Chapter 887 Doctor Xu is awesome!
Xu Qiu also looked at it himself.
There were no visible problems with the liver under examination.
So... are there other reasons?
But now was not the time to dwell on this. Xu Qiu put aside other thoughts and concentrated on the artificial blood vessel replacement.
More than an hour later, the operation was over and the patient was out of danger.
The atmosphere in the operating room finally calmed down.
Shi Lian also breathed a sigh of relief and said doubtfully: "Teacher, there is one thing I can't figure out."
"explain."
“How does an abdominal aortic dissection rupture?”
"The cause is unknown, but it may be caused by high blood pressure."
The human body is very complex, and even Xu Qiu can only give the most likely guess.
Moreover, the saying "acute abdomen is the grave of a surgeon" is no joke.
Many doctors have fallen into the trap of acute abdomen. Clinicians become more timid and doubt their abilities.
This time it looked like ordinary acute appendicitis.
If Shi Lian had not discovered the hematoma and was not acutely aware of the problem, he would have had his appendix removed and his abdomen closed, and he would have been able to eat the next day.
…
The artificial blood vessel replacement surgery was over, and the cost of the surgery also increased by more than 20,000 yuan.
Before closing the abdomen, Xu Qiu conducted another detailed investigation.
No matter what the investigation was, another terminal ileal diverticulum was discovered.
Fortunately, no necrosis occurred.
Xu Qiu casually put on a patch and stitched it inside.
Including the fleshy volcano wound on the abdomen, Xu Qiu also performed anti-infection treatment after debridement and sewed up the inverted T-shaped wound.
Compared with the previous ones, Xu Qiu's suturing skills were simply astonishing.
Even on the layers of fat, he accurately brought the edges of the injury together.
However, Pang Honggu's sutures are different from those of ordinary patients.
Like many postpartum women, in order to pursue a beautiful effect, Xu Qiu often chooses to hide sutures in the skin texture and overlap them with the folds of the abdomen.
Doing so can, firstly, minimize the traces of sutures, and secondly, it can also reduce damage to muscles and speed up recovery.
However, Pang Honggu is different.
She was too old, her metabolism was too slow, and she was very slow to repair damage to her body.
Coupled with age, the aesthetic requirements for sutures are almost zero.
If you continue to hide the sutures in the skin folds, a large amount of sweat, as well as stuffy heat that is not easy to spread, may cause the sutures in the skin folds to breed bacteria and cause infection...
After many considerations, Xu Qiu gave up the pursuit of beauty and chose to sacrifice beauty and replace it with absolute restoration effects.
However, even so, there was no obvious hole in the abdomen after the sutures were completed.
Compared with the shocking flesh volcano wound before, it is much better now.
After completing these, the flap repair surgery follows.
The operation was originally scheduled for the next two days. Xu Qiu's plan was to resolve the dangerous acute appendicitis first and then deal with the ulcer on the thigh.
But now that we are on stage, and the anesthetic is still within the range of effectiveness, we simply merge the two surgeries.
For other burn doctors, it is difficult to treat the wound where the skin on half of the buttocks is damaged.
But Xu Qiu is not among them.
Having trained many times in simulated operating rooms, he had long ago found the most suitable distraction plan.
By the time Xu Qiu returned from washing her hands and disinfecting before surgery, the assistant had completed thorough debridement.
Xu Qiu took the opportunity to take over the stall, cut down with one knife, and freed the skin flaps on both sides.
Suture the wound on the right hip according to the design, then change the 1-0 suture to sew the right gluteal muscle and cover the exposed fascia of the sacrococcygeal area.
After the skin flap is covered and stretched, a drainage tube is placed and suturing is completed.
For Xu Qiu, this is considered a minor surgery.
In less than half an hour, the stitching was done perfectly.
A room full of surgeons were stunned.
How can such a huge defect be saved?
What a miraculous skill!
"Doctor Xu 666!"
"Doctor Xu is so annoying!"
"Dr. Xu, hang up!"
"???"
The operating room suddenly fell silent.
Everyone was silent, leaving only the little nurse who had made a mistake and lowered her head, her face turning into a red scarf.
The traveling nurse glanced at it and smiled contemptuously.
Such a young bird dares to imitate some glib surgeon!
Go get acupuncture for two more years!
After three hours and twenty minutes, this dangerous operation was finally over.
The patient's life was saved.
The operating room erupted in cheers.
Everyone looked at Xu Qiu. Some applauded, some clenched their fists, and some crossed their legs. In the eyes of a thousand little nurses, Xu Qiu could be seen in a thousand postures.
"Not bad." Xu Qiu glanced at Shi Lian and praised her performance this time.
If it weren't for Shi Lian's solid basic skills and strong overall ability, the result this time would be unimaginable.
"Old, old, old teacher! Who is better, senior sister or me?" Shi Lian looked like he was begging for praise, his eyes full of expectation.
Xu Qiu thought for a while and gave a straight man's answer: "Not really good."
Shi Lian's little mouth suddenly pursed, with a look of grievance on his face.
The doctors and nurses around him quickened their pace, lowered their heads and left in a hurry.
There is no way to get into this class...
Even if Shi Lian can beat them, what do they think?
Waste utilization?
mmp, is this the world of bosses?
…
After declining the difficult kneeling gesture from his family to thank him, Xu Qiu slipped back to the office.
As soon as he sat down, he called up Pang Honggu's medical records.
At this time, several new examinations had been completed.
One was a CT scan of the sacrum and coccyx.
The examination showed that the physiological curvature of the sacrum and coccyx was normal, the vertebral columns were continuous, and the morphology of each vertebra and appendage was normal...
However, the soft tissue of the posterior part of the sacrum and coccyx was swollen, the density increased, and the edges were irregular.
The right femoral head also became flat, the central density increased, and broken bone fragments were visible. The right femoral head and femoral neck were obviously separated and displaced, and the bone on both sides of the edge also showed signs of sclerosis. The femoral neck became shorter and thicker, and the bone cortex was not continuous...
The imaging doctor gave a diagnosis.
1. Poor healing of right femoral neck fracture, secondary right femoral head fracture, accompanied by hip subluxation, or possible traumatic arthritis;
2. Degenerative lesions of right hip joint;
3. Swelling of soft tissue behind the sacrum and coccyx, consider pressure sores;
4. Sclerosis of bilateral common iliac arteries, external iliac arteries and internal iliac arteries;
5. ...
Seeing this diagnosis, Xu Qiu's eyes lit up slightly, and the clues in his brain suddenly connected.
The iliac artery actually has signs of sclerosis!
No wonder the patient had abdominal aortic dissection rupture during the operation...
The blood vessels of ordinary people are like soft and elastic rubber tubes, which can withstand a certain impact force, even the blood flow impact under high blood pressure.
But Pang Honggu's blood vessels are close to rubber tubes that have been exposed to the sun for 180 days. The surface has cracked and hardened. It is estimated that they will break into pieces if pulled casually.
Under the multiple stimulations of high blood pressure, anesthetic drugs and pain, it is not surprising that they rupture quickly in a short period of time.
...
Other diagnostic aspects.
Poor fracture healing was expected. The good news was that the patient only had a tibia fracture, which had not yet reached the stage of necrosis.
If it was the latter, it would be troublesome and he would have to do it himself.
It was just a lower fracture, and he could arrange for the orthopedic surgery department to handle it. This kind of minor surgery was far from requiring Xu Qiu to do it himself.
"However, this kind of fracture is a bit ambiguous..."
