Chapter 346: Deputy spleen?
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Live Surgical Broadcast
- 真熊初墨
- 1317 characters
- 2021-03-01 08:54:58
Because family members and patients have no close contact history, they can't do the most appropriate Yin B-mode ultrasound. Zheng Ren can only do abdominal B-ultrasound.
Although it is a little worse, Zheng Ren has the system of this big pig hoof.
However, the diagnosis given by the big pig hoof this time made Zheng Ren can't believe it.
The spleen reversed...
This diagnosis... If the patient has pain in the upper abdomen, Zheng Ren estimates that he will immediately believe it. The patient is suffering from lower abdomen, so Zheng Ren is cautiously preparing to do B-ultrasound.
No abnormalities were found in the uterus and bilateral ovaries. A mass of about 5 cm in diameter was seen next to the left ovary.
It seems that the differences are here.
Zheng Ren held the B-ultrasound probe in his right hand and pressed his left hand on the patient's abdomen.
When pressed, Zheng Ren noticed that the tumor was separated from the ovary, and several large blood vessels were visible inside.
Zheng Ren agrees with the opinion of the doctor of the B-room, although the physical examination looks like an ectopic pregnancy.
"Family." Zheng Ren asked.
An anxious middle-aged woman stood next to me and hurriedly asked, "How is my doctor?"
"The source of the tumor is unknown and needs to be surgically explored." Although Zheng Ren has a fixed number in his heart, he is cautiously using a more general vocabulary description, "preparing for hospitalization and surgery."
The sweat of middle-aged women went straight down.
Most people have heard that they have to undergo surgery, and there is no fear.
A segment similar to the death of patients after appendicitis resection is widely spread among all people. Although the chance is very low, it has a fear of surgery.
"Zheng Zong, when the operation is called, I will go and see." Gynecological hospitalization always sees this tricky work in the emergency department, and I am very happy.
However, she is very interested in the diagnosis. She does not think that her diagnosis is wrong, but the doctor of B-ultrasound also makes sense, so she is going to see what is going on.
Under normal circumstances, doctors most hate laparotomy, thoracotomy and other types of surgery.
Because after opening, no one knows what is going on inside.
Need a wealth of clinical and surgical experience to solve some of the unexpected symptoms.
One is careless and the consequences are unpredictable.
Therefore, the gynecological hospitalization did not insist, anyway, it is a probe, if you find a disease such as ectopic pregnancy, it is done directly.
She followed, in addition to looking at the truth, but also afraid that Zheng Ren did not have experience in ectopic pregnancy surgery.
Now Zheng Ren’s reputation in gynecology is high because of medical treatment. Although the gynaecological hospitalization does not agree with Zheng Ren’s diagnosis, he still wants to help him.
Zheng Ren did not care, nodded.
Today is Zhong Min's Zhong Min duty, Zheng Ren walked and informed Yang Lei to come over for surgery, and then called Chu Yuzhi.
He didn't know how the two sisters of the Chu family were scheduling. Anyway, they just called one.
Take the patient to the emergency room and prepare for the operation.
Zhong Min is responsible for picking up patients, asking about medical history and writing various written materials. Zheng Ren took the time to give the patient's family a preoperative explanation.
Regardless of the diagnosis, it is an emergency, and time is precious.
The patient's mother, while wiping her tears, signed her name on the surgical consent form.
After the signing of the face, the nurse has left the stomach tube and the urinary tube.
Yang Lei’s home is a bit far away. Zheng Ren and the patient’s family directly pushed the patient to the operating room.
When he was sent to the operating room, Chu Yuzhi had arrived, and several people joined forces to move the patient to the operating table. Zheng Ren went to change clothes.
How to get preoperative preparation for ten minutes, because the procedure of anesthesia is rather cumbersome, Zheng Ren is not particularly anxious.
What about the spleen? Zheng Ren has been thinking about the diagnosis given by the system.
In terms of histochemistry, the accessory spleen is due to the failure of spleen primordium fusion in the dorsal mesenteric of the fifth week of the embryo.
Clinical diagnosis is more difficult.
CT scans of the spleen are generally less than 2 cm of smooth, evenly reinforced agglomerates. MRI scan showed that a feeding artery derived from the splenic artery entered the parasplem.
B-ultrasound can only be used as an aid. It is impossible to find the branch of the spleen artery to support the blood vessels like the MRI scan, and enter the tissue that may be the accessory spleen.
Because the patient is an emergency patient, there is no time or condition to complete the various tests. Therefore, you can only choose a laparotomy to solve such a procedure.
Zheng Ren changed the isolation suit and gave the medical office a phone call, called the colleagues in the pathology department to add a class.
If the upper spleen of the upper abdomen is not necessary.
But it happens in the pelvic cavity, the distance is very far away, and there is a possibility of tumor.
If you want to rule out that the tumor is a tumor tissue and is separated from the splenic artery, it can only be determined by pathological diagnosis.
At this point, Zheng Ren has already explained in detail to the patient's mother.
And because of this possibility, Zheng Ren could not do laparoscopic surgery.
Because the small hole of the endoscopic surgery can not remove the parasplem. If it is broken, if it is a tumor tissue, there will be a lot of planting metastasis, leading to a direct progression of the tumor.
Everything was considered carefully. Zheng Rencai came out of the locker room and went to the hospital for gynecology to get a call and began to prepare for surgery.
Chu Yu’s lively jump, the patient has been anesthetized, she is chatting with the Shei people.
In fact, it is chat, mainly because she is talking, and the Xie Yi people are busy preparing surgical equipment, and they are okay.
She asked the Xie Yi people where to go, why not go home, and did not notice the slight silence of Xie Yi and Zheng Ren.
The girl with thick lines is the opposite of Chu.
I don't know if all the delicate thoughts of the identical twins have fallen to the side of Chu.
Yang Lei has not arrived yet, and Zheng Ren does not wait for him. After brushing his hands, he will directly disinfect and lay out the sterile sheets and prepare to start the stage.
It is no big deal for a person to have surgery. Zheng Ren has long been used to it.
The shadowless light was bright, and Zheng Ren took a look at the operation area. Because he considered the patient's age, he hesitated. Finally, he took the incision near the left rectus abdominis near the middle and lower abdomen, about 8cm long.
The mouth is a bit long ~EbookFREE.me~ because the source of blood vessels should be explored during surgery.
If the mouth is too small, it will be extended during the operation.
Cut the skin, bluntly separate the subcutaneous tissue, fat all the way to the peritoneum.
The patient is younger and the fat layer is not thicker. The operation is very good.
At this time, the hospitalization of gynecology always came over.
Seeing Zheng Ren alone in the operation, she asked: "Zheng Zong, I am on stage?"
"No, Yang Lei will arrive soon." Zheng Ren made a film protection, directly open the abdominal cavity.
Seeing the opening of the abdomen, the gynecological hospitalization always stopped talking, but focused on the surgery.
The large hook pulled the skin and muscle tissue of the lower abdomen. Zheng Ren and the gynaecology hospital always found the source of pain in the lower abdomen of the patient - a dark red soft tissue beside the ovaries.
However, the dark red is a bit dark and some is black.