A family member raised his foot and kicked him. The obstetrician reacted quickly and moved sideways to avoid it, but he had no choice but to let go of the hand holding the cart.
"As long as I'm here, you have to be responsible for anything that happens!" The old lady pointed at the obstetrician's nose and said sharply, "You are shirking responsibility! You are still saving lives and healing the wounded, and your conscience is being eaten by dogs! "
"..." Zheng Ren was speechless.
"Don't send her away. It's still too late for a caesarean section. The time you mentioned is not possible at all!" The obstetrician did not struggle with the old lady and tried to grab the flat forehead, but was pushed away by another person.
Watching the elevator arrive and the flat car being pushed into the elevator, the noise at the door of the operating room gradually quieted down.
But, this is just the beginning.
Seeing that the persuasion was ineffective, the obstetrician immediately called the director and the medical office. While explaining the situation, he hurried downstairs to change clothes.
Yes, this is just the beginning. More troublesome things are yet to come.
The obstetrician and Zheng Ren walked across each other. Zheng Ren stepped out of the way and watched her leave in a hurry, feeling helpless.
If you don’t believe what large tertiary hospitals say, you have to go to a private hospital or an underground clinic to deliver your baby. The child has already shown symptoms of unstable fetal heart rate, and it will take several hours to regenerate...
Sounds ridiculous, but it's true.
Zheng Ren shook his head. Some things cannot be solved by high-level medical technology.
However, Zheng Ren knew something in his heart. This kind of thing was definitely not something he could solve by himself. He could only look at it.
He found the second hand that Su Yun said, opened the sealed door, and walked in.
"Boss, what's going on outside?" Su Yun stood in the assistant's position, and an older training doctor was pushed aside by him.
"What's going on with the pericardium?" Zheng Ren didn't answer Su Yun's words, but asked instead.
"Liquid pericardium is rare." Su Yun said with a smile.
Zheng Ren's heart moved, is it the pericardium of gas and liquid? Why didn't the system diagnose me
He glanced at the patient and saw that the last item on the system panel was the diagnosis of air-liquid pericardium.
This is…
The patient is so lucky! Zheng Ren thought.
Generally, pericardial effusion is relatively common, and the traumatic condition is very dangerous. Zheng Ren encountered several cases in Haicheng where emergency thoracotomy was required and the pericardium was cut open under direct vision to decompress.
Pneumopericardium, however, is uncommon. Traumatic pneumothorax combined with pericardial breach without damage to the great vessels is a reasonable source of pneumopericardium.
Then there are the side injuries caused by anesthesia intubation and mechanical ventilation.
Zheng Ren knew that when he was in the emergency department, there was no diagnosis of air-liquid pericardium on the system panel, but there was one on the operating table. It might be caused by mechanical ventilation.
"Have you done it?" Zheng Ren asked.
"When repairing the diaphragm, the tension was extremely high."
"Boss Zheng, here we come." Fang Lin put down the needle holder in his hand, turned around and said with a smile.
Zheng Ren didn't speak to Fang Lin. He came over and took a look at the surgery area.
The diaphragm atrophy is relatively obvious, and my previous judgment was quite accurate.
The right diaphragm has been sutured with the help of patches. Judging from the tension, there should be no problem.
Fang Lin's surgery was quite good, and the level of the chief resident of 912 was a little higher than that of the director of Haicheng City No. 1 Hospital.
"Explore the bullae, mediastinum, and pericardium." Zheng Ren said in a deep voice.
"The alveoli in the lower lobe of the right lung had already closed during the second thoracotomy," Su Yundao said.
"Check it out, otherwise there is no way to explain the gas pericardium." Zheng Ren said.
Su Yun touched the pericardium with a hemostatic forceps, hesitated for a moment, and said, "The pressure on the pericardium is greater than before."
As he spoke, he picked up the knife and cut open the pericardium without hesitation.
If this happens off the stage or during transportation, the patient will face an extremely dangerous situation. But on the operating table, a pericardiotomy to decompress could not be simpler.
Fang Lin didn't say anything to Zheng Ren, and started to perform pericardial fenestration. The removed pericardium was sent for pathological examination, and a part of the pericardial effusion was extracted with a syringe for related examinations.
The volume of pericardial effusion was about 700ml and the color was clear, ruling out the possibility of bloody pericardial effusion.
Normally, it would be time to flush the chest and the surgery would be over.
But when the chest was flushed, a small amount of gas was found to have escaped.
Fang Lin and Su Yun were having trouble finding themselves on the stage for a while, but finally discovered a problem in the mediastinum.
A small sinus is formed between the trachea and the pericardium. Strangely, there is also a channel in the small sinus that leads to the chest cavity.
During the transfer, the patient had a small amount of pneumothorax, which could be explained by this. Because the patient was weak and had insufficient pulmonary ventilation, there was no large amount of air-liquid pericardium.
However, during general anesthesia, along with mechanical ventilation, the patient's ventilation volume increases, and part of the gas enters the pericardial cavity, forming a gas-liquid pericardium.
There's nothing special about his condition, at least that's what Zheng Ren seems to be seeing. But this patient... The successive surgeries were like facing the missing God of Death in Death Comes.
Such a complicated hernia eventually led to the appearance of gas-fluid pericardium. Zheng Ren said that this was the first time he had seen it.
Even in the numerous medical journals and papers, there is no mention of relevant cases.
But as long as the problem is found, the subsequent surgery is not difficult. It is just to remove the sinus tract and eliminate hidden dangers.
"Boss Zheng, this patient is really dying." After repeatedly flushing the chest, no problem was found, and when he was about to close the chest, Fang Lin said with emotion.
"It's okay. Take the time to close your chest." Su Yun clamped the ribs on both sides with the closure device and began to tighten the screws to close the closure device.
Suturing is the most basic, but Su Yun seems to have not had a chest surgery for a long time, so he does not miss even this opportunity. The people studying next to me looked helpless, but they couldn't say anything.
Fortunately, there are a lot of 912 surgeries. If you are determined to do it, there is always no shortage of surgeries.
Coming here, the biggest problem is that my body can’t keep up. If every operation was performed, everything could be done on the operating table except for eating and sleeping.
Hidden dangers are eliminated and the atmosphere becomes relaxed. While talking and laughing, the anesthesiologist told Su Yun and Fang Lin about the mother who had just given birth.
Everyone unanimously judged that something was going to happen with a high probability. This kind of thing would kill two people, and the obstetrician would be in big trouble.
"When I was an intern, I met a family member who told the doctor that if it was a girl, the mother's right fallopian tube would be ligated by the way." Su Yun sneered.
"Uh... why?" Zheng Ren was stunned for a moment.
Should the fallopian tube on one side just be closed
"Because the male is on the left and the female is on the right." Su Yun said: "If the right fallopian tube is closed, you can give birth to a boy next time."
"..." Zheng Ren was speechless.
Although I have been in clinical practice for so many years, I still have a very absurd idea when I encounter similar patients and cases.
…
…
Diaphragmatic hernia complicated by air-fluid pericardium was mentioned in a case report in "New England" magazine, involving a patient from Argentina.