Chapter 962 Lucky or Unlucky

A family member raised his foot and kicked it. The obstetrician reacted quickly and avoided sideways, but he had to let go of the hand holding the flat car.

"As long as I've been here, you'll be responsible if something goes wrong!" The old lady pointed at the obstetrician's nose sharply and said, "You're shirking responsibility! You're saving lives, your conscience is eaten by dogs! "

"..." Zheng Ren was speechless.

"Don't send it away, it's still too late for the caesarean section. The time you mentioned is absolutely impossible!" The obstetrician didn't struggle with the old lady, and tried to grab the flat cart, but was pushed away by another person.

Seeing the elevator arrive, the flat car was pushed into the elevator, and the hustle and bustle at the door of the operating room gradually quieted down.

But, this is just the beginning.

Seeing that the dissuasion was ineffective, the obstetrician immediately called the director and the medical office, explained the situation, and hurriedly went downstairs to change clothes.

Yes, this is just the beginning. More troublesome things are yet to come.

The obstetrician and Zheng Ren walked across each other. Zheng Ren stepped aside and watched her leave in a hurry, feeling very helpless.

I don't believe what the big tertiary hospitals say, so I have to go to a private hospital or an underground black clinic to deliver the baby. The child has already shown symptoms of fetal heart instability, and has to wait a few hours to regenerate...

Sounds ridiculous, but it's the truth.

Zheng Ren shook his head. There are some things that cannot be solved by a high level of medical technology.

However, Zheng Ren had a certainty in his heart. This kind of matter is definitely not something that he can solve by himself. He can only look at it.

He found what Su Yun said was second-hand, opened the closed door, and walked in.

"Boss, what's going on outside?" Su Yun stood in the assistant's position, and an older doctor who was in training was pushed aside by him.

"What's the situation with the pericardium?" Zheng Ren didn't answer Su Yun's words, but asked instead.

"Qi-liquid pericardium, it's rare." Su Yun said with a smile.

Zheng Ren's heart skipped a beat, is it gas liquid pericardium? Why didn't the system give a diagnosis?

He glanced at the patient, the last item in the system panel was the diagnosis of air-fluid pericardium.

This is……

The patient is just so damn lucky! Zheng Ren thought about it.

Generally, pericardial effusion is more common, and the condition of traumatic nature is very dangerous. Zheng Ren met several times in Haicheng, and it was necessary to open the chest in an emergency, open the pericardium under direct vision, and decompress the pressure.

Pneumopericardium, however, is uncommon. Traumatic pneumothorax with pericardial tear without injury to the great vessels is a plausible source of pneumopericardium.

Another is the secondary injury caused by anesthesia intubation and mechanical ventilation.

Zheng Ren knew that when he was in the emergency department, there was no gas-fluid pericardium diagnosis on the system panel, but there was a diagnosis on the operating table, which may be caused by mechanical ventilation.

"Did you do it?" Zheng Ren asked.

"When repairing the diaphragm, the tension is particularly high."

"Boss Zheng, here we come." Fang Lin put down the needle holder in his hand and smiled back.

Zheng Ren didn't speak to Fang Lin, he leaned over and glanced at the surgery area.

The atrophy of the diaphragm is more obvious, and my previous judgment is still very accurate.

The right diaphragm has been sutured with the help of a mesh, and there should be no problem depending on the tension.

Fang Lin's surgery was pretty good, and the total number of hospitalizations in 912 was a little higher than that of the director of Haicheng No. 1 Hospital.

"Check the bullae, mediastinum, and pericardium." Zheng Ren said in a deep voice.

"The bulla in the lower lobe of the right lung was closed during the second thoracotomy," Su Yun said.

"Look it up, if there is no way to explain the pericardium," Zheng Ren said.

Su Yun touched the pericardium with the hemostatic forceps, hesitated for a moment, and said, "The pressure on the pericardium is greater than before."

As he said that, without hesitation, he picked up the knife and cut open the pericardium.

If this happens offstage or during transportation, the patient will face an extremely dangerous situation. But on the operating table, a pericardiotomy and decompression couldn't be simpler.

Fang Lin didn't say anything to Zheng Renduo, and began to perform pericardial fenestration. The pericardium that was removed was sent for pathological examination, and part of the pericardial effusion was extracted with a syringe for related examination.

The volume of pericardial effusion was about 700ml, and the color was clear, which ruled out the possibility of bloody pericardial effusion.

Normally, it's time to flush out the chest cavity and the surgery is over.

However, when flushing the chest cavity, it was found that a small amount of gas escaped.

Fang Lin and Su Yun struggled to find it on stage for a while, and finally found a problem in the mediastinum.

A small sinus tract is formed between the trachea and the pericardium, and the strange thing is that the small sinus tract also has a channel leading to the chest cavity.

During the transfer, the patient had a small pneumothorax, which can be explained by this. Because the patient was weak and the lung ventilation was insufficient, there was no large amount of air-liquid pericardium.

However, during general anesthesia, with mechanical ventilation, the patient's ventilation volume increases, and part of the gas enters the pericardial cavity, forming a gas-liquid pericardium.

There was nothing special about the condition, at least it seemed to Zheng Ren that way. But this patient... had surgery after surgery one after another, as if facing the missing god of death in The Coming of Death.

Zheng Ren said it was the first time he had seen such a complicated hernia that eventually led to the appearance of gas-fluid pericardium.

Even in the vast medical journals and papers, there is no mention of related cases.

But it's good to find the problem. The next operation is not difficult, but it is to remove the sinus and eliminate hidden dangers.

"Boss Zheng, this patient is really fatal." After repeated flushing of the chest cavity, no problem was found, and when he was about to close the chest, Fang Lin said with emotion.

"It's fine, hurry up and close your chest." Su Yun clamped the ribs on both sides with a closer, and began to screw the screws to close the closer.

Suturing is the most basic, but it seems that Su Yun hasn't had chest surgery for a long time, and he doesn't miss even this chance of surgery. The people studying next to him looked helpless, but they couldn't say anything.

Fortunately, there are so many surgeries on 912, if you want to do them, there is always a shortage of surgeries.

Coming here, the biggest problem is that the body can't keep up. If every operation is performed, it is absolutely possible to spend all the time on the operating table except for eating and sleeping.

Eliminate hidden dangers and relax the atmosphere. Talking and laughing, the anesthetist told Su Yun and Fang Lin about the expectant mother.

Everyone unanimously judged that there was a high probability that something would happen. In this kind of thing, one dead body and two dead, the obstetrician will be in big trouble.

"During my internship, I met a family member who told the doctor that if it was a girl, the right fallopian tube of the parturient would be ligated by the way." Su Yun sneered.

"Uh...why?" Zheng Ren froze for a moment.

Will the fallopian tube on one side be closed if it is said to be closed?

"Because men are on the left and women are on the right." Su Yun said, "If you close the right fallopian tube, you will be able to give birth to a boy next time."

"..." Zheng Ren was speechless.

Although I have been clinical for so many years, when I encounter similar patients and cases, I still have a very ridiculous idea.

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Diaphragmatic hernia complicated by air-fluid pericardium was mentioned in a case report in the "New England" magazine, which was a patient in Argentina.