"Ruan Bin, open your stomach to check!" The Bluetooth headset on Ruan Bin's ear came from Jiang Yurong's voice.

"Good!"

After confirming that the anesthesia was effective, he made a transverse incision under the left costal margin.

After the incision was opened, he saw a dark red area of blood and ascites in the cavity.

"Suction device!" Ruan Bin said to Huang Hongwen next to him.

"Give. ”

Take the suction device and begin to absorb and remove the blood and ascites fluid from the cavity and abdomen.

When the blood and ascites fluid in the cavity and abdomen are cleaned, the organs in the abdomen are suddenly exposed.

At this time, I saw a crack in the middle of the spleen that ran through most of the spleen, and the thickness of the crack was also very deep, almost two-thirds of the depth of the spleen! I also saw a rupture of a splenic artery and a rupture of a splenic vein, and blood was still gushing out.

Seeing this, Ruan Bin's face was instantly solemn, because the spleen is generally supplied by the splenic artery, and the spleen vein returns, and now there are two such blood vessels in it, and the damaged part of the spleen can no longer circulate. So the problem is serious!

To be honest, Ruan Bin was a little panicked when he saw it now, only the entry-level he didn't know how to deal with such a heavy hemorrhage. Straight excision, excision, excision, or repair?

Anyway, he didn't have a clear answer in mind!

At this time, Jiang Yurong outside saw the extent of damage to the patient's spleen, and her eyebrows furrowed.

"Although the spleen has not been completely shattered, this penetrating wound is too big and deep, and there is almost a high chance that it will have to be completely removed!" Jiang Yurong immediately judged how to deal with it.

"Although the wound is quite large, as long as the bleeding is stopped, can it be saved with stitches?" Ruan Bin asked triedly.

"It's difficult, it's too difficult! Because the spleen texture is relatively brittle, and it is difficult to suture, even if it is sutured well, it is easy to bleed a second time. Generally speaking, if the crack of the spleen penetrates more than 2 centimeters thick, it is generally selected to be partially or completely excised!" Jiang Yurong shook her head and explained.

"The thickness of 2 cm is not very large?" Ruan Bin thinks that with his world-class suturing technique, can he give it a try?

"It's true that a 2 cm penetrating deep wound is nothing in other organs, but the texture of the spleen is very brittle, just like the cooked duck blood we eat in hot pot, and a second injury will occur when pulling the sutures a little hard when suturing. Of course, there are also masters of spleen surgery who have tried suturing the tear up to 3 cm (normal spleen thickness is 3.5 cm), and the operation was successful. But there are very few examples of such success! Even the master has a less than half of the chance. ”

"If there is a second bleeding from the injury with sutures, and then you have to open the abdomen again, the risk of a second laparotomy is higher. Jiang Yurong shook her head and said.

Just when she was about to instruct Ruan Bin on how to stop the bleeding quickly, Qian Haomin ran in sweating!

"Director Jiang, where is the patient?" said Director Qian, gasping for air.

"In the operating room, by the way, why did you come here so quickly? I heard that your house is fifteen minutes away from here at the earliest?" Jiang Yurong was a little curious. From calling someone to call each other, only six or seven minutes have passed now!

"I happened to be shopping with my wife nearby, so I came over quickly!" Director Qian explained.

"By the way, someone in the operating room is operating on a patient?"

When he heard that they were all sent to the operating room, he couldn't help but ask.

"Well, Ruan Bin is opening the abdomen of the patient inside, and you still have to come to the excision operation. Jiang Yurong said quickly.

"I'll go now!" Director Qian walked to the operating room quickly.

Once inside, get dressed and walk to the operating table.

"Director Qian. "Ruan Bin was in the Bluetooth headset just now, and the conversation outside was quite big.

"Hmm. Director Qian glanced at Ruan Bin and nodded.

He took a quick look and found that Ruan Bin had only opened his abdomen to check the injury, and had not yet started the operation. He thinks that Ruan Bin should not be able to perform this tertiary operation, and it is estimated that Jiang Yurong outside will command him to open his abdomen and shorten the time as much as possible!

"It's been a long time to bleed, isn't it? Now we have to stop the bleeding first!" Director Qian said, stretched out his hands and pulled it in.

Ruan Bin only saw that Director Qian pinched the spleen pedicle with his index finger and thumb with his right hand, and together with his left hand, he held the entire spleen out of the incision.

"Take a big gauze pad to fill the spleen bed!" Director Qian said to Ruan Bin.

"Good. Ruan Bin immediately filled the spleen bed with a large gauze, and then he was shocked to find that the wound of the ruptured spleen was no longer bleeding!

Huang Hongwen on the side also had an expression as if he had seen a ghost, obviously he also found out.

The blood was still bleeding just now!

At this time, Director Qian also seemed to notice the shocked expressions of these two people, so he smiled and said: "In the face of this kind of massive bleeding of spleen arteries, the circulation is unstable. At this time, it is necessary to put saving life first, so as long as you quickly control this spleen, control the arteries and veins of the spleen, and block its source, it will not be able to produce blood. ”

"I see!" Ruan Bin nodded admiringly, worthy of being the director of the emergency department, this method of stopping bleeding is really simple and practical.

"However, the patient's spleen penetrated too deep into the wound, reaching 3 centimeters thick. In this case, the only way to do this is to make a full cut. Then Director Qian took a closer look and sighed helplessly.

Hearing this, Ruan Bin frowned, Director Qian and Jiang Yurong's judgment was still the same, it could only be completely removed!

But when he thought that this patient was only thirteen or fourteen years old, and his entire spleen was about to be removed, he couldn't bear it!

"Ding-dong...... Temporary Mission: Show the host world-class debridement and suturing techniques to save the poor boy. If the patient recovers, 3,000 points will be awarded!"

Originally, Ruan Bin was like trying it, but now that there is a task in the system, he is suddenly moved!

"Director, can you try to suture it and see what if, what if it can be revived? This patient has no spleen at such a young age, what can I do in the future~" Ruan Bin said in a deep voice.

Once the spleen is removed, the immune response will be impaired, immunoglobulin and complement function will be insufficient, affecting the opsonization, causing macrophages and multinucleated leukocytes to move slowly, and the phagocytosis of pneumococci will be weakened.

The spleen is also an important base for various immune cells to inhabit, proliferate, respond and produce immune effector substances (such as antibodies, etc.), and the spleen also produces immunoactive cells, such as macrophages, T cells, etc. T cells have an immune effect on tumor cells, and the spleen is the only organ that produces T cells, so tumors are very likely to occur after the spleen is cut!

If the patient is forty or fifty years old, Ruan Bin certainly does not want to take the risk and supports the removal of the spleen! After all, even if it is possible to get a tumor in the future, it will be a matter of seventy or eighty years old, and it does not matter whether there is a tumor or not.

But now this patient is only thirteen or fourteen years old, so young, and his life will be so long!