Gastroscopy showed: chronic, atrophic, superficial gastritis. Abdominal CT showed signs of obstruction in the patient's duodenal segment.
There was also a gastrointestinal tract radiograph, which suggested that there was obstruction in the duodenal segment, and the imaging findings were very typical.
The diagnosis should be very clear. Zhou Litao looked at the patient's various examination values and mentally evaluated whether surgery could be performed.
Just as I watched, the gastrointestinal doctor came in a hurry.
Zhou Litao told the resident of the gastrointestinal surgery department the information he had obtained. There was nothing to hesitate. It was serious to seize the time for emergency surgery.
Even if there is no intestinal perforation, there are already inflammatory changes in local tissues. And depending on the patient’s condition, the changed areas will be long and the inflammation will be severe.
There is no way to solve this problem using internal medicine.
Surgery, only emergency surgery can solve the problem.
This is the consensus.
The resident of the gastrointestinal surgery department hurriedly pushed the patient away, followed by the patients' family members who arrived one after another and followed behind.
Zhou Litao looked at the relieved 120 emergency doctors from other places, smiled and chatted a few words.
"It's really scary to run a long distance." The doctor from other places smiled bitterly and said, "I'm just afraid of something going wrong. There is temporary rescue medicine in the car..."
Talking too much will only lead to tears, and it will be meaningless.
Rushing back from the imperial capital is a serious matter.
Zhou Litao watched the 120 emergency personnel leave, thinking about the patient just now.
A duodeno-jejunostomy should be performed to expose the problematic intestine.
Depending on the severity of the disease, you can choose to leave it alone or remove it.
Because the duodenum is involved, even if you choose resection surgery, you must be very careful.
The gastrointestinal surgery department in 912 has a very high level of surgery, so there should be no problem.
Zhou Litao immediately forgot about the patient.
In the emergency department, if you remember every patient, you will probably collapse soon.
…
In the gastrointestinal surgery department, Feng Jianguo led the chief resident and Quan Xiaocao to perform urgent physical examinations and diagnoses.
There are CT films, medical history, and physical signs. There is no doubt about it, go up and open it and take a look without delay!
No matter whether the obstructed segment is mild or severe, it must be opened before considering the next step of treatment.
The treatment measures are nothing more than a few techniques.
For Feng Jianguo, there is no difficulty at all. The really difficult thing is to make a choice based on the condition during surgery.
The nurse hurriedly made preoperative preparations, and the family members went through the hospitalization procedures. Out of caution, Feng Jianguo did not let Quan Xiaocao give pre-operative instructions to the patient's family, but explained the condition himself.
Feng Jianguo made it clear about the selection of several techniques. The specific choice must also be decided intraoperatively.
Because he was relatively unfamiliar with the patient's family, Feng Jianguo carefully told the patient's family that he would come out to communicate with the patient's family after seeing the situation, and he would discuss with them the choice as soon as possible.
The family members burst into tears of gratitude.
Unexpectedly, the doctors in the imperial capital were more considerate than those in my hometown.
Although Feng Jianguo emphasized that there was a high possibility that the patient would not be able to get off the operating table, the family members expressed their gratitude again and again.
After all, this is one of the most technically advanced hospitals in the country. If the patient cannot be cured, he will die.
22' later, the preoperative preparations were completed, and Quan Xiaocao pushed the patient onto the stage.
If it was a general intestinal obstruction, it would definitely be done in the hospital.
But when it came to the duodenum, the hospital manager still pulled Feng Jianguo up and gave him a slap.
"Mr. Feng, how do you think the operation will be done?" the resident asked while changing clothes.
"Duodeno-jejunostomy." Feng Jianguo said with certainty: "The patient's delay was a bit long. I hope not too much of the intestines will be cut."
The hospital manager was about to continue asking when he suddenly heard Quan Xiaocao's voice coming from outside.
"Teacher Feng, are you there?"
"What's wrong?" Feng Jianguo was a little surprised. Shouldn't Quan Xiaocao have changed his clothes at this time and look at the patient in the operating room? Looking for me at the door of the running men's locker room, is this a change in the patient's condition
Thinking of this, his blood pressure suddenly increased by 10 mmHg.
"That..." Quan Xiaocao hesitated, and Feng Jianguo was a little angry.
Talk about something when you have something to do, and go to work when you have nothing to do. Emergency surgery is about to happen, why are you here to falter
Xiaocao is good at everything, he works hard and doesn't complain, but he is too timid.
I am a little timid when encountering any unexpected situations.
Feng Jianguo felt a little anxious, so he immediately put on his clothes and walked out quickly.
"What's going on?" Feng Jianguo asked with a serious expression.
"Teacher Feng, I just met Boss Zheng who stepped down. He said that the patient did not have intestinal obstruction and would not allow surgery." Quan Xiaocao said in a low voice.
"..." Feng Jianguo was stunned.
No surgery? This seems a bit big.
Not to mention Boss Zheng, even Director Wei has to think twice before suspending an emergency operation.
If the existing diagnosis can be overturned, it seems that it can be considered.
However, the patient's diagnosis is quite clear, with abdominal CT and gastrointestinal angiography as the basis for diagnosis.
"Let's go and take a look." Feng Jianguo recalled the film and physical examination process in his mind, and strode towards the emergency operating room.
"Teacher Feng, don't be angry, Boss Zheng... Boss Zheng..." Quan Xiaocao obviously wanted to help Zheng Ren talk, but he didn't know how to say the words.
"What's going on?" Feng Jianguo asked.
"I sent the patient up, spoke to the emergency anesthetist, and then went to change clothes. After I changed clothes, Boss Zheng and Brother Yun were watching films in the operating room." Quan Xiaocao said, "Then Boss Zheng said, The patient does not have intestinal obstruction, let me tell you not to do surgery.”
"He didn't say anything else?"
"Yeah." Quan Xiaocao said, "I just said a few words. The anesthesiologist asked if I wanted anesthesia. The patient was not in good condition, so I ran down."
Feng Jianguo knew that Boss Zheng was not a fool, but the diagnosis of this patient should not be too clear.
Why can’t surgery be performed on such a typical intestinal obstruction
Subconsciously, he believed in Zheng Ren's character, but he did not trust Zheng Ren's judgment.
This tangled mentality is a bit complicated.
Walking quickly to the emergency room, Feng Jianguo saw Boss Zheng Renzheng reading the film in the familiar posture and the familiar formula.
"Boss Zheng, what's going on?" Feng Jianguo asked directly without having time to be polite.
"It is suspected that the patient has myasthenia gravis, complicated by intestinal smooth muscle weakness." Zheng Ren also answered directly.
The patient is lying on the operating table, not in a good condition, and all the masks of hypocrisy and politeness have been torn off. It is important to seize the time for diagnosis and treatment.
Don't be polite here. If the patient dies on the operating table in the end, it's the end of the world.
"Myasthenia gravis?" Feng Jianguo was stunned for a moment.
Myasthenia gravis is an autoimmune disease caused by dysfunction of transmission at the neuromuscular junction.
The main clinical manifestations are partial or systemic skeletal muscle weakness and easy fatigue, which are aggravated after activity and relieved after rest.
Generally, it is mainly manifested in skeletal muscles. Smooth muscle symptoms are rare.