Most patients have a history of more than one abdominal surgery, often combined with a history of inflammatory bowel disease (Crohn’s disease), tumors, tuberculosis or trauma, or radiation therapy, and have a long and complex course. Most patients with enterocutaneous fistula have a history of long-term treatment with antibiotics and nutritional drugs, and these drugs and nutritional support have a great impact on the subsequent surgical treatment of patients and need to be understood in detail. Patients with enterocutaneous fistula often have complications such as hypoproteinemia, anemia, severe malnutrition, and major organ insufficiency such as liver and kidney, making treatment extremely difficult and the patient’s mortality rate high (currently still about 20%).
In the course of the clinic, we often see patients from all over the country, such as Jilin and Inner Mongolia or even more distant places, who have travelled for two days and nights on the train to come here, queuing up at the hospital clinic at 4:00 a.m. to get a specialist’s appointment, but during the consultation, because of inadequate preparation of medical records, important information is missing, or they simply do not bring their medical records and tests, such as pre-operative surgical records, relevant imaging and CT, etc. However, during the consultation process, because of inadequate preparation of medical records, important information is missing, or there is no medical records and examination materials, such as preoperative operation records, relevant imaging and CT, etc., which may affect the expert’s assessment of the condition, or the family can only mail or go home to get the relevant information, which wastes a lot of money and time, and delays the treatment time. As we all know, the consultation time of the specialist clinic is limited, which is bound to delay your precious consultation time.
The actual fact is that you can find a lot of people who have been in the market for a long time.
1, please make sure you bring all the medical records (especially surgical records, pathology results) and relevant examination and imaging data (abdominopelvic enhanced CT, total gastrointestinal tract imaging, sinus tract imaging, Pet-CT, etc.) before your visit, these data will be of great help to us in making a clear diagnosis and determining the next treatment plan and surgical plan. The medical records of the previous hospitalizations can be copied from the case room of the original hospital, and the imaging data can be collected from the doctor in charge of the hospital when you are discharged.
2. Please organize the patient’s course of illness and treatment and surgical procedures in chronological order so that you can quickly, accurately and comprehensively show the development of the disease. Example of organizing the process of diagnosis and treatment: Wang Moumou, female, XX years old, X X, 201X, the patient was operated in a hospital in Beijing for abdominal pain and distension, with surgical records, postoperative pathology return: Crohn’s disease (see pathology report for details), X day after surgery, high fever, found digestive fluid outflow at the incision, given a change of medication, drainage, anti-inflammatory (antimicrobial drug name), water fasting, gastrointestinal decompression, nutrition support The patient was treated with anti-inflammatory, rehydration and nutritional support, and now the patient’s vital signs are stable. Please prepare and mark clearly the x-ray, abdominopelvic enhancement CT, total gastrointestinal tract imaging, sinus tract imaging, Pet-CT and other examinations done during the patient’s previous visits (you can mark the time and content of the examinations on the imaging data bag, for example: abdominal CT performed on X day, 20XX, before the first operation; abdominal CT performed on X day, 20XX, after the first operation, when the intestinal fistula was found). It is better to attach the examination report of the corresponding examination to facilitate the expert’s view during the consultation, to obtain important information quickly and save your consultation time.
If your condition allows, it is better to bring the patient with you to the consultation, because the direct dialogue between the doctor and the patient, including detailed questions about the development of the disease and abdominal physical examination, is the best way for the doctor to collect first-hand medical information and understand the condition.
We wish all patients with intestinal fistula a speedy recovery!