Ectopic pregnancy, rupture and bleeding, and signs of peritonitis are all obvious.
Zheng Ren wants to find the specific location of the ectopic pregnancy.
As long as it can be found, the patient will not suffer greater damage during the operation and the postoperative recovery will be faster. In other words, you can't open the mouth of heaven and earth and turn over it at random.
If you do that, problems such as intestinal obstruction will most likely come to your door after surgery.
The B-ultrasound machine was pulled over and Zheng Ren started to perform B-ultrasound on the patient.
He did it very carefully, starting from the lower abdomen and pelvic cavity, and working his way up little by little.
The patient's family members stood aside anxiously. It was obvious that they still did not understand why a young doctor was doing the examination.
Soon, residents from the hepatobiliary department and gynecology department were all gone.
Zhou Litao called Zheng Ren first, and then went to the relevant departments. This is a kind of subtle trust. When you encounter difficult and complicated diseases, you should go to Boss Zheng.
In his mind, the words "Boss Zheng" are no different from the old Chinese medicine doctor or old military doctor mentioned in the small advertisement posted on the telephone pole.
It is the same as Su Yun said when he encounters difficult and complicated diseases, he should seek help from rheumatism and immunology.
"Mr. Zhou, what's going on?" The chief resident of the gynecology department was shocked to see Director Lin standing in the emergency room, and his voice became a little softer.
Zhou Litao gave a brief introduction to the condition and expressed his judgment.
In fact, it is very simple to judge the condition. The key is the location, which is a difficult point. The doctor in the B-ultrasound room was not found, so now I can only see Boss Zheng.
The hospital chiefs of gynecology and liver and gallbladder stood aside with hands down. With Ringer around, their breathing became much gentler.
"No abnormalities were found in the intestines. A small amount of liquid dark area was seen in the intestinal space. It was considered to be bleeding." Zheng Ren briefly stated, and Zhou Litao wrote down his words.
After all, an inspection requires a report. The B-ultrasound doctor was busy, so Zhou Litao could only record it and send it back to the doctor there.
Keep swiping up.
When the spleen was scanned, Zheng Ren discovered the problem. An abnormal echo appeared on the screen, and the two residents realized that the problem must have been found.
"A 2.6 cm heterogeneous and slightly stronger echogenic mass was seen in the lower pole of the spleen, with clear boundaries and a regular shape. An echo-free zone with a diameter of 0.9 cm was found inside, and multiple punctate blood flow signals were seen around and inside the mass." Zheng Ren Speaking of.
Zhou Litao quickly wrote down this passage.
Hepatobiliary hospitalization always felt that this was a rare case of splenic pregnancy, and it was all under the control of hepatobiliary surgery.
But as soon as he moved, he saw Boss Zheng sitting there, as motionless as a mountain.
Didn't you find the problem
The patient in hospital was stunned for a moment. Why was Boss Zheng not relieved, but still observing
Lin Ge doesn't understand B-ultrasound, but he understands people and can read them very accurately.
He could clearly see the subtle movements of several people.
"Any judgment?" Ringer asked.
"It is considered to be splenic pregnancy." The resident of the Department of Hepatobiliary Surgery said: "It is rare, but the operation is not difficult. I have done it."
"Huh?" Lin Ge saw that Zheng Ren was holding a B-ultrasound probe in his hand and pressing it on the left upper abdomen of the patient. He had been looking at something and knew something was wrong. "What is Boss Zheng doing?"
"..." The resident in the Department of Hepatobiliary Surgery didn't know how to answer.
"Maybe we're looking at the fetal heartbeat and fetal buds?" the gynecology resident said.
Ringer nodded, noncommittal.
Time passed bit by bit, Zheng Ren looked at the screen of the B-ultrasound machine without saying a word.
The patient's family members were anxious and walked around, suppressing their anxiety and anger.
"Doctor, what are you looking at?" The patient asked in a low voice as she was sweating profusely in pain.
"While you're looking at the fetal heart rate, don't talk, take a deep breath, and hold it in until you can't hold it in any longer," Zheng Ren said.
"Can you do it?" A middle-aged woman finally couldn't hold back her anger and lowered her voice and said, "If I press you like that, it won't hurt!"
"I'm sorry, I can't help it. Please hold on a little longer." Zheng Ren said calmly without getting angry: "It involves the scope of the operation. If the inspection is not careful, it can easily lead to a second laparotomy."
"I just know how to scare people." The middle-aged woman's expression changed and she muttered in a low voice, but did not continue to say anything.
One minute later, Zheng Ren removed the B-ultrasound probe from the patient's spleen and began to search for the liver area.
The emergency B-ultrasound doctor finished her work and ran all the way to the emergency room. Seeing Zheng Ren scanning the B-ultrasound, he breathed a sigh of relief.
Boss Zheng is still very stable, everyone admits this.
"Mr. Zhou, what's going on?" She carefully avoided Lin Ge, came to Zhou Litao's side, and asked.
"A 2.6 cm heterogeneous and slightly stronger echogenic mass was seen in the lower pole of the spleen." Zhou Litao said.
"Uh..." All the doctors in the B-ultrasound room knew about the previous situation.
Have you encountered the rare spleen pregnancy? She quickly looked at the screen of the B-ultrasound machine.
Boss Zheng was scanning the liver. Why else would he be looking for the liver if he had already determined that it was spleen pregnancy
She was confused.
"Boss Zheng, you..." the doctor in the B-ultrasound room asked softly.
"I looked at the echo of the lower pole of the spleen for several minutes, but couldn't find the fetal heart or fetal bud. I thought it was a hemangioma." Zheng Ren said, "There is fluid accumulation in the liver area, and the depth of the fluid accumulation in the liver and kidney crypts is 3.3cm."
Zhou Litao immediately wrote down the B-ultrasound images described by Zheng Ren.
"Are there any problems with the liver?" the doctor on the B-ultrasound asked.
"No, there are no problems anywhere that can be seen on the surface of the liver." Zheng Ren said.
"That's because the spleen was pregnant, and it ruptured and caused bleeding, so it flowed through." The doctor on the B-ultrasound asked in a low voice.
Although the sound is small, it has a different meaning to the ears of the patient's family members.
What splenic pregnancy is, they don’t understand. But rupture and bleeding are a big deal.
Coupled with the fact that the patients were pale and sweating profusely, their anxiety became increasingly difficult to contain.
"Mr. Zhou, I think it's an ectopic pregnancy in the liver. Let's order a CT scan and prepare an endoscopic examination of the liver and gallbladder." Zheng Ren finally put down the B-ultrasound probe and said with certainty.
Well…
This conclusion is a bit strange.
Seeing the problematic spleen, it turned out to be fine. How did he say it was a liver problem
The key is that no abnormal images have been seen in the liver.
The B-ultrasound doctor was stunned for a moment. She disagreed with Boss Zheng's diagnosis.
"Doctor, are you okay?" the patient's family asked anxiously.
"I'm bleeding and need emergency surgery." Zheng Ren said, "Can we do it?"
The liver and gallbladder resident general nodded. He just disagreed with Boss Zheng's diagnosis, but there was no problem with the operation.
This kind of surgery is a minor surgery, a general hospital-level emergency, and even second-tier professors don't need to take care of it. He took the training doctor with him and went directly to the stage.
There is no problem with the spleen surgery, but the liver... the overall hospitalization level is not enough.
"Yes." Zheng Ren nodded, "Hurry up and do the CT scan. Give me a call when you're done. I'll take a look at the eye images. Notify the operating room and prepare for the operation."