Chapter 346 Vice Spleen?

Because the family members and the patient themselves reported that they had no history of close contact, they could not perform the most appropriate vaginal ultrasound. Zheng Ren could only do abdominal ultrasound.

Although it's a bit worse, Zheng Ren has the big hoof of the system.

It's just that Zheng Ren couldn't believe the diagnosis given by Big Pig's Trotter this time.

Vice spleen torsion...

This diagnosis... If the patient had upper abdominal pain, Zheng Ren would probably believe it right away. But the patient had pain in the lower abdomen, so Zheng Ren cautiously prepared to do a B-ultrasound examination by himself.

The uterus and bilateral ovaries were normal, and a mass with a diameter of about 5 cm was seen next to the left ovary.

It seems that the difference is here.

Zheng Ren held the B-ultrasound probe in his right hand, and pressed the patient's abdomen with his left hand.

When pressing, Zheng Ren noticed that the tumor was separated from the ovary, and several thick blood vessels could be seen inside.

Zheng Ren agreed with the doctor in the B-ultrasound room, although the physical examination looked like an ectopic pregnancy.

"Where's the family?" Zheng Ren asked.

An anxious middle-aged woman stood up next to her and hurriedly asked, "Doctor, how is my daughter?"

"The source of the tumor is unknown, and surgical exploration is required." Although Zheng Ren had made up his mind, he still cautiously described it in broad terms, "Preparing for hospitalization and surgery."

The middle-aged women's sweat came down immediately.

Ordinary people are not afraid when they hear that surgery is going to be done.

Stories about the death of patients after appendicitis surgery are widely circulated among everyone. Although the probability is very low, it makes people feel afraid of surgery.

"Mr. Zheng, call me during the operation, and I'll go take a look." The head of the gynecology hospital was very happy to see that the emergency department took over this tricky job.

But she is very interested in the diagnosis. She doesn't think her diagnosis is wrong, but what the B-ultrasound doctor said is also reasonable, so she is going to find out.

Under normal circumstances, doctors hate such operations as laparotomy and thoracotomy the most.

Because after opening, no one knows what's inside.

It requires rich clinical and surgical experience to solve some unexpected symptoms.

If one is not careful, the consequences are unpredictable.

So the gynecology department did not insist on being hospitalized. Anyway, it was just an investigation. If an ectopic pregnancy was found, it would be done directly.

She followed, not only to see what happened, but also because she was afraid that Zheng Ren had no experience in ectopic pregnancy surgery.

Now Zheng Ren has a very high reputation in the gynecology department because of the trouble caused by the doctor. Although the inpatient of the gynecology department disagrees with some of Zheng Ren's diagnoses, he still wants to help him out.

Zheng Ren didn't care, so he nodded.

Zhong Min from the internal medicine department was on duty today, Zheng Ren notified Yang Lei to come over for surgery while walking, and then called Chu Yanzhi to come over.

He didn't know how the two sisters of the Chu family arranged shifts, anyway, he just called one of them.

Take the patient to the emergency ward and prepare for surgery.

Zhong Min is responsible for picking up patients, asking about medical history, and writing various written materials. Zheng Ren seized the time to explain to the patient's family before the operation.

No matter what kind of diagnosis, it is an emergency department, and time is precious.

The patient's mother signed her name on the operation consent form while wiping away tears.

After signing this side, the nurse has placed a gastric tube and a urinary tube.

Yang Lei's home was a little far away, so Zheng Ren and the patient's family members directly pushed the patient to the operating room.

When it was sent to the operating room, Chu Yanzhi had already arrived, several people worked together to move the patient to the operating table, and Zheng Ren went to change clothes.

It took ten minutes to prepare for the operation anyway, because the anesthesia procedure was relatively cumbersome, and Zheng Ren was not particularly in a hurry.

Vice spleen? Zheng Ren kept thinking about the diagnosis given by the system.

In terms of tissue culture, the accessory spleen is caused by the failure of the fusion of the spleen primordium located in the dorsal mesentery of the stomach at the 5th week of the embryo.

Clinical diagnosis is difficult.

On CT scan, the accessory spleen is generally a smooth-edged, homogeneously enhancing mass less than 2 cm in size. MRI scan shows a feeding artery originating from the splenic artery entering the accessory spleen.

B-ultrasound can only be used as an aid, and it cannot find the branch of the splenic artery feeding blood vessels like MRI plain 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 various examinations. Therefore, we can only choose a laparotomy to solve it.

After Zheng Ren changed into the isolation suit, he called the medical office and asked colleagues from the pathology department to come overtime.

If it is the accessory spleen in the upper abdomen, there is no need for this.

But it occurs 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 tumor tissue, which is supplied by a branch of the splenic artery, only pathological diagnosis can be confirmed.

Zheng Ren had already explained this point to the patient's mother in detail.

And because of this possibility, Zheng Ren couldn't do laparoscopic surgery.

The accessory spleen could not be removed because of the small hole in the laparoscopic surgery. If it is smashed and taken out, once it is tumor tissue, a large number of implants and metastasis will occur, causing the tumor to directly enter the advanced stage.

After everything was considered carefully, Zheng Ren came out of the dressing room, called the gynecological inpatient, and began to brush his hands to prepare for the operation.

Chu Yanzhi was alive and kicking, the patient had been anesthetized, and she was chatting with Xie Yiren.

In fact, it was a chat, mainly because she was talking, Xie Yiren was busy preparing the surgical equipment, and at the same time agreed.

She asked where Xie Yiren had gone and why he didn't come home, but she didn't notice the slightly awkward silence of Xie Yiren and Zheng Ren.

The girl with thick lines is the complete opposite of Chu Yanran.

I don't know if it's because all the delicate thoughts of the identical twins fell on Chu Yanran's side.

Yang Lei hadn't arrived yet, and Zheng Ren didn't wait for him. After brushing his hands, he sanitized directly, laid the sterile sheet, and prepared to start the stage.

It's no big deal to do surgery alone, Zheng Ren has long been used to it.

The shadowless lamp was brightly lit. Zheng Ren glanced at the operation area. Considering the patient's age, he hesitated a bit. Finally, he made an incision on the left side of the rectus abdominis close to the middle and lower abdomen, about 8 cm long.

The incision is a little long because the source of the blood vessel must be detected during the operation.

If the incision is too small, the mouth must be extended during the operation.

The skin is incised, and the subcutaneous tissue, fat, and all the way to the peritoneum are bluntly dissected.

The patient is relatively young, and the fat layer is not thick, so the operation is easy to do.

At this time, the gynecological hospital always rushed over.

Seeing Zheng Ren doing the operation alone, she asked, "Mr. Zheng, shall I go on stage?"

"No, Yang Lei will be there soon." Zheng Ren put on a protective film and opened the abdominal cavity directly.

Seeing the opening of the abdominal cavity, the gynecological hospital manager stopped talking, but concentrated on watching the operation.

The large retractor pulled apart the skin and muscle tissue of the lower abdomen, and Zheng Renhe's gynecological hospital always found the source of the pain in the patient's lower abdomen - a dark red soft tissue next to the ovary.

It's just that the dark red is a little darker and a little black.