Boss Zheng was too cautious, as was the judgment of the two inpatient and B-ultrasound doctors.
Just because of the patient's condition, is it really allowed to have another CT scan
The hepatobiliary doctor at the hospital always checked the blood pressure, which was 80/50 mm Hg. It seemed to be okay. There should be time for an abdominal CT scan.
The patient's family members have become agitated. If they want to deal with this matter, they must get checked immediately.
Just take the time to get on stage and enter the operating room.
Several people scrambled to carry the patient onto the flat car. Zhou Litao took the examination receipt and handed it to the patient's family. Zheng Ren came to the side of the hepatobiliary hospital chief and whispered: "You can do spleen removal. Liver surgery , if you are not sure, hurry up and find the second line."
The resident of the Department of Hepatobiliary Surgery nodded blankly.
What he didn't understand was why Boss Zheng insisted that a normal liver might have an ectopic pregnancy, but a faulty spleen was fine.
But with Boss Zheng's words, he breathed a sigh of relief.
In my own department, from the director to the leading professors, no one questions the level of Boss Zheng when talking about him. Although the director doesn't say much, it can always be seen from the hospitalization that the director recognizes Boss Zheng's level.
The director didn't say anything. The reason was that during the liver cancer resection, Boss Zheng used interventional surgery to open up a big hole.
It’s still a live broadcast. Doctors all over the world know that when treating liver cancer, intervention is done first, and the surgical effect will be better.
Specific long-term data will take time to refine. But from the most basic operation point of view, the effect of interventional embolization + surgical resection is much better than that of simple surgical resection.
This is undoubtedly a huge blow to hepatobiliary surgery.
Uh... I'm thinking too much. The chief resident of the Department of Hepatobiliary Surgery thought to himself that Boss Zheng meant that calling the second line from home in the middle of the night should not be a big deal.
Watching a group of people leave, Zhou Litao asked doubtfully: "Boss Zheng, why isn't it about the liver?"
"Generally, after 50 days of ectopic pregnancy, you should be able to see the fetal heart and fetal buds. I think the location of the spleen looks like a hemangioma. A round or oval heterogeneous hyperechoic mass can be seen in the spleen parenchyma, with a border It is clear, the edges are not smooth, and there are intervals between anechoic and strong echoes inside.”
"But… "
"Doing a CT scan will not affect the patient's surgery." Zheng Ren said, "If you make a hasty diagnosis and the bleeding continues after the spleen is removed, then you are screwed."
When thinking of this result, Zhou Litao felt a little guilty.
When entering the palace for the second time, the first thing it brings to the patient's family is an almost devastating psychological blow. It came out fine, but there was still bleeding. Who can understand this kind of thing
The hidden dangers of medical disputes.
Although the patient's family members are very impatient now, if the operation goes well, the patient will be fine after coming back.
It’s easy to relate to this. No matter who the patient's family members were, they would probably behave the same.
"Is spleen pregnancy common?" Ringer asked.
"Not much." The ultrasound doctor said immediately.
This disease, even in large tertiary hospitals like 912, generally does not see one case a year.
"The incidence of abdominal pregnancy in ectopic pregnancy is only 1/10000~1/3000, among which splenic pregnancy is even rarer, and there are few reports at home and abroad." Zheng Rendao, "From 1990 to now, the sci impact factor 5 There are only 40 cases reported in the above-mentioned journals and magazines.”
Ringer smiled.
This kind of logic of using data to speak is the standard thinking of science men. I have seen Boss Zheng say this many times, and I have a sense of recognition.
It's just that it requires a lot of reading and memory support to be able to grasp it at your fingertips.
How could anyone else say such detailed data for a rare disease
"Strange, how come it grows on the spleen and liver?" Ringer was a little curious.
"According to research, the cause of splenic pregnancy may be that the fertilized egg was discharged into the abdominal cavity due to abnormal retroperistalsis in the fallopian tube, and was not absorbed by the peritoneum and did not enter the contralateral fallopian tube. At the same time, excessive intestinal peristalsis pushed the fertilized egg to move to the spleen and liver and Implantation and growth." Zheng Ren explained: "The probability of ectopic pregnancy in the liver is slightly greater than that in the spleen."
As he spoke, he lowered his head and thought for a moment, then continued, "There were 22 cases of liver pregnancy and 18 cases of spleen pregnancy. Less than 33% of the patients were more than 3 months pregnant, and most of them were caused by miscarriage or rupture in the early stages of pregnancy. Diagnosis and treatment of abdominal bleeding.”
"Liver, is that true? This is quite strange. It actually grows on the liver." Lin Ge already believed Zheng Ren's words and excluded the spleen in his words.
"90% probability." Zheng Ren said, "It's very dangerous. Take the time to do an examination and then do the surgery. The surgery is not difficult. The difficult thing is to diagnose it as soon as possible."
After saying that, he glanced at Zhou Litao and said: "Mr. Zhou, go to urge blood. He said that the patient needs an urgent blood transfusion, a large amount."
Zhou Litao responded and ran to call the blood transfusion department.
"So serious?" Ringer was surprised.
“The liver, spleen and other organs have rich blood circulation and low surface tension. The blood from the portal circulation of the gastrointestinal tract is rich, which is conducive to embryonic growth.
As the embryo develops and grows, organ rupture may occur, causing rapid and massive bleeding. If rescue is not performed in time, hemorrhagic shock or even death may occur. The risk of death is much greater than with an ordinary ectopic pregnancy. "
Zheng Ren said with certainty.
People who are admitted to the gynecology department are always very curious. Even if the diagnosis of ectopic pregnancy is OK, the diagnosis is not made because the spleen is occupying the space, but it is diagnosed as liver ectopic pregnancy.
this…
She greeted Director Lin and ran away immediately.
Going up to the stage and taking a look would be a great experience. Boss Zheng has been praised as a miracle in the hospital recently. Let's see if it is so magical.
"Boss Zheng, you are really busy today." Lin Ge smiled.
"I'm used to it." Zheng Ren said: "When I was in Haicheng, I stayed in the hospital every day. When I got home and it was quiet, I didn't sleep so soundly."
This is a problem among emergency doctors. They work in a messy environment all year round. Once they calm down, they will subconsciously think about whether there will be a wave of outbreaks waiting for them.
There was no sound, and I really couldn't sleep.
Zhou Litao came back after making the call and said: "The blood transfusion department knows that it is an ectopic pregnancy and has prepared 20 units of red blood cells and 1000 ml of plasma."
Zheng Ren was relieved that he was well prepared and there should be no problem with the patient.
Normally, he would have followed him on stage to take a look.
But there is no suction in front of him... The patient with congenital porphyria is waiting for consultation. Zheng Ren can't wait to go to the system operating room to dissect the patient with congenital porphyria.
In fact, it is not accurate to say that it is congenital porphyria. He thinks that this disease only has symptoms consistent with congenital porphyria. In fact... it is more likely that the ancient and mysterious family is just a vampire.