CT showed: The scanning positioning image was that the right upper lobe bronchus was cut off, and the right upper lobe showed a wedge-shaped high-density shadow with uneven density, including round-like low-density shadows and punctate calcification shadows. Most of the mediastinal lymph nodes are calcified. The left bronchus was patent.
"Lung torsion, prepare for emergency surgery." Su Yun said with certainty.
"Brother Yun, I think it's also a lung torsion. I'm about to report to the second-tier professor." Fang Lin said with a smile.
However, he saw Zheng Ren still watching the movie and was a little confused.
"Boss Zheng? What do you think?" Fang Lin asked.
"The possibility of pulmonary torsion is high." Zheng Ren said with certainty: "But the differential diagnosis is difficult to distinguish between localized pleural effusion, atelectasis, intrapulmonary hematoma, and coagulative hemothorax."
"They're all the same. Tell me, which situation doesn't require you to go on stage?" Su Yun said disdainfully.
"Aren't you talking about diagnosis? If it's about surgery, you can prepare to do it directly." Zheng Ren still looked at the film and ignored Su Yun's provocation.
"You are too cautious." Su Yun said: "In the standing and lying positions, it is obvious that the high-density area has moved. This is the clearest diagnosis."
"Localized pleural effusion can also work." Zheng Ren looked at the movie with his chin in his hands.
"There is a difference."
"I know." Zheng Ren said: "Fang Lin, the patient's family said whether the condition is urgent or not?"
"It should be fine. There are no signs of vascular obstruction for the time being, leading to venous return obstruction and pulmonary parenchymal congestion, resulting in venous infarction or gangrene. However, Mr. Cui from the emergency department was anxious and asked Mr. Zhou to bring the patient's family members directly, saying that he should seize the time. Surgery." Fang Lin said.
"Then do a dynamic fluoroscopy of the chest. The diagnosis will be clear and we will start surgery immediately." Zheng Ren said.
Su Yun also knew that thoracic artery fluoroscopy was the best way to diagnose pulmonary torsion, but the patient's images were no longer too standard, although spontaneous pulmonary torsion was rare. But no matter what, there should be nothing wrong with doing the surgery directly.
Is it really necessary to be so cautious
But I still did what my boss said. It seems that I owed him a confession just now. If this guy really thinks about it and uses this sentence to criticize himself...
Su Yun didn't dare to continue thinking.
"Fang Lin, we are here to see a patient with double esophageal malformation. When can patients with pulmonary torsion be hospitalized?"
"If there is no traffic jam, it will take about an hour." Fang Lin said.
"Well, come on stage and tell me, and I'll take a look." Zheng Ren said.
"Okay."
It was just a grandstand surgery, so Fang Lin had no reason to refuse.
After taking a look at the patient with double esophageal malformation, Zheng Ren reviewed all the medical records and laboratory test sheets, and then used the system panel to compare them.
I left the thoracic surgery department with confidence that I would have surgery tomorrow.
Back in the department, Liu Zewei was busy correcting the case with his head plate shining brightly. Chang Yue went to communicate with the patient's family, while the professor was sorting out the data on TIPS surgery.
Because more and more doctors have learned the new TIPS surgery, the number of surgeries has skyrocketed. Professor Rudolf Wagner spent almost all his energy on sorting out relevant information besides surgery.
"Boss, the patient with pulmonary torsion that I just saw, will there be thrombosis transfer when the torsion is relieved?"
"It's possible. You have to be very careful when doing the surgery." Zheng Ren said: "It can't be done with a laparoscope, and the level of detail is still a little bit worse."
"By the way, you have good laparoscopic skills, but why are you so unsure about laparoscopic surgery?" Su Yun asked.
"It's not that I don't have confidence, but I have more confidence in my own hands." Zheng Ren said: "Did you notice what Dr. Charles said later?"
"With just a touch of your hand, you know how hard to use to sew?"
"Well, that's it." Zheng Ren said: "Although the damage of laparoscopic surgery is small, there is no comparison between laparoscopic forceps and hands. If you can take this advantage from Chu Nuangsai, If used, perhaps endoscopic technology can be further improved."
"Stop talking nonsense." Su Yun said: "There are definitely not many people who can master this. I have just touched the threshold, and it doesn't necessarily take long to cross. Do you expect others?"
"Yes, it's always good. Let's not talk about surgical operations, just talk about interventional operations. The feel is very important." Zheng Rendao.
"No wonder you can realize this, is it because the interventional surgery was done well?" Su Yun seemed to have found something.
"Probably." Zheng Ren said without hesitation, "Interventional surgery relies heavily on touch, especially after reaching a certain level. If you do it more, you will start to use the surgical side without realizing it."
"It seems that Dr. Charles is more talented than you. He doesn't know how to perform interventional surgery, but he has also touched the threshold of touch." Su Yun also understood the reason.
"Absolutely." Zheng Ren said: "I am a bystander, because I have the strongest interventional surgery to pave the way for me to understand this."
After Su Yun heard Zheng Ren talking about the most powerful interventional surgery, he immediately wanted to retort. But when the words came to his lips, they stopped suddenly.
Is this sentence wrong
That's right!
He is the strongest interventional surgeon, and he can't even find a similar example.
“Feel…”
"For example, if you feel the intestines, you can know how hard to use to peel them off, so as not to cause complications such as intestinal rupture and intestinal perforation." Zheng Ren recounted his experience.
Su Yun was silent and nodded.
This is a brand new field, and Su Yun can only vaguely understand what Zheng Ren is talking about, but he still has a long way to go before he can realize this and use it in surgical operations.
Thinking about it, Su Yun was a little confused.
Recently, I have been more focused than ever and worked harder than before, but why do I feel like I am getting further and further away from my boss
"You are back." Chang Yue came back from the ward and saw Zheng Ren and Su Yun chatting, so she greeted, "I seem a little unhappy, Mr. Zheng, please be careful."
"..." Zheng Ren felt a thunder falling from the sky.
"Huh?" Su Yun glanced at Chang Yue and asked, "Why?"
"If you don't eat at noon, you will disappear without a trace as soon as lunch time comes." Chang Yue was busy when he sat down.
"Isn't this something happened in the emergency department?" Su Yun didn't care.
"You don't reply even after sending messages. Don't you know how big a deal this is for a girl?" Chang Yue turned around, adjusted her glasses, and looked at Zheng Ren with gloating.
"..." Zheng Ren then remembered that he went to the emergency department after stepping down. He first listened intently to Su Yun's lecture to Zhou Litao, and then did the differential diagnosis of amoeba. He even forgot to look at his phone!
Although Zheng Ren's emotional intelligence is not high, or he is too lazy to think about it. But he knew that not replying to his girlfriend’s messages would be a huge mistake!
Zheng Ren felt a chill running down his spine and his whole body was frozen.