My Medical Skills Give Me Experience Points

Chapter 1373 545: Rectal Fistula, Relatives Who Cause Trouble at the Drop of a Hat

Out of caution, he always maintained a certain wariness towards Jiang Wei.

It always felt a bit unreal.

Because this woman was overly outstanding, blindly committing herself to Zhou Can, a small resident doctor, seemed a bit inconsistent with her displayed high intelligence and experience.

Anything unusual must be closely guarded against, and Zhou Can couldn't help but be on guard.

"That female patient is in her fifties, both lower limbs have superficial varicose veins, with the left limb being the most severe. The preoperative swelling was intense, so I performed high ligation and stripping surgery on her. After the operation, her vital signs were stable, and her left leg has been bandaged for compression. If nothing unexpected happens, she should recover soon."

Hee Hansheng's surgical skills have always been good.

When he says everything's fine, it's generally not a problem.

What Jiang Wei described doesn't differ from what he said.

Zhou Can couldn't help but ponder, is he being overly cautious? Maybe she just wanted some freelance work to earn a bit of pocket money.

The next day, Zhou Can went to work, and Jiang Wei was, as usual, early in her work attire waiting for him.

Undeniably, when she wore the nurse's uniform, it perfectly outlined her curvaceous figure. Plus, her inherent beauty was quite eye-catching.

Unlike ordinary beauties, her skin was a healthy olive tone, and her body was incredibly proportionate.

She's also much more agile than most women.

She must have regularly worked out.

"Hi, good morning!"

She greeted Zhou Can with a smile.

Upon seeing Zhou Can, a genuine smile naturally appeared on her face. This smile made Zhou Can feel extremely comfortable, like a breath of spring air.

"Have you been waiting long?"

After yesterday's events, Zhou Can felt much less wary of her.

"I haven't been here long. Thank you for introducing me to a doctor with excellent surgical skills yesterday. I also earned a bit of extra money." She proactively expressed her gratitude to Zhou Can.

It could be considered feedback for Zhou Can.

"No problem. I'll just go and change my clothes first."

After greeting her, Zhou Can went into the office changing room and came out after putting on his white coat.

Then he went on rounds with Jiang Wei.

As they continued, when they reached a rectal cancer surgery patient, Zhou Can checked the gastrointestinal decompression device while asking, "How are you feeling after the gastrointestinal decompression? Can you adapt?"

The patient was only forty-six years old, relatively young.

Diagnosed with rectal cancer, she had undergone nearly three days of preoperative preparation, with Zhou Can having operated on her yesterday.

With rectal cancer surgery, preoperative preparation is crucial. For example, dietary control begins three days before surgery, allowing only the intake of liquid foods. During bowel preparation, to ensure the patient's nutritional intake, doctors even administer enteral nutrition.

They generally use Bai Pusu or Ensure.

Furthermore, patients are advised to drink water infused with 10g of senna leaves daily.

If patients find it inconvenient, they can take about 50ml of 25% magnesium sulfate orally every evening.

Some patients have concerns, making them more receptive to senna leaf water. It's similar to having tea.

"Quite good!"

The patient was notably strong, a true brave woman.

"Keep observing, with continuous gastrointestinal decompression for about forty-eight hours. Once you pass gas, you can start consuming some liquid foods. Today, a nurse and a doctor will come to perform anal dilation, and we'll need your cooperation then."

After examining the patient, Zhou Can gave some instructions.

After this surgery, anal dilation is necessary for about three to four days, depending on the patient's physical condition. Besides being embarrassing, the dilation process can be quite painful.

All these are in preparation for normal postoperative bowel movements.

"Jiang Wei, please review her care plan, especially nutritional care. If there are areas for optimization, feel free to make adjustments."

For such a critical patient, Zhou Can usually asks Jiang Wei to review medicine, nutritional support, and other care aspects.

"Everything else looks good, but the amount of plasma and albumin supplementation might be slightly adjusted. I will also plan a postoperative liquid diet for the patient." She reviewed and provided her suggestion.

"Sure!"

Zhou Can nodded in agreement.

For female rectal cancer patients who undergo this surgery, it's easiest to develop a fistula between the rectum and the urinary area. If a fistula occurs, stool can flow from the urinary area. Repairing this is often difficult, with results being less than satisfactory.

If a simple vaginal fistula repair fails, an abdominal surgery is generally considered.

Due to this patient's poor bowel condition, Zhou Can was particularly worried about a rectal-'urethral' fistula developing. This is why he let Jiang Wei optimize the care plan.

...

On the third postoperative day, the thing Zhou Can feared the most happened.

During rounds, the family reported a strong foul odor emanating from the patient's lower body. As he lifted the quilt, the distinctive odor of stool hit him, and a heavy feeling settled in his heart. Upon examination, stool indeed had leaked from the urinary area.

The stool contains countless bacteria, and its leakage from the urinary area can easily lead to various female inflammations, even major problems.

This patient's pelvic adhesions were too severe, and her bowel condition was poor.

While performing surgery on her, Zhou Can had an uneasy feeling.

His premonition came true, and the patient developed a rectal-'urethral' fistula.

This condition only occurs in female patients due to their unique anatomical structure. Simply put, the posterior walls of the rectum and 'urethra' are too close.

Especially this patient, who had her uterus removed due to a malignant uterine tumor.