Chapter 1115 [1115] How to See It From the Surgical Perspective

He doesn't like to talk, and is not very good at talking, but when it really has to be said, every word this person says must have weight.

Fang Xueqing raised her head and looked at the real light in Song Xuelin's brown eyes, and nodded unconsciously.

The medical records were opened, and several doctors studied it with their heads together.

The family members of the patients outside could hardly wait any longer, and they had to ask for an explanation today.

"It's a patient with gastrointestinal hemorrhage." Fang Xueqing pointed to the key points in the medical records for two young doctors, "He arrived at the emergency department of our hospital during the day three days ago. The main symptom was hematemesis and heavy bleeding. Compression stopped the bleeding, and after the blood transfusion, the condition was slightly stable. The emergency CT examination report showed bleeding from esophageal and gastric varices, liver cirrhosis, and portal hypertension.”

"Because there is no bed in the surgery department, the patient's condition has stabilized. With the consent of the patient's family, he was first transferred to our internal medicine department for treatment." Dr. Ma then added the patient's situation, "In our internal medicine department, Director Zhang performed an endoscopic esophagus for the patient the day before yesterday. Gastric varicose veins were treated with sclerotherapy and ligation. Then last night, the patient suddenly became very irritable, and the reason was not clear. The vital signs were relatively stable, and there was no further bleeding, and no loss of consciousness. The pupil reflex and other examinations are all normal. The family members are very nervous and have always hoped to be transferred to surgery for another operation."

Hearing what Dr. Ma said, it seems that the irritability caused by brain-derived diseases such as acute cerebral hemorrhage and cerebral infarction can be ruled out first? There were no signs of further bleeding. It is true that the patient's current condition is irritating, which makes people feel a little strange.

Fang Xueqing tapped her finger on the medical record, feeling that this patient's strange reaction was beyond her professor's medical experience, and she was a little puzzled for a while. Turning around, she asked Song Xuelin: "Doctor Song, what do you think? Can this patient be sent to the surgeon for another operation?"

After endoscopic treatment, emergency hemostasis is completed. If further radical treatment is required, devascularization or shunt can be performed, and then sent to surgery for traditional surgery, or interventional surgery such as TIPS transjugular intrahepatic portocaval shunt.

Therefore, after the surgeon came for consultation, he said that elective radical surgery could be done and asked the patient to wait. Who makes the patient no longer have indications for emergency surgery.

"Let Dr. Xie speak first," Song Xuelin said.

The female medical student must be the first to say, what is this Song Xuelin thinking about? Fang Xueqing was puzzled, so she looked at Xie Wanying and asked, "You are going to be a surgeon. How do you think about this case from a surgical point of view?"

"I personally think that the consultation report given by the surgery department yesterday is reasonable. The patient's condition did not seem to be particularly urgent yesterday, and he had to undergo surgery for the esophageal and gastric varices." Xie Wanying said, "Yes, he has bleeding control. More than that, his hemoglobin was 97 at the beginning, which can only be regarded as mild anemia. I guess the family members of the emergency patient said that the patient vomited a lot of blood at home is an exaggeration. Because the patient was conscious when he arrived at the emergency department, the amount of bleeding should be Not a big one. Endoscopic treatment doesn't look like a big bleeding either."

"What do you mean?" Fang Xueqing and Doctor Ma heard a deeper meaning buried under her words.

Xie Wanying looked serious, and said, "I'm afraid that if the patient's condition fails, he will be transferred to surgery immediately, not to general surgery, but to cardiothoracic surgery."