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Abstract: A 42-year-old male with intestinal polyps found during a physical examination 1 month ago came for intestinal polypectomy at the suggestion of the examining physician and was admitted to the outpatient clinic as a small intestinal polyp. Combined with the results of the patient’s colonoscopy, the diagnosis was clear. After communicating with the patient about the surgical complications and related risks, the patient agreed to the surgical treatment. The patient was treated and the polyps were removed without any obvious discomfort and had a good postoperative recovery with good healing of the incision.
Basic information】Male, 42 years old
Disease Type】Small intestine polyp
Hospital】The First Affiliated Hospital of Kunming Medical University
Date of consultation】May 2022
Treatment plan】Surgical treatment (endoscopic polypectomy) + anti-infection treatment (cefamandole sodium for injection) + nutritional support (5% glucose injection)
Treatment period】3 days of hospitalization and 1 month of postoperative review
Treatment effect】After treatment, the patient had polyps removed, no obvious discomfort, and recovered better after surgery, and the incision healed better
I. Initial consultation
The 42-year-old male patient had a family history of intestinal cancer, so he had a colonoscopy every year, and no intestinal abnormalities were found until some time ago, when the colonoscopist informed him that a 0.5×0.7 cm polyp was found in his intestine during the examination. Therefore, the patient came to our outpatient clinic. Based on the patient’s family history of intestinal cancer, we highly suspected the malignant tendency of the polyp, so we suggested the patient to be admitted to the hospital for surgical excision and treatment, to which the patient agreed.
II. Treatment process
After admission, we arranged for the patient to complete routine blood tests, coagulation function, electrocardiogram, and screening for infectious diseases, etc. The tests showed no significant abnormalities, and the temperature and blood pressure were monitored normally after hospitalization. The patient and family members agreed to perform endoscopic polypectomy after they communicated with the patient and family members about the precautions and risks associated with the procedure. The next day, the patient was cleaned out and sent to the operating room for surgical treatment. The procedure went smoothly, and the intraoperative polyp was removed from the small intestine, and the intraoperative specimen was sent for pathological examination, and the operation was finished after there was no bleeding or perforation under the microscope. The pathological examination was reported as benign polyp. After the operation, the patient was asked to take a liquid diet and observed whether there was abdominal pain and blood in the stool, and was given cefamandole sodium for injection as anti-infection and 5% glucose injection to enhance nutritional support after the operation.
III. Treatment effect
After treatment, the patient’s polyps were excised without obvious discomfort, and the patient recovered well after surgery, the incision healed well and could move normally. Further examination suggested that no mass was palpable in the whole abdomen, mobile turbid sounds (+ -) and normal presence of bowel sounds. The electrocardiogram, blood pressure, blood and urine routine were normal. The patient felt that he was recovering well and requested to be discharged. According to the patient’s symptoms and signs, it was agreed that the patient should be discharged from the hospital to continue drug treatment and to review the colonoscopy at the outpatient clinic one month after the operation.
IV. Notes
We are glad that the patient’s intestinal polyp was successfully removed. However, we need to pay attention to the review of intestinal polyps 1 month after surgery, and then once every 6 months. This case is a low-risk patient, so we can gradually extend the review interval, closely observe the changes of the disease, and follow up promptly if there is any discomfort. Patients must pay attention to rest, combine work and rest, avoid overexertion, eat a diet high in protein, calories, vitamins and easy to digest, and avoid spicy and stimulating food. Maintain a relaxed mood, develop good habits of regular exercise, pay attention to a regular life, and avoid high mental tension or excessive excitement. Keep the bowel movement smooth, do sports and exercise appropriately to enhance your immunity and further promote gastrointestinal peristalsis.
V. Personal insight
Small intestinal polyps early due to small size, small impact on the gastrointestinal tract, most patients do not have obvious conscious symptoms, like the patient in this case, no obvious symptoms of discomfort, only found during physical examination, only a few patients can appear more frequent bowel movements, blood in the stool, abdominal pain, abdominal distension and other symptoms. If small intestinal polyps are not treated in time, they may become cancerous and develop into intestinal cancer. Therefore, if diagnosed, it is recommended to arrange treatment such as electrosurgery under colonoscopy and mucosal resection under endoscopy to avoid deterioration of the disease.