Dr. Lin asked tentatively, "Excuse me, are you Monday?"

Zhou Zhou was stunned for a moment, and said strangely: "Do we know each other?"

He was really Zhou Yi.

Dr. Lin smiled, "It's the first time we've met, but I've heard people talk about you. When I saw it today, I was really young and promising. ”

In the face of Dr. Lin's praise, Zhou Zhou was a little blindsided.

He thought about it, and he was outside his chest, as if he had no acquaintances.

I don't know where Dr. Lin heard about him.

There is a serious illness in front of me that needs to be consulted, and there is no time to delve into this matter on Monday.

Zhou Yi had no choice but to laugh and stop answering.

There is not much time for small talk.

The consultation time will be officially entered soon.

The first is, of course, a presentation of the patient on Monday.

At the same time, Bai Mingming put the patient's chest X-ray on the reading light.

In the consultation room, the eyes of several people from outside the chest were immediately attracted.

Monday begins to introduce the patient's condition and analyze the chest x-ray.

Typical mediastinal emphysema.

Dr. Lin understood at a glance.

He was more concerned about how Zhou Zhou found out about the patient's condition.

Zhou Yi also briefly talked about the diagnosis process.

Dr. Lin listened and nodded his head in agreement.

At the same time, he was also slightly surprised in his heart.

From Monday's description, it took only two hours for the patient to go from admission to the diagnosis of spontaneous esophageal rupture.

This is a very rare disease. It can be said that it is fast.

Dr. Lin vaguely recalls a consultation he participated in three or four years ago for a ruptured esophagus.

At that time, the emergency center was still an emergency department.

It took more than 10 hours to confirm the condition in the emergency department.

Dr. Lin sighed in his heart, these young people in the emergency department are not simple!

Wait for Zhou to finish the situation concisely.

The next step is to determine the patient's current condition.

The premise of the judgment is, of course, to have an examination report on the esophagus.

Dr. Lin asked, "Did the patient's esophagus take a photograph?"

Zhou Zhou said: "I have been ready for a long time. Teacher Bai, a film of cinematography. ”

Bai Mingming immediately stepped forward to replace the film on the reader.

Dr. Lin secretly praised in his heart, and said that the preparation for this week's life is quite sufficient. There is no consultation yet, and the esophageal imaging has been done.

It seems that they are quite confident in their judgment of the disease!

The esophageal picture is hung up.

Monday continued to analyze the condition through this photo.

"There is leakage of contrast medium, there is contrast in the chest, mediastinal emphysema, and there is no septic shock at present. The location of the esophageal rupture is in the lower segment, and the length is about 3 cm from the photographic observation, which is typical of esophageal thoracic fistula."

Esophageal rupture is divided into esophageal thoracic fistula and esophageal mediastinal fistula according to the type.

Fistula, phonetic leakage. In Chinese, it refers to the ducts formed by the outward bursting of lesions in the body, from which the secretions in the lesions flow out.

This word is used to describe the rupture of the esophagus.

As for thoracic fistulas and mediastinal fistulas, it can be seen literally that fistulas affecting the chest cavity are thoracic fistulas. Affecting the mediastinal is known as a mediastinal fistula.

It is obvious that a thoracic fistula is larger than a mediastinal fistula and affects a wider range of organs and organs.

Monday finished stating his condition.

It stands to reason that the next step should be to be an expert in this area, Dr. Lin from the chest to give advice on supplementation and treatment.

But the newborn calf on Monday is not afraid of tigers.

In other words, I have not been in the hospital for a long time, and I have not yet been contaminated with the atmosphere of the workplace.

The wolf nature on the operating table, unconsciously, was also brought to the consultation on Monday.

"This situation should be done with fasting, gastrointestinal decompression, anti-infection, blood volume and albumin replenishment, correction of water and electrolyte acid-base balance, and nutritional support"

On Monday, several interns, including Cao Xin, were working hard to memorize their brains, which was a rare opportunity for clinical learning.

Even Bai Mingming and the two chest residents listened carefully. Secretly note down the response given next Monday.

Dr. Lin wasn't angry that Wednesday stole his lines.

On the contrary, he listened quietly, and the treatment measures given on Monday were very pertinent.

If the esophagus is ruptured, it must be fasted. Fasting requires nutritional supplementation.

Food and bacteria in the esophagus enter the chest cavity, and poisoning and infection must be considered. It is also necessary to fight infection, replenish blood volume and albumin, and correct the acid-base balance of water and electrolytes.

At this point, Dr. Lim didn't think there was anything outstanding about the treatment given by Zhou Zhou. It's just a decent clinical treatment for esophageal rupture.

But I never expected that Zhou Yi would not finish speaking.

He continued: "The patient's wound was not particularly large, and it was detected in a timely manner. However, considering that food, digestive juices, and bacteria have entered the chest cavity, thoracostomy drainage and gastroscopic salvage stent placement should be performed as soon as possible to close the fistula. ”

Hearing this, Dr. Lim was a little surprised.

In the past, treatment for this type of esophageal rupture, regardless of the size of the wound, generally required standard surgery. Esophageal repair, drainage, or even esophageal removal.

However, with the continuous development of endoscopic technology, thoracic surgery more often uses esophageal stent graft implantation to close small gaps.

But these are cutting-edge technologies.

And because there are not many patients with esophageal rupture.

This surgery may not always be done once a year.

Therefore, not many people know about advanced endoscopic surgery.

This week, he was a little surprised that he was young and still in the emergency department, and he actually knew about endoscopic treatment.

Monday said this in one breath.

There is a feeling of vomiting as pleasure.

There is goods in the stomach, not to mention that it must not hold back internal injuries.

But after saying it completely.

Zhou Zhou also felt that he had talked a little too much.

"Dr. Lin, I'm done, you can give your professional opinion. ”

Dr. Lin smiled, this should be almost said, what else do you say.

It can only be added that let yourself bring these few "students" to continue to increase the clinical experience of this disease.

"Dr. Zhou's analysis is in place, especially for the treatment, and has given a general direction. I agree that the patient's onset time was not more than 24 hours, and the radiographic showed that the wound was about 3 cm, which was suitable for endoscopic treatment. Without further ado, this case was admitted to our department and surgery was scheduled this morning. ”

This concludes the consultation.

The people outside the chest left one after another.

The rest of the transfer department will be arranged by Bai Mingming.

Monday and Cao Xin returned to the lounge and changed their clothes.

The two left the emergency center one step ahead of Bai Mingming.

The two walked side by side.

Monday asked on Monday: "How did you feel about the emergency work on the first day?

Cao Xin smiled, "It's okay." It's very fulfilling. ”

"Will you hold on? Will you want to leave?"

"It's impossible, unless it's Team Leader Zhou, you don't want me anymore. ”

"I don't want you, that's impossible, Dean Cheng introduced you, how could I drive you away, start following Su Quan from tomorrow, if you have any questions, you can come to me at any time." ”

"Roger!"

The two walked and talked, and they didn't part until near the hospital parking lot.