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Abstract: This 36-year-old Mr. Wang complained of abdominal discomfort for more than 1 year continuously and had a history of gastritis, arthritis, hypertension, etc. After perfecting the relevant examinations, Mr. Wang was initially diagnosed with gastric polyps. Mr. Wang was given the surgical method of high-frequency electroshock therapy, and after postoperative treatment with rehydration and nutritional support and medication for liver protection, Mr. Wang’s condition gradually recovered and his abdominal discomfort basically disappeared.
Basic information】Male, 36 years old
Disease Type】Gastric polyp
Hospital】The First Affiliated Hospital of Kunming Medical University
Date of consultation】March 2021
Treatment plan】Surgical treatment (endoscopic high-frequency electrode treatment) + intravenous infusion (glucose sodium chloride injection, fatty milk injection (C14-24)) + oral medication (dacronin hydrochloride syrup, dicyclomine tablets, ricegrine tablets)
Treatment period】5 days of hospitalization and regular follow-up
【Treatment effect】Improvement, no uncomfortable symptoms
I. Initial consultation
Mr. Wang came to the consultation room complaining of abdominal discomfort with no cause 1 year ago, with occasional symptoms of burning sensation in the stomach, acid reflux and abdominal distension, but no more obvious abdominal pain, and these symptoms can be relieved by themselves. After asking about his past history, we found that Mr. Wang had a 2-year history of hypertension and rheumatoid arthritis. He had previously undergone gastroscopy in another hospital and was found to have gastric polyps, superficial gastritis and reflux esophagitis, and was diagnosed with gastric hyperplastic polyps. After that, he had been taking oral medication for antacid and no other treatment. In order to seek further treatment, he came to our department, and a simple physical examination of Mr. Wang revealed no obvious abnormalities.
II. Treatment process
After Mr. Wang was admitted to the hospital, Mr. Wang was further investigated, and the CT examination showed obvious polyps and low absolute values of lymphocytes, leukocytes, eosinophils and monocytes, which were presumed to be caused by rheumatoid arthritis through past history.
In order to ensure a smooth surgery, Mr. Wang was given oral treatment with ricoderm tablets as a priority to prevent white blood cell and thrombocytopenia. Other than that, all tests showed no abnormalities and no obvious contraindications to surgery. Therefore, Mr. Wang was treated with endoscopic high-frequency electrode therapy for multiple gastric polyps. Before the surgery, Mr. Wang was given sodium chloride glucose injection for rehydration, and he was also given dacronin hydrochloride gum slurry for laryngeal lubrication and anesthesia to remove the luminal foam and make a clear view. The surgery was performed for several minutes and went very well, and after the surgery, he was given continued sodium chloride glucose injection, along with fatty milk injection (C14-24) for nutritional support, and dicyclomine tablets for oral protection of the liver. Licoderm tablets for leukocytopenia and thrombocytopenia.
(CT: a large gastric polyp can be seen at the gastric sinus)
III. Treatment effect
Mr. Wang was hospitalized for 5 days. There was no abnormal bleeding from the stump of the resected part of the surgery, and the postoperative recovery was good, with no obvious discomfort, no abnormal adhesions, and normal signs. After 5 days of hospitalization, we communicated with Mr. Wang to take medicine home for recuperation. Although the pathological result was fundic glandular polyp and no deterioration occurred, Mr. Wang was still advised to come for regular review.
IV. Precautions
I am very glad that Mr. Wang’s condition has improved, but at the same time, I also need to advise Mr. Wang to pay attention to the following points.
1, after discharge from the hospital, you need to gradually resume a normal diet, starting with a liquid diet, must not eat too hard, greasy, spicy food, should be gradual, in the beginning can drink a small amount of water, and then gradually drink some porridge, soup and other well-digested food, and then gradually resume a normal diet.
2, any discomfort in the body needs timely feedback, need to pay attention to the bleeding reaction after the removal of the lesion, so as to determine whether the local organs have perforation. Look at the daily stool for signs of blackening, blackening is a sign of bleeding, if there is abdominal pain, abdominal muscle tension, abdominal distension symptoms may be a sign of perforation, need to report to the doctor in a timely manner.
V. Personal insight
1, gastric polyp is a common lesion in the stomach, most of them are not cancerous, but some of them may become cancerous. Gastric polyp refers to the result that the cell clusters in the stomach gather together and form a bulge in the stomach lining. In this article, Mr. Wang is a polyp caused by chronic gastritis, usually gastric polyps need surgery and medication, so high frequency electrode therapy was used for Mr. Wang.
2, Mr. Wang is more timely, and also has been using drugs did not make the polyps worse, polyps do not show signs of cancer, but also need to come to the follow-up regularly. In addition, Mr. Wang’s primary hypertension and rheumatoid arthritis can be used under the guidance of the relevant doctors to use drugs that are less irritating to the stomach to avoid prolonging the disease.