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Abstract: Duodenal polyps mainly originate from mucosal epithelial tissues, and most patients do not have obvious clinical manifestations. As in this case, the patient came to the clinic with epigastric discomfort, abdominal distension and nausea. Through physical examination and endoscopy, she was diagnosed with duodenal polyp and given surgery + conventional treatment, after which the abdominal pain, abdominal distension and nausea disappeared.
Basic information】Female, 61 years old
Disease Type】Duodenal polyp
Hospital】The First Affiliated Hospital of Kunming Medical University
Date of Consultation】March 2022
Treatment plan】Surgical treatment (endoscopic mucosal resection)
Treatment period】4 days of hospitalization and 1 month of outpatient follow-up
Effectiveness of treatment] Abdominal pain, bloating and nausea disappeared
I. Initial consultation
On a day in March 2022, a 60-year-old female patient came to the clinic with epigastric discomfort, abdominal distension and nausea. Observing the overall condition of the patient, we found that she was mentally fine, slightly pale and clearly conscious. After detailed questioning, we learned that the patient had no other discomfort before, but 1 week ago she had epigastric discomfort with nausea and vomiting. He was found to have clear respiratory sounds in both lungs, strong heart sounds, regular rhythm, no murmur in each valve auscultation area, no obvious mass on abdominal palpation, painful on pressure, no abnormal blood tests, etc. Endoscopic findings showed that the duodenal mucosa, a pile of tissue, 0.1 cm in diameter, was in good health with no history of allergy. He was initially diagnosed as duodenal polyp, and was admitted to the hospital for further diagnosis of polyp type.
II. Treatment history
After admission, the patient continued to improve blood glucose, lipids, liver and kidney function, C-reactive protein and other related tests, and the results were not significantly abnormal; the occult blood test showed negative, indicating no intestinal bleeding; the patient was clearly diagnosed as a duodenal polyp, and after discussion with the patient, agreed to surgery. On the second day of admission, endoscopic mucosal resection (EMR) was performed to remove the duodenal polyp, and the specimen was sent for pathological histological examination, with a small amount of intraoperative bleeding of about 5 ml, and the trauma was closed with titanium clips. Postoperative pathological return: inflammatory polyps. The patient was discharged on the 4th day of admission, and the patient was asked to follow up after 1 month.
III. Treatment effect
After surgical resection, the patient’s condition was relatively stable, the patient had no obvious discomfort, no other adverse reactions, no abdominal pain and distension, nausea and vomiting and other uncomfortable reactions. After discharge, the patient followed the doctor’s prescription and took the medication on time. In the re-examination after 1 month, the patient was in good mental condition, his appetite gradually recovered, and the polyp had been removed by endoscopy, and the surface of intestinal mucosa was smooth, soft and movable.
IV. Notes
The patient was successfully operated and discharged from the hospital, so we are really happy for her. After discharge from the hospital, without the supervision of the doctor, the patient should observe his condition by himself, and if there is persistent abdominal pain, fever, vomiting and other symptoms, he should visit the doctor for review in time; if there are no other uncomfortable symptoms, he should also visit the doctor for review one month after the operation. The diet should be reasonably arranged, with less and more meals. At the beginning, it is recommended to eat warm and cool liquid food, and gradually transition to normal diet after 6 days, with light and steamed food as the main food; less fried and indigestible food; for half a month, alcohol, spicy and stimulating food and drugs to promote intestinal peristalsis are prohibited. In terms of lifestyle, pay attention to adjusting work and rest, avoid overwork, do not do heavy physical work, prohibit all strenuous exercise, and prevent falls.
V. Personal insight
Duodenal polyps originate from the mucosal layer, most patients do not have clinical symptoms, and generally after treatment, as the patient can achieve clinical cure, but patients need regular postoperative follow-up checks. For some duodenal polyps have the possibility of cancer, they should be detected and treated in time, which is important for the cure of the disease. In addition, a good lifestyle, adequate sleep, regular work and rest, and healthy and safe eating habits can prevent the disease from attacking. For patients, good attitude and emotion are equally important for the treatment and recovery of the disease. Patients should build up confidence to overcome the disease and actively cooperate with doctors for early recovery.