Subdural hematoma bleeds slowly, and early clinical symptoms are not obvious or even asymptomatic, resulting in missed early diagnosis and treatment time.
When clinical symptoms appear, the hematoma has been formed for a long time, and the main manifestations are atypical symptoms such as chronic intracranial hypertension and cerebral ischemia.
Liu had no external injuries, but Zheng Ren considered that it was the result of vascular recession, increased fragility and permeability, and chronic leakage caused by long-term heavy drinking, which was induced, aggravated, and worsened by emotional excitement.
I guess his brother didn't say anything nice to him after he came. After successive blows, Da Liu finally couldn't stand it any longer.
This man is a bit pitiful.
It's just that poor people must be hateful, and Zheng Ren doesn't know how to say such things. Da Liu's current situation is largely caused by himself.
It has nothing to do with him, so let's put it aside, Zheng Ren thought with a forced smile.
"Boss Zheng, the students at Imperial Medical University had nausea and vomiting in the past two days. What was the final diagnosis?" Zhou Litao then asked.
"My consideration is mass hysteria." Zheng Ren said.
Su Yun and Zhou Litao both had doubts about this diagnosis. After all, there are no clear substantive changes in hysteria, and there is no evidence, so the credibility has dropped a lot.
"Boss Zheng, there is a case that I solved two days ago. Give me a slap in the face." Zhou Litao put aside his mass hysteria and began to show off.
"Huh? What's the disease?" After hearing Zhou Litao's words, Zheng Ren immediately became interested.
"A spoon was taken out of the esophagus." Zhou Litao smiled with a proud look on his face.
Esophagus… spoon…
"Here, I kept one of the films. The patient also said he didn't want it, so I kept it." Zhou Litao said.
Esophageal foreign bodies refer to foreign bodies, such as small animal bones, root foods such as peach cores, sweet potato pieces, corn bone cobs, etc., as well as children's toys, wires, fish hooks, plastic products, etc. that stay in the esophagus.
Zheng Ren remembered a case report about a man who swallowed 40 knives and left them in his esophagus.
This is a bit too much, Zheng Ren doesn't really believe it. 40 knives, are they magic? If it could be taken out at will, it would become a sword-swallowing trick.
Zhou Litao saw that he was not busy, so he took Zheng Ren and Su Yun to his duty room.
He installed a plastic hook on the side of the cabinet and hung a dozen film bags from it.
After finding the film and handing it to Zheng Ren, Zhou Litao said: "The patient came to see a doctor because he had an argument with someone while eating at night and was punched in the chest. He then developed symptoms such as chest tightness and nausea."
"I'll see if I take a picture." Su Yundao said.
Zheng Ren took out the film and looked at it through the window.
There was an obvious image of a spoon in the esophagus, and there were no esophageal diverticula or the like.
It's really hard to imagine how the spoon stayed in the esophagus.
It is estimated that it is relatively large and cannot enter the stomach along the cardia, so it wanders in the esophagus and is finally wrapped in fiber.
"Tsk, tsk, it's so big." Su Yun admired as he looked at the film.
"No." Zhou Litao took out a plastic bag. There was a spoon in it, about 10cm long, with food residue, pus and other things on the surface.
"You don't want to take a shower either," Su Yun said.
"Looking at it this way, it's more eye-catching." Zhou Litao said with a smile: "It's so clean that the children should wonder if this happened. Did I just buy a spoon to deceive people, or is it true? Even if there were movies at that time , and not very credible.”
What Zhou Litao said makes sense. This guy has always been thinking about teaching students at the Medical University Affiliated Hospital in the future.
I don’t know where he put all the messy things he collected.
According to Su Yun, this is a collection habit.
This is a disease and must be cured.
"How did you take it out?" Zheng Ren asked.
"Send it to the endoscopy room. Director Luo used a gastroscope to get it." Zhou Litao said, "Director Luo also said that if you were here, the patient might be less damaged."
Zheng Ren smiled.
Just remove a foreign body from the esophagus. No matter who does it, the damage will definitely not be serious.
Spoons are relatively rare. Foreign bodies in the esophagus of adults are usually dentures and the like.
I forgot to take off my dentures at night and swallowed them while sleeping. After waking up, some careless people do not feel that the dentures are in the esophagus, but just think that they have forgotten to put the dentures somewhere.
Finally, it causes foreign bodies in the esophagus.
"It's so big, it must be quite troublesome to take it out." Zheng Ren sighed with emotion.
"It was taken out under general anesthesia. I went to the chest department at that time. If the endoscopy failed, I was prepared for a thoracotomy."
What Zhou Litao said is right, make all kinds of preparations to avoid problems.
If one way can't solve it, use another way. This was on 912. If I had gone to another local hospital, I would have had to undergo a thoracotomy to remove my esophagus.
Just cutting into the esophagus to remove foreign objects is a very troublesome and risky operation.
Unlike open skin resection for lipoma, local ischemia may occur after surgery and the incision cannot heal, leading to the possibility of chest infection, lung infection, lung abscess, and empyema.
If it can be taken out with an endoscope, that would be the best.
After watching the movie, he looked at the spoon he took out and saw Zhou Litao carefully putting the spoon away. Zheng Ren felt that he was really an interesting person.
But when he has a family in the future, he doesn’t know if his lover can accept these things.
After chatting for a while, Zhou Litao received a call from the doctor who sent Da Liu for examination.
Head CT showed that Liu was diagnosed with subacute right frontotemporal subdural hematoma and was immediately transferred to surgery for craniotomy to remove the hematoma.
Although craniotomy is very risky, it is definitely a "minor" operation in terms of neurosurgery.
As long as it can be detected early and diagnosed and treated early, the possibility of postoperative coma or long-term bed rest is unlikely.
"I'm going to have a look at the neurosurgery." Su Yun glanced at Zheng Ren and asked, "Don't you want to go?"
Zheng Ren nodded.
He instinctively resists patients with messy housework. As long as the disease is treated, it will be cured, but heart disease...
Forget it, let's leave it to Su Yun.
After leaving the emergency department, the two went their separate ways.
Su Yun went to the neurosurgery department, while Zheng Ren went directly back to the interventional department.
Sitting in the sun, Zheng Ren dived into the system library to read. Although he has almost a photographic memory, the system library updates so much that new journals come one after another, and it is impossible for Zheng Ren to read them all.
After watching it for a while, Xie Yiren sent a WeChat message asking what to eat for dinner.
In the evening, Qin Tang also said that he wanted to treat a guest. As for the specific matter, Zheng Ren didn't know.
While flipping through his phone, Zheng Ren suddenly felt something in his heart.
I haven’t looked at the QQ of the little boy who had cancer for a long time, and I don’t know how he is doing now.
When I opened QQ, I saw that the little boy's avatar was bright, but his signature had not been updated and stayed nearly a month ago.