Interviewee/Yan Lubin, Deputy Director of Pediatric Surgery Department of the Sixth Affiliated Hospital of Sun Yat sen University
Case 1: Intestinal perforation
Whether for adults or children, we all know that jujube is a good thing. However, everything has two sides. Although the small jujube is very good, the jujube skin is easy to stay in the intestines and not easy to discharge, so the jujube skin should be removed when giving children jujube. Do you think eating dates is just indigestion? Yan Lubin, Deputy Director of Pediatric Surgery of the Sixth Affiliated Hospital of Sun Yat sen University, told the reporter that there were some children before the age of 3 who could not spit out the date stone well after eating the date, which caused eating by mistake and serious complications such as asphyxia, intestinal stones and even intestinal perforation!
Xiaoming was weak when he was 3 years old. Grandma made various kinds of soup for the children to mend his body. A few days ago, she specially made lotus seed and jujube soup. Xiaoming drank several bowls of soup a day. However, in the afternoon of the second day after drinking the soup, the child slowly developed abdominal pain, accompanied by nausea, and the anus stopped defecation and exhaust, similar to intestinal obstruction symptoms. When he came to the hospital, peritonitis had already occurred. Emergency surgical exploration found a small perforation 10 cm from the ileocecal part, and a date stone near the perforation. It turns out that Xiao Ming drank jujube soup, but did not spit out jujube stones, resulting in intestinal perforation.
The small jujube stone may be excreted with the stool when adults swallow it, while the children may have obstruction or even perforation due to the incomplete intestinal function, especially the narrow intestinal cavity, and the special structure of the appendix and ileocecal valve when they reach the ileocecum. Yan Lubin said that the child found it in time and it was a small date. If it was a relatively large date stone and he did not seek medical attention in time, it might cause serious perforation. Moreover, the greater omentum of children is not well developed, and the perforation cannot be wrapped in time, which can easily lead to severe diffuse peritonitis and even infectious shock.
When children eat too many dates, they will suffer from abdominal distention due to poor digestion, and then anorexia, nausea and other discomfort; If the symptoms are not alleviated, then abdominal distension will increase, and intestinal obstruction symptoms such as anus stop exhaust and defecation will appear. If there is no timely medical treatment leading to intestinal perforation, abdominal pain will increase, accompanied by abdominal muscle tension and other peritonitis. In case of any of the above symptoms, it is necessary to seek medical advice in a timely manner, and during this process, do not give any food and water to the child, so as not to increase the burden on the gastrointestinal tract, induce vomiting and increase the pollution of perforation.
Case 2: Intestinal calculus
In clinical practice, there are too many cases of intestinal perforation in young children due to swallowing jujube stones. In another special case, the jujube skin and stone did not cause obstruction and perforation, but they were not discharged with the stool, and stayed in the intestinal tract for a long time, which caused intestinal stones.
Two year old Xiao Liang has a big appetite even though he is small. He likes to eat everything and put everything in his mouth. His family doesn't pay attention to him, so they eat what they shouldn't eat. A few days ago, my family relatives brought big dates, and the little guy couldn't put them down. Although the adults were living in Tibet, they still ate some of them. At that time, the family didn't care too much.
About a week ago, Xiao Liang, who was restless at ordinary times, often wilted and said that he had stomach pains. Because he couldn't explain clearly, his parents thought he had accumulated food and didn't care. Slowly, Xiao Liang's stomach became more and more distended, which attracted parents' attention. When he came to the hospital, he had stopped defecation and exhaust from anus for two days. If his stomach was distended, plain abdominal film showed intestinal obstruction, and the white blood cell count was also very high. At that time, he considered intestinal obstruction caused by appendicitis. Emergency surgical exploration found that the appendix was only an ordinary inflammatory manifestation, which was not enough to cause such a serious manifestation. Careful exploration found that there was a large fecal stone in the ileocecal region. When the fecal stone was cut open, we saw the date stone inside. It was the small date stone that caused the intestinal stone to make the little guy uncomfortable.
Yan Lubin said that because the date stone was round and tossed in the intestinal tract, although it did not lead to intestinal perforation, it could not pass through the ileocecal part. When intestinal chyme accumulated on the date stone for a long time, it caused fecal stone. Slowly, the fecal stone grew larger, which led to the occurrence of intestinal obstruction. Because of intestinal obstruction, the pressure of ileocecal part is too high, which leads to high pressure in the intestinal cavity of the appendix, intestinal edema, and finally shows signs of appendicitis such as abdominal pain. This is also one of the main reasons for the formation of intestinal stones, another new disease in clinical practice.
Therefore, when giving jujube to young children, we must process it, remove the stone of jujube, and remove the skin of thicker ones. If the baby is worried that it will not be easy to digest after eating, we can put the dried jujube meat in the porridge and boil it together for them to eat jujube porridge, which is also very nutritious. In addition, dates are too sweet, which can easily lead to dental caries. Therefore, the consumption must be well controlled. It is OK to eat 3-5 dates every day, not too many. Wen/reporter Chen Hui Correspondent Jian Wenyang
