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¡¾1329¡¿Inexplicable illness

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    It appears to be a patient after surgery.

    The liquid in the drainage bag is a little turbid, with yellow, white and black spots in color, which may be signs of suppuration and leakage plus a little feces.  The patient's body 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, so it is speculated that the possibility of him being a tumor patient is relatively small.

    Xie Wanying agrees with her classmates¡¯ views.  Cancer patients are not the only ones who undergo surgery.  In her opinion, the fact that this case was transferred to Guoxiang for treatment showed that it had some characteristics that Guoxiang was good at treating, so she boldly deduced: "It may be Crohn's disease."

    Crohn¡¯s disease is an inexplicable intestinal inflammation.  It is said to be 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.

    The disease that does not know the cause can only make the doctor helpless.  Therefore, the clinical treatment of Crohn's disease consists of symptomatic treatment and immunotherapy based on existing immunological evidence.  This is what the National Association is good at, because the immunology subject of the National Association is very famous in the country, ranking 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 fistula formation.  Inflammatory lesions penetrate the intestinal wall and reach other tissues and organs such as the intestine, forming fistulas.  These fistulas cause adhesions between various organs and tissues, forming mass abscesses.  Everyone who has studied general surgery knows how scary abdominal abscess is.

    When an abscess has actually formed, it is not suitable to perform surgery to remove the diseased intestinal segment immediately. Incision and drainage of the intra-abdominal abscess must be performed first.  Incision and drainage of abdominal abscess requires laparotomy. It is not an ordinary bedside puncture with a needle. General anesthesia, spinal anesthesia, or epidural anesthesia is required. The skin, subcutaneous tissue, and peritoneum are incised, and the abdominal cavity is opened.  For inflammatory masses, use gauze to isolate the mass to prevent the spread of infection, incise the abscess and drain the pus, and finally put a drainage tube in and close the cavity.

    ??The patient has now entered the surgical stage but was transferred to the National Association of Hospitals. 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 classmate Xie again: "Should we go to internal medicine for treatment? There are signs of increased pus after surgery. Surgery can't handle it cleanly, so we need to consider conservative treatment by internal medicine, because our Department of Gastroenterology has research on Crohn's disease."  Better at it.¡±

    Listening to what Mr. Feng said, it was fully demonstrated that he was a medical student who knew a lot about internal medicine.

    There was a lot of pus accumulated in the patient¡¯s drainage bag, indicating that if this surgical operation was not done well, it would not be very effective in relieving the patient¡¯s condition.  It should be the usual reasoning to transfer 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 fellow surgeons, what Xie Wanying learned the most was how to deal with patients before and after surgery.  (Remember the website address: www.hlnovel.com
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