Chapter 1685 Boss Zheng, You Want to Kill Me

If I hadn't followed the director to the operation and saw the appendix cut out with my own eyes, I really suspected it was an ectopic appendix.

I don't know if Boss Zheng of the Imperial Capital of Ectopic Appendices has done it or not. This is a life-threatening operation. Once you can't find it, the helpless feeling on the operating table is enough to make people collapse.

The pain point was found, only tenderness, no rebound tenderness and muscle tension.

Percussion is also very standard. But nothing new, I do it myself.

auscultation……

After the physical examination, Zheng Ren restored the patient's clothes and turned to leave the ward.

"Boss Zheng, you..." Li Yong was a little nervous.

He saw that Zheng Ren's expression was neither sad nor happy, as if the victory was in his hands, and he seemed to be at a loss.

"Fill 5ml of Meilan from the urinary catheter, and draw the abdominal effusion after 30 minutes." Zheng Ren gave the doctor's order as he walked.

"Ah?" The little doctor was startled.

"If you can see blue liquid when pumping ascites, it proves that the bladder has ruptured. It may be caused by the rupture of the surgical scar many years ago." Zheng Ren said as he walked.

"..."

"Boss Zheng, this..." The little doctor felt a little incredible.

"Young man, the medical history and physical examination must be detailed and serious.

The medical records reflect that the patient's medical history collection, especially the past medical history, was not exhaustive when he was admitted to the hospital. For example, the patient had missed partial cystectomy due to bladder mass more than 20 years ago, resulting in missed diagnosis and mistreatment of important diseases. "Zheng Ren said very gently.

Although this little doctor is more attentive, but because he has worked in the town-level hospital for a long time, he has not paid attention to too many details. Zheng Ren also just reminded kindly, not scolding at all.

"When the first appendectomy was performed, it was found that the lesions did not match the diagnosis, the inflammation of the appendix was not typical, and the amount of fluid extracted was a bit large. Did you consider whether it was caused by other reasons?

No further exploration was made, and it is unknown whether there was a large amount of ascites at the time of the operation. It is estimated that there was a small amount of urine during the operation. But it didn't attract the attention of the surgeon, or you regarded the urine as exudation at that time. "

"..." The little doctor was sweating profusely.

"Third, the patient's abdominal distension became significantly worse after the application of diuretic drugs. I remember that you wrote this sentence in the medical record. As long as you think more about it, you will come to the truth." Zheng Ren smiled.

"The patient's renal function is fine. After using diuretics, especially 40mg of furosemide, 500-1000ml of urine will be excreted. However, the yellowish urine produced by the urinary catheter does not increase, which is the biggest problem."

"To sum up, I think it is a bladder rupture. Take the time to do the Merlin test. If the blue fluid is drawn out by abdominal puncture, you will be transferred to the urology department for surgery. The surgery is not too difficult, and the sutures are done."

"Boss Zheng, is it really?" Li Yong still felt unbelievable. He saw Zheng Ren's still a little green face, and he was a little confused.

"Huh? What's the truth?" Zheng Ren didn't understand. He had said it so carefully and thoroughly, how could he not understand it?

"I'll go right away." Seeing that Zheng Ren was about to leave, the little doctor gathered up his courage and asked, "Boss Zheng, I... can I leave you a WeChat?"

"Um?"

"I'll do abdominal puncture in half an hour. If blue liquid appears, I'll report it to you." The little doctor had an idea and found a reason.

Zheng Ren smiled.

He took out his mobile phone, opened the WeChat QR code for the little doctor, and the two added WeChat.

"You guys are busy, I'll go back and see Lao Liu." Saying that, Zheng Ren left by himself.

The level of diagnosis and treatment and surgery in Xilin Town is indeed the level of grassroots hospitals. Simple and rough, the pain in the lower right abdomen is appendicitis, and I don't think about it at all.

Differential diagnosis is not made, and abnormal situations are seen during operation and are not dealt with. After the operation... Sigh, I used furosemide, the urine volume was not much, and the kidney function was fine. I didn't notice such obvious points.

Forget it, it has nothing to do with him, Zheng Ren doesn't think about it anymore when he walks out of the general surgery ward.

Such a small medical record, now Zheng Ren does not use the system panel of the big pig's hoof at all. First go through the medical history, look at the laboratory test sheet and the course of the disease record, and then you can basically follow the clues to come to a conclusion.

It was obvious that the bladder was ruptured, and the ascites was urine. Zheng Ren finally used the system panel of the big pig's trotter to refer to it, and gave the answer with certainty.

As for the operation, simply suturing the bladder, Zheng Ren has no interest at all.

In addition to having to open the abdomen, this kind of operation is not even as difficult as appendicitis. And going to Xilin Town People's Hospital to rush for urology surgery is a bit too much.

Back in the ward, he wentssips with Liu Xuzhi about Li Yong's lover's condition, and Liu Xuzhi's lover came in with a lunch box.

She specially made hot soup hand-rolled noodles for Zheng Ren, and the noodles were particularly strong.

"Boss Zheng, if I go to the imperial capital and Lao Liu can't support his family, I'm going to find a small noodle restaurant to work." Liu Xuzhi's lover said.

"No, you can rest assured." Zheng Ren smiled: "Across the country, there are no more than 500 people who have performed better interventional operations than Lao Liu."

500, which is a big number.

In fact, Zheng Ren wanted to say 100, but it was just a TIPS operation. All things considered, 500 is relatively standard.

As a doctor, he can be ranked in the top 500 in the country, and the level of a group professor in a provincial hospital.

And Lao Liu's daughter-in-law was so worried that Liu Xuzhi almost died for 30,000 yuan.

It sounds ridiculous.

A handful of bitter tears.

Zheng Ren saw that Liu Xuzhi and his daughter-in-law had already made preparations for a last-ditch battle, so he did not persuade them much. When you go to the imperial capital, even if you have a high level, you have to work hard.

You can live by lying down...it seems that you can now.

A tenured professor at the Massachusetts General Hospital, with a salary of hundreds of thousands of dollars a month, can enjoy life in style.

Tsk tsk, I didn't even notice that I would come this far so quickly.

Seeing that Liu Xuzhi's body was fine, Zheng Ren ate the noodles in a big mouth, and asked Feng Xuhui to book the ticket after the meal, and returned to the imperial capital as soon as possible.

Xilin Town brought back Liu Xuzhi, and the matter was over.

After Lao Liu recuperates for a few days, he drags his family to the imperial capital, and then he can carry out large-scale embolization of the gastric fundus and left gastric artery.

Knock on him for a few operations to see how much Lao Liu can handle.

Zheng Ren already knew about his talent. It belongs to the middle class, and the height that Liu Xuzhi can reach in this life is not expected to exceed the level of Su Yunyanyi.

But as a human being, you can't compare yourself to Su Yun, Zheng Ren smiled.

Lao Liu estimates that it will not be too bad. After all, he can touch the threshold of TIPS surgery by himself, which is much better than most people.

Before the noodles were finished, a short, stout man knocked on the door and entered.

When he saw Zheng Ren, he immediately showed a flattering smile, stretched out his hands and said, "Boss Zheng, you want to kill me!"