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Abstract: The patient in this case presented with abdominal pain, blood in the stool and other uncomfortable symptoms 3 months ago, but was not treated immediately until a colonoscopy was performed in our outpatient clinic half a month ago, when multiple polyps in the colon were diagnosed. According to the patient’s condition, endoscopic colon polypectomy was performed, and postoperative antibiotics were routinely applied. After 5 days of hospitalization, she recovered well and agreed to be discharged, but she needs to review the colonoscopy once a year.
Basic information】Female, 55 years old
Disease Type】Colonic polyp
Hospital】The First Hospital of China Medical University
Date of consultation】March 2019
Treatment plan】Surgical treatment (endoscopic polypectomy) + medication (ampicillin sodium for injection)
Treatment period】5 days in hospital
Effectiveness of treatment】Polyp removed, abdominal pain and blood in stool disappeared
I. Initial consultation
The patient had pain and discomfort in the left lower abdomen 3 months ago without any obvious cause, and it was not related to eating, the stool was formed, the frequency was normal, there was no abdominal distension, no nausea and vomiting, the stool was occasionally bloody, the blood was fresh, the amount was small, no special treatment, half a month ago in our hospital for colonoscopy, the results showed: colon multiple polyps, for further treatment, today came to our hospital, outpatient examination of the abdomen percussion drum sound, liver and kidney area without In combination with the colonoscopy report form half a month ago, she was admitted to our hospital with multiple polyps in the colon for follow-up treatment.
II. Treatment process
After communicating with the patient and his family, we decided to perform surgical treatment. First of all, we improved the ECG, X-ray and other auxiliary examinations, excluded other diseases, and then performed intestinal preparation and endoscopic colon polyp resection, and no erosion or bulging lesions were observed in the colonic mucosa during the operation. The patient returned to the ward safely after surgery, fasted for 8 hours, and was given injectable ampicillin sodium to prevent postoperative infection, while the patient’s vital signs were closely observed, as well as whether there was more blood and fluid discharge from the anus.
III. Treatment results
The patient’s surgery was relatively successful, and all the colon polyps were removed without intraoperative complications. About 8 hours after the operation, the patient’s anus was exhausted and gradually resumed normal diet. 4 days after the operation, the patient reported that he had a good diet and slept well, and his stool also returned to normal, with no abdominal pain, blood in stool and other uncomfortable symptoms. At the same time, there was no pressure pain or rebound pain in the abdomen, the bowel sounds were normal, and no postoperative infection occurred.
IV. Notes
The patient was very happy that the abdominal pain disappeared and the bowel movement returned to normal. I reminded the patient that he should pay attention to rest after discharge, and that heavy physical labor is not recommended within one month to avoid affecting the normal recovery of his body, but he can do square dancing, Tai Chi, walking, etc., and do appropriate activities. And pay attention to adjust their dietary habits, eat less heavy oil, heavy salt food, so as not to lead to the recurrence of colon polyps, and finally, they need to review the colonoscopy once a year, if there is blood in the stool, abdominal pain and other uncomfortable symptoms, they should always follow up.
V. Personal insight
Colon polyps usually do not have obvious discomfort symptoms in the early stage, so they are usually diagnosed after the polyps increase in size and symptoms such as abdominal pain, as in the patient in this article, and then can be treated by surgical excision, the specific procedure needs to be decided according to the size and number of polyps, most patients with multiple small polyps are suitable for the transcolonoscopic excision surgery mentioned in this article, in addition, the subsequent treatment plan also needs to be determined according to the nature of the polyps If the polyp is benign, no special treatment is needed; if it is malignant, follow-up treatment is required according to medical advice.