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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
Appendicitis belongs to which department?
Appendicitis falls under the domain of general surgery, and its pathological changes can be categorized into several types. The first type is acute simple appendicitis, characterized by mucosal congestion and edema, with patients typically presenting mild symptoms. The second type is acute suppurative appendicitis, also known as cellulitis, where symptoms worsen, and patients may develop fever and experience tenderness and rebound pain in the lower right abdomen. The third type includes acute gangrenous and perforative appendicitis, where the condition further worsens. The appendix wall is necrotic or partially necrotic, and perforation usually occurs at the proximal end of the appendix, potentially leading to the formation of a periappendiceal abscess. If the perforation extends into the abdominal cavity, it can lead to diffuse peritonitis, often requiring emergency surgical exploration. The fourth type involves a periappendiceal abscess, typically progressing slowly. The omentum can move to the lower right side and envelop the appendix, forming adhesions and leading to the formation of an abscess. Most cases are treated conservatively, and traditional Chinese medicine is used adjunctively to promote the absorption of the abscess.
How many times do you need to get a tetanus shot?
The number of tetanus shots required depends on the specific condition of the wound and the patient's previous immunization history. Generally, for smaller, superficial, and cleaner wounds, which are considered to have a low risk of tetanus infection, the body can produce protective antibodies on its own. In such cases, a tetanus toxoid injection is given once a month, usually three times in total, allowing the patient's body to produce active antibodies and obtain long-term protection. If the wound is large, deep, and contaminated, with a substantial amount of foreign material or necrotic tissue, the chances of tetanus infection are very high. In such cases, passive immunization is actively conducted, usually involving tetanus antitoxin or immunoglobulin. Here, typically three doses of tetanus toxoid are administered to stimulate the body to produce active antibodies and achieve long-term protection.
Is tetanus fatal?
Tetanus infection is quite frightening, with current statistics showing that the mortality rate of tetanus infections can be as high as 40%, and about a million people die from tetanus globally each year. The current principle is to promptly inject tetanus antitoxin or tetanus immunoglobulin for sharp, deep wounds. For tetanus infection, the main symptoms manifest as local or systemic muscle rigidity and spasms. The incubation period varies; if a tetanus vaccination has been previously administered, or depending on the infection and treatment of the wound, the severity of the onset can differ. The prodromal period typically presents symptoms like dizziness, headache, heightened reflexes, restlessness, and possible difficulty opening the mouth; during the convulsive phase, there is continuous muscle contraction, eventually causing persistent spasms in the diaphragm and intercostal muscles.
Causes of intestinal obstruction
Generally, the basic causes of intestinal obstruction can be divided into three categories. The most common is mechanical intestinal obstruction, which mainly includes blockage of the intestinal lumen, such as large fecal masses or corresponding foreign objects, and even parasites. The second type is compression of the intestinal tube, which can be caused by adhesions leading to torsion of the intestine or compression by tumors, and congenital inflammatory strictures and tumors can cause mechanical intestinal obstruction. The second major category is dynamic intestinal obstruction, which is primarily due to weakened peristaltic ability of the intestine, resulting in paralytic intestinal obstruction. This condition can be improved by adjusting intestinal function disorders or treating intestinal spasms. The third type is intestinal obstruction caused by vascular issues in the intestines, most commonly thrombosis of the mesentery or compression causing vascular disorders of the intestines.
How long does a tetanus shot last?
Regarding how long a tetanus shot lasts, it depends on which type has been administered. Generally, there are two types of tetanus injections: tetanus immunoglobulin and tetanus antitoxin. Typically, doctors perform a skin test before administering the tetanus antitoxin; if the patient has a positive skin test and cannot tolerate desensitization treatment, tetanus immunoglobulin can be administered instead. These two medications have different metabolic times and their preventive effects vary. The metabolic time for tetanus antitoxin is generally one week, whereas for tetanus immunoglobulin, it can last about 28 days. Therefore, how long a tetanus shot lasts depends on the specific circumstances of the patient’s injection.
