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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 location
The location of appendicitis is generally in the lower right abdomen, as the appendix is mostly located in the right iliac fossa. There are very few cases of situs inversus, where it is located on the left, but the appendix usually originates from the base of the cecum, attached to the posterior wall of the cecum, at the confluence of the three taeniae coli. Therefore, the surface projection of the appendix is mostly at the junction of the outer one-third of the line connecting the navel and the right anterior superior iliac spine, which is also commonly used as the marking point for surgical incisions. In cases of appendicitis, there may be pain in the upper right abdomen or pelvic region due to changes in the position of the appendix. For confirmed diagnoses of appendicitis, surgery is generally considered, and minimally invasive methods can be chosen. If an abscess forms around the appendix and the patient's condition can be managed, conservative treatment is usually preferred initially, followed by elective removal of the appendix after three months.
Can I breastfeed after getting a tetanus shot?
Current research indicates that lactating women are not contraindicated for tetanus vaccination; the main contraindication is allergy to the tetanus vaccine. Generally, if there are high-risk factors for tetanus infection, timely wound debridement and care should be performed, followed by early administration of passive immunization with tetanus vaccine. Generally, tetanus antitoxin can be used based on the results of a skin test. If the skin test result is strongly positive, its use should be avoided, and tetanus immunoglobulin should be chosen instead. The effective metabolic period of tetanus immunoglobulin is about three weeks. If high-risk factors for infection still exist beyond this time limit, timely enhancement of immune therapy should be considered. Regarding the tetanus vaccine, it is generally advised that the earlier it is administered, the better, as early administration can neutralize the tetanus toxin already present in the blood. However, if the tetanus toxin has already bound to nerve cells, treatment becomes relatively difficult.
Is hot compress useful for umbilical hernia?
In cases of umbilical hernia, applying heat generally has no effect. For infants, it is often acceptable to observe conservatively until the child is about two years old. Adhesive tape therapy can be used in this period. By the age of two, the umbilical ring in most children will close on its own. For those over two years old with an umbilical ring diameter still greater than 1.5 cm, surgery should be considered. For patients over five years old, it is generally recommended to undergo surgery sooner rather than later. In adults, the causes of umbilical hernias are mainly due to factors such as pregnancy, excessive fat in the greater omentum, chronic coughing, cirrhosis with ascites, etc., which increase abdominal pressure. Incarceration can occur, involving either the greater omentum or the small intestine, and surgery is usually the chosen treatment method, either through traditional tissue repair techniques or open tension-free hernia repair. In some cases, laparoscopic umbilical hernia repair may be chosen when necessary.
Is rectal cancer hereditary?
This answer is also possible, as one of the causes of any cancer includes the possibility of genetics. However, this possibility is generally small and not everyone is likely to have it. It also depends on the incidence of disease within the entire family. If one is in a high-risk category due to certain genetic factors, then it is crucial to have regular and thorough follow-up checks. Some people might even try treatments specifically targeting genetically inherited colorectal cancer.
What are the circumstances in which a tetanus shot should not be administered?
Tetanus is a strict anaerobic bacterium. Clinically, for deeper contaminated wounds, especially those contaminated by soil or punctured by rusty iron objects, an active injection of tetanus vaccine is recommended. Generally, for superficial scratches or clean and shallow wounds, as long as proper wound cleaning is performed, it is usually not necessary to administer a tetanus shot. For patients who have completed a full course of immunization or booster immunization within the last ten years and have high antibody levels in the body, if the wound is small, superficial, and free of foreign bodies or necrotic tissue residue, it is not necessary to inject the tetanus vaccine. For wounds that are larger, deeper, and heavily contaminated, with substantial residues of foreign bodies and necrotic tissue, or in cases where thorough wound cleaning is not achievable, an enhanced injection of tetanus antitoxin or immunoglobulin should be administered.
How is umbilical hernia treated?
In treating umbilical hernias, we need to consider both the age of the patient and the size of the hernia specifically caused. Generally, children under the age of two do not require surgery. Typically, we consider using a coin or cardboard larger than the umbilical ring, wrapping it up, pressing against the umbilical ring, and securing it with adhesive tape to prevent movement. Most can close by themselves and heal. For children over two years old, if the hernia is still larger than 1.5cm, surgical treatment should be considered. In adults, traditional tissue repair methods are generally used, or an open umbilical hernia tension-free repair. The repair can be placed in front of the muscle or can use a hernia ring filling method. For most patients, if there is an opportunity for minimally invasive treatment, laparoscopic umbilical hernia repair can be selected. This method generally involves a smaller incision and can preserve the navel, reducing the chance of incision infection, and is particularly suitable for obese patients.
Will an umbilical hernia get bigger as it grows?
Umbilical hernias may increase in size, particularly in middle-aged, obese women who have been pregnant multiple times, have excessive fat in the greater omentum during pregnancy, or have chronic conditions such as persistent coughs, which can cause continuous increased pressure in the abdominal cavity. This may lead to the gradual enlargement of the hernia sac in an umbilical hernia, and it is very prone to becoming incarcerated. The contents of the incarceration might include the greater omentum or the intestines, particularly the small intestine. Once incarceration and strangulation occur, it is generally recommended that adults with umbilical hernias undergo surgery as soon as possible, with emergency surgical treatment needed in cases of incarceration. Traditional surgical methods include tissue suture repair or open umbilical hernia tension-free repair. If a minimally invasive option is available, it is generally less traumatic and particularly suitable for obese patients.
What should I do if I drink alcohol with tetanus?
If there are high risk factors for tetanus infection after an injury, and alcohol has been consumed, it is generally advisable to wait until sobriety before conducting relevant skin tests. Currently, there is no clear research on the relationship between alcohol consumption and an allergy to tetanus antitoxin. It is not very clear whether alcohol impacts the results of a skin test, so it is safer to perform the test after sobering up. Since the consequences of a tetanus infection can be severe, and the tetanus injection itself carries a certain risk of anaphylactic shock, which can lead to multiple organ problems and even be life-threatening, it is generally safer to conduct the skin test after sobering up and then proceed with the timely injection treatment. If the skin test is positive, tetanus immunoglobulin should be chosen promptly.
How come hemorrhoids bleed?
In this case, it depends on the cause of the hemorrhoids. In general, the most common cause of hemorrhoids is varicose veins around the rectal veins, which can be caused by obstructed venous return. Generally, there are no corresponding venous valves around the upper rectal veins, and the veins or small vein walls of hemorrhoids are very thin. In the case of hemorrhoidal venous varicose, if the stool is relatively dry, it is easy to cause the veins to rupture and bleed during defecation. This type of bleeding is generally painless, and the bleeding can stop on its own, usually being bright red blood. Due to high local pressure, some people may experience significant bleeding, or even show signs of shock. In this case, surgical treatment measures must be taken to achieve radical cure.
Can an umbilical hernia heal itself?
Umbilical hernia has the potential to heal on its own, but it requires conservative treatment methods to be adopted. Generally, children under the age of two can undergo conservative observational treatment, such as using adhesive tape, as the umbilical ring in most cases can close by itself between the ages of 1 and 2. However, if the child is over two years old and the diameter of the umbilical ring still exceeds 1.5 cm, choosing surgical treatment is a wise decision. For patients over the age of five, it is recommended to undergo surgery as early as possible regardless of the situation, as the chances of incarceration or strangulation can increase after the age of five. Generally, surgical intervention is required for a cure. Options include traditional tissue suture repair methods or open umbilical hernia tension-free repair.