Chapter 1166 Aged Old Bottle (28500 Plus Change × 14 Ask for a Monthly Ticket)

"Dangdangdang~" Zheng Ren gently knocked on the door of the consultation room, heard the voice of Mr. Cui inside, and pushed the door in.

"Xiao Zheng, you're here so early." Cui Lao was studying an X-ray film with all his heart and pushing the flower mirror.

"Well, I came over as soon as I stepped down." Zheng Ren smiled honestly and leaned over.

"It's not good to not eat. When you reach my age, you will feel uncomfortable." After Cui Lao finished speaking, he pointed to the film and asked, "Tell me, what do you think."

Zheng Ren was silent.

The film in front of me, the image is incredible. A broken glass bottle was in the rectum, and the tip punctured the rectum. The bone surface at the lower end of the ischium was damaged, especially the pubic symphysis. The bone surface was eroded and the degree of damage was about 90%.

The sharp part of the bottle reaches the gluteus medius muscle backwards, and the surrounding organic tissue is wrapped. Diffuse inflammatory lesions occur in the perirectal area where the foreign body is located, and atrophic steatosis occurs in the right lower extremity muscle.

Zheng Ren saw a lot of rectal foreign bodies in the emergency department, and most of them were wine bottles, steel pipes, massage sticks, and mousse bottles.

But usually, I went directly to the hospital for treatment at that time, and when I took it out, I took it out. Except for a little embarrassment, it was nothing.

This case is different.

Severe inflammatory changes and wear and erosion of the bone at the pubic symphysis, as well as the surrounding adhesion tissue mean that the foreign body has not been removed for a long time.

Is this abuse? Or something else?

Zheng Ren's brows furrowed unconsciously.

"The patient began to describe the unknown medical history, but later, through repeated inquiries by Xiao Zhou, he learned that it was five years ago when he and his girlfriend drank too much and had fun, and stuffed a beer bottle into the rectum. Because of my embarrassment, the patient I'm also more introverted, so I didn't come to the hospital to take out the foreign body." Cui Lao slowly mentioned the patient's medical history while watching the film.

Uh... As soon as Zheng Ren sketched the picture of the injury at that time in his mind, he felt extremely strange.

Are you introverted? I didn't see it.

But this has nothing to do with Zheng Ren. What he has to consider is how the patient should be treated. As for answering Lao Cui's words, to make the atmosphere in the consultation room less awkward, Zheng Ren didn't realize it at all.

Before she knew it, her left hand had reached her right armpit, her right hand was resting on her cheek, and she was staring at the X-ray film.

Cui Lao was not angry because Zheng Ren didn't speak, and he continued to introduce his condition.

"The patient complained of lameness for 1 month and weakness of the right lower extremity, which is considered to be caused by disuse fat changes. This visit was due to fecal incontinence and watery stools, and he came to the emergency department of our hospital for treatment."

"Where's the patient?" Zheng Ren asked.

"I have a CT of the lower abdomen and pelvis. I think the patient should undergo surgical treatment, and the treatment is very difficult, so it is better to check in detail." Old Cui said, "Xiao Zheng, look at this X-ray, right? Any ideas for surgery?"

"Like radical rectal cancer surgery, both the colon and anus should be left out of the way for double surgery, and a second-stage operation will be performed after the recovery is better." Zheng Ren said.

Old Cui nodded slightly, this was what he could think of.

It's just that the difficulty of the operation is definitely not something that can be described in such simple words.

The patient's rectal foreign body is too long, so that the foreign body is highly organized and wrapped in the body. If you want to clean it thoroughly, you will definitely lose a lot of blood.

This operation is a great test of the surgeon's surgical technique.

Once the operation is slightly rougher, there may even be a possibility of a large area of ​​oozing blood but no bleeding vessels can be found.

All capillaries were coagulated with electrocautery, and postoperative healing and rebleeding became a big problem.

The surgery needs to be very meticulous and requires extremely high manipulations.

Zheng Ren's brain began to run at a high speed, analyzing X-ray films, performing 3D reconstruction, and judging the direction of blood vessels, capillary branches and related body tissue locations.

Even with the passive skills of reconstruction, Zheng Ren still felt that the operation of this patient was so difficult that it almost reached the sky.

As time passed by, Zheng Ren repeatedly reconstructed in his mind, trying to find a reasonable path to enter as much as possible. To minimize damage, but also to achieve the purpose. But even with Zheng Ren's ability, it is difficult to solve this problem in a short time.

Soon, Zhou Litao knocked on the door, "Cui Lao, the patient just came back from the CT scan."

Old Cui nodded, stood up and said, "Xiao Zheng, let's go see the patient."

Zheng Ren looked at the X-ray, and the glass bottle in his rectum looked so dazzling.

Accompanying Mr. Cui to the emergency room, the patient was lying on his stomach on the flat car. It's a young man who looks young, only 23 or 4 years old.

He was accompanied by a girl, wearing a plain plaid dress, shawl hair, simple and clean.

"Li Mingchao, right?" Cui Lao asked.

"Doctor, I'm not going to die." The young man was lying on the flat car with a look of panic.

"Examination first, then send to Gastrointestinal Surgery. Xiao Zhou, call the Gastrointestinal Surgery Department and reserve an emergency bed." Cui Lao did not answer the patient's question, but said to Zhou Litao.

"Doctor, are you alright?" the girl asked anxiously.

"How can it be okay?" Zheng Ren stood between Cui Lao and the girl, and said lightly, "Why did you come here with such a serious injury?"

"..." The girl concluded, she was a little timid, a little embarrassed, a little tangled, and tears fell crackling.

Zheng Ren was speechless, at this time the girl's cry made him helpless.

"Are you from the Imperial Capital, or are you working here?" Zheng Ren asked.

"Work here after college," said the boy.

"Are you married?"

"Nope."

"Notify the family, hurry up and come here." Zheng Ren said: "The condition is very serious and a major operation will be required."

"Don't..." The boy endured the pain and said, "I... that... sign the operation so that my girlfriend can come."

"For such a high-risk operation, immediate family members are required. You are not married, you can't sign, and no doctor dares to perform such an operation." Zheng Ren said.

Just watched the film, Zheng Ren has a basic judgment on the condition. Even if you operate on the stage yourself, there will be a lot of intraoperative bleeding.

It's entirely possible that you can't come down to the stage.

"doctor……"

"If you don't sign, no one will dare to do the surgery. If you don't do the surgery, you will definitely not be fine for another five years." Zheng Ren said firmly.

Suddenly, the patient and his girlfriend were in a panic.

They fell silent, Zheng Ren watched Cui Lao's physical examination, and the patient's physical examination sent a letter that his abdomen was soft, without tenderness, and no rebound tenderness. The perianal fistula and anal sphincter tension were significantly decreased in digital rectal examination, and the lower end of the foreign body could be obviously touched.

Zheng Ren sighed and shook his head slightly.

...

Note: The case was reported by Dr. Mucahit Ozbilgin in International Journal of Surgery Case Reports. Listening to the case mentioned by my brother, it is really tiring to find information.