The liquid in the drainage bag is a little turbid, with yellowish white and black spots in color. I'm afraid there are signs of pus and leakage plus a little feces. The patient's temperature was measured to be high, 38 degrees 9.
"Is this patient a tumor patient?" Without seeing the medical records, Feng Yicong and Xie discussed it by themselves. The patient was too young, so it was speculated that the possibility of him being a tumor patient was relatively small.
Xie Wanying agreed with her classmates’ point of view. Cancer patients are not the only ones who undergo surgery. In her opinion, this case was transferred to the National Association for treatment, indicating that it has some characteristics that the National Association is good at treating, so she boldly inferred:
"It could be Crohn's disease."
Crohn's disease is an inexplicable intestinal inflammation. It is inexplicable because the medical community is still confused about its pathogenesis. It may be an infection or an immune disease. In short, there are many possible causes.
A disease whose cause is unknown can only leave doctors helpless. Therefore, the clinical treatment of Crohn's disease consists of symptomatic treatment and immunotherapy based on existing evidence related to immunology. This is the national association
He is good at it, because the immunology department of the National Association is famous in the country. It ranks first and no one dares to rank second. If this young man has this disease and has reached the stage of surgery, it means that the disease has entered a serious stage. It may be intestinal.
Obstruction or intestinal fistula or acute perforation and bleeding.
A very typical clinical feature of Crohn's disease is the formation of fistulas. Inflammatory lesions penetrate the intestinal wall and reach other tissues and organs such as the outside of the intestines, forming fistulas. These fistulas cause adhesion between various organs and tissues and become wrapped in bags.
Massive abscess. Anyone who has studied general surgery has experienced how scary an abdominal abscess is.
If an abscess has actually formed, it is not suitable to operate immediately to remove the diseased intestinal segment. Incision and drainage of the intra-abdominal abscess must be done first. Incision and drainage of abdominal abscess requires laparotomy, not ordinary bedside needle use.
Puncture requires general anesthesia or spinal anesthesia or epidural anesthesia. The skin, subcutaneous tissue and peritoneum are incised, the abdominal cavity is opened, the inflammatory mass is found, the mass is isolated with gauze to prevent the spread of infection, and the abscess is incised to drain the pus.
Finally, the drainage tube was placed and the cavity was closed.
The patient has now entered the surgical stage but was transferred to the National Association. Should he continue surgical treatment or transfer to medical treatment?
After studying the medical records, Yu Xuexian went to talk to his family members. Feng Yicong asked Xie again: "Should we go to internal medicine for treatment? There are signs of increased pus after surgery. Surgery can't handle it completely, so conservative treatment by internal medicine should be considered."
, because our Department of Gastroenterology is good at researching Crohn’s disease.”
Listening to Mr. Feng’s words, it fully shows that he is a physician student who knows a lot about internal medicine.
There was a lot of pus accumulated in the patient's drainage bag, indicating that if the surgical operation was not done well, it would not be very effective in relieving the patient's condition. It should be a common reasoning to transfer the patient to internal medicine.
Without jumping to conclusions, Xie Wanying looked at the patient's abdominal drainage tube and began to think further.
As a surgical student, I have a surgeon's thinking, which is different from Feng's internal medicine student's thinking, so the direction of thinking about the problem is not consistent.
Having stayed in two surgeries, apart from performing surgeries with her teachers and seniors, what Xie Wanying learned the most was how to deal with patients before and after surgery.