"Doctor, what's wrong? I don't hurt anymore. Looking at the expressions of the two of them, the patient was also a little worried.

"You, why don't you tell the truth?" Liu Banxia said helplessly.

"I came to the hospital after eating and still had some pain. I didn't say that I wanted you to examine it carefully, I should be fine, right?" the patient sat up.

"It's okay? Liu Banxia said.

"Hey...... I can still hear bowel sounds when I first receive the doctor, but now I can't hear it, and it is possible that there is intestinal necrosis now. Xu Hui sighed.

"Before you came here, you had symptoms of heart and mouth pain, probably some blood vessels were blocked by blood clots. Then you have abdominal pain, which is when the blood clot moves into the blood vessels in the bowel. ”

"It's just that the symptoms were mild at that time, and they didn't jam. So in terms of pain, you don't feel that intense. When it really hurts, the effect of ibuprofen comes into play again. ”

"There is a reasonable explanation for the high levels of creatine and blood lactate, you are cheating yourself. If you had told me earlier, we would have been able to do a targeted and precise examination. ”

"A very ordinary thrombectomy or thrombolysis was dragged into intestinal necrosis by you. And you definitely don't take a pill of ibuprofen, no matter how good the drug is, it is impossible for a person to achieve such an analgesic effect with a piece of ibuprofen. ”

"It's thanks to us that we kept you, otherwise after your necrosis increases, peritonitis, sepsis, either of them can kill you. You...... , why are you so confused? ”

In the end, Xu Hui's voice was much higher, and he was really angry.

Because of the rules of receiving patients, they will ask about their recent medication history to see if the symptoms are caused by the effect of the drug. But this patient chose to hide it, the reason was to test the doctor, so as not to be fooled by the doctor.

He really didn't understand why someone had such an idea, and who was the one who was fooled in the end, wasn't it himself?

"You should contact your family now, although you don't know which part of your bowel is necrotic, and the bowel sounds have disappeared, which means that there is something wrong with your bowel peristalsis. Liu Banxia patted Xu Hui on the shoulder and took over the conversation.

"If you want to live, then we're going to go straight to the stage for surgery. Laparotomy revealed direct resection of the necrotic bowel. You still have half an hour to think about whether or not to contact your family. ”

"Doctor, don't be kidding. "The patient's face was pale.

"What am I kidding you for? Am I kidding with your life? Listen to it yourself, see what a normal person's bowel sounds look like, and then listen to your own. Liu Banxia said and put his stethoscope on the patient.

This can be regarded as the fastest proof method at present, the patient listened to his own bowel sounds, and after listening to Liu Banxia's bowel sounds, he was silent.

Although he is still a little reluctant to accept the idea, he knows whether he can hear the movement or not.

"Don't hesitate, we don't know the extent of necrosis yet, so we can only wait for the open exploratory examination. Liu Banxia said.

"If you agree, I'll make an appointment in the operating room and prepare you for the operation. Delaying the time will only make the necrosis worse. ”

"And because you haven't fasted from food and water before surgery, the chance of postoperative complications will be greater. Miao Rui, you go and prepare the surgical notice for laparotomy and bowel resection. ”

"Okay, I'll do it, I'll call my family first. The patient looked at him, then at Xu Hui, and nodded.

"Let's make pre-operative preparations, Qingkova helps, and the rest of the people follow on stage. Liu Banxia said.

Although they knew that there was something wrong with such an occasion, Huang Bo and the others were still a little excited. This is a third-level operation, and Mr. Liu brought everyone with him.

"Hey...... , Shoutian, why don't you think I understand?" Xu Hui sighed.

"Then don't think about it yet, it's not easy for patients to fool doctors. Today, even a director-level figure is in charge, and he can't see his true illness. Liu Banxia said.

"You can keep an eye on it here a little longer, and I'll go to the operating room, hoping that there are not many necrotic bowels, otherwise removing too much will have a great impact on his quality of life in the future." ”

Xu Hui nodded, he really tried his best, he also thought about it seriously at that time, and did his best to retain the patient. Although it didn't cause much harm in the end, I really didn't expect the patient to lie and play.

It can be regarded as thanks to the fact that I and Liu Banxia have brushed so many surgeries some time ago, and the preoperative preparation is very familiar.

This is an emergency operation, and after the anesthesiology department and the operating room were notified, the people who were still eating had to hurriedly throw down their plates and rush directly to the operating room.

"Mr. Liu, intestinal necrosis?" asked anesthesiologist Li Liwei.

"Eight or nine are not far from ten, now it depends on the necrosis situation, and I can't hear the bowel sounds. Liu Banxia nodded.

"Now I have to do preoperative preparations, so I don't have to make a medical accident. I took ibuprofen and didn't tell Dr. Xu, and I wanted to go home after I found that it didn't hurt. ”

The people in the operating room didn't know what to say, and while such a thing was rare, it wasn't uncommon in the hospital.

