Boss Zheng was too cautious. The two resident doctors and the ultrasound doctors all came to the same conclusion.
However, did the patient's condition really allow him to do another CT scan?
The chief resident of the Department of Hepatobiliary and Pancreatic Surgery glanced at the blood pressure. 80/50 mmHg seemed fine. There should be enough time for an abdominal CT scan.
The patient's family was already starting to get annoyed. If they wanted to deal with this matter, they had to do the examination immediately.
They had to hurry up and enter the operating theater.
A few people hurriedly carried the patient onto the stretcher trolley. Zhou Litao took the examination receipt and handed it to the patient's family. Zheng Ren moved closer to the chief resident of the Department of Hepatobiliary and Pancreatic Surgery and whispered, "You can do a splenectomy. If you're not confident in liver surgery, hurry up and find a second-line surgeon. "
The chief resident of the Department of Hepatobiliary and Pancreatic Surgery nodded blankly.
What he did not understand was why Boss Zheng insisted that there might be an ectopic pregnancy in the liver that was not a problem, but the problematic spleen was fine.
However, with Boss Zheng's words, he breathed a sigh of relief.
From the department chief to the group of professors, no one questioned Boss Zheng's standard when it came to his skills. Although the chief did not say much, the chief resident could see the chief's recognition of Boss Zheng's skills.
The reason the chief did not say was that the liver cancer resection had been forcibly torn open by Boss Zheng's interventional surgery.
It was also a live broadcast. All the doctors in the world knew that for liver cancer, the effect of the surgery would be better with interventional surgery.
The specific long-term data would need time to grind. However, from the most basic surgical point of view, the effect of interventional embolization and surgical resection was much better than simple surgical resection.
This was undoubtedly a huge blow to the Department of Hepatobiliary and Pancreatic Surgery.
Uh … He was thinking too much. The chief resident of the Department of Hepatobiliary and Pancreatic Surgery thought that it should not be a big deal for Boss Zheng to call the second-line surgeon from home in the middle of the night.
Watching the group of people leave, Zhou Litao asked doubtfully, "Boss Zheng, why not the liver?"
"Generally, after 50 days of ectopic pregnancy, we should be able to see the fetal heart and fetal buds. I think the location of the spleen looks like a hemangioma. In the spleen parenchyma, there is a circular or oval heterogeneous high-echo mass. The boundary is clear and the edge is not smooth. The interior is separated by no echo and strong echo. "
"But …"
"Doing a CT won't affect the patient's surgery," Zheng Ren said. "If we make a hasty diagnosis and the bleeding continues after the splenectomy, it will be over."
Thinking of this, Zhou Litao felt a little guilty.
Entering the palace for the second time was a devastating psychological blow to the patient's family. He was fine, but he was bleeding. Who could understand such a thing?
It was a hidden danger of medical disputes.
Although the patient's family members were very anxious now, if the surgery went well, the patient would be fine after he came down.
It was easy to empathize with that. Anyone who was the patient's family member would probably react the same way.
"Is spleen pregnancy common?" Lin Ge asked.
"Not much," the ultrasound doctor immediately said.
Even in a large Class Three Grade A Hospital like the 912, this kind of disease was usually not seen even once a year.
"The incidence of abdominal pregnancy in ectopic pregnancy is only 1/10000 to 1/3000, and splenic pregnancy is even rarer. There are very few reports both at home and abroad." Zheng Ren said, "Since 1990, there have only been 40 cases reported in journals and magazines with an SCI impact factor of more than 5."
Lin Ge smiled.
This logic of using data to speak was the standard thinking of a science guy. He had seen Boss Zheng say this many times, so he had a sense of approval.
However, this required the support of a large amount of reading and memory in order to be at his fingertips.
If it were anyone else, how could they casually come up with such detailed data for a rare disease?
"Strange, why does it grow to the spleen and liver?" Lin Ge was a little curious.
"According to research, the reason for spleen pregnancy may be that the fertilized egg is discharged into the abdominal cavity due to abnormal reverse peristalsis of the fallopian tube. It is not absorbed by the peritoneum, nor does it enter the opposite fallopian tube. At the same time, excessive intestinal peristalsis pushes the fertilized egg to move to the spleen and liver and grow," Zheng Ren explained. "The probability of ectopic pregnancy in the liver is slightly higher than in the spleen."
As he spoke, he lowered his head and pondered for a moment before continuing, "There are 22 cases of liver pregnancy and 18 cases of spleen pregnancy. Less than 33% of the patients were pregnant for more than three months. Most of them were diagnosed in the early stages of pregnancy due to abortion or abdominal bleeding caused by rupture."
"Liver, exactly? This is quite strange. It actually grew on the liver. "Lin Ge already believed Zheng Ren's words. In his words, he ruled out the spleen.
"90% probability," Zheng Ren said. "It's very dangerous. Hurry up and do the examination, then surgery. The surgery isn't difficult. The difficult thing is to diagnose it immediately. "
After saying that, he glanced at Zhou Litao and said, "Chief Zhou, go and urge the blood. Say that the patient needs an emergency blood transfusion, a large amount."
Zhou Litao responded and ran to call the blood transfusion department.
"It's that serious?" Lin Ge was surprised.
"The liver, spleen, and other organs have rich blood circulation, and the surface tension is not high. The blood from the gastrointestinal tract and portal vein is rich, which is conducive to the growth of the embryo.
As the embryo develops and grows, organ ruptures may occur, forming rapid and large amounts of bleeding. If the rescue is not in time, it is easy to cause hemorrhagic shock or even death. The risk of death is much greater than ordinary ectopic pregnancies, "Zheng Ren said with certainty.
The chief resident of the gynecology department was very curious.
Even if the diagnosis of ectopic pregnancy was not a problem, they did not diagnose the spleen occupying the space. Instead, they diagnosed it as liver ectopic pregnancy.
This …
She bade farewell to Chief Lin and immediately ran away.
Following him on stage to take a look was considered an eye-opener. Recently, Boss Zheng had been praised in the hospital to be so magical. She wanted to see if it was really that magical.
"Boss Zheng, you're really busy today," Lin Ge said with a smile.
"I'm used to it," Zheng Ren said. "When I was in Sea City, I stayed in the hospital every day. When it was quiet at home, I didn't sleep so soundly. "
This was the problem of the emergency department doctors. They worked in a chaotic environment all year round. Once it was quiet, they would subconsciously think about whether there would be a wave of outbreak waiting for them.
If there was no sound, they really could not sleep.
Zhou Litao came back after the call and said, "The blood transfusion department knows that it's an ectopic pregnancy. They have already prepared 20U of red blood cells and 1000ML of plasma."
Zheng Ren was relieved. They were well prepared, so the patient should be fine.
If it was any other time, he would have followed them on stage to take a look.
However, there was not a vampire in front of him … A patient with congenital porphyria waiting for a consultation. Zheng Ren could not wait to go to the operating theater to dissect the patient with congenital porphyria.
In fact, it was not accurate to say that it was congenital porphyria. In his heart, he thought that this disease only had symptoms that matched congenital porphyria. In fact … the ancient and mysterious family was more likely to be vampires.
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