Patient: Description: Radical surgery for colon cancer Time: 2013-08-26 to 2013-10-16 Department: Gansu Landa Second Hospital, Department of General Surgery My father underwent radical surgery for colon cancer on August 26, and after surgery, he had a high fever and was given antibiotics. on September 18, he had an intestinal fistula, and a drainage tube was placed. on September 28, he leaked a lot of stool from around the tube, and was given negative pressure suction, fasting, TPN, and antibiotics. on October 8, he stopped taking the drugs and ate a liquid diet. On October 8, he stopped taking the medication and ate liquid food. On October 13, his body temperature rose to 38.8 degrees, and on October 15, his stomach rose, and he took a CT report on the thickening and gathering of the mesentery. on October 16, stool came out of the drainage hole again. On the 16th, the stool came out of the drainage hole again, and on the 16th, there was occult blood in both post-operative tests. Is the occult blood in the stool a recurrence of cancer? Is my father’s condition Crohn’s disease? Can the fistula grow back after 50 days of surgery? Can the infection be completely eliminated? I am very afraid of delaying the treatment, and I am eagerly waiting for your reply! Thank you! General Hospital General Surgery Department Ren Hua Jian: Occult blood in the stool does not indicate cancer recurrence, and tumors usually do not recur so quickly, it may be caused by the inflammation around the intestinal fistula. Tumor and Crohn’s disease are two completely different diseases. The current infection needs to be controlled by improving drainage. The longer you delay, the less likely it is that the intestinal fistula will grow back on its own, and eventually surgery may be required, so please treat it as early as possible. Patient: Hello, Dr. Ren! Thank you very much for your reply in your busy schedule. The doctor is now using saline drip into the abdominal cavity with negative pressure suction. Can this method completely eliminate the infection? I’ve been fasting for 4 days now, but my stomach is still a little bit up, my stomach is always ringing inside, I don’t have much gas, and I don’t have any stool, is this normal? Does the thickening and gathering of the mesentery affect the self-healing of the fistula? And the CT report shows that the right lower abdominal wall is not connected, is this a serious problem? I am waiting for your reply! Thank you! The best weapon for treating intestinal fistula is the double cannula of Li, other drains are similar in principle, but the effect of drainage is greatly reduced, there are many factors that affect the healing of intestinal fistula, drainage, drugs and nutritional status are very important, to be evaluated comprehensively, and is more comprehensive only after seeing the patient, not just based on some examination reports Patient: Hello Dr. Ren! Thank you for your prompt reply! I would love to bring my dad to your hospital to receive good treatment, but due to the long distance and many other factors, I can’t come for now. I can only do so by getting your help. You are right, you can’t judge by the test report alone. But I still have a few questions that I would like your help with. 1. how many days of parenteral nutrition and then enteral nutrition? 2. my stomach rises, loud, not much gas, and no stool, is this the cause of the intestinal fistula or is it another complication? 3. how much would it cost to come to your hospital for treatment? The choice of nutritional support is determined by the principle of treatment, not that after the use of parenteral nutrition must be changed to enteral nutrition at a certain time. The benefits of enteral nutrition need not be mentioned, but if the infection is not yet controlled, the drainage is not smooth enough, and the intestinal function has not yet recovered, enteral nutrition is not considered for the time being, because it may aggravate the disease. Moreover, the possibility of self-healing of the fistula decreases after the use of enteral nutrition. If you come to our hospital for treatment, the total cost may be between 150,000 and 200,000.