Chapter 959 Patch Repair

After all, it was not an operation performed by oneself, and the condition of the patient's chest and abdomen could never be guessed based on the operation records.

Zheng Ren met such a patient when he was in the general surgery department of Haicheng No. 1 Hospital.

After caesarean section, the patient suffered from sudden massive bleeding. The doctor at the township hospital performed an emergency laparotomy and found that during the caesarean section, the spleen was punctured for some reason.

This is proper medical malpractice, but the bizarre things don't stop there.

Emergency splenectomy was performed, and the patient found dyspnea again after the operation. So I checked the lung CT and found left diaphragmatic hernia, pneumothorax, and lung tissue compression.

The director of the township hospital panicked and rushed the patient to the No. 1 Hospital in Haicheng City.

For them, Haicheng No. 1 Hospital is their higher-level hospital and their heaven.

Liu Tianxing had a good relationship with the director of the township hospital, so he saw the patient and wiped his ass.

On examination, a large pneumothorax was found in the patient's left chest cavity.

I came to the stage together with the chest department, and found that when the patient underwent splenectomy, a hole in the diaphragm was somehow broken, and the lung ruptured.

After a while of repairs and sutures, the patient was finally discharged from the hospital half a month later.

The level of doctors in the township hospitals is really not flattering, just like the doctors of the large tertiary hospitals in the imperial capital and the Shanghai city examine the No. 1 Hospital of Haicheng City.

This is a gap in technical level, and there is absolutely no way around it.

Zheng Ren still can't figure out why a caesarean section can break his spleen. Why cutting a spleen can cause lung rupture and diaphragm rupture.

This is just too scary.

It's really a joke to take your life to have doctors with low technical level on the booth. However, it is not realistic to expect all doctors to be of a high level.

This is also the main purpose of Zheng Ren's operation live broadcast room. Anyway, when something happens, he can do his best.

The situation of the patient in front of him was similar to that of the female patient who underwent caesarean section that Zheng Ren experienced, but the actual situation was different.

The moment Zheng Ren saw the film, he was sure that it must be a liver hernia.

This is caused by secondary injuries, there is no doubt, but it is not the doctor who made a low-level mistake that is embarrassing. It is because the disease of congenital retrosternal diaphragmatic hernia is relatively rare, and the patient is older and the diaphragm muscle does not work hard.

Zheng Ren made a judgment immediately.

Mr. Cui put on his glasses and began to read the film 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 all taken aback.

Director Zhang said with a smile: "Boss Zheng, the operation just now was really beautiful!"

"Thank you." Zheng Ren smiled and said modestly.

"It's good to do 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 have come, so it seems that there is no need for more reports.

Soon, after listening to the medical history, everyone began to study the film.

The condition of the patient is very bad. After two general anesthesia operations, his body has just improved after a week of recovery. However, liver hernia occurred again, and after a long journey, I arrived at 912.

After tossing for so long, even a body made of iron will have some problems.

For emergency surgery, it is a question of whether to perform thoracic surgery or hepatobiliary surgery.

No one is willing to accept a patient who has been cut badly, so Mr. Cui directly "invites" the directors of the two related departments to his office to avoid arguing with each other.

Of course, the emergency department has the right to directly push patients to a certain department, and that side cannot refuse to accept them. But it is a better choice for everyone to sit together, explain the truth in a friendly manner, and then go on stage together.

This matter was done extremely skillfully, but only seniors at the academician level had the confidence to bring the chief directors and emergency department directors of the two relevant departments over for a joint consultation.

Zheng Ren originally prepared salted fish.

The patient's condition is relatively clear, surgery, detailed exploration, and repair of the diaphragm are all that is needed. This kind of thing, I can't tell which director to accept it.

Anyway, with Mr. Cui here, is it a pleasure for me to be salted fish for a while?

However, his wishful thinking was quickly shattered, and none of the directors spoke, but looked at Zheng Ren.

"Xiao Zheng, tell me what you think." Cui Lao said slowly.

"..." Zheng Ren was puzzled. He looked left and right. Seeing that no one was talking to the two chief executives, he knew he had to say something.

On the one hand, Mr. Cui attached great importance to it, and on the other hand, the surgery for Gaucher's disease, which had just been completed, received Director Zhang's attention.

It's an honor to be a different person. But Zheng Ren knew how deep the water was, so he found it difficult.

Zheng Ren pondered slightly, and Elder Cui's eyes were whipped on Zheng Ren's body like a whip.

"Then I'll throw bricks and stones first, and briefly talk about my opinion." Zheng Ren pondered for a while, and said politely, "If there is something unexpected, I will ask the directors to give advice."

"The patient had atrophy of the right diaphragm due to congenital retrosternal diaphragmatic hernia and older age.

Moreover, because the primary hernia was too large and the course of the disease was relatively long, diaphragm dysfunction occurred after the operation. In addition, the en bloc resection of the hernia sac during the operation further weakened the function of the diaphragm and possibly damaged the surrounding tissues. "

"To sum up, I think the reason for the patient's liver hernia is that the hernia sac of the congenital retrosternal hernia was resected, resulting in excessive tension of the diaphragm, combined with pulmonary bullae, excessive tension of mechanical ventilation, and a large area of ​​the right diaphragm due to traction. tear."

"For surgical repair, it is best to use a patch to relieve the local tension. Do we have relevant patches in our hospital?" Zheng Ren asked.

"Hmm." Director Zhang nodded, and said, "I estimate the length of the tear to be about 15cm. I agree with Boss Zheng's analysis. If the operation is performed from the abdominal cavity, it will be obstructed by the liver, so it is difficult to obtain a surgical field. It is recommended For thoracotomy, we can help on stage.”

Thoracotomy has been the most common invasive procedure for hernia surgery, especially since excision of the hernia sac is more amenable to this procedure. The morbidity and mortality rate after laparotomy is considered to be the highest, and Director Zhang's statement is not wrong.

But Zheng Ren hesitated for a while, but finally remained silent.

"Xiao Zheng, what do you want to say?" Although Mr. Cui was wearing reading glasses, he knew everything clearly.

"I think Director Zhang is right. I think the key to the patient's surgery lies in the patch." Zheng Ren said, "The patient's diaphragm has a high probability of atrophy, so the tension is too high due to the resection of the hernia sac. There is a situation of being torn. The patch itself is more flexible than the diaphragm and can fully relieve the tension of the diaphragm.”

"Such a large mesh, the operation is a bit difficult." Director Li of the Thoracic Department pondered and said.