ZHANG Zhiyuan's Experience in Using Baizhu （Atractylodes macrocephala） in Clinical Practice / 中医杂志

Professor Zhang Zhiyuan， a master of Chinese medicine， made good use of Baizhu （Atractylis macrocephala （Koidz.））. Except for defecation in clinical practice， he usually prescribed processed Baizhu after stir-frying with soil. Baizhu is good at excreting water and removing dampness， so applied it in the formula series with Fuling （Poria cocos） and Guizhi （Cassia Twig） or self-made decoction for diarrhea. High-dose Baizhu could be used for edema by treating obstructive syndrome with tonics， so Baizhu were added in self-made Shugan Qushui Decoction （疏肝祛水汤） or modified Lizhong Decoction （理中汤） for liver cirrhosis ascites. It was emphasized that Baizhu could eliminate phlegm， so added it in modified Zexei Decoction （泽泻汤） for excess syndrome of vertigo. It was also acknow-ledged that Baizhu could strengthen the spleen and stomach， and was suitable for deficiency or excess syndrome of abdominal distension， so applied it in Burun Decoction （补润汤） for abdominal distension with deficiency-excess in complexity， and applied it in Zhizhu Decoction （枳术汤） or self-made Tiaozhong Decoction （调中汤） for deficient abdominal distention.

Two Cases of Abdominal Distension Successfully Treated with Tokishigyakukagoshuyushokyoto / 日本東洋医学雑誌

Abdominal distension is one of the common symptoms and can cause abdominal pain and anorexia, which may raise adverse effect on general well-being and quality of life. In Western medicine, there are specialized treatments for structural lesions associated with abdominal distension, but functional abdominal distension is often difficult to treat. There have been some reports of Kampo medicine for treatment of abdominal distension, but no case reports on tokishigyakukagoshuyushokyoto. We experienced two cases of abdominal distension successfully treated with tokishigyakukagoshuyushokyoto. Case 1 was 86-year-old woman who developed abdominal distension with frequent belching. Case 2 was 59-year-old man who developed abdominal distension associated with opioid. Regulating qi medicine was not effective for abdominal distension in both cases. Both cases had reversal coldness of the extremities, tympanic sounds of abdomen, coldness of abdomen, and inguinal tenderness and resistance. Therefore, we diagnosed them as tokishigyakukagoshuyushokyoto sho. After administration of tokishigyakukagoshuyushokyoto, in Case 1, the frequency of belching decreased and the appetite increased with the improvement of abdominal distension. In Case 2, increasing the dose of goshuyu in tokishigyakukagoshuyushokyoto relieved abdominal distension. Tokishigyakukagoshuyushokyoto can be effective for abdominal distension with interior cold pattern.

Effect of symptom management theory-based nursing care on postoperative abdominal distension in patients with primary hepatocellular carcinoma / 中国实用护理杂志

Objective:To investigate the effect of symptom management theory(SMT)-based nursing care for the prevention of postoperative abdominal distension in patients with primary hepatocellular carcinoma.Methods:A total of 80 primary hepatocellular carcinoma patients in the Second Affiliated Hospital of Wenzhou Medical University from May 2016 to May 2019 were assigned to the experimental group and the control group according to the admission time, there were 40 cases in each group. The patients in the control group received routine postoperative nursing care, while the patients in the experimental group added SMT-based intervention. The postoperative first exhaust time and defecation time were recorded; the abdominal distension degree after 1, 3, 7 days of surgery were evaluated. In addition, the symptom distress was assessed by The Symptom Module Specific to Primary Liver Cancer (TSM-PLC).Results:The postoperative first exhaust time and defecation time were (69.08±11.44), (78.80±15.54) h in the experimental group, which were significantly lower than those in the control group (76.03±12.26), (86.03±13.48) h, the differences were statistically significant ( t=2.62, 2.22, both P<0.05). After 3, 7 days of surgery, the abdominal distension degrees were significantly alleviated in the experimental group compared to the control group, the differences were statistically significant ( Z =2.31, 2.34, both P<0.05). After 7 days of surgery, the abdominal distension, weight loss, fever symptom scores in TSM-PLC were 1.80±0.28, 0.76±0.21, 0.48±0.19 in the experimental group, which were significantly lower than those in the control group 2.16±0.31, 0.93±0.25, 0.74±0.20, the differences were statistically significant ( t=5.38, 3.27, 5.90, all P<0.05). Conclusions:SMT-based intervention can promote the recovery of postoperative gastrointestinal function and alleviate abdominal distension symptom distress of patients with primary hepatocellular carcinoma.

