Inner Mongolia, Horqin Right Middle Banner.
The gastroenterology department of a certain second-class hospital was holding a consultation.
The directors, deputy directors, and chief residents of the relevant departments were sitting in the office, flipping through the patient's medical records and radiographic films in boredom, but no one spoke.
The deputy chief of the medical administration department, who was in charge of the consultation, looked at the crowd, then at the time and said, "Then let's stop here."
"Chief, do you want …"
"The patient's diagnosis is clear. It's advanced cirrhosis. We can only recommend that the patient go to a higher-level hospital for treatment. In our hospital … "As he spoke, he looked at the silent doctors and shook his head.
Then, he stood up and the deputy chief of the medical administration department announced the end of the meeting.
The interventional doctor sat in the corner, dejected.
He did not think that the patient could not be treated, but it was not something he could treat.
Severe ascites, his limbs were as thin as firewood, and his entire person looked like a four-legged spider. He lay on the bed, and even his breathing was not smooth.
Listening to the patient's eye-catching breathing, the interventional doctor felt that his airway was beginning to spasm.
He really wanted to learn from the surgeon in the surgery live broadcast room, but he knew that this was just an unrealistic idea.
He lowered his head and left the gastroenterology department. He sighed. The disease that seemed to be an incurable disease in this second-class hospital in Horqin might be just an ordinary disease in the surgery live broadcast room.
He walked back to his department while thinking about all kinds of miscellaneous thoughts.
Just as he was thinking, his phone rang with the sound of the first-aid ambulance.
He immediately became energetic, as if he had been injected with adrenaline.
He quickly ran to the duty room, took out the pad from the locker, and used his fastest speed to go to a small room. He turned on his phone and pad and began to watch the surgery live broadcast room.
Somehow, the interventional doctor felt that today's live broadcast was very important to him.
The pad was playing the live broadcast of the patient's surgery, and he was using his phone to look at the patient's information.
When a few words fell into his eyes, he was stunned.
His hunch was right!
Spider-man! Boot sign! These symptoms were completely consistent!
It turned out to be Budd-chiari syndrome, not advanced cirrhosis, stubborn ascites!
His hand trembled slightly, but then he calmed down.
The surgeon in the surgery live broadcast room had already begun the surgery.
The camera had already been returned, and a sense of regret rose from the bottom of his heart. But he didn't have time to regret or think about what ifs.
He watched the live broadcast of the surgery on the PAD with rapt attention. He tried to remember every detail with his memory, which had already begun to decline due to his age.
Although he knew that it was impossible, he still had to do something.
The guide wire entered the inferior vena cava. No! The interventional doctor was stunned. The guide wire didn't look right!
It was familiar, but it didn't seem right.
Could it be … The interventional doctor had a guess in his heart, but the surgeon in the surgery live broadcast room did not explain it from the beginning. This time, he would not make an exception just because he did not understand it.
Countless thoughts converged in the interventional doctor's mind, spinning and turning into a huge vortex.
The surgeon did not use a micro-guide wire but the most common guide wire. It was just that the shape was a little strange … It seemed to be upside down …
When the guide wire entered the inferior vena cava, it ignored the countless venous branches and arrived at the location where the contrast agent was blocked.
The interventional doctor's right wrist moved slightly like a marionette.
He didn't even realize that his wrist had moved. It was a subconscious movement. In his subconscious mind, when the guide wire came to this position, the problem should be solved next.
The interventional doctor did not know where the problem was. He only felt that the inferior vena cava was blocked by something, which was the source of the problem.
Sure enough, the strangely shaped guide wire moved slightly and directly penetrated the blockage.
Opening the inferior vena cava?
Then, the stent entered along the guide wire.
The stent was opened, the contrast was done, and the inferior vena cava was completely unobstructed.
After the surgery, the live broadcast room was closed.
It was so simple … The interventional doctor sighed in his heart, but then, an electric current flowed through his entire body.
This surgery, such a simple surgery, he could do it himself!
Thinking back to the "Spiderman" hospitalized in the gastroenterology department, the interventional doctor seemed to have some understanding.
He began to search for all kinds of information about Budd-chiari syndrome.
As for the surgery in the live broadcast room? It was such a simple surgery. Even if he wanted to forget it, there was nothing to forget.
It was just opening, placing the stent, imaging, and the surgery was over.
It was even simpler than appendicitis. It was an order of magnitude simpler!
He could do it, he could definitely do it!
The interventional doctor realized excitedly. However, he immediately suppressed this excitement, calmed down, and began to search for all kinds of literature about Budd-chiari syndrome.
He knew that it was not difficult for others to carry the burden, but it was tiring for him to carry the burden himself.
The TIPS surgery was extremely simple for the surgeon. It was completed with one needle puncture. However, after many days of research, the interventional doctor finally gave up helplessly.
Only the surgery video was definitely not enough.
He could not grasp the key to how the surgeon determined where to puncture.
He hoped that the interventional treatment of Budd-chiari syndrome would not have such an easy to overlook but crucial point!
After searching and pondering for a few hours, the interventional doctor walked around the small storage room excitedly.
There was not much information in the library of Horqin Right Banner Hospital in Inner Mongolia. He searched the network of the provincial library.
There was not much information in the provincial library, but he found two documents about Budd-chiari syndrome.
The interventional surgeon believed that he could do it by comparing the surgeon's surgical process with the gastroenterology patient's.
It was just an extremely simple surgery!
Sometimes, it was just a layer of window paper. If it was pierced, there would be no secrets to speak of.
This was the case with tuberculosis more than a hundred years ago. More than twenty years ago, when there was no interventional surgery, Budd-chiari syndrome was an incurable disease. Even if surgery was performed, there was a problem with the position of the second hepatic portal, and the mortality rate was extremely high.
Moreover, the condition … was quite simple. There was a membrane-like object in the inferior vena cava. At first, it was open, but as he grew older, it gradually closed.
This kind of closure was physiological, not pathological.
When the inferior vena cava was completely closed in youth, the venous blood flow was blocked, and venous blood flow could only be completed through collateral circulation.
Therefore, everything could be explained.
This was not ascites caused by portal hypertension in the late stage of cirrhosis, but ascites caused by inferior vena cava occlusion!
Moreover, it could be cured after interventional treatment!
The interventional doctor was excited. He simulated the surgery countless times in his mind. It was not difficult at all!
He went to the gastroenterology department, looked for the chief, and looked for the patient's family.
The interventional doctor printed out the information he found, prepared it properly, and went to the gastroenterology department confidently.
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