Soon, Su Yun sent all the received image data to Zheng Ren.
It's just a few films and test sheets, but it can be seen that the old man's physical condition is really very poor, and his condition is quite difficult.
The ion disorder was quite serious when I was admitted to the hospital, but it has basically returned to normal now, but judging from the images, the surgery was not done just as promised.
Zenker diverticulum is a type of pharyngoesophageal diverticulum. It is different from ordinary esophageal diverticulum. In 1874, German pathologist Zenker made a correct analysis and observation of pharyngoesophageal diverticulum, so it was named Zenker diverticulum.
Pharyngoesophageal diverticula account for about 60% of esophageal diverticula, and are more common in patients aged 50 to 80 years.
This type of pharyngeal esophageal diverticulum that occurs at the pharyngeal esophageal junction is a Zenker diverticulum. Its occurrence is related to pharyngeal esophageal muscle dyskinesia, increased intraesophageal pressure caused by cricopharyngeal muscle achalasia, and weakness in the local muscle anatomy. .
There is no doubt about the diagnosis. Gastroscopy has proved that what this old patient needs is not diagnosis and differential diagnosis. The difficulty lies in treatment.
"Boss, I see that all the indicators are maintained well. There is a possibility of surgery. But it is only a possibility. It is more likely that you will not be able to get off stage. It is difficult for this body to withstand the impact of surgery and anesthesia." Su Yun looked at the test sheet again. Said later.
"I thought about it." Zheng Ren put down his phone and looked at the neon flashing distance, thinking about the patient's condition.
The old man is 84 years old. He found progressive dysphagia 6 years ago and was diagnosed with Zenker's diverticulum. At that time, the patient's family decided to refuse surgical treatment after discussion because of his older age.
That was 6 years ago. I rejected it then, let alone now.
Before admission, the old man could only eat a semi-liquid diet and suffered from intermittent vomiting.
After admission, upper gastrointestinal tract angiography showed a huge diverticulum on the right wall of the esophagus from the cervical to the upper thoracic segment, with the lower end reaching the level of the carina, about 10cm × 6cm in size, the base of the diverticulum was about 7cm wide, and the ridge between the diverticulum and the thoracic esophagus was about 3cm long.
Chest CT scan shows that pharyngeal esophageal diverticulum located in the chest squeezes and narrows the trachea and esophagus.
Electronic gastroscopy revealed a huge diverticulum on the right side of the esophagus 16 to 23 cm away from the incisors. The diverticulum wall mucosa was obviously congested, and the esophageal lumen was compressed and narrowed into intermittent open holes, making it impossible for the gastroscope to pass through.
"Because the base of the diverticulum is in the cervical esophagus and upper thoracic esophagus, neither the cervical incision nor the transthoracic incision can completely expose the diverticulum base, and it is impossible to completely remove the diverticulum." Zheng Ren recalled it and said to Su Yun.
"Yes." Su Yun frowned, "The diverticulum is too large, so it is not suitable for diverticulum suspension surgery. At such an old age, it is definitely not possible to perform surgery with combined neck and chest incisions."
"Well, it definitely won't work. If we use combined incisions, I'm afraid I can step down but not get out of the ICU. I guess the commander-in-chief's office also thinks so, and it makes sense for the patient's family to refuse treatment." Zheng Ren said thoughtfully.
There was silence in the car, and Zhou Chunyong felt quite embarrassed. Boss Zheng and Su Yun were both deep in thought, and he did not want or dare to disturb their thoughts.
Arriving at the hotel in silence, Zheng Ren got off the car, walked into the private room with Zhou Chunyong, and asked the waiter, "Do you have a pen and paper, please?"
"Uh... Yes, please wait a moment, sir." The waiter politely went to get paper and pen.
"Boss, do you have any ideas?" Su Yun asked.
"I have a vague idea, but it's not very clear yet. I'll draw it for you to take a look at." Zheng Ren simply didn't go to the table and sat directly on the sofa next to him. He put his elbows on his knees and narrowed his eyes slightly, looking at the person in front of him. coffee table.
"Who are they?" Dean Bao asked Zhou Chunyong in a low voice.
"I told Boss Zheng about Mr. Peng's wife. It was just a casual chat, but I didn't expect Boss Zheng to take it seriously." Zhou Chunyong said helplessly.
"Is there any way?" Dean Bao asked in disbelief.
"I don't know, let's take a look." Although Zhou Chunyong had seen Boss Zheng undergo numerous difficult surgeries, he still refused to believe it.
The old man lives in Shuaifu. Xiehe is known as the last stop in the domestic medical field. Shuaifu is the point with the strongest technical power. There is nothing that can be done there. It is probably impossible for Boss Zheng to solve the problem like a fairy.
Is it necessary to use intervention methods again? Zhou Chunyong suddenly thought of such a possibility. Bullet embolism, Boss Zheng used intervention methods to remove the bullet. This idea is like a fairy from heaven, and I still feel amazing when I think about it now.
It is also possible that Zhou Chunyong knelt down in front of Boss Zheng early and thoroughly because he could not use his own level to predict Boss Zheng.
The waiter brought the pen and paper, and Zheng Ren immediately began to draw a sketch. Zhou Chunyong looked down from a high position and saw a schematic diagram of human anatomy of the neck and chest. Although it is just a sketch, the shape is realistic, and the 3D structure is clearly shown with shadows.
Boss Zheng and Su Yun started talking about the idea of surgery, and Dean Bao was particularly helpless.
Ordinarily, I should be fully respected when I sit here, whether it is out of politeness or seniority. Come up and chat, talk and laugh over a meal. Everyone has a deeper understanding of each other, and it will be more convenient to do things in the future.
This is the most basic idea, and it seems that anyone with a little bit of emotional intelligence will do it.
But Boss Zheng and Su Yun didn't even look at me. They were chatting enthusiastically there, and occasionally they even argued, which was very intense.
"Dean Bao, Boss Zheng has such a temper." Zhou Chunyong sighed and said, "How about we order first?"
"Wait a minute." Although Bao Longtao was a little angry, he couldn't tell what was wrong. He was trying to figure out a treatment plan for his wife. Even if he felt that his family had given up on treatment and there was no need to think about these things, it was hard to interrupt him.
In fact, it doesn't matter whether you think about it or not. Even if you interrupt Boss Zheng, you still have to deal with yourself. It is said that Boss Zheng has a very strong fighting ability. He would really dare to hit someone if he crossed his eyes during emergency treatment.
Not guilty, not guilty, Bao Longtao shook his head, "Just wait a while."
He found a seat and sat down, took out his mobile phone and clicked on a small group. When he saw the messages in the group, his expression was gloomy.
"The two elderly people discussed it and have been discharged from the hospital voluntarily." Bao Longtao said, "They are preparing to return to their hometown."
"Uh..." Zhou Chunyong looked at Boss Zheng and Su Yun, who were having a heated discussion, with mixed feelings in his heart.
Is their discussion still meaningful? It makes absolutely no sense at all.
Chinese people pay great attention to returning to their hometown. Many people have to go back to their hometown when they die, especially the elderly people.
"Dean Bao, where is your hometown?"
"On the Fenhe River side, it's time to drive." Bao Longtao said softly, "I'm still preparing the car. I'll leave early tomorrow morning and arrive in the evening. Let's go see him off tomorrow and take another look at the old man."