvenile polyps of the intestinal tract is very common in clinical practice, with different sizes, and it is a long-term and chronic disease process. In addition to intermittent painless mucus and bloody stools in children, , there are no other obvious symptoms, and it is often mistaken for constipation and anal fissure bleeding. Therefore, when an older child is sick, it is difficult for parents to detect and pay attention to it in time. However, if bleeding for a long time, it will cause anemia; if polyps fall off, it may also cause Heavy bleeding. It is recommended that parents regularly ask or observe the child’s defecation in order to detect abnormalities early.”
Editor: Sun Jun Source: New Jiangsu·China Jiangsu Net