A study of forty eight patients with ilecoceacal mass presenting as intestinal obstruction requires surgical intervention and their outcome

Background: Intestinal obstruction is defined as obstruction of the passage of the intestine for its contents. Successful conservative treatment may leave adhesions that could cause recurrence; on the other hand, surgery may be the source of new adhesions like any other abdominal surgery. Hence, the present study was undertaken for assessing the 48 patients with ilecoceacal mass presenting as intestinal obstruction requires surgical intervention and their outcome.Methods: Of a total of 48 patients with ilecoceacal masses who presented with intestinal obstruction and underwent surgical intervention for the same. Surgical management outcome was classified as “favorable” or “unfavorable” outcome according to the retrospective secondary data extracted from their medical records. Unfavorable outcome was considered if the patient died or has one or more postoperative complications. Favorable outcome was considered if the patient was discharged alive and does not have any history of postoperative complications.Results: Abdominal pain, abdominal distension, vomiting and failure to pass faeces were the prominent presenting symptoms among intestinal obstruction patients.  Favourable outcome was seen in 76 percent of the patients while unfavourable outcome was seen in 24 percent of the patients. Mortality occurred in 6 patients. Prolonged ileus was found to be present in 1 patient. Failure to wean from ventilator for more than 48 hours was seen in 2 patients.  Conclusions: Surgical management had high efficacy of more than 75 percent in managing patients with intestinal obstructions. With precise technique and adequate care, complication rate can be reduced.

Think beyond ascites

In children with gross, persistent ascites wherein clinical scenario is not agreeable to common conditions, one needs to revise the diagnosis and rule out the surgical cause for abdominal distension mimicking ascites. We are reporting here, a case of two year old female child who presented with abdominal distension, clinically suggestive of ascites and subsequently diagnosed to have a large chylous mesenteric cyst which was determined on biochemical investigations, imaging and confirmed on surgical intervention. She was managed surgically with successful outcome.

Type IV jejunal atresia in a newborn: a rare birth defect presenting with bilious vomiting

Background: Type IV jejunal atresia is a rare birth defect, which occurs due to late intrauterine vascular accidents that results in complete obstruction of intestinal lumen. There is no genetic predilection. It occurs most commonly in proximal jejunum. Clinical presentation includes bilious vomiting, abdominal distension, feeding difficulties, failure to pass stools and/or absence of bowel movements after birth. Here author report a case of premature newborn, who was admitted in NICU at birth in view of prematurity. As the baby had bilious vomiting and bilious NG aspirate on day 3 of life, possibility of intestinal obstruction was kept. It was diagnosed as a case of jejunal atresia by abdominal radiograph displaying dilated stomach, duodenum and proximal jejunum with gasless abdomen. Further jejunal atresia confirmed by the upper GI study exhibiting the level of obstruction. Surgical resection of the atretic segment and primary anastomosis was done. This case emphasizes the need of rapid identification of jejunal atresia and its adequate management to prevent morbidity and mortality associated with fore shortened intestine.

Clinical control study of water colonoscopy and gas colonoscopy / 中国实用内科杂志

OBJECTIVE: To evaluate the satisfaction and performance of water colonoscopy and gas colonoscopy. METHODS: 240 continuous cases were randomly divided into two groups(gas colonoscopy group, water colonoscopy group). Record the general condition, success rate, period of performance and abdominal pain score. Investigate the degree of abdominal pain, distension and the will of receiving anesthetic colonoscopy next time in the follow-up. RESULTS: There were no significant difference between two groups in the general condition, success rate, depth of insertion, abdominal pain after examination or the will of receiving anesthetic colonoscopy next time(P>0.05). The period of insertion, period of withdrawal and period of performance in water colonoscopy group was longer than those in the gas colonoscopy group(P<0.001, P=0.013, P<0.001). The degree of abdominal distension at 1 hour after colonoscopy in water colonoscopy group was higher than those in the gas colonoscopy group(P<0.001), but no significant difference was found at6 hours after examination. CONCLUSION: Patients undergoing water colonoscopy have better outcomes with less abdominal pain and abdominal distension except for longer time of performance.

