Chapter 1496 Cat Scratch Colon

"Guess what Director Luo is doing?" Director Du asked with a smile.

"Busy doing endoscopy? Are you still going out of the clinic?" Zheng Ren answered casually without hesitation at all.

"I'm learning about your first few days of ESD surgery." Director Du said, "We don't do it, and we don't know how good it is, but I heard people say that Director Luo has organized his doctors who are engaged in endoscopy to learn it 3 times."

The operation performed on the old monitor Fan Tianshui?

Zheng Ren smiled, the operation was really good, at least he was satisfied.

Systematic review, 100% completion, no doubt it is a perfect level of surgery.

Director Luo's eyes are really bright. The surgery was completed with microscopic techniques to remove precancerous tumors, which is an area that ESD surgery has not yet touched.

Under normal circumstances, Fan Tianshui's old monitor would have to open his abdomen and cut a section of his intestines to solve the problem.

However, using microscopic techniques and minimally invasive excision, the patient recovers very quickly and the damage is small, which should indeed be taken seriously.

Especially in live broadcast surgery, I don’t know how many doctors who are engaged in endoscopy have noticed.

The two came to the endoscopy room, changed their clothes and went in.

In the corridor of the endoscopy room, some patients waiting to be diagnosed sat quietly. Director Du led Zheng Ren directly to the final classroom.

"Here, the difficulty of microsurgery." Director Luo wore glasses and was very serious in front of the screen.

The door was open, Zheng Ren saw Director Luo's figure, and when he heard his voice, a smile appeared on the corner of his mouth.

For senior directors in their fifties, safe retirement is the first consideration for many people.

Therefore, exposure to new technologies is basically a matter of younger professors. But looking at the situation in front of him, Director Luo is still full of energy, and he is very high.

In his fifties, he was exposed to microsurgery, and it was unlikely that he could perform the surgery himself.

Whether the eyes are blurry or not, and whether the hands are shaking or not, are all important issues.

It is very likely that Director Luo can't do it himself, but he must also promote this technology.

It looks like there will be fewer gastrointestinal surgeries in the future.

Just as Zheng Ren was about to go in, a nurse ran over.

"Director Luo, there is a small situation in the 8th hand, you can give it a shot." The nurse said at the door.

Director Luo nodded, just in time to see Zheng Ren.

"Boss Zheng, why are you here?" Director Luo was a little surprised, but when he saw Director Du, he immediately knew the reason.

"Is it for the jejunal feeding tube under the endoscope." Director Luo came out and asked.

"Well." Zheng Ren followed Director Luo to the 8th hand, and said as he walked, "There are not many patients with hyperemesis gravidarum, and there are not many cases of indwelling jejunal feeding tubes until delivery, so I can only try to come."

"Is it necessary?" Director Luo still felt that he was afraid of problems by giving patients enteral nutrition for several months.

"The patient refused to induce labor and vomited violently. Even if it lasted, I was worried that the child would have problems." Zheng Ren said.

"Okay." Director Luo simply agreed.

After 8 hands, the patient was under basic anesthesia, and a doctor was holding a colonoscope in his hand and looking up at the screen.

On the screen, there should have been a red patch, which was the color of the colon lining.

Even if sometimes because the patient's enema is not complete, there is still a small amount of stool left, but it will never be a lot.

However, the colonic lining displayed on the screen in front of me is red and white, which looks very similar to the pattern of watermelon rind.

"Director, give me a look, what's the situation?" said the doctor who was doing a colonoscopy.

Director Luo was not very sure either, he pondered for a while.

"It's a cat scratching colon," Zheng Ren said in a low voice.

"Huh? Do you have a name? I've seen a few cases, and I followed them up later. There's nothing special about the operation." Director Luo was very frank.

Zheng Ren only had an impression, because the video was too typical, so he blurted out.

After speaking, he also became silent, and went to the system library to read various materials.

"Boss Zheng, what is a cat scratch colon?" Director Luo asked.

"It appeared very late, and it is still just a statement, which has not been finally confirmed clinically." Zheng Ren smiled and said: "A similar description was first made by McDonnell in 2007. Later, in 9754 cases of colonoscopy, 32 similar cases."

"..." Director Luo was speechless and glanced at Zheng Ren.

"This data was published by the doctor in Johns Hopkins' endoscopy room the year before, and the probability of the cat scratching colon appearing as a whole should be so high." Zheng Ren said: "I look at the image, and it shouldn't be a problem."

His eyes were fixed on the screen, already fascinated.

After all, I'm not a doctor in the endoscopy room, so I can't squat in the endoscopy room every day to do gastroenteroscopy, so I just saw similar data. This is the first time I have observed the true appearance of the cat-scratch colon.

The imaging of the colon in the present patient is particularly typical, with the colonic mucosa being red and surrounded by linear tears in white.

Seeing the same as the watermelon rind, Zheng Ren felt that it was more appropriate to call it a watermelon rind-like change, rather than a cat-scratch-like colon.

But it doesn't matter.

Whatever the name is, it is a disease.

Of course, it is too arbitrary to say that the disease is too arbitrary, and the clinical judgment of cat scratch colon is not a disease at all.

"Boss Zheng?" Director Luo called softly.

"Uh..." Zheng Ren was observing the colon, when he was woken up by Director Luo, a little embarrassed, and said, "It's okay, cat scratch colon is more common in the cecum and ascending colon, more common in collagenous colitis, diversion Colitis patients."

"Is it a disease? How to treat it?" Director Luo asked.

"It should not be caused by disease, and most studies believe that colonic mucosal barotrauma caused by excessive gas injection during colonoscopy is the main pathogenesis.

Of course, there are also studies that believe that the disease of the intestine itself causes the occurrence of this sign. "

Zheng Ren explained while admiring the microscopic features of the cat-scratch colon.

"In the vast majority of cases, nothing will happen. In the reported cases, only 1 had a delayed perforation. Because the number is too small, it can be assumed that the perforation is caused by other complications, rather than hyperinflation in the colon. caused."

"Director, next..." The doctor who was doing the operation asked hesitantly.

"Keep doing it, hurry up." Director Luo replied, "Keep the image and send it to my mailbox."

After speaking, Director Luo glanced at Zheng Ren and asked, "Can it be avoided?"

"It shouldn't." Zheng Ren was also thinking about this question, "Inflating the colon is based on a high probability and routine gas supply. Some patients have problems with the colon wall, which cannot be predicted in advance. In short, be careful. "

"Yeah, always be careful." Director Luo murmured, "When we do clinical work, we just have to be careful and don't be careless."