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Abstract: Rectal polyps are mostly distributed in the lower rectum, which are polyps on the rectal mucosa. The patient visited the clinic with light red blood in the stool, and the cause of the blood in the stool could not be determined in the outpatient examination, so colonoscopy was performed and rectal polyps were found, and colonoscopic electrocoagulation and electrodesiccation were given along with adjuvant drug therapy.
Basic information】Male, 45 years old
Type of disease】rectal polyp
Hospital】Hegang City People’s Hospital
Date of consultation】March 8, 2022
Treatment plan】Surgical treatment (colonoscopic electrocoagulation and electrodesiccation) + medication (glucose injection, compound amino acid injection, injectable hemagglutinin, Yunnan Baiyao capsule)
Treatment period】4 days of hospitalization and 3 months of follow-up
Treatment effect】The symptoms of blood in the stool disappeared, and the treatment effect was good, and the patient was discharged successfully.
I. Initial consultation
Patient’s description: In the past half month, there was light red blood on the surface of the stool. After further questioning of the patient’s medical history, we learned that the patient had formed stools, had daily morning bowel movements, had no abdominal pain or bloating, and had not lost weight. The patient had a history of diabetes mellitus and was taking oral metformin hydrochloride extended-release tablets with good glycemic control. The patient was given an anal finger examination in the outpatient clinic: no swelling was palpated at the end of the rectum of the anal canal, and no stained pus or blood was seen on the exit of the finger sleeve. Anoscopy showed that the mucosa of internal hemorrhoid was smooth and no bleeding point was seen. The stool routine suggested that the stool was positive for occult blood. After communication with the patient, colonoscopy was performed under anesthesia, and a subtibial polyp, about 0.3×0.6cm in size with blood staining on the surface, was found about 10cm away from the anus, and the rest of the intestinal canal did not show any abnormality, and then stool routine examination was performed, and the preliminary diagnosis was rectal polyp.
(Stool routine)
II. Treatment history
After the rectal polyp was found, we informed the family that rectal polyp has a certain chance of cancer, and the treatment was suggested to be resected under colonoscopy, and after the family agreed, the patient was given colonoscopic electrocoagulation and electrodesection. The whole operation went smoothly without any accidents such as intestinal bleeding and perforation, and the patient was then hospitalized. After hospitalization, the patient was given fasting for 2 days, glucose injection, compound amino acid injection, saline, etc. for rehydration and nutritional support, hemostatic symptomatic treatment with injectable hemagglutinin and blood glucose monitoring. 2 days later, the patient resumed eating and stopped rehydration. On the 4th day after hospitalization, the patient had normalized his diet and was discharged immediately. The patient was advised to continue taking Yunnan Baiyao capsules orally for 2 weeks to prevent delayed intestinal bleeding. After discharge, the patient was advised to review the colonoscopy regularly to prevent the rectal polyp from growing again.
III. Treatment effect
This is a case of rectal polyp patient, who was treated with electrocoagulation and electroexcision during the colonoscopy. No complications such as intestinal bleeding and perforation occurred during the treatment, and no delayed intestinal bleeding occurred, and the patient recovered and was discharged from the hospital in 4 days, and the patient no longer had the symptoms of blood in the stool after discharge, and the patient got good treatment results. The patient’s treatment process was also safe, with no anesthesia accidents and no hypoglycemic reactions because the patient had diabetes, and he was finally discharged from the hospital cured. In conclusion, the patient’s complaints disappeared at the time of consultation, the treatment effect was good, and he was discharged smoothly, and the patient and his family were very satisfied with the treatment effect.
IV. Notes
We are glad that the patient’s symptoms of blood in stool disappeared after treatment. Patients should pay attention to the presence of abdominal pain and blood in stool after rectal polyp removal, and inform the medical staff in time if it occurs. As the patient has a history of diabetes, patients as well as their family members should pay attention to the patient’s performance and seek medical attention promptly when there are symptoms such as sweating, dizziness and discomfort in the precordial area, and prepare some sugar cubes or sugar water to prevent hypoglycemic reactions on a daily basis. After surgery, avoid strenuous exercise to avoid bleeding from trauma tear or even intestinal perforation. After you can eat, you can consume liquid and easily digestible food in the early stage and gradually transition to normal diet. In addition, care needs to be taken not to take drugs with blood-activating effects, such as aspirin enteric tablets, for 2 weeks.
V. Personal insight
The patient paid more attention to the symptoms of blood in the stool, and did not treat herself with medication, but came to the hospital in time, and was diagnosed with rectal polyps after colonoscopy, and was cured by microscopic treatment, avoiding the evil consequences of rectal polyps developing into rectal cancer, which shows the importance of timely diagnosis and treatment. For patients, don’t think that you should ignore it after removal, but still need to regularly review colonoscopy, so as to achieve timely detection and treatment. The occurrence of rectal polyps is related to a variety of factors, such as genetic factors, environmental factors, poor dietary habits, etc. Combined with the characteristics of patients, it is recommended that people over 40 years of age have an annual colonoscopy physical examination to achieve early detection and early treatment to avoid its development into malignant tumors.