Síndrome de Ogilvie en cuidados intensivos pediátricos / Ogilvie syndrome in pediatric intensive care

Introducción: el síndrome de Ogilvie es una entidad infrecuente, más aún en la edad pediátrica, caracterizada por la dilatación aguda del colon, y que suele complicar la evolución de distintas enfermedades. Dentro de sus causas más comunes está la cirugía ortopédica y/o traumatológica. Objetivo: actualizar sobre el diagnóstico y tratamiento del síndrome en las edades pediátricas. Presentación del caso: se presenta una paciente de 16 años, operada de escoliosis toraco abdominal, que a las 24 horas de operada comenzó con distensión abdominal progresiva y marcada, y se le diagnosticó de síndrome de Ogilvie. Conclusiones: la entidad, aunque infrecuente, puede presentarse en pacientes con diversas afecciones, y se debe conocer adecuadamente sobre su diagnóstico y tratamiento para lograr la recuperación del enfermo(AU)

Introduction: Ogilvie syndrome is an uncommon condition, even more so in childhood. It is characterized by acute dilation of the colon, often complicating the evolution of different diseases. Its most frequent causes include orthopedic and/or trauma surgery. Objective: update the information about the diagnosis and treatment of the syndrome in pediatric ages. Case presentation: a female 16-year-old patient who had undergone thoraco-abdominal scoliosis surgery and had developed progressive, marked abdominal distension 24 hours after the operation, was diagnosed with Ogilvie syndrome. Conclusions: infrequent as it is, the condition may present in patients with various diseases. It is necessary to have adequate knowledge about its diagnosis and treatment to achieve successful recovery in patients(AU)

Observation on curative effect of Maren Soft Capsules in treatment of senile constipation / 中草药

Objective To observe the curative effect of Maren Soft Capsules in the treatment of senile constipation. Methods A total of 120 elderly patients with constipation were randomly divided into the observation group and the control group with 60 patients, in each group had. The observation group was treated with Maren Soft Capsules, and the control group was treated with Maren Pills. After one week's treatment, the efficacy and symptom improvement of the two groups were observed. Results The total effective rate of the observation group was 90.0%, which was significant higher than that of the control group (P < 0.05), and the dry stool, defecation, defecation incompletely, and abdominal distension symptoms were obviously improved. There was no obvious adverse reaction in two groups during the treatment. Conclusion Maren Soft Capsules are effective in the treatment of senile constipation.

Comparison of Clinical Effects of Electroacupuncture of Abdominal and Limb Acupoints in the Treatment of Acute Pancreatitis / 针刺研究

OBJECTIVE: To compare the difference of therapeutic efficacy of electroacupuncture (EA) stimulation of abdominal acupoints and limb acupoints in the treatment of acute pancreatitis (AP), so as to provide a reference for EA treatment of AP. METHODS: A total of 60 patients with AP were equally and randomly divided into abdominal acupoint group and limb acupoint group. On the basis of retention enema of Chaiqin Chengqi Decoction (containing Radix Bupleurum, Radix Scutellaria, etc.), and abdominal external application of Liuhe Powder ointment (containing Cinnabaris, pearl powder, etc.), patients of the two groups were also treated with acupuncture stimulation of acupoints at the abdomen or limbs. The abdominal acupoints were Shangwan (CV 13), Zhongwan (CV 12), Xiawan(CV 10), Liangmen (ST 21, left), Taiyi(ST 23, left), Chengman (ST 20, left), Fu'ai (SP 16, left), Yindu(KI 19, right), and the limb acupoints were Hegu(LI 4), Neiguan(PC 6), Zusanli(ST 36), Shangjuxu(ST 37), Xiajuxu(ST 39), and Yinlingquan(SP 9) which were punctured with filiform needles by retaining the needles for 30 min after twirling for a while. CV 12 - ST 21, CV 10- SP 16 of the abdomen group, and bilateral PC 6 and ST 36 of the limb group were administered EA (2 Hz/15 Hz, 1 mA and duration of 30 min). The treatment was conducted once daily for 5 days. The abdominal pain severity and distension severity were assessed using the visual analogue scale (VAS), and the abdominal girth was measured by using a soft ruler. RESULTS: Following the treatment, the abdominal pain and distension symptom scores in the lightest and most severe phases of AP and the abdominal girth levels were considerably decreased on the 5th day in the two groups in comparison with their own pre-treatment in the same one group (P 0.05). In addition, no adverse events were found in both groups. CONCLUSION: EA has a good curative effect in the treatment of AP patients. The curative effect of acupuncture of the abdominal acupoints is significantly superior to that of limb acupoints in relieving abdominal pain.

