(Disclaimer: This article is for scientific use only, and the information in the following content has been processed to protect patient privacy)
Abstract: This is a case of a 78-year-old male patient who recently presented with abdominal distension and pain, and a lump could be felt with his hand, so he came to the hospital because he was worried that it was a tumor. Examination of the abdominal mass revealed that it could change with the change of body position, and the initial diagnosis was hernia. After admission, CT examination was performed, and the results suggested a lateral abdominal hernia, so the diagnosis was clarified. The patient was operated on, and after treatment, the patient recovered well.
Basic information】Male, 78 years old
Disease Type】Hernia
Hospital】The First Affiliated Hospital of Kunming Medical University
Date of Consultation】June 2020
Treatment plan】Surgical treatment (tension-free hernia repair)
Treatment Period】14 days of admission and 1 month of follow-up
Effectiveness】The symptoms of abdominal distention and pain and masses have improved, and all indicators are improving
I. Initial consultation
In June 2020, when I was on duty in the general surgery clinic, the patient’s family brought the patient in and looked at the patient covering his stomach, I hurriedly asked what the situation was. The family said that the patient had been saying for some time that his stomach felt painful and a little distended, so he thought it was because he had eaten bad stomach, so he went to the pharmacy and bought some stomach medicine, but he did not see any improvement after eating, and recently he found a raised lump in his right abdomen. The patient’s family was very nervous because the patient was old and worried about the possibility of a tumor in the stomach, so they rushed to the hospital for examination. After careful examination of the mass in the lower abdomen, which could change with the change of position, the initial diagnosis was hernia, and the patient was admitted to the hospital.
II. Treatment history
After the patient was admitted to the hospital, he perfected the treatment related to blood routine, blood biochemistry and coagulation examination, no narrower and necrosis were found, and the condition was still in the early stage. The CT examination report showed that a 13×6 mm defect was visible in the right abdominal wall, located at the lateral edge of the rectus abdominis muscle, which belonged to the lateral ventral hernia. After confirming the patient’s condition, we communicated meticulously with the family and explained that the patient’s hernia might be caused by the weakening of the abdominal wall muscles as she grew older, and there was a risk of aggravation if the condition was not treated in time. After listening to our detailed explanation, the family understood the patient’s condition and agreed to undergo surgery. Considering the patient’s age and condition, we discussed and decided to use tension-free hernia repair. The patient’s surgery went smoothly and she returned to the ward safely after surgery.
III. Treatment results
The patient recovered quickly after the operation and the pain level was mild, and was discharged after 14 days of hospitalization. The patient’s family also said that the patient did not have any more stomach distension and pain after returning home, and no more lumps were felt. The patient’s family was instructed to pay more attention to the patient’s condition to prevent recurrence of the disease and to go to the hospital for timely consultation if any abnormality was found. The family and the patient were happy and thankful.
IV. Notes
After treatment, the patient recovered and I was happy for the patient. Patients should also pay attention to the following points after going home.
1. The family should pay more attention to the healing of the patient’s wound, keep the wound dry and clean, and prevent it from becoming infected and septic. Pay attention to the patient’s condition in a timely manner, and if any signs of recurrence are found, they must go to the hospital for consultation and treatment in a timely manner.
2, postoperative rest should be paid attention to avoid lifting and squeezing heavy objects, reducing weight-bearing activities, reducing the number of bending, avoiding coughing and sneezing.
3, reasonable rest, eat more fruits and vegetables, develop healthy eating habits, avoid constipation, and quit smoking and drinking.
V. Personal insight
Most hernias can be cured with timely treatment, but if the condition is delayed due to untimely treatment, patients with lateral abdominal hernia may even develop entrapment and strangulation, which can cause shock in serious cases; among them, brain hernia is very dangerous, with very high mortality and disability rates, and one of the keys to its prognosis is early detection and treatment, so once you find that you are not feeling well, you must go to the hospital in time. The patient in this case is a lateral ventral hernia. Because of timely diagnosis and treatment, the disease has not yet caused irreversible damage to the body, and she will not recur after going home and recovering in strict accordance with medical advice.