I came to see Boss Zheng because I wanted to see his superb anatomy skills.
But who would have thought that Boss Zheng did not follow the routine and did not find the location of the cerebral hemorrhage. Instead, he directly discovered the internal carotid artery thrombosis through dissection.
"Zheng...Boss, what do you mean?" Li Zhaosen was speechless.
"The deceased had carotid atherosclerosis and poor blood vessel elasticity. During the process of avoiding and fighting, the neck would undergo strenuous movements such as hyperextension or lateral bending.
The carotid artery is pulled violently in an instant, causing the intima of the carotid artery to tear, causing thrombosis and occlusion of the lumen.
Brain tissue suffers from vascular occlusion or partial detachment of thrombus to embolize intracranial branches, causing acute cerebral ischemia and multiple large-scale necrosis. "
Zheng Ren slapped the knife in front of Li Zhaosen, took off his gloves, and said neatly.
"..." Everyone was stunned.
"Boss, the incidence rate of carotid artery intimal avulsion is very low. How did you come up with this?" Su Yun asked with a frown.
"The disease developed very strangely, and I became incontinent for no reason. The main disease being considered is carotid intimal avulsion syndrome." Zheng Ren said casually.
"How do you know?" Su Yun was concerned about this.
"Before you went to the emergency department, there was a similar patient in the observation room, and he was later sent to the Medical University." Zheng Ren said nonsense. Anyway, Su Yun arrived at the emergency department a few days later than him, so what he said was what he said.
If he has the ability to return to Haicheng to look for medical records, Zheng Ren believes that Su Yun is not so free.
Su Yun just asked casually, and he didn't think twice about what Zheng Ren said.
It’s a very clear logical chain. If you have the opportunity to do an anatomy, you must look at the carotid artery. In this regard, Su Yun will not question his boss's IQ.
That guy's emotional quotient is very low, but his IQ is definitely not low. Only a little lower than himself, Su Yun thought in his mind.
"Boss Zheng, you..." Li Zhaosen was stupid and didn't know what to say.
"Huh?" Zheng Ren looked sideways at him, smiled, and said, "What's wrong?"
"Traumatic carotid artery occlusion and cerebral infarction have completely different judgments from the court. Forensic doctors must be cautious. Are you... sure?" Li Zhaosen whispered.
Zheng Ren looked at his expression carefully and felt that he was not defending the other party, but just asking himself to be more cautious.
Perhaps in Li Zhaosen's view, his judgment was a bit far-fetched, but in his own view, it was extremely obvious.
In fact, how can we find the top diagnostic and surgical experts in the country to do something like an autopsy
A top-notch surgery costs tens of thousands, so if you have the time, you might as well go under the knife. If I want to do an autopsy, who will pay for it
This time it was a coincidence, I might as well teach Li Zhaosen something.
This man was very skilled in dissection, but an autopsy couldn't be done just by dissection alone.
Corresponding clinical knowledge and disease progression will provide many clues.
Zheng Ren could guess a thing or two by looking at his attitude towards medical records.
"That's it." Zheng Ren turned around and took off his white clothes and said: "Traumatic carotid artery occlusion refers to blunt or sharp injury to the neck, excessive extension and lateral bending of the neck, or involvement of the petrous part of the temporal bone of the skull. Fractures, etc., lead to tearing and rupture of the intima of the internal carotid artery, and even complete thrombotic occlusion."
"This disease is divided into two types: open and closed. The patients...the conditions of the deceased are relatively easy to distinguish."
"Well... Teacher Li, just doing an autopsy is not enough. If the deceased comes from the hospital, you should read more about the medical records. There are some narratives in the medical records that can infer a lot of things." Zheng Rendao.
"..." Li Zhaosen looked at Zheng Ren silently, with a look of grievance on his face. But he was not unconvinced, more confused.
After the ESD autopsy that day, Li Zhaosen's attitude toward Zheng Ren had skipped over from being ordinary, friendly, respectful, and reverent to worshiping him.
Zheng Ren thought Li Zhaosen was quite interesting and was willing to talk to him. While washing his hands, he said: "Just like clinical differential diagnosis, forensic medicine must also have it. They are all cerebral infarctions, and there is a difference between traumatic and pathological." of."
"What's the difference?" Li Zhaosen asked immediately like a student.
“First, there is a clear history of head and neck trauma; the area where external force acts can easily cause excessive extension or lateral bending of the neck.
Second, there is an incubation period between injury and onset. The patient just now had an incubation period of 2-3 days. During the incubation period, the patient is completely fine. This is also the basis for my main judgment that the patient has carotid intimal avulsion syndrome.
Third, mild hemiplegia, hemi-sensory impairment and aphasia may occur after the onset, and some may be accompanied by Horner's syndrome. This is not obvious in medical records, because it is difficult for district and county-level hospitals to make targeted judgments.
Fourth, brain CT examination showed multiple large-scale encephalomalacia on one or both sides, which was inconsistent with the predilection site of the latter.
Fifth, autopsy showed carotid intimal rupture and thrombosis. "
Zheng Ren had a standard science student's thinking. He said one, two, three, four, five, which confused Li Zhaosen.
What the hell is this
Although I couldn't understand it, the feeling of unconsciousness echoed in my heart. Boss Zheng is so professional, Li Zhaosen felt extremely emotional.
Although he is a doctor, he was directly crushed during the autopsy.
"Zheng...Boss, please speak slowly and I will take note of it." Li Zhaosen had an expression of admiration on his face.
Unlike Liu Zewei, a veteran in the world, Li Zhaosen is a single-minded person. He writes everything on his face instead of hiding it in his heart.
Zheng Ren felt that Li Zhaosen was a bit crazy and obsessed with technology, but he was actually a good person.
He spoke slowly bit by bit, and when Li Zhaosen recorded it, Zheng Ren finally thought that WeChat voice could be used.
"Boss Zheng, Teacher Gross has brought the specimens." Zhou Chunyong answered the phone and said.
Li Zhaosen's ears perked up when he heard the words "general teacher".
"Okay." Zheng Ren and Li Zhaosen said, "Teacher Li, let's first..."
Just as he said this, Zheng Ren's cell phone rang.
They said they should write a love song quickly, which would be appreciated by both refined and popular people...
Zheng Ren picked up the phone, "Dean, I..."
"Well, I'm at the Medical University." Zheng Ren's expression immediately became solemn, and Zhou Chunyong was trembling in his heart after seeing it.
An ominous premonition quickly rose in his heart.
"Okay, I'll rush over right away!" Zheng Ren said with a serious expression.
"Boss, what's wrong?" Su Yun asked.
"An employee working overseas was injured locally with a gunshot wound. After simple treatment, he was sent back home. It has been eight days and the bullet has not been found. Vice President Yuan asked me for a consultation to see if I can find anything." After Ren finished speaking, he hurried away.
"Boss Zheng..." Zhou Chunyong spoke in a low voice, getting quieter and quieter.