Hinchazón/distensión funcional: un enfoque práctico / Functional abdominal bloating/ distension: a practical approach

Although abdominal bloating and distension are frequent symptoms, they are considered a challenge in medical practice. Treatment alternatives with varying efficacy levels, associated to the lack of knowledge about this problem, generate difficulties in the doctor­patient relation, and patient's frustration and anxiety. Advances in understanding their etiopathogenetic factors have lead treatment of these patients towards a personalized approach. The purpose of the article is to provide a brief description about abdominal bloating and distension, and ultimately give a practical approach of this condition.

A pesar de que la hinchazón (bloating) y la distensión abdominal son síntomas altamente frecuentes, son considerados un desafío en el quehacer médico. Alternativas terapéuticas con grados de eficacia variables, asociado a un desconocimiento en el enfrentamiento clínico, generan dificultades en la atención de estos pacientes por parte de los médicos, además de frustración para el paciente. Avances en la comprensión de su etiopatogenia han permitido dirigir el tratamiento de estos pacientes de manera personalizada. Este artículo tiene como objetivo realizar una breve descripción del cuadro, y dar finalmente un enfoque práctico frente a esta condición.

Effect of oral dietary fiber on recovery of intestinal function after two cesarean section / 肠外与肠内营养

Objective:To observe the effect of oral administration of dietary fiber (DF) on flatus and defecation promotion and abdominal distension reduce,as well as the impact on exclusive breastfeeding and adverse reactions.Method:A total of 80 pregnant women who received repeated cesarean section at obstetrics department in Shanxi Provincial People's Hospital(2016.12 ～ 2017.03) were randomly divided by computer into two groups.DF group included 40 cases,and the patients took DF (1 bag,15g,with 200ml warm boiled water) 6h after cesarean section in 10min,and repeated it 8 ～ 12 h after operation.Patients in control group only received 200ml warm boiled water at the same point-in-time.The two groups shared the same dietary guidance,nursing and medical treatment.Bowel sound,flatus and defecation conditions as well as the incidence rates of abdominal distension and exclusive breastfeeding were compared between two groups.The adverse reactions after administration of DF were collected.Result:There were 38(97.4 ％)cases that had bowel sound in 12h pro-operation in DF group.There were 25(62.5 ％) cases that had bowel sound in 12h pro-operation in control group.There were 30(76.9 ％) and 12(30.0 ％) cases had first flatus during 24h pro-operation respectively in DF group and in control group.There were 22 (56.4 ％) and 7 (17.5 ％)cases had first defecation ＜48h pro-operation respectively in DF group and in control group.The differences were all statistically significant (P ＜ 0.01).In the comparison of gastrointestinal reaction,there were more cases reported abdominal distension(3,7.7％;12,30.0％) and nausea (3,7.7％ ∶10,25.0 ％),with statistical significances (P ＜ 0.05).There was no statistical significance (1,2.6 ％ ∶ 4,1.0 ％,P ＞ 0.05) in vomiting.Breast feeding rate was no statistical significance (56.％ ∶52.5 ％,P ＞ 0.05).One case of DF group discovered adverse reactions,such as nausea and vomiting.Conclusion:Oral administration of soluble DF significantly promoted the flatus and defecation after repeated cesarean section,however,patients with intestinal irritability need to be paid more attention to the adverse reactions,such as nausea and vomiting.

<b>A Case of Functional Constipation and Abdominal Distension Treated with K</b><b>obokushokyohangeninjinkanzoto</b> / 日本東洋医学雑誌

<p>Constipation is one of the most common symptoms seen in elderly people, and is sometimes difficult to treat. Daikenchuto is a well-known Kampo formulation for treating ileus. Here, we report a case in which daikenchuto was not effective and constipation was effectively treated with kobokushokyohangeninjinkanzoto. The patient was an 81-year-old woman who had been hospitalized for treatment of a thighbone fracture. She was originally constipated, and her constipation had worsened over the course of hospitalization. Colonoscopy examination and abdominal computerized tomography showed no structural lesions. Her constipation improved after the administration of daikenchuto, but the improvement was transient. Since the constipation and abdominal distension worsened after she began eating again, we administered kobokushokyohangeninjinkanzoto. Subsequently, her condition improved remarkably. Eight days later, we changed the initial kobokushokyohangeninjinkanzoto to ninjinto and hangekobokuto. Her complaint did not recur, and she was discharged 17 days later. In case of deficiency pattern ileus, kobokushokyohangeninjinkanzoto may be considered as an alternative to daikenchuto. Furthermore, we believe that the combination of ninjinto and hangekobokuto is an effective alternative to kobokushokyohangeninjinkanzoto.</p>

