Subscribe
80
Zhang Peng
General Surgery
About me
Studied at Changzhi Medical College from 2004 to 2009, graduated with a bachelor's degree; Studied at Qinghai University from 2009 to 2012, graduated with a master's degree in surgery; Employed at Linfen People's Hospital in July 2012, working in general surgery to present. Visiting scholar at Peking University Medical School from March to December 2019.
Proficient in diseases
Common diseases in general surgery: comprehensive treatment of gastrointestinal tumors, thyroid and breast diseases, inguinal hernia, etc.
Voices
Where does appendicitis hurt?
In general clinical practice, the pain associated with appendicitis mostly occurs in the lower right abdomen. Some patients experience very typical migratory right lower abdominal pain which usually starts in the upper abdomen, gradually moves around the navel, and finally localizes in the lower right abdomen. Direct pain in the lower right abdomen could also be indicative of appendicitis. In rare cases, if there is a reversal of organs or an abnormal position of the appendix, pain may occur in the upper right abdomen or lower abdomen as well. For pregnant women, the appendix may be positioned higher and could cause pain under the rib cage. Therefore, the diagnosis of appendicitis should be based on the specific condition of the patient and related diagnostic tests.
Difference between hemorrhoids bleeding and rectal cancer bleeding
The difference between bleeding from hemorrhoids and rectal cancer is distinct. For hemorrhoids, bleeding is mostly painless and intermittent, primarily manifesting as bright red blood either dripping or spraying into the toilet bowl. Patients may even experience significant blood loss, potentially leading to shock. On the other hand, bleeding from rectal cancer usually involves blood mixed with stool and generally does not involve large volumes. Most patients present with dark-edged stool. Anemia is often detected during routine blood tests, which leads to further investigation with a colonoscopy that may reveal rectal cancer. Therefore, the bleeding characteristics of the two conditions are different. In cases where rectal cancer is suspected, proactive endoscopic examinations are recommended to confirm the diagnosis through tissue pathology, followed by aggressive surgical treatment.
Is umbilical hernia hereditary?
Umbilical hernia is not a hereditary disease and generally does not occur genetically. Umbilical hernia is due to the incomplete healing of the umbilical ring, causing the abdominal organs to protrude through the umbilical ring, and is a congenital disease. Developmental inadequacies of the navel, or the presence of scar tissue, thinness, and lack of toughness in the navel area can lead to this condition when abdominal pressure increases. In general, children with an umbilical hernia may show discomfort, which can manifest as frequent crying or constipation. For most cases of umbilical hernia, conservative treatment is an option. In children under two years old, surgery can be avoided by using adhesive tape treatment, which can achieve very good therapeutic effects. If the diameter of the umbilical ring is still greater than 1.5 cm after the age of two, timely surgery is necessary. For adults with umbilical hernia, incarceration and strangulation are common, and surgery is recommended as soon as a clear diagnosis is made.
Is surgery recommended for lipomas?
Whether lipomas need surgical treatment often depends on the location, size of the lipoma, and whether it causes related clinical symptoms. If the lipoma grows too fast during observation, is in a special location, or severely affects appearance, surgical treatment can be considered. Alternatively, if the lipoma shows evident symptoms like localized redness, pain, surface itchiness, and uneven surfaces, timely color ultrasound re-examination should be done as malignancy cannot be ruled out, and timely surgical removal and biopsy are necessary. Thirdly, if the lipoma grows too quickly and causes compression symptoms, damaging other organs, surgical treatment should also be considered. Generally, lipomas are benign lesions, but there is also a possibility that they could develop into liposarcomas, which should be confirmed based on postoperative biopsy.
Can an umbilical hernia cause abdominal bloating?
