Famous Among Top Surgeons in the 90s

Chapter 1342: 【1342】Arrive at Consultation



Wei Guoyuan whispered into his ear: "She's a female doctor."

There was only one female doctor on site, very noticeable. Shao Jialiang had no difficulty recognizing Xie Wanying, and a hint of surprise flashed in his eyes. It wasn't about her being a female doctor, but rather that she was really young. There are many excellent female doctors in internal medicine. Like those at Xuanwu Hospital, there are many.

"Didn't I tell you? She's an intern yet to graduate." Wei Guoyuan lifted his eyebrows at him, "And besides, she studies surgery."

This girl wants to be a surgeon? Shao Jialiang was puzzled. Not that girls can't be surgeons, but why a surgery student claims to have unique skills in digestive endoscopy.

It could only be that he was in a hurry and clutching at straws, Wei Guoyuan said something he didn't fully hear, just felt that getting anyone to help solve the problem was good, even a medical student was brought in to join the crowd.

"Thank you for coming to help so strongly." Shao Jialiang sincerely expressed gratitude to several doctors from Guoxie.

"No need to be polite." Yu Xuexian replied, glancing at Wei Guoyuan, knowing that this person was thicker-skinned than Shao Jialiang.

Wei Guoyuan acted as if he didn't notice the gaze, smiled, and said to the group: "The patient is in the digestive endoscopy room."

On the way, Shao Jialiang introduced his patient to the companions: "Malnutrition, wound healing much slower than normal person, now enhancing intravenous nutrition."

"Intravenous nutrition? Can't do enteral nutrition, didn't plan on making a jejunostomy?" As an internal medicine doctor, Yu Xuexian was equally aware of all surgical methods used in the digestive department. Because even for his internal medicine patients, such situations must consider asking surgery for assistance to create a stoma.

Jejunostomy is the insertion of a tube into the patient's jejunum to facilitate the external drip of nutrient solution directly entering the intestinal tract. Generally as a temporary measure, once the patient recovers normal gastrointestinal eating, it must be removed.

Yu Xuexian explained the basic clinical principles for dealing with patients unable to eat normally through the digestive system. Doctors must, even if they have to cut a hole in the patient, pour nutrient liquids into the patient's intestine, trying to avoid intravenous nutrition, i.e., total parenteral nutrition. The reason is simple: the risk of total intravenous nutrition is too high, causing many complications like hyperglycemia, cholecystitis, blood clots, bacterial infections, and so on, which can be fatal.

Only in cases where enteral nutrition is impossible do doctors consider giving long-term intravenous nutrition out of necessity. For example, today's newly-admitted patient with Crohn's, Chen Chengran, completely unable to eat, intestines inflamed, making enteral nutrition unfeasible, relying only on total parenteral nutrition by intravenous delivery of nutrient solution.

Upon receiving the consultation doctor's questions, Shao Jialiang explained: "This patient has esophageal lower segment cardia fundus adenocarcinoma diagnosed four months ago, tumor size quite large, underwent total gastrectomy with esophago-jejunostomy digestive tract reconstruction, lymph nodes around cleared. Surgery must have reserved an intestinal nutrition tube for him so that nutrient solution through nasal feeding directly reached his jejunum for enteral nutrition. During the postoperative early non-eating period, provide him enteral nutrition support."

Speaking of enteral nutrition again, it is divided into oral and tube feeding by eating pathway. Orally, meaning patients can supplement nutrient solution using their mouth. Tube feeding, most commonly, is nasogastric tube, tube from nasal cavity to stomach.


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