Essence Experience of Professor SHI Zai-xiang in Treatment of Intractable Abdominal Distension / 中国中医药信息杂志

Intractable abdominal distension refers to the reasonable application of the general dialectical therapy with no significant efficacy. Professor SHI Zai-xiang believes that on the basis of hepatosplenic disorder, there are the etiology and pathogens of spleen yang not raising and spleen and stomach in disorder in intractable abdominal distension, which should be treated with raising qing yang, tonifying qi, and consolidating the superficial resistance. Therefore, modifiedBuzhong Yiqi Decoction was used; as for abdominal distension with blood stasis and meridian stasis, the treatment should be motivating blood circulation and eliminating stasis, motivating qi stagnation, and making free the passage of blood in the vessels, which should be treated withGexia ZhuyuDecoction combined withDahuang Zhechong Pills; as for abdominal distension with lung qi stagnation, the treatment should be motivating lung qi, moisturizing dryness and laxation, promoting qi and eliminating swelling, which should be treated with modified WenbaiPills; as for abdominal distension with cold and yang deficiency, the treatment should be warming and expelling cold, warmly tonifying spleen and kidney, which should be treated withJiuzhuan Yuhu Pills; as for abdominal distension with extra meridians tiredness and deficiency of yin and yang, the treatment should be tonifying extra meridians, warmly tonifying yin and yang and tonifying liver and kidney, which should be treated with modified Roucongrong Pills. Intractable abdominal distension needs the overall dialectical and alternative treatment.

A Case of Giant Hydronephrosis Hidden by Obesity in an 11-year-old Boy

Giant hydronephrosis (GH) is a rare urological entity and usually presents with more than a liter of fluid in the collecting system. It may mimic a progressive and benign abdominal cystic tumor. We report a case of GH in an 11-year-old obese boy who presented with abdominal distension and dyspnea on exercise. Hydronephrosis was caused by ureteropelvic junction obstruction, with 2,300 mL of fluid in the collecting system. Diagnostic and therapeutic features of this case are discussed, with reference to current literature.

A Case of Giant Hydronephrosis Hidden by Obesity in an 11-year-old Boy

Giant hydronephrosis (GH) is a rare urological entity and usually presents with more than a liter of fluid in the collecting system. It may mimic a progressive and benign abdominal cystic tumor. We report a case of GH in an 11-year-old obese boy who presented with abdominal distension and dyspnea on exercise. Hydronephrosis was caused by ureteropelvic junction obstruction, with 2,300 mL of fluid in the collecting system. Diagnostic and therapeutic features of this case are discussed, with reference to current literature.

Neonatal Gastrointestinal Emergencies in a Tertiary Care Center in Bhopal, India: A Prospective Study.

Background: In emergency neonatal surgery is challenging and difficult, causing high morbidity and mortality. In our country, only few reports are there about the results and consequences of acute surgical abdominal emergencies in newborns. Objective: The aim of present study was to determine the etiology and clinical results in neonates with acute abdomen requiring surgical intervention. Materials and Methods: This was a 3 years prospective hospital-based study of all neonates who underwent surgery for acute gastrointestinal emergencies at Chirayu Medical College and hospital Bhopal from January 2012 to January 2015. Patient’s profile, symptoms, causes of acute surgical abdomen, clinical outcomes were analyzed. Results: A total of 25 neonates were studied, males were the majority being 18 (72.0%) Neonatal intestinal obstruction was the main abdominal surgical emergency. Anorectal malformation was seen in 12 (48%) cases. Abdominal distension was seen in 15 cases and failure to pass meconium was seen in 15 (19.2%) cases. Palliative surgery was done in 16 cases and definitive surgery was done in 9 cases. The mortality was seen in 5 neonates (20%). Conclusion: In present study, Intestinal obstruction was the major cause of acute surgical abdominal emergency. There is a need to increase care at all levels of referral in our country for the early management of sick newborns. Facilities such as neonatal ventilators, specialized neonatal surgeon, and operative facilities will result in better outcome.

