Chapter 521: 【521】Quick preoperative judgment

   Chapter 521 [521] Quick preoperative judgment

   This is the first time the two of them have met again since Xiao Yazhi's surgery that day when the envelope was dropped.

   Xie Wanying's attention falls on the patient.

   Heart rate is 126 beats/min, blood pressure is a little low, and it is estimated that there are signs of intestinal incarceration. Xie Wanying speculated.

   Soon, Dr. Liu Chengran arrived at the hospital.

   "Bring the CT film." Liu Chengran, who walked into the operating room, commanded.

  All kinds of preoperative patient information are submitted.

   Liu Chengran checked the patient's information and asked Xie Wanying: "Tell me, what's the condition of this patient?"

In the evening, the emergency teacher's torture made people nervous. Xie Wanying quickly explained her understanding of the case: "The initial diagnosis of paraduodenal hernia PDH. This disease is very easy to be misdiagnosed and missed, so the patient's symptoms were not obvious before in other hospitals. No medical treatment was found. This time, the patient's symptoms were aggravated due to strenuous exercise after eating and could not be relieved by drugs. The family members urgently sent the patient to our hospital for emergency help, and there was no major obstacle in the diagnosis after CT. The para hernia is divided into left and right sides. From the CT results, this patient should be on the left side, and the jejunum enters the Landzert recess. On CT, a slightly obvious sac between the pancreas and stomach can be seen in the upper abdomen Sexual loops."

   "How do you think this operation can be done?" Liu Chengran continued to ask her.

"The patient has symptoms of intestinal obstruction, vomiting, intestinal volvulus, and intestinal strangulation and necrosis are not excluded. Digestive endoscopy cannot enter, so a laparotomy is needed. The incision is made from the midline of the abdomen, and the intestinal tube in the hernia sac is taken out and given Correction, close the hernia ring. I hope that the bowel has not ruptured and necrotic, otherwise it will be peritonitis. Now the patient has no peritonitis symptoms for the time being, and this operation should be done as soon as possible."

   Listening to her quick and steady answer, Liu Chengran determined that Tan Kelin's order could be executed, and ordered: "You do it."

  What did the teacher say? It was so sudden that the students couldn't react.

   Liu Chengran waved his hand: "Go wash your hands, you will be the chief surgeon in this operation tonight."

  Li Qi'an took a deep breath: What? ! Didn't you hear that the surgical student tried to perform an appendicitis operation as the main surgeon?

  Appendicitis? If the exploratory laparotomy for appendicitis is basically severe diffuse peritonitis, their attending treatment may not be able to save this kind of patient. The elective appendicitis surgery is now all laparoscopic, so where can I give the intern a chance? Interns learn to do traditional laparotomy first to lay a solid foundation, and then do laparoscopy.

   Now there is such an opportunity to give the interns a try. After this store, there is no next one.

  Is this operation difficult? It's not necessarily much more difficult than the appendicitis that I used to practice for the interns. In fact, the previous appendicitis surgery was quite difficult, and some interns had to go in and find the location of the appendix for a long time. For surgical interns, how to quickly find the lesion site is a threshold. The intern needs to connect the imaging film with the thinking experience of the actual anatomical position of the various organs in the patient's abdomen.

   You can take it for granted, but the actual operation is another matter. Otherwise, why do seniors often say that juniors are superior and inferior. You can speak eloquently, but every move is rotten.

   "Didn't you do it with your teacher Sun?" Liu Chengran said to the students.

   In an operation case done by Mr. Sun before, she found a paraduodenal hernia and dealt with the hernia, and she was fortunate to participate in it. She had the impression that she had a better idea of ​​how to proceed with this procedure.

"Do!"

   (end of this chapter)