"Dang Dang Dang~" Zheng Ren gently knocked on the door of the consulting room. Hearing Mr. Cui's voice inside, he pushed the door open and went in.
"Xiao Zheng, you're here so early." Mr. Cui was studying an X-ray film attentively and pushed up the spectacles.
"Well, I came right over as soon as I got off the stage." Zheng Ren said with a simple smile and leaned over.
"It's not good not to eat. When you're your age, you'll be in trouble." After Mr. Cui finished speaking, he pointed at the film and asked, "Tell me, what do you think?"
Zheng Ren was silent.
The images in the film in front of me are incredible. A broken glass bottle was lodged in the rectum, with the tip stabbing the rectum. The bone surface at the lower end of the ischium was damaged, especially at the pubic symphysis. The bone surface was eroded and the degree of damage was about 90%.
The sharp part of the bottle reached backward to the gluteus medius muscle, and was surrounded by organic tissue. Diffuse inflammatory lesions occurred in the perirectal area where the foreign body was located, and disabling fatty degeneration occurred in the muscles of the right lower limb.
Zheng Ren has seen a lot of rectal foreign bodies in the emergency department. Wine bottles, steel pipes, penises, and mousse bottles are the most common ones.
But usually you go directly to the hospital for treatment at that time, and it is taken out. Apart from being a little embarrassed, there is nothing wrong with it.
This case is different.
Severe inflammatory changes, as well as wear and erosion of the bone at the pubic symphysis, as well as surrounding adhesive tissue, meant that the foreign body had not been removed for a long time.
Is this abuse? Or something else
Zheng Ren's brows wrinkled unconsciously.
"The patient began to narrate an unknown medical history, but later, after repeated questioning by Xiao Zhou, he learned that it was five years ago when he and his girlfriend drank too much and had fun, and stuffed a beer bottle into the rectum. Because he was embarrassed, the patient He was also relatively introverted, so he didn't come to the hospital to remove the foreign body." Mr. Cui slowly talked about the patient's medical history while watching the film.
Uh... Zheng Ren felt extremely weird as soon as he pictured the scene of being injured in his mind.
Introverted? Didn't see it.
But this has nothing to do with Zheng Ren. What he has to consider is how to treat the patient. As for answering Mr. Cui's words to make the atmosphere in the clinic less awkward, Zheng Renze didn't realize it at all.
Unknowingly, his left hand had reached his right armpit, his right hand was holding his chin, and he was looking at the X-ray attentively.
Mr. Cui was not angry because Zheng Ren didn't speak. He continued to introduce the condition.
"The patient reported lameness for 1 month and weakness in his right lower limb, which is considered to be caused by apraxia of fat changes. He came to the emergency department of our hospital because of fecal incontinence and watery stool."
"Where is the patient?" Zheng Ren asked.
"I'm going for CT scan of the lower abdomen and pelvis. I think the patient should undergo surgical treatment, and the treatment is very difficult, so it's better to do a more detailed examination." Mr. Cui said: "Xiao Zheng, look at this X-ray, right? Do you have any ideas about surgery?”
"It should be like a radical resection for rectal cancer. For double surgeries, the colon and anus should be left alone. When the recovery is better, the second stage surgery can be performed." Zheng Rendao.
Cui Lao nodded slightly, this is what he could think of.
It's just that the difficulty of the operation cannot be described in such simple words.
The patient has had a foreign body in the rectum for so long that the foreign body is highly organized and wrapped in the body. If he wants to clean it thoroughly, he will definitely lose a lot of blood.
This surgery puts the surgeon's surgical skills to a great test.
Once the surgery is a little rough, there may even be a possibility of large-scale bleeding but no bleeding blood vessels can be found.
It is necessary to use electric cautery to coagulate all capillaries, and postoperative healing and re-bleeding have become a big problem.
The surgery requires special care and requires extremely high techniques.
Zheng Ren's brain began to work at high speed, analyzing X-rays, performing three-dimensional reconstruction, and determining the direction of blood vessels, capillary branches, and the location of related body tissues.
Even with the passive skill of reconstruction, Zheng Ren still felt that the difficulty of this patient's surgery had almost reached the sky.
As time passed by, Zheng Ren reconstructed it repeatedly in his mind, trying to find a reasonable path to enter. The damage must be minimal and the purpose must be achieved. But even with Zheng Ren's ability, it would be difficult to solve this problem in a short time.
Soon, Zhou Litao knocked on the door and said, "Mr. Cui, the patient just now has returned from a CT scan."
Mr. Cui nodded, stood up and said, "Xiao Zheng, let's go see the patient."
Zheng Ren looked at the X-ray, and the glass bottle in his rectum looked so dazzling.
Mr. Cui accompanied Mr. Cui to the emergency room, where the patient was lying on his stomach on the flat car. He is a young man, he looks young, about 23 or 4 years old.
There was a girl accompanying him, wearing a plain plaid dress, with shoulder-length hair, simple and clean.
"Li Mingchao, right?" Mr. Cui asked.
"Doctor, I won't die." The young man lay on the flat car with a look of fear on his face.
"First have a physical examination, and then send him to the gastrointestinal surgery department. Xiao Zhou, call the gastrointestinal surgery department and reserve an emergency bed." Mr. Cui did not answer the patient's question, but said to Zhou Litao.
"Doctor, are you okay?" The girl also asked anxiously.
"How could it be okay?" Zheng Ren stood between Mr. Cui and the girl and said calmly, "Why did you get such a serious injury?"
"..." the girl concluded. She was a little timid, a little embarrassed, a little entangled, and tears fell down.
Zheng Ren was speechless. The girl's crying made him helpless.
"Are you from the Imperial Capital, or do you work here?" Zheng Ren asked.
"I'll work here after I graduate from college," the boy said.
"Are you married?"
"Nope."
"Notify your family and rush over as soon as possible." Zheng Ren said: "The condition is very serious and requires a major operation."
"Don't..." the boy endured the pain and said, "I... um... sign for the surgery so that my girlfriend can come."
"A surgery with such a high risk must be performed by immediate family members. Since you are not married, you cannot sign. No doctor dares to perform this kind of surgery." Zheng Rendao.
Having just watched the movie, Zheng Ren had a basic judgment on the condition. Even if you perform the operation yourself, there will be a lot of bleeding during the operation.
It's entirely possible that I won't come to Taiwan.
"Doctor..."
"If you don't sign, no one will dare to do the surgery. If you don't do the surgery, you won't be able to survive for another five years." Zheng Ren said firmly.
Suddenly, the patient and his girlfriend were in a panic.
They fell silent, and Zheng Ren watched Mr. Cui's physical examination. The patient's physical examination revealed that the abdomen was soft, non-tender, and had no rebound tenderness. Digital rectal examination revealed perianal fistulas, anal sphincter tension decreased significantly, and the lower end of the foreign body could be clearly palpated.
Zheng Ren sighed and shook his head slightly as this matter was noisy.
…
Note: The case comes from "international journalsurgery case reports" reported by Dr. Ozbilgina. After hearing about this case from my senior brother, I was really tired of searching for information.