Zheng Ren gently knocked on the door of the consultation room. When he heard Cui Lao's voice from inside, he pushed the door open and entered.
"Little Zheng, you're here so early." Cui Lao was focused on studying an X-ray film. He adjusted his reading glasses.
"Yes, I just got off the stage and came straight over." Zheng Ren smiled honestly and leaned over.
"It's not good not to eat. When you reach my age, you'll suffer." Cui Lao pointed at the scans and asked, "Tell me, what do you think?"
Zheng Ren was silent.
The radiographic films in front of him were incredible. A broken glass bottle was in the rectum, and the tip of the bottle had pierced the rectum. The bone surface of the lower part 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 reached the gluteus medius muscle, which was surrounded by organized tissue. The area around the rectum where the foreign body was located had diffuse inflammatory lesions, and the right lower limb muscle had disuse steatosis.
Zheng Ren had seen a lot of rectal foreign bodies in the emergency department. Alcohol bottles, steel pipes, steroids, and mousse bottles were the most common.
However, they usually went straight to the hospital for treatment and took it out. Other than being a little embarrassed, there was nothing else.
The case in front of him was different.
The severe inflammation, the wear and erosion of the pubic symphysis, and the surrounding adhesion meant that the foreign body had not been removed for a long time.
Was this abuse? Or was there something else?
Zheng Ren's brows furrowed subconsciously.
"At first, the patient's medical history was unclear, but after repeated questioning from Xiao Zhou, he found out that five years ago, when he and his girlfriend had too much to drink, he shoved a beer bottle into his rectum. Since the patient is more introverted, he didn't come to the hospital to remove the foreign body. "Cui Lao looked at the scan as he slowly talked about the patient's medical history.
Uh … The moment Zheng Ren pictured the scene of him being injured, he felt extremely strange.
Introverted? He couldn't tell.
However, this had nothing to do with Zheng Ren. He had to think about how to treat the patient. As for answering Cui Lao's question to make the atmosphere in the consultation room less awkward, Zheng Ren did not realize it at all.
Unknowingly, his left hand had already reached under his right armpit, and his right hand was resting on his cheek as he stared at the X-ray.
Cui Lao was not angry because Zheng Ren did not speak. He continued to explain the condition.
"The patient complained of limping for one month and weakness in his right lower limb. It is considered to be caused by the loss of fat. The reason for this visit is due to fecal incontinence and watery stool. She came to the emergency department of our hospital for treatment. "
"Where's the patient?" he asked.
"He went for a lower abdomen and pelvic CT scan. I think that the patient should be treated with surgery, and the treatment is very difficult. It's better to have a more detailed examination. "Cui Lao said," Little Zheng, look at this X-ray. Do you have any thoughts about surgery? "
"It has to be like the radical surgery for rectal cancer. For the double surgery, the colon and anus have to be left open. When the recovery is better, the second surgery will be done," Zheng Ren said.
Cui Lao nodded slightly. This was something he could think of as well.
However, the difficulty of the surgery was definitely not something that could be described with just a few words.
The foreign body had been in the patient's rectum for too long, so the foreign body was highly organized and wrapped in the body. If they wanted to clean it completely, they would definitely lose a lot of blood.
This surgery was a huge test of the surgeon's surgical skills.
If the surgery was a little rough, there might even be a possibility of a large area of bleeding but no blood vessels could be found.
To use electric cauterization to coagulate all the capillaries, postoperative healing and bleeding again became a big problem.
The surgery had to be especially meticulous, and the requirements for technique were extremely high.
Zheng Ren's brain began to work at high speed. He analyzed the X-ray, carried out three-dimensional reconstruction, and judged the direction of the blood vessels, the branches of the capillaries, and the location of the relevant body tissues.
Even with the passive skill of reconstruction, Zheng Ren still felt that the difficulty of this patient's surgery had almost reached the sky.
Time passed minute by minute. Zheng Ren repeatedly reconstructed in his mind, trying his best to find a reasonable path to enter. He had to minimize the damage and achieve his goal. However, even with Zheng Ren's ability, it was difficult to solve this problem in a short period of time.
Soon, Zhou Litao knocked on the door. "Cui Lao, the patient just now came back from the CT scan."
Cui Lao nodded, stood up, and said, "Little Zheng, let's go see the patient."
Zheng Ren looked at the X-ray film. The glass bottle in the rectum looked so dazzling.
He accompanied Cui Lao to the emergency resuscitation room. The patient was lying on the stretcher trolley. It was a young man who did not look old. He was only 23 or 24 years old.
There was a girl beside him. She was wearing a plain plaid dress and had shoulder-length hair. She looked simple and clean.
"Li Mingchao, right?" Cui Lao asked.
"Doctor, I won't die, right?" The young man lay on the stretcher trolley with a terrified expression.
"Let's do a physical examination first, then send him to the gastrointestinal surgery department. Little 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 okay?" the girl asked anxiously.
"How can I be okay?" Zheng Ren stood between Cui Lao and the girl and said indifferently, "Why did you only come now with such a serious injury?"
"…" The girl was speechless. She was a little timid, a little embarrassed, and a little conflicted. Tears fell down her cheeks.
Zheng Ren was speechless. At this time, the girl's crying made him helpless.
"Are you from the Imperial Capital or do you work here?" Zheng Ren asked.
"I worked here after graduating from college," the boy said.
"Are you married?"
"Not yet."
"Inform the family to hurry over," Zheng Ren said. "His condition is very serious. He needs to undergo a major surgery."
"Don't …" the boy endured the pain and said, "I … That … I can get my girlfriend to sign for the surgery."
"For such a high-risk surgery, we must have an immediate family member. You're not married, so you can't sign it. No doctor would dare to perform this kind of surgery, "Zheng Ren said.
After looking at the radiographic films, Zheng Ren had a basic judgment of the patient's condition. Even if he performed the surgery himself, there would be a lot of intraoperative bleeding.
It was entirely possible that he would be put on the spot.
"Doctor …"
"If they don't sign, no one will dare to perform the surgery. If you don't have surgery, you won't be able to live for another five years, "Zheng Ren said firmly.
All of a sudden, the patient and his girlfriend fell into a panic.
They fell silent. Zheng Ren watched Cui Lao perform a physical examination. The patient's physical examination report showed that his abdomen was flat and soft. There was no tenderness or rebound pain. Rectal digital examination showed that the anal fistula and anal sphincter tension had decreased significantly, and the lower end of the foreign body could be clearly touched.
Zheng Ren sighed and shook his head slightly.
…
Note: The cases were obtained from
"
The doctor reported. After listening to his senior brother talk about this case, it was really tiring to find the information.
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