Umbilical hernias can potentially cause abdominal distention because they may become incarcerated or even strangulated. The contents entering the umbilical hernia can include the omentum or intestines. If the small intestine or colon becomes incarcerated in the hernia, it can cause partial intestinal obstruction, with symptoms potentially including abdominal pain, distension, and nausea and vomiting. In cases where an umbilical hernia becomes incarcerated or ruptured, timely surgical treatment is necessary. Generally, umbilical hernias in children before the age of two do not require surgical intervention unless incarceration occurs. Most can be treated with adhesive strapping to allow for natural healing. If the umbilical ring still has a diameter greater than 1.5cm after the age of two, surgery should be considered promptly. For children over five with an umbilical hernia, surgery is recommended regardless of the specifics. Adults diagnosed with an umbilical hernia are also advised to undergo surgical treatment as soon as possible.
How deep does a wound have to be to cause tetanus?
There is no specific rule about how deep a wound needs to be to develop tetanus. Generally, any relatively contaminated wound that is sharp and deep should receive a prompt tetanus injection, as tetanus is a strictly anaerobic bacterium. Generally, if a wound is particularly prone to forming a locally hypoxic environment, active immunization should be pursued. Usually, the following types of wounds should be given high attention: deep puncture wounds, bullet or shrapnel injuries, open fractures, or crush injuries. Burns, frostbites that require surgical intervention, and wounds that have not been treated in a timely manner after more than six hours should also be taken seriously. Attention should be heightened if there are foreign objects in the wound or a significant amount of necrotic tissue, especially if contaminated by surrounding dust or animal feces.
How many years does the tetanus vaccine last?
Tetanus vaccines generally involve an active immunization process against tetanus with a complete immunization schedule, providing effective protection for up to ten years for those who have completed the full course of prevention. Typically, newborns must receive three doses of the DTP (diphtheria, tetanus, pertussis) vaccine, with the first dose administered at three months of age, followed by a dose each subsequent month, and booster shots at eighteen months or six years of age. If vaccinated, no further tetanus antitoxin or tetanus immunoglobulin injections are required for injuries incurred within ten years of vaccination. If no active immunization has been done and the wound is heavily contaminated, it is crucial to promptly administer tetanus antitoxin or tetanus immunoglobulin. A skin test must be performed before using tetanus antitoxin; if the test is strongly positive, immunoglobulin should be administered for preventive treatment.
How long do you have to get a tetanus shot?
It is generally recommended to receive an injection as soon as possible after a trauma, ideally within 24 hours, because tetanus has a certain incubation period, with the shortest being able to cause disease within 24 hours. There is still value in receiving the injection after 24 hours; it can alleviate symptoms and play a preventive treatment role. For tetanus, it is usual to administer a tetanus shot, and most people can choose between tetanus antitoxin or tetanus immunoglobulin. The duration of these two drugs is not the same; tetanus antitoxin lasts about three days, while tetanus immunoglobulin can last up to three weeks. However, this is not an absolute conclusion. Beyond this time, if there are high-risk factors for reinfection, a repeat injection is needed. If a patient has previously been protected by an active immunization regimen, in most cases, no special preventive treatment is needed within three years of the last vaccination.
When is the best time to get a tetanus shot?
Tetanus infection carries a certain mortality rate, with current statistics indicating that the death rate from tetanus infection can reach around 40%. Typically, tetanus is caused by an acute, specific infection resulting from the growth and reproduction of Clostridium tetani in human wounds, which produce toxins. Generally, it can only grow and reproduce in an anoxic environment, so it is most commonly found in soil, human and animal feces, and rust. For wounds, especially sharp and deep cuts, it is usually vital to administer a tetanus shot promptly. The choices generally are tetanus immunoglobulin or tetanus antitoxin, which have different half-lives; tetanus antitoxin generally lasts about three days, whereas tetanus immunoglobulin can last up to three weeks. Therefore, in the presence of high-risk infection factors, it is advisable to administer the injection as soon as possible, generally recommended within 24 hours.
How long does thyroid nodule surgery take?
This depends on individual circumstances. Generally, when performing thyroid surgery, there are two methods: open and minimally invasive, though the treatment procedures are largely similar. For nodules, we first need to determine their nature. If they are benign, then removal within a certain range during surgery may suffice. However, if intraoperative freezing suggests malignancy, then we face the issue of lymph node dissection, which could significantly prolong the duration of the surgery.