Chapter 1329 【1329】Inexplicable Illness

Appears to be a post-surgical patient.

The liquid in the drainage bag was a bit cloudy, with yellowish white and black spots in color, which may be signs of suppuration and leakage plus a little feces. The patient's temperature was measured to be high, thirty-eight degrees nine.

"Is this patient a cancer patient?" Without seeing the medical records, Feng Yicong and classmate Xie first discussed by themselves. The patient is too young, so it is speculated that the possibility of being a tumor patient is relatively small.

Xie Wanying agrees with her classmates. Cancer patients are not the only ones who undergo surgery. In her opinion, the transfer of this case to Guoxie for treatment shows that some of its characteristics are the scope of treatment that Guoxie is good at, so she boldly infers: "It may be Crohn's disease."

Crohn's disease is an inexplicable intestinal inflammation. It is inexplicable because its pathogenesis has been baffled by the medical community so far. Say it may be an infection, it may be an immune disease, in short, there are many possible causes.

A disease of unknown etiology can only leave doctors helpless. Therefore, the clinical treatment of Crohn's disease, one is symptomatic treatment, and the other is immunotherapy based on some existing evidence related to immunology. This is what the National Association is good at, because the immunology subject of the National Association is well-known in China, and no one dares to rank second when it ranks first. If the young man is suffering from this disease and has reached the stage of surgery, it means that 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 and reach other tissues and organs outside the intestine, forming fistulas. These fistulas allow adhesions between various organs and tissues, wrapping into mass abscesses. How terrible abdominal abscess is, everyone who has studied in general surgery has experienced it.

If an abscess is really formed, it is not suitable for immediate surgery to remove the diseased intestinal segment. Incision and drainage of the intra-abdominal abscess must be done first. The incision and drainage of abdominal abscess requires laparotomy, not ordinary bedside puncture with needles, but general anesthesia, spinal anesthesia or epidural anesthesia, incision of the skin subcutaneous tissue peritoneum, opening the abdominal cavity, and finding For the inflammatory mass, use gauze to isolate the mass to prevent the spread of infection, incise the abscess and drain the pus, and finally put the drainage tube in and close the cavity.

The patient is now in the stage of surgery but transferred to the National Association of China. Should he continue surgical treatment or be transferred to internal medicine?

After studying the medical records, Yu Xuexian went to talk to his family members. Feng Yicong asked classmate Xie again: "Do you want to go to the internal medicine department for treatment? After surgery, there are still signs of increased pus. The surgical treatment is not clean, so we should consider conservative treatment in the internal medicine department, because our department of gastroenterology has research on Crohn's disease. Better at it."

Listening to Feng's words, it fully shows that he is an internal medicine student who understands internal medicine very well.

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 effective in relieving the patient's condition. It should be the usual reasoning to switch to internal medicine.

Without jumping to conclusions, Xie Wanying stared at the patient's abdominal drainage tube and began to think further.

As a surgical student, he has the thinking of a surgeon, which is different from Feng's thinking of an internal medicine student, so the direction of thinking about the problem is not consistent.

Having stayed in two surgical departments, apart from performing operations with her teacher and senior brother, Xie Wanying learned the most about how to deal with patients before and after surgery.