Subdural hematoma bled slowly, and the early clinical symptoms were not obvious. There were even no symptoms, so the time for early diagnosis and treatment was missed.
When clinical symptoms appeared, the hematoma had been formed for a long time. The main symptoms were chronic intracranial hypertension and cerebral ischemia and other atypical symptoms.
Da Liu did not have any external injuries. Zheng Ren thought that it was the result of long-term heavy drinking that caused blood vessels to decline, increase in brittleness and permeability, and chronic leakage.
It was estimated that after his brother came, he did not say anything good to him. After one blow after another, Da Liu finally could not take it anymore.
This person was a little pitiful.
However, there must be something hateful about a pitiful person. Zheng Ren did not know what to say about such a thing. A large part of Da Liu's current situation was caused by himself.
It had nothing to do with him, so it was better to put it aside. Zheng Ren smiled bitterly and thought to himself.
"Boss Zheng, two days ago, the students of Imperial Capital Medical University were nauseous and vomiting. What was the final diagnosis?" Zhou Litao asked.
"My consideration is collective hysteria," Zheng Ren said.
Su Yun and Zhou Litao both had doubts about this diagnosis. After all, there was no clear substantive change in hysteria. Without evidence, the credibility would be greatly reduced.
"Boss Zheng, there's a case that I solved two days ago. Take a look." Zhou Litao put the collective hysteria aside and began to show off.
"Huh? What illness? "Zheng Ren immediately became interested when he heard Zhou Litao's words.
"I took out a spoon from the esophagus." Zhou Litao chuckled with a smug look on his face.
Esophagus … Spoon …
"Come, I kept one of the radiographic films. The patient also said that he did not want the spoon, so I kept it, "Zhou Litao said.
Foreign bodies in the esophagus referred to foreign bodies, such as small bones and roots of animals, food such as peach pits, sweet potato pieces, corn cobs, as well as children's toys, wire, fish hooks, plastic products, and so on.
Zheng Ren remembered a case report saying that a man swallowed 40 knives and left them in his esophagus.
This was a little too much. Zheng Ren did not really believe it. 40 knives. Was it magic? If it could be taken out casually, it would become a sword swallowing trick.
Zhou Litao saw that he was not in a hurry, so he brought Zheng Ren and Su Yun to his duty room.
He installed a plastic hook on the side of the cabinet with a dozen or so film bags hanging from it.
Zhou Litao found the scan and handed it to Zheng Ren. "The patient had an argument with someone at dinner and was punched in the chest. Then, he developed chest tightness, nausea, and other symptoms. He came for treatment."
"We'll see it after taking an X-ray," Su Yun said.
Zheng Ren took out the radiographic films and looked at the window.
There was a clear image of a spoon in the esophagus, but there was no presence of esophageal diverticulum.
It was hard to imagine how the spoon had ended up in the esophagus.
It was probably because it was too big to enter the stomach through the cardia, so it swam in the esophagus and was finally wrapped in fibers.
"Tsk tsk, it's so big." Su Yun looked at the radiographic films and praised.
"Exactly." Zhou Litao took out a plastic bag with a spoon inside. It was about ten centimeters long, and its surface was covered with food residue and pus.
"Why don't you wash up?" Su Yun said.
"If you look at it this way, it's more eye-catching." Zhou Litao smiled and said, "If it's so clean, the children will doubt whether it's true or not. Did I randomly buy a spoon to lie to them or was it real? At that time, even if there were radiographic films, they wouldn't be very trustworthy. "
Zhou Litao's words made sense. This guy had always been thinking about teaching the students at the First Affiliated Hospital of Provincial Capital Medical University in the future.
He did not know where he had put all the random things he had collected in the end.
According to Su Yun, this was a collector's hobby.
This was an illness that had to be treated.
"How did you take it out?" Zheng Ren asked.
"Send it to the endoscopy room. Chief Luo took it out with an endoscope," Zhou Litao said. "Chief Luo also said that if you were there, the patient's injuries might be less severe."
Zheng Ren smiled.
It was just taking out a foreign object in the esophagus. No matter who did it, the damage would definitely not be too big.
Spoons were relatively rare. Foreign objects in the esophagus of adults were usually things like dentures.
They forgot to take off their dentures at night and swallowed them when they were sleeping. After waking up, some careless people could not feel that the dentures were in the esophagus. They just thought that they had forgotten where they had put them.
In the end, it caused a foreign object in the esophagus.
"It's so big. It must have been quite troublesome to take it out," Zheng Ren sighed.
"I used general anesthesia before I could take it out. At that time, the thoracic department went there. If the endoscopy failed, they were prepared to open the chest. "
Zhou Litao was right. They had to make all kinds of preparations to avoid problems.
If one method could not solve it, they would change to another method. This was also in the 912. If it was another hospital, they would probably have to open the chest to cut the esophagus.
However, cutting the esophagus to remove the foreign object was a very troublesome and risky surgery.
It was different from cutting the skin to remove the lipoma. After the surgery, there might be local ischemia and the incision would not heal, leading to chest infection, lung infection, lung abscess, and empyema.
It would be best if it could be taken out with an endoscope.
After looking at the radiographic films, he looked at the spoon that he had taken out. Seeing Zhou Litao carefully put away the spoon, Zheng Ren felt that he was really an interesting person.
However, in the future, when he had a family, he did not know if his wife would be able to accept these things.
After chatting for a while, Zhou Litao received a call. It was from the doctor who sent Da Liu for examination.
The head CT showed that Da Liu was diagnosed with a subacute right frontotemporal subdural hematoma. He was immediately transferred to the surgery department for a craniotomy to remove the hematoma.
Although the risk of a craniotomy was very high, it was definitely a 'small' surgery in the neurosurgery department.
As long as it could be detected early and diagnosed early, the possibility of coma after the surgery and long-term bedridden was not high.
"I'll go to the neurosurgery department to take a look." Su Yun glanced at Zheng Ren and asked, "Do you not want to go?"
Zheng Ren nodded.
He was instinctively resistant to this kind of patient who had a messy housework. As long as he could treat the disease, it would be fine. As for the heart …
Forget it, it would be better to leave it to Su Yun to handle.
After leaving the emergency department, the two of them parted ways.
Su Yun went to the neurosurgery department while Zheng Ren went straight back to the interventional department.
Sitting under the sun, Zheng Ren went into the System library to read. Although he had a photographic memory, the System library was updated too often. There were new journals one after another. It was impossible for Zheng Ren to finish reading them.
After reading for a while, Xie Yiren sent him a WeChat message asking what he wanted to eat tonight.
In the evening, Qin Tang said that he wanted to treat her. As for the details, Zheng Ren did not know.
As he flipped through his phone, Zheng Ren's heart suddenly skipped a beat.
He had not looked at the QQ of the little boy with cancer for a long time. He wondered how he was doing now.
He opened QQ and saw that the little boy's profile picture was lit up, but his signature had not been updated. It was almost a month ago.
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