After waiting for a while, the patient came to the operating room, checked that it was correct, and directly operated under general anesthesia.

"Qingkova, the middle incision of the abdomen, according to the height of the patient, choose 7 centimeters, and promise to do an open abdomen. Liu Banxia said.

There wasn't that much time to determine which part of the intestine was the problem, so the incision had to be made. 7 cm, Liu Banxia is confident that he can handle it well.

"Exploring the abdomen, no lesions were found in the intra-abdominal organs, and there was no effusion or exudate in the abdominal cavity. Necrotic segments were found in the small intestine, about 30 centimeters long, and black in color. After opening the abdominal cavity, Qingkova did a very detailed exploration.

"Okay, I'll do it next, you guys look closer. Liu Banxia nodded.

Standing on the edge of the operating table, Liu Banxia lifted the necrotic intestinal tube out of the abdominal cavity, "Liu Yiqing, what should I do next." ”

"Incision protection is required, separated by a large gauze pad with warm saline. Then use two pieces of dry sterilized gauze underneath for complete protection. Liu Yiqing hurriedly said.

"Why do you want to do this?" Liu Banxia still didn't move.

"Because...... Because...... , the patient's enteric substance may contaminate the incision. Liu Yiqing was a little anxious.

"Don't be so nervous, the patient is only about 30 centimeters at this time, and the impact on him after surgery will not be great. Liu Banxia said with a smile.

"Su Wenhao, you tell me the next surgical steps, and I will do it according to your instructions. If you do something wrong, it's your responsibility. ”

"Separate the mesenteric blood vessels, remove the intestine, anastomostomoses the intestine. Su Wenhao said.

"You have to learn from Lao Su, you don't usually talk a lot, and you can say it concisely. Liu Banxia praised.

"You have to watch my operation carefully, and you have to fully expose the blood vessels when you separate them. The shear should be close to the distal end, and the ligation sequence is also distal first, then proximal. ”

"This patient has a lot of fat, and if you don't have strong enough confidence to deal with it, you can use a light to shine it, so that you can see the direction of the blood vessels and then proceed with the operation. ”

Liu Banxia said while dealing with the mesenteric blood vessels very quickly.

"In the next process of removing the intestinal tube, we need Miao Rui for the use and location of the intestinal forceps, you. Liu Banxia asked coldly again.

"It can't be clamped too tightly, and it is good to be able to block the flow of intestinal contents. The location should be 3-5cm away from the edge. Miao Rui hurriedly said.

"The answer is correct, since this is the opportunity for you to help this patient cut off this necrotic bowel. Liu Banxia said with a smile.

Although it was just a very ordinary small operation, it also made Miao Rui very excited.

The reduced intestinal tube was wrapped in sterilized gauze and placed on the storage tray on the side. I don't know if the patient's family has rushed over, so I'll show them after the operation.

The two broken ends of the bowel have been carefully cleaned and disinfected, and if this is not treated properly, there is a high risk of leakage in the sutures when the patient recovers.

"The next thing is that the end of the intestinal tube is sutured, don't talk to you, if you don't know what to pay attention to, you can go back and read a book secretly. Liu Banxia said while stitching it up.

No one had time to care what he said, they were all watching his stitches very seriously.

Even though I've seen him many times, I'm fascinated every time I see him stitched. Because Liu Banxia's stitching gives them the feeling that it is fast and stable, no matter how you look at it, you can't see enough.

"In fact, many times the techniques are the same, although this surgery can be classified into the ranks of tertiary surgery, the place that needs to be paid attention to is the current suture. Liu Banxia still spoke.

"It is best to be able to do without stitches, and the strength of the sutures also needs to be grasped by you in the future operation. In fact, it is just a basic suture technique exercise, how advanced and difficult is it?"

"A lot of major surgery is a combination of the most basic operational knowledge. Work is required on anatomy, sensitivity and coordination of the hands. Okay, loosen the pliers and look at the blood vascularity. ”

Let's talk about it, Liu Banxia finished stitching. After the forceps are released, blood circulation is normal. After careful inspection of the suture, no exudate was found, and the suture was successful.

"Regular closure, work done. Liu Banxia retreated to the back.

Ding! Patient reception is done

Gain 100 XP, 30 Diagnostics Skill, 200 Suture Skill, 100 Dressing Change Skill, and 500 Bowel Surgery Skill

This mission is rated Perfect

Gain 300 XP, 50 Diagnostics Skill, 200 Suture Skill, 100 Dressing Change Skill, 800 Bowel Surgery Skill, and 10 Glory Points

Congratulations to the host intestinal surgery level for being upgraded to level 2, 6000/19999

Although the reward is not small, Liu Banxia still has some regrets, he hasn't experienced the taste of level improvement for a long time.

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