Zheng Ren believed that what he said was enough to differentiate Meckel's diverticulum from appendicitis, and went on to talk about the identification of another disease: "But the urachal remnants are generally more closely related to the top of the bladder, rather than to the distal ileum. "
"Where's the clonal disease?" Although Su Yun was hindered by the sterile cap to dissipate heat, his mind was still spinning quickly.
He already understood what Zheng Ren was talking about, but he was still trying his best to find faults.
"The CT image of the tubular enhancement of the distal ileum with adjacent fatty infiltration is sufficient to indicate Meckel's diverticulitis rather than Crohn's disease."
"If you have time to do enhanced CT, you should find that the enhanced CT scan coronal reformatted image, several consecutive image sequences, will show an edge-enhancing fluid-filled structure originating from the distal small intestine."
Su Yun stopped talking and stared straight at the abdominal radiograph.
Feng Jianguo was dumbfounded.
It’s just a flat film, but so many things can be seen
What is basic imaging data? Although Feng Jianguo has watched countless abdominal imaging films over the years, he is still ignorant about it.
What the hell is this!
He stood behind Zheng Ren and Su Yun, looking blankly at the plain abdominal X-ray. Could it be that the local density was wrong... But it was converted into abdominal CT or even abdominal contrast-enhanced CT...
But I really can’t do it!
"The diagnosis should be relatively clear. Are there any other problems?" Zheng Ren asked calmly.
"..." Su Yun was silent.
When Zheng Ren told the story, his thinking also kept up.
It was indeed Meckel's diverticulitis. According to Zheng Ren's thinking, the diagnosis was quite clear.
It's all the fault of the sterile cap. If its existence hadn't hindered heat dissipation, it might have taken a few seconds to see the true nature of the problem.
Next time, be sure to wear a sterile cap with good breathability.
Su Yun thought in his heart.
"Boss Zheng, the anesthesia is over." Lao He said.
"Su Yun, are you coming?" Zheng Ren asked.
"I'm going to disinfect." Su Yun felt very bored. It turned out that this thing was really seen through dialectics, not some clairvoyance that peeked into the little widow's bath.
Life is so boring. Su Yun silently brushed and disinfected his hands.
"Boss, do you need to ask the beautiful woman to come up?" Su Yun suddenly thought of it and asked loudly.
"No, the operation is very fast. I guess it's over when Director Wei comes up." Zheng Ren said, glanced at Feng Jianguo, and said with a smile: "Old Feng, can I help you?"
Feng Jianguo cried.
Crying very sadly.
It was clear that he was allowed to go on stage as an excuse, and then after the operation, he had to sew the skin and write the operation record.
These jobs are all done well by graduate students and doctoral students like Quan Xiaocao.
But Feng Jianguo did not refute or refuse. Instead, he was as silent as Su Yun and brushed his hands honestly.
"Will the operation be completed soon, Boss Zheng?" Lao He took a look at the patient's blood pressure and other vital signs.
The vital signs are very stable, but the blood pressure is slightly lower, nothing serious.
At this time, he became relaxed and had a sense of presence in front of Zheng Ren.
As long as he has the opportunity to show his face, Lao He never wastes it. But I am troubled by my profession, an anesthesiologist, but I don’t understand the imaging knowledge that Boss Zheng just talked about, so I can’t praise it.
But it doesn't matter if I don't understand it. It seems that Feng Jianguo doesn't understand it either.
"Well, if there are no accidents, it should be done soon." Zheng Ren narrowed his eyes and seemed to give Lao He a smile.
"Where's Director Wei?"
"I squatted twice in a row, but my waist has some problems and I can't run." Zheng Ren said: "Let me explain to the patient's family below and sign before the operation."
"It's time to soak the wolfberries in the thermos cup." Lao He said with a smile.
"By the way, Lao He, can you call Director Wei and leave here first?" Zheng Ren was about to wash his hands and explained to Lao He.
It's still appropriate to inform Director Wei.
This is the most basic respect.
Otherwise, Zheng Ren was worried that he would not be able to get surgery in the future.
To be a human being, you need to have some compulsion in your heart.
After Zheng Ren finished wiping his hands, Lao He shouted: "Director Wei signed the preoperative instructions for laparotomy. He said that Lao Feng would be the surgeon. Boss Zheng, please help me."
This is just a common saying. You can't say that Boss Zheng bothered you to perform the surgery.
Su Yun quickly laid out the sheets, then disinfected, changed into sterile clothes, and stood directly at the second assistant's position.
Feng Jianguo smiled bitterly, it seemed that he was the real second assistant.
I didn't understand what Boss Zheng said just now, but Dr. Su understood it.
Is it just Meckel's diverticulum
Forget it, if you don’t want this, just open it and take a look.
Feng Jianguo was not competitive. It was not that he was not strong, but that under the influence of one operation after another that was extremely difficult, he subconsciously judged that Boss Zheng's level was really high.
Just keep a good watch on your own, why rush in to fight
Zheng Ren stood in Yishu's position and stretched out his hand. The equipment nurse was startled.
"Boss Zheng is the surgeon." Feng Jianguo said calmly.
The instrument nurse immediately patted the handle of the knife into Zheng Ren's hand.
"What incision?" Feng Jianguo felt a little embarrassed by the hesitation of the instrument nurse, so he asked casually.
"Appendix incision in the right lower abdomen." Zheng Ren raised the knife and dropped it, and a few drops of blood appeared in the surgical field.
A piece of white sterile dry gauze was put on it, and then it was taken away and the electric heat was applied gently to stop the bleeding from the capillaries on the body surface.
Just as Feng Jianguo expected, he really became an assistant in the position of a surgeon.
Boss Zheng and Su Yun cooperated in a tacit understanding, without speaking, they just performed the operation in silence.
Su Yun was especially silent this time. Unlike when he usually performed surgery, he would chatter, drive occasionally, and adjust the atmosphere in the operating room. He was not restless at all.
This guy seems to be in a bad mood today, and his hand speed is very high.
Feng Jianguo looked at the progress of the operation. Except that the instrument nurse could not keep up with the speed and delayed the operation a little, everything was so perfect.
The skin is opened, the subcutaneous tissue, fat, muscle, and fascia are bluntly separated, the retractor is opened, the peritoneum is protected, and the abdomen is entered.
A section of intestine was "fished out" by Zheng Ren.
There is a bubble-like protrusion on the ileum, with a thin wall and a white appearance, with slight black stripes of ischemic necrosis on it.
Feng Jianguo was startled.
This is the most typical Meckel diverticulum!
It was true, and there was no exploration at all. I just made an incision on the appendix and "fished out" the Meckel diverticulum.
MD! Can surgery still be done
How much confidence does this require in preoperative diagnosis
At this point, Zheng Ren and Su Yun's hand speed slowed down. The intestine was clamped, 5 cm of ileum was removed, and then anastomosis was started.
Feng Jianguo was fine and began to play with the cut specimens.
A bottle cap appears in the pathology basin.
The cap says - One more bottle.