After all, he did not perform the surgery himself. The condition of the patient's chest and abdominal cavity cannot be guessed based on the surgical records.
Zheng Ren encountered such a patient when he was in the general surgery department of Haicheng City No. 1 Hospital.
After caesarean section, the patient suffered a sudden massive hemorrhage. The doctor at the township hospital performed an emergency laparotomy and discovered that the spleen had been pierced during the caesarean section.
This was a proper medical accident, but the bizarre things did not end there.
Emergency splenectomy was performed, and the patient found difficulty breathing again after surgery. So a CT scan of the lungs was performed, which revealed left diaphragmatic hernia, pneumothorax, and lung tissue compression.
The director of the township hospital panicked and quickly sent the patient to Haicheng City No. 1 Hospital.
For them, Haicheng City No. 1 Hospital is their superior hospital and their heaven.
Liu Tianxing had a good relationship with the director of the township hospital, so he admitted the patient and helped him wipe his butt.
Upon inspection, it was discovered that the patient had a large pneumothorax on the left side of the chest.
I went to the thoracic department and found out that when the patient underwent splenectomy, a hole was made in the diaphragm and the lung ruptured.
After a while of repairs and sutures, the patient was finally discharged from the hospital successfully half a month later.
The quality of doctors in rural hospitals cannot be complimented, just like doctors from large tertiary hospitals in imperial and magical cities look at the No. 1 Hospital in Haicheng City.
This is a gap in technical level, and there is absolutely no solution.
Zheng Ren still doesn't understand why a caesarean section can rupture the spleen. Why cutting out the spleen can cause lung rupture and diaphragm rupture
This is absolutely terrifying.
Doctors with low technical skills are really making fun of their lives. However, we cannot expect all doctors to be of high quality, that is unrealistic.
This is also the main purpose of Zheng Ren's operation live broadcast room. Anyway, when encountering problems, he just has to do his best.
The situation of the patient in front of him was similar to that of the female patient who had a caesarean section that Zheng Ren had experienced, but the actual situation was different.
The moment Zheng Ren saw the film, he was sure it must be liver hernia.
This is caused by secondary injuries, there is no doubt about it, but it does not mean that the doctor made a low-level mistake that is embarrassing. It is caused by the fact that congenital retrosternal diaphragmatic hernia is relatively rare, and the patient is older and the diaphragm is not working hard.
Zheng Ren made a judgment immediately.
Mr. Cui put on his spectacles and began to read the pictures frame by frame.
Soon, Director Ren of the Emergency Department, Director Zhang of the Hepatobiliary Surgery Department, and Director Li of the Thoracic Surgery Department also rushed to Mr. Cui's office.
When they saw Zheng Ren there, they were stunned.
Director Zhang said with a smile: "Boss Zheng, the surgery just now was really beautiful!"
"Thank you." Zheng Ren smiled slightly and said modestly.
"It's good if it's done well. It's not good for young people to be too modest." Director Zhang said with a smile and began to listen to Zhou Litao's medical history report again.
Hospitalization is always the most annoying job. The same medical history has to be reported once or twice, or even three or five times.
Fortunately, several directors are here, so it seems that no more reports are needed.
Soon, after listening to the medical history, everyone began to study the film.
The patient's condition was very bad. He was originally shocked by two general anesthesia surgeries, but after a week of recovery, his body had just improved somewhat. However, liver hernia occurred again, and he had to travel a long distance before arriving at 912.
After struggling for so long, even a solid body will have some problems.
Whether emergency surgery requires thoracic surgery or hepatobiliary surgery is a question.
No one was willing to accept a badly cut patient, so Mr. Cui was experienced and directly "invited" the two directors of relevant departments to his office to avoid arguing with each other.
Of course, the emergency department has the right to push patients directly to a certain department, and they cannot refuse admission there. But it is a better choice for everyone to sit together, explain things clearly in a friendly manner, and then go on stage together.
This was done with great skill, but only academician-level elders had the confidence to bring the chief directors of two related departments and the director of the emergency department over for a joint consultation.
Zheng Ren originally prepared salted fish.
The patient's condition is relatively clear, and all it takes is surgery, detailed exploration, and diaphragm repair. I can't tell which director to accept this kind of thing.
Anyway, with Mr. Cui here, I can feel happy for a while.
However, his wishful thinking was quickly shattered. None of the directors spoke and looked at Zheng Ren.
"Xiao Zheng, tell me what you think." Mr. Cui said slowly.
"..." Zheng Ren was puzzled. He looked left and right and saw that no one spoke to the two chief directors. He knew that he must say something.
On the one hand, Mr. Cui paid attention to it, and on the other hand, the surgery for Gaucher's disease that had just been completed received Director Zhang's attention.
For anyone else, this would be an honor. But Zheng Ren knew how deep the water was and found it very difficult to handle.
Zheng Ren groaned slightly, and Mr. Cui's eyes struck Zheng Ren like a whip.
"Then let me throw some light on it first and briefly talk about my opinion." Zheng Ren thought about it and said politely, "If you have anything you can't think of, please ask a few directors for advice."
“The patient’s right side diaphragm atrophied due to congenital retrosternal diaphragmatic hernia and older age.
Moreover, because the primary hernia is too large and the course of the disease is relatively long, diaphragm dysfunction occurs after surgery. In addition, en bloc resection of the hernia sac during surgery further weakens diaphragm function and may cause damage to surrounding tissues. "
"To sum up, I think the reason for the patient's liver hernia is that the resection of the congenital retrosternal hernia hernia sac resulted in excessive diaphragm tension, combined with bullae, and excessive mechanical ventilation tension, which stretched the right diaphragm over a large area. Tear apart.”
"For surgical repair, it is best to use patches to relieve local tension. Do we have related patches in our hospital?" Zheng Ren asked.
"Yes." Director Zhang nodded and said: "I estimate the length of the tear to be around 15cm. I agree with Boss Zheng's analysis. If this surgery is performed from the abdominal cavity, there will be liver obstruction and it will be difficult to have a surgical field. It is recommended For chest thoracotomy treatment, we can go on stage to assist.”
Thoracotomy remains the most common invasive procedure for hernia surgery, particularly because resection of the hernia sac is more appropriate. The morbidity and mortality rates after laparotomy are considered to be the highest, and Director Zhang’s statement is not wrong.
But Zheng Ren hesitated for a moment and finally remained silent.
"Xiao Zheng, what are you going to say?" Although Mr. Cui was wearing reading glasses, he understood everything clearly.
"I think Director Zhang is right. I think the key to the patient's surgery lies in the patch." Zheng Rendao, "The patient's diaphragm is likely to atrophy, so the resection of the hernia sac will cause excessive tension. In case of tearing, the patch itself is more flexible than the diaphragm and can fully relieve the tension of the diaphragm."
"With such a large patch, the operation is somewhat difficult." Director Li of the Department of Thoracic Surgery muttered and said.