Do intestinal obstructions cause vomiting?
The typical four major symptoms of intestinal obstruction are pain, vomiting, bloating, and constipation. Vomiting refers to the urge to vomit; however, it does not mean that every patient with an obstruction must exhibit symptoms of vomiting, as the symptoms vary depending on the location of the obstruction. Obstructions can be categorized into lower and upper types. Upper obstruction may present more apparent vomiting symptoms, while lower obstruction might lead to significant bloating but less obvious vomiting. Therefore, vomiting is not a necessary symptom for the treatment of intestinal obstruction, but it can help in assessing the condition of the obstruction.
Can an umbilical hernia heal itself?
Umbilical hernias can heal on their own, but we need to choose the appropriate method during the treatment process. Generally, if the umbilical hernia occurs before the age of two, we can choose a coin larger than the umbilical ring or a flat board, wrap it in gauze to press against the umbilical ring, and then use tape to secure it to prevent it from moving. In such cases, the hernia may heal on its own. During the observational treatment of an umbilical hernia, it is also important to prevent the child from engaging in vigorous activities or crying. If the diameter of the umbilical ring exceeds 1.5cm after the age two, we recommend choosing surgical treatment. Generally, if the umbilical hernia has not healed by the age of five, we actively recommend opting for surgical treatment. If the child's improper lifestyle can cause aggravation or even rupture of the umbilical hernia, emergency surgery is required in such cases.
Is allergic purpura with abdominal pain easy to treat?
Allergic purpura with abdominal pain, also known as abdominal allergic purpura, involves gastrointestinal symptoms associated with allergic purpura, primarily characterized by episodic severe abdominal pain, usually around the navel or lower abdomen, and may sometimes be accompanied by vomiting. Treatment typically involves bed rest, actively identifying the cause, controlling infections, and supplementing relevant vitamins. It's also important to check for any symptoms of gastrointestinal bleeding. If there are signs of gastrointestinal bleeding, strict dietary management is necessary, blood transfusions may be required when needed, and the healing of the gastrointestinal tract must be monitored. Medications to suppress acid or protect the gastric mucosa could be considered. Generally, the prognosis for allergic purpura is favorable, though very few severe cases may experience gastrointestinal complications such as bleeding, intussusception, or even necrosis. Although the prognosis is generally good, relapse is common. (Please use medications under the guidance of a professional physician and do not self-medicate.)
Can umbilical hernia be treated with moxibustion?
Umbilical hernia is fundamentally a surgical condition. The effectiveness of moxibustion in treating umbilical hernia is generally not very clear, and currently, there is no scientific basis to prove that moxibustion can cure umbilical hernia. Typically, umbilical hernias occur when the umbilical ring does not completely close. In children under six months, a conservative treatment approach is usually chosen. This can involve using a coin or cardboard larger than the umbilical ring, wrapping it to press against the ring, and securing it with adhesive tape to prevent movement. Most patients under six months old can heal naturally. For umbilical hernias, if the child is over two years old and the umbilical ring is still larger than 1.5 cm, surgical treatment is recommended. Moxibustion treatment does not offer significant benefits in the treatment of umbilical hernias. Therefore, as umbilical hernia is a surgical condition, it is advised that patients undergo surgery if their condition permits.
Is intestinal obstruction dangerous?
Whether intestinal obstruction is dangerous depends on the actual individualized level. If the obstruction has progressed to symptoms of peritonitis, and if intestinal necrosis cannot be ruled out, not performing timely exploratory laparotomy surgery could potentially endanger the patient's life. However, if it is just a mild incomplete obstruction, with signs of passing gas and stools, and the patient’s abdominal symptoms are not pronounced, and related examinations are not concerning, then the risk to the patient might be relatively smaller. Therefore, in such cases, it is not possible to generalize, and decisions need to be made based on the individual situation.