BXBX NOVEL Chapter 1329: 【1329】Inexplicable disease
The liquid in the drainage bag is a little cloudy, with yellow, white and black spots in color, probably because there are signs of suppuration, leakage and a little feces in it. The patient's temperature was measured to be high, thirty-eight degrees nine.
"Is this patient a tumor patient?" Without seeing the medical records, Feng Yicong and Xie discussed it by themselves. The patient is too young to speculate that it is less likely to be a tumor patient.
Xie Wanying agrees with the students' point of view. It is not only cancer patients who undergo surgery. In her opinion, this case was transferred to the National Association for treatment, indicating that some of its characteristics are the scope of treatment that the National Association is good at, so she boldly inferred: "It may be Crohn's disease."
Crohn's disease is an inexplicable intestinal inflammation. Said it is inexplicable, because its pathogenesis has so far been puzzled by the medical community. It may be an infection, it may be an immune disease, in short, there are many possible causes.
Illnesses that do not know the cause can only leave doctors helpless. Therefore, in clinical treatment of Crohn's disease, one is symptomatic treatment, and the other is immunotherapy based on the existing evidence related to immunology. This is what the National Association is good at, because the National Association's immunology discipline is well-known in China, and no one dares to rank second. If this young man is suffering from this disease and has reached the stage of surgery, it means that the development of the disease has entered a severe stage. There may be intestinal obstruction or intestinal fistula or acute perforation bleeding.
A typical clinical feature of Crohn's disease is fistula formation. Inflammatory lesions penetrate the intestinal wall to other tissues and organs outside the intestine, forming fistulas. These fistulas allow adhesions between organs and tissues to form a mass abscess. How terrifying an abdominal abscess is, has been experienced by anyone who has been to general surgery.
It is really an abscess, but it is not suitable for immediate surgery to remove the diseased intestinal segment. The incision and drainage of the intra-abdominal abscess should be done first. The incision and drainage of abdominal abscess is to open the abdomen, not a common bedside needle puncture. General anesthesia, spinal or epidural anesthesia is required, the skin and subcutaneous tissue peritoneum is incised, the abdominal cavity is opened, and the Inflammatory mass, use gauze to isolate the mass to prevent the spread of infection, cut the abscess to drain pus, and finally put the drainage tube to close the cavity.
The patient is now in the surgical stage but is transferred to the National Association. Should he continue surgical treatment or be transferred to internal medicine?
After studying the medical records, Yu Xuexian asked his family to talk. Feng Yicong asked Xie again: "Do you want to go to internal medicine for treatment? After surgery, signs of increased pus continue to appear. Surgery is not clean, so conservative medical treatment should be considered, because our gastroenterology department has research on Crohn's disease. rather good at.”
Listening to what Feng said, it fully shows that he is an internal medicine student who knows internal medicine very well.
There was a lot of pus accumulated in the drainage bag of the patient, indicating that if this surgical operation was not done well, it would not be effective in relieving the patient’s condition. Switching to internal medicine should be the usual reasoning.
Without jumping to conclusions, Xie Wanying stared at the patient's abdominal drainage tube and began to think further.
As a surgical student, I have the thinking of a surgeon, which is different from that of a medical student of Feng, so the direction of thinking about the problem is not the same.
Having stayed in two surgeries, apart from going to the stage with her teacher and brother to perform surgery, Xie Wanying has learned the most about how to deal with patients before and after surgery.
(end of this chapter)