Pay it forward! Pay it forward! "How much did this kid eat!" Zhang Fan could keep silent during the surgery, but this was too suffocating. Zhang Fan took advantage of the opportunity to exhale the unpleasant gas while he was talking.
"Yeah!" The director of general surgery just nodded and barely responded.
"Pliers!" Suddenly, Zhang Fan said to the instrument nurse, because he discovered the intestinal stump during the removal process.
"Clamp directly?"
"We can only clamp it directly, there is no other way." Zhang Fan replied.
The structure of the human body is like a closed ring. The left heart pumps oxygen-rich blood into the aorta, and then relies on the strong heart power and the elasticity of the arteries to spread the arterial blood throughout the body.
The aorta first divides into two parts, one goes to the head, and the other goes down to the abdominal cavity. When an organ is encountered in the abdominal cavity, one branch is separated.
Finally, it becomes extremely small arterioles, and then these arterioles slowly develop into venules. These veins begin to converge, and finally enter the right heart, enter the lungs to exchange carbon dioxide, and then enter the left heart.
Human blood circulation is probably like this. Especially after reaching the intestines, the blood vessel branches are extremely thin, almost like balls of wool.
According to conventional intestinal surgery, the blood vessels attached to the intestine must first be separated and ligated before subsequent operations, such as appendix surgery, can be continued.
The difficulty in appendix surgery is not its location. No matter where it is hidden, you can find the cecum and follow the cecum to pull it out. The difficulty is the artery on this cecum. If the ligation or separation is not done well, hemorrhage may result and death may result.
"I can't save it. The rectum and sigmoid colon have been turned into rotten cotton wool!" Zhang Fan sighed after cleaning the intestinal contents in the abdominal cavity. The young man was young and it was delivered in time. If it had been a little later, everyone would probably be gone.
"It's good if you can save your life!" The director of general surgery was not surprised at all. From what Zhang Fan took out, he could see a large amount of intestinal tissue, piece by piece.
This is like putting a big firecracker directly inside the chrysanthemum, and then the intestines really bloom.
Although the two occasionally communicated, they were not idle at all. The cooperation was quite tacit and the speed was relatively fast. After the pliers clamped the intestines, the blood pressure finally improved.
"It's not easy!" Zhang Fan took a long breath. This special smell was mixed in the air. It was like eating haggis in a small, airtight room on the hottest day of summer. The offal hasn’t been washed yet~!
Outside the operating room, Ms. Jiang was on the phone. No matter what, she had the responsibility to explain the situation clearly to her sister.
"Sister, something happened to Xiaoguang! Don't worry, he has been sent to the hospital. But the situation is quite critical."
"What's going on? Did he get into a fight again or drive fast!" A mother knows her son too well.
Ms. Jiang was too embarrassed to open her mouth to talk about this, so she directly said, "Your son is playing the trumpet!" It was estimated that her sister would be pissed to death. Her tangled tone made her sister even more anxious.
"Come on, give it to me!" Ouyang called over the phone at the right time. "Hello, I am the director of Chasu City People's Hospital. Your son is undergoing surgery due to intestinal rupture."
"How did it break~!"
"While swimming, my buttocks may have accidentally faced the rejection duct, and the intestinal tract was damaged due to the strong suction." Ouyang thought for a while and reported it in the most concise language.
"How is the situation now, doctor?"
"It's very dangerous. It may cause severe bleeding..., so please ask your immediate family members to come to the hospital as soon as possible."
The other party was speechless and hung up the phone. It’s too embarrassing to ask anyone for this matter. Parents know their children best. If the government hadn't repeatedly emphasized the need to pay attention, Ouyang wouldn't have rushed here. What the hell? After hanging up the phone, Ouyang thought about what was wrong with this child and couldn't help but tilt his mouth.
In the operating room, "What is the difference between this operation and rectal cancer?" After Zhang Fan cleaned the abdominal cavity, the director of general surgery said after looking at it.
"Rectal cancer is not that dangerous, but fortunately there is no need to clean up the lymph nodes." Because the suction power of the swimming pool is so strong, the rectum and sigmoid colon can no longer be seen.
The anus, rectum, and sigmoid colon were as if they had been bitten by the flat-headed brother, and the internal damage was terrible.
To stop bleeding, clamp the superior rectal artery, look for the sigmoid enteric artery, and also look for the middle rectal artery. To be honest, the messy intestines are so difficult to find.
The intestines are not very sensitive to cutting or temperature. In other words, if you scratch it with a knife, it will break at most, but pulling it will not work.
After this thing is stretched a few times, the intestines will feel unsafe, and then it will suffer from intestinal paralysis, that is, it will stop moving, which will directly lead to obstruction.
Therefore, Zhang Fan did not dare to disturb the intestines too frequently. He could only slowly search for all the places where arteries should appear. The regular tissues had been sucked out of shape.
This operation was very difficult for Zhang Fan. The tissue relationships were broken into pieces, and the blood vessels that were originally like spider webs became even more difficult to ligate.
"If that doesn't work, just ligate the inferior mesenteric artery from a high place, and then ligate the middle mesenteric artery that branches off the internal iliac artery from a high place to create a fistula." The director of general surgery looked at Zhang Fan's troubled look and suggested that .
"I want to keep a little more of the sigmoid colon, if it's too little..."
"Now the blood vessel clamping time is no longer short. If you hesitate any longer, intestinal necrosis may occur after the operation." Director of General Surgery Zhao Pingquan said through gritted teeth.
There is a reason why Zhang Fan wanted to keep a little more of the sigmoid colon. Here we will talk about the function of this large intestine. The large intestine consists of the ascending colon, transverse colon, descending colon, and sigmoid colon, and roughly surrounds the abdomen.
The place where the large and small intestines connect is the cecum. The digested food in the small intestine contains a large amount of water and is a chylo-like pasty liquid. After entering the large intestine from the cecum, the water begins to be absorbed until the sigmoid colon reaches the chylo-like liquid. It will be formed into feces.
If the damage to the large intestine tissue is too severe, something terrible will happen. The water cannot be completely absorbed, so the patient has to excrete a large amount of feces and replenish a large amount of water, otherwise dehydration symptoms will occur. In other words, the toilet cannot be separated and the kettle cannot be turned on.
The reason why it is difficult to perform surgery is because it must be dealt with based on basic knowledge and combined with the specific situation. Generally, there are not many variables in surgery, but once there are variables, the difficulty will increase by an order of magnitude.
I want to keep my intestines longer, but time doesn’t allow. If the patient is not kept for a long time, the quality of life of the patient will be lost in the future. Zhang Fan hesitated.
"We can no longer hesitate. If we hesitate any longer, if large areas of intestinal necrosis occur, the issue will not be a matter of length, but a matter of life and death."
"Ligate!" Zhang Fan made up his mind. He had no choice but to avoid the vital point and give up the relatively unimportant organization. Because blood vessels fill poorly due to bleeding, many arteries, like veins, fluctuate very weakly.
"Procaine is diluted." Since he decided to have a sterilization, Zhang Fan stopped worrying and decided to stay alive first. The mesenteric artery has poor ripples, and infusion of procaine enhances its ripples.
The blood vessels were tied off one by one. Two hours have passed since pieces of intestinal tissue were cleaned.