Clinical observation of Rhubarb and mirabilite with comprehensive nursing in treatment of abdominal surgery in patients with abdominal distension / 中国生化药物杂志

Objective To study the clinical effect of complex treatment combined with external application of Rhubarb and Mirabilite on abdomen of patients with abdominal distension after abdominal surgery .Methods 90 patients with abdominal distension after gynecological abdominal surgery from June 2014 to September 2015 were randomly divided into conventional group(45 patients) and comprehensive group(45 patients).Patients in the conventional group were given routine gynecological postoperative care, and patients in the comprehensive group were given complex treatment combined with external application of Rhubarb and Mirabilite on abdomen.The abdominal distension duration, anal exhaust time, time of resuming peristaltic sound, first defecation time, treatment effect, depression and anxiety emotions, changes of life quality of the two groups before and after intervention were compared.Results The comprehensive group had higher treatment effect than the comprehensive group ( P<0.05 ) .The abdominal distension duration, anal exhaust time, time of resuming peristaltic sound, first defecation time of the comprehensive group were shorter than that of the conventional group(P<0.05).The comprehensive group had better depression, anxiety emotions and life quality compared to the conventional group (P<0.05).Conclusion Complex treatment combined with external application of Rhubarb and Mirabilite on abdomen has a very significant clinical effect on patients with abdominal distension after abdominal surgery, it can improve patients’negative emotions and the symptom of abdomen distension, promote life quality.

NURSING OBSERVATION ON THE ANAL EXHAUST EFFECT IN PATIENTS TREATED WITH WARM WATER FOOT BATH AFTER LAPAROSCOPIC SURGERY / 现代医院

Objective To observe the anal exhaust effect in patients treated with warm water foot bath after laparoscopic surgery.Methods 90 cases after laparoscopic surgery including renal cancer , renal cysts, epinephrine-tumor patients were randomly divided into A , B and C group.Nursing measures were given at 6 hours after operation. A group were treated with warm water feet bath ; B group received abdominal ring massage ; And C group were control group.Time of anal exhaust postoperatively was observed among the 3 groups.Results Anal exhaust time after oper-ation in A group was average (24.34 ±0.28) hours, which was significantly shorter than in B group (33.07 ±0.18) h and C group (37.90 ±0.19) h (p <0.01).Conclusion Warm water foot bath can promote the anal exsufflation rapidly, effectively after laparoscopic surgery in Urology patients , and has great significance helpful to early recovery .

Safety and efficacy of carbon dioxide versus air insufflations during endoscopic retrograde cholangiopancreatography / 中华胰腺病杂志

Objective To investigate the safety,efficacy of CO2 insufflations during ERCP.Methods One hundred and forty eligible patients who underwent ERCP in Fuzhou General Hospital of Nanjing Military Command from January to December 2012 were randomized according to random digits in a double blind manner to receive either CO2 insufflations or air insufflations (65 vs 75).The patient's experience of abdominal pain and distension at 1 h,2 h,6 h and 24 h post-ERCP were evaluated by visual analogue scale (VAS).The heart rates,blood pressure,SpO2,PaCO2 were recorded before,during,after ERCP,and 24 h after the examination.Plain abdominal radiographic images were collected to show abdominal distention before and after ERCP,waist circumference,operative time,recovery time,intraoperative and post-ERCP complications were also determined.Results Post-ERCP the VAS of abdominal pain at 3 h was (4.08 ± 1.36) in CO2 group,which was significantly lower than that in air group [(4.59 ± 1.66),P ＜ 0.01].The VAS of abdominal distension at 1 h,3 h,6 h after ERCP were(1.78 ± 1.90),(0.72 ± 1.15),(0.12 ±0.45),which were significantly lower than those in air group [(3.53 ± 2.71),(2.51 ± 2.04),(0.84 ± 1.24),P ＜ 0.05] ; the intraoperative SpO2 was (93.29 ± 1.40)％,which was significantly lower than that in air group [(93.52 ± 1.06) ％,P ＜ 0.01].The waist circumference at 1 h after ERCP increased by (2.48 ± 1.33)cm,which was significantly lower than that in air group [(3.56 ± 2.13) cm,P =0.00).Recovery time was (11.2 ± 2.5) rain in CO2 group,which was significantly longer than that in air group [(9.7 ± 1.7) min,P =0.00].And the difference between the two groups was statistically significant.The plain abdominal radiographic images showed the degree of bowel distension was severer in air group than that in CO2 group (P =0.04).Conclusions CO2 insufflations are safe and efficacy during ERCP.CO2 can better alleviate abdominal pain and distension than air.