Regarding this question, Huang Zhilei wanted to scratch his head. Senior Brother Cao didn't say anything after he picked up the child, and he couldn't figure out the reason and how to answer.
Let's say this child is seriously ill. If he is seriously ill, he should be sent to the emergency room and not to the office. There is not even oxygen in the office.
What a bunch of famous doctors are arguing about is not to recommend emergency medicine to patients or to give patients emergency intubation, cardiac compression, defibrillation, etc... but whether enema is useful.
"It's useless for your surgeon to just give him an enema." Jiang Mingzhu said, "If he doesn't need surgery for appendicitis, you can try to use a colonoscopy to check the intestines and appendix. Colonoscopy is more accurate and intuitive than CT.
You can clearly identify whether there are fecal residues in the intestines, and if so, take them out and flush them to reduce inflammation."
(At that time, there was no ERAT endoscopic retrograde appendicitis treatment. The principle of ERAT surgery is similar to the method mentioned by Jiang Mingzhu. It uses endoscopic examination of the appendix and fecal extraction and flushing to treat appendicitis. It is mainly targeted at patients with fecal stones.
Appendicitis caused by residual.)
Xie Youtian’s child’s condition is indeed suspected to be appendicitis caused by feces.
"You're too impatient. I just finished the enema and I don't know what the effect will be. We'll have to wait and see if the situation changes later." Dr. Jiang, a general medical student, waved his hand at her suggestion.
"I'm not in a hurry. I just think that if I make up my mind not to perform surgery to remove the appendix on this child and want to try more other methods, I can make a plan for digestive endoscopic surgery in advance." Jiang Mingzhu said. Internal Medicine
The doctor is more careful and advocates the need to take precautions.
Yu Xuexian's words to her: Yes.
After hearing what the two of them said, the surgeon disagreed and refuted:
"Your endoscopy is fine for examination, but other treatments are normal. The appendix is a very special part. It's very difficult for you to reach the appendix with the endoscope. This child will definitely not be able to cooperate. He needs to be anesthetized, otherwise he won't be able to do it."
"The endoscopic examination method you mentioned is not much different from conservative treatment. If the inflammation is small, it will naturally dissipate under conservative treatment. We will give the child blood for injection later. If the inflammation is large, you can just rinse the two cells like this
How can it be possible to eradicate the inflammation in this place? A sufficient course of treatment is required for the antibiotics to be effective. If it is serious, our surgery will perform incision, open drainage and flushing of the suppurated area. It is impossible to do it multiple times at one time. Therefore, the appendix is very easy to treat.
If it recurs, the only option is surgery to remove it."
(Future ERAT surgery will also have this flaw and will have different indications.)
It is very difficult to preserve the appendix.
Surgery's current confidence in conservative treatment is mainly based on the fact that the child's condition was discovered relatively early.
After being yelled at by the surgeon, Jiang Mingzhu took a few breaths, thought about it again, and insisted on her internal medicine opinion.
The internal medicine department present was not limited to gastroenterology. Dr. Lin from the cardiology department said: "The child's heart rate is too fast and his breathing rate is too fast. It's hard to tell whether it's just fear. Because he has pain and fever, all of which can cause...
Increase his heart rate and respiratory rate. If you want to feel at ease, let him stay in a hospital for observation, right?" After saying that, he looked at Jin Tianyu.
Jin Tianyu was not as simple as his colleagues thought. The issue of enema caused such a quarrel. If the child was hospitalized, which department should be arranged to go to.
Besides, don’t you have any objections?
Fu Xinheng didn't speak.
Zhu Huicang adjusted his glasses: "The attending doctor is still silent?"
The opinions of each subject are all here. Letting the attending physician get the final opinion is the right approach.
