Because the family and the patient had no history of intimate contact, they could not do the most appropriate vaginal ultrasound. Zheng Ren could only do an abdominal ultrasound.
Although it was a little lacking, Zheng Ren had the System.
However, Zheng Ren could not believe the diagnosis given by the System this time.
Accessory splenic torsion …
This diagnosis … If the patient had epigastric pain, Zheng Ren would probably believe it immediately. However, the patient had lower abdominal pain, so Zheng Ren was cautious and prepared to do an ultrasound examination himself.
There were no abnormalities in the uterus and both ovaries.
A lump of various sizes.
It seemed that this was where the disagreement was.
Zheng Ren held the ultrasound probe in his right hand and pressed on the patient's abdomen with his left.
When he pressed, Zheng Ren noticed that the lump was separated from the ovaries. Several large blood vessels could be seen inside.
Zheng Ren agreed with the ultrasound doctor's opinion. Although the physical examination looked like an ectopic pregnancy.
"Where are the family members?" Zheng Ren asked.
An anxious middle-aged woman stood up and asked hurriedly, "Doctor, how is my daughter?"
"The source of the lump is unknown. Surgery is needed." Although Zheng Ren had a rough idea in his heart, he still carefully described it in a more general way. "Prepare to be hospitalized and operated on."
The middle-aged woman broke out in a cold sweat.
Most people would be afraid when they heard that they were going to have surgery.
Jokes like the death of patients after appendectomy were widely spread among everyone. Although the probability was very low, it made people feel a sense of fear towards surgery.
"Chief Zheng, call me when the surgery is over. I'll go take a look." The gynecology chief resident was very happy to see that the emergency department had taken on this tricky task.
However, she was very interested in the diagnosis. She did not think that her diagnosis was wrong, but the ultrasound doctor's words made sense, so she was ready to see what was going on.
Under normal circumstances, doctors hated laparotomy and thoracotomy surgeries the most.
This was because after it was opened, no one knew what was going on inside.
It required rich clinical and surgical experience to solve some unexpected symptoms.
If they were not careful, the consequences would be unpredictable.
Therefore, the gynecology chief resident did not insist. After all, it was just an exploration. If they found ectopic pregnancy or something like that, they could just do it directly.
Other than wanting to see what was going on, she was also afraid that Zheng Ren did not have experience in ectopic pregnancy surgery.
Due to the medical dispute, Zheng Ren's reputation in the gynecology department was very high. Although the gynecology chief resident disagreed with some of his diagnoses, she still wanted to help him.
Zheng Ren did not care and nodded.
Zhong Min from the internal medicine department was on duty today. As he walked, he informed Yang Lei to rush over for surgery and Chu Yanzhi.
He didn't know how the Chu sisters arranged themselves. In any case, they just called one of them.
He brought the patient to the emergency ward for preoperative preparations.
Zhong Min was responsible for receiving patients, inquiring about their medical history, and writing all kinds of written information. Zheng Ren made the best use of his time to inform the patient's family before the surgery.
No matter what kind of diagnosis it was, it was an emergency, and time was very precious.
The patient's mother wiped her tears and signed her name on the surgical consent form.
After signing the papers, the nurse had already inserted a gastric tube and urinary catheter.
Yang Lei's house was a little far away, so Zheng Ren and the patient's family members wheeled the patient to the operating theater.
Chu Yanzhi was already there when he arrived at the operating theater. They worked together to move the patient to the operating table while he went to change his clothes.
The preoperative preparation would take at least ten minutes. Since the anesthesia procedure was complicated, he was not in a hurry.
An accessory spleen? Zheng Ren kept thinking about the System's diagnosis.
In tissue culture, the accessory spleen was due to the embryo's
Failure to fuse with the splenic primordium located in the dorsal mesentery of the stomach.
Clinical diagnosis was more difficult.
Scans of the accessory spleen were generally less than
The edges of the accessory spleen were smooth,
Scans showed that the splenic artery feeding into the accessory spleen.
Ultrasonography could only be used as an aid. It could not be used like a plain MRI to find the branch of the splenic artery feeding into the accessory spleen.
Since the patient was an emergency patient, there was no time or condition to complete the various examinations. Therefore, exploratory laparotomy was the only option.
After changing into the isolation suit, Zheng Ren called the medical administration division and asked his colleagues in the pathology department to work overtime.
If it was an accessory spleen in the upper abdomen, it would not be necessary.
However, it was in the pelvic cavity and was very far away, so there was a possibility of a tumor.
To rule out the possibility that the tumor was tumor tissue fed by a branch of the splenic artery, a pathological diagnosis was the only way to confirm it.
Zheng Ren had already explained this in detail to the patient's mother.
Also, because of this possibility, Zheng Ren could not perform laparoscopic surgery.
The small hole in the laparoscopic surgery could not remove the accessory spleen. If the accessory spleen was broken and removed, there would be a large number of metastases, causing the tumor to enter the late stage.
After considering everything thoroughly, Zheng Ren came out of the changing room and gave the gynecology chief resident a call. Then, he began to scrub in and prepare for surgery.
Chu Yanzhi was lively. The patient had been anesthetized and she was chatting with Xie Yiren.
In fact, it was more of a chat than a chat. Xie Yiren was busy preparing the surgical tools while replying to Chu Yanzhi.
She asked questions like where Xie Yiren had been and why she did not go home. She did not notice the slightly awkward silence between Xie Yiren and Zheng Ren.
What a careless girl, the complete opposite of Chu Yanran.
He did not know if it was because the identical twins' meticulous thoughts fell on Chu Yanran.
Yang Lei had not arrived yet, so Zheng Ren did not wait for him. After scrubbing in, he disinfected and laid out the sterile surgical drapes, ready to start the surgery.
It was not a big deal to perform the surgery alone. Zheng Ren had long gotten used to it.
The shadowless surgical lamp was bright. Zheng Ren glanced at the operating area. Considering the patient's age, he hesitated for a moment before making an eight-centimeter incision next to the left rectus abdominis, near the middle and lower abdomen.
The incision was a little long because the source of the blood vessels had to be explored during the surgery.
If the incision was too small, the incision would be extended during the surgery.
The skin was cut open, subcutaneous tissue and fat were bluntly separated, all the way to the peritoneum.
The patient was relatively young and had a thin layer of fat, so the surgery was easy.
At that moment, the gynecology chief resident rushed over.
Seeing Zheng Ren performing the surgery alone, she asked, "Chief Zheng, should I go onstage?"
"No need, Yang Lei will be here soon." Zheng Ren covered the abdominal cavity with a protective membrane and opened it.
The gynecology chief resident did not say anything after the abdominal cavity was opened. She focused on the surgery.
Zheng Ren and the gynecology chief resident pulled open the skin and muscle tissue of the lower abdomen with a large retractor. They found the source of the pain — a dark red soft tissue next to the ovaries.
However, the dark red was a little darker and darker.
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