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 patients.
The heart rate is 126 beats/minute and the blood pressure is a little low. It is estimated that there are signs of intestinal incarceration. Xie Wanying speculated.
Soon, Dr. Liu Chengran arrived at the hospital.
"Bring the CT scan." Liu Chengran walked into the operating room and commanded.
Submit various preoperative patient information.
Liu Chengran checked the patient's information and asked about Xie Wanying: "Tell me, what's going on with this patient?"
The emergency room teacher’s interrogation at night made people nervous. Xie Wanying quickly expressed her understanding of the case: “The preliminary diagnosis is paraduodenal hernia PDH. This disease is very easy to be misdiagnosed and missed, so the patient was treated in other hospitals when the symptoms were not obvious. No medical treatment was found. This time, the patient's symptoms worsened due to strenuous exercise after a full meal and could not be relieved with medication. The family rushed the patient to our hospital for emergency help. After taking a CT scan, there was no major obstacle to diagnosis. Duodenum Paralateral hernias are divided into left and right sides. Judging from the CT results, this patient should have occurred on the left side, with the jejunum entering the Landzert recess. On CT, you can see a slightly obvious bursa between the pancreas and stomach in the upper abdomen. Sexual intestinal 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, intestinal strangulation and necrosis cannot be ruled out. The digestive endoscope cannot enter, so a laparotomy is required. Incision is made from the midline of the abdomen, and the intestinal tube in the hernia sac is taken out and given Correct and close the hernia ring. I hope the intestinal tube has not been ruptured and necrotic, otherwise it will be peritonitis. Now the patient has no symptoms of peritonitis for the time being, so this operation should be performed as soon as possible."
Hearing her quick and steady answer, Liu Chengran was sure that Tan Kelin's order could be carried out and ordered: "You do it."
What did the teacher say? It was so sudden that even the students couldn't react.
Liu Chengran waved his hand: "Go and wash your hands. You will be the one doing the surgery tonight."
Li Qian took a deep breath: What? ! Didn’t you hear that surgical students tried to perform an appendicitis operation?
appendicitis? If appendicitis is detected by laparotomy, it is basically severe diffuse peritonitis, and even their attending doctors may not be able to save such patients. Elective appendicitis surgeries are now all laparoscopic, so where are the opportunities for interns? It is best for interns to first learn to perform traditional laparotomy surgery to lay a solid foundation, and then perform laparoscopy.
Now that you have such an opportunity, let the interns try it out. There is no next store after passing this one.
This surgery is not difficult, but it is not necessarily much more difficult than the appendicitis surgery that I used to practice on interns. In fact, appendicitis surgery was quite difficult in the past. 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 after opening the abdomen is a threshold. The interns need to associate the imaging films with the thinking experience of the actual anatomical locations of the various organs in the patient's abdomen.
You can take it for granted in your mind, but actually doing it is another matter. Otherwise, why do seniors often say that juniors have high ambitions and low abilities? He can speak clearly and eloquently, but his actions are all bad.
"Didn't you do it with your teacher Sun?" Liu Chengran said to the student.
Teacher Xiao Sun had previously performed a surgical case where she discovered a paraduodenal hernia and had to deal with the hernia. She was the first to participate in the operation. I have the impression that she knows the steps of this surgery relatively well.
"Do!"
