After all, it is not a self-done operation, and the condition of the patient's chest cavity and abdominal cavity cannot be guessed according to the surgical records.

When Zheng Ren was in the Department of General Surgery of Haicheng First Hospital, he met such a patient.

After the caesarean section, the patient had sudden and heavy bleeding. The doctor at the township hospital had an emergency laparotomy and found that when he had a caesarean section, he didn't know how to do it and punctured his spleen.

It's a proper medical malpractice, but the bizarre doesn't end there.

Emergency splenectomy, after which the patient was again found to have difficulty breathing. So the CT of the lungs was examined, and it was found that the left diaphragmatic hernia, pneumothorax, and lung tissue compression.

The director of the township hospital panicked and hurriedly sent the patient to the first hospital in Haicheng.

For them, Haicheng No. 1 Hospital is their superior hospital and their heaven.

Liu Tianxing had a good relationship with the director of the township hospital, so he took over the patient and helped people wipe their buttocks.

A first examination revealed a large pneumothorax in the patient's left ribcage.

I went to the stage with the chest department and found that when the patient had a splenectomy, the diaphragm somehow broke a hole, and the lung ruptured.

So after a period of repair and suturing, the patient was finally discharged from the hospital after half a month.

The level of doctors in township hospitals really can't be complimented, just like the doctors of the large tertiary hospitals in the imperial capital and the magic capital inspect the first hospital in Haicheng.

This is a gap in the level of technology, and there is no way at all.

Zheng Ren still can't understand why he did a caesarean section and broke his spleen. Why cutting a spleen can lead to lung rupture and diaphragm rupture.

It's terrifying.

Putting up a doctor with a low level of skill is really a joke with his life. However, we cannot expect all doctors to be of a high level, that is unrealistic.

This is also the main purpose of Zheng Ren's live broadcast room for surgery, anyway, in case of trouble, he will do his best.

The situation of the patient in front of him is similar to the process of the female patient who had a caesarean section that Zheng Ren experienced, but the actual situation is different.

The moment Zheng Ren saw the film, he was sure that it must be a liver hernia.

It's a secondary injury, it's certain, but it's not a low-level mistake on the part of the doctor. It is caused by the relatively rare occurrence of congenital retrosternal diaphragmatic hernia, and the patient's age makes the diaphragm weak.

Zheng Ren made a judgment at the first time.

Cui Lao put on his glasses and began to read the film frame by frame.

Soon, Director Ren of the Emergency Department, Director Zhang of the Department of Hepatobiliary Surgery, and Director Li of the Department of Thoracic Surgery also rushed to Cui Lao's office.

When they saw Zheng Ren there, they all froze.

Director Zhang said with a smile: "Boss Zheng, the operation just now is really beautiful!"

"Prizes. Zheng Ren smiled slightly and said modestly.

"It's good to do well, it's not good for young people to be too modest. Director Zhang finished with a smile and began to listen to Zhou Litao's medical history report again.

Hospitalization is always the most annoying work, and the same medical history has to be reported once or twice, or even three or five times.

But fortunately, several directors are here, and it seems that there is no need for more reports.

Soon, after listening to the medical history, everyone began to study the film.

The patient's condition was very bad, and after two general anesthesia surgeries, his body just improved after 1 week of recovery. But there was a liver hernia again, and after a long journey, I came to 912.

After tossing for so long, even if it is an iron body, there will be some problems.

The question of whether emergency surgery should be performed by thoracic surgery or hepatobiliary surgery.

No one wants to accept a sliced and messy patient, so Mr. Cui's experienced experience directly "invited" the directors of the two relevant departments to his office to avoid fighting each other.

Of course, the emergency department has the right to directly push the patient to a certain department, and that side cannot refuse to admit it. But it is better for everyone to sit together, explain in a friendly manner, and then go on stage together.

This thing is extremely sophisticated, but only the old man at the academician level has the confidence to bring the directors of the two related departments and the director of the emergency department over for a joint consultation.

Zheng Ren was originally preparing salted fish.

The patient's condition is relatively clear, and the surgery, detailed exploration, and repair of the diaphragm are enough. This kind of thing, I can't say which director will accept it.

Anyway, with Cui Lao here, is it cool for a while.

However, his wishful thinking was quickly shattered, and several directors did not speak, looking at Zheng Ren.

"Xiao Zheng, tell me what you think. Cui Lao said slowly.

"......" Zheng Ren was puzzled, looked left and right, and saw that no one spoke to the two directors, knowing that he must say something.

Cui Lao's attention is on the one hand, and the other is the just completed operation for Gaucher disease, which has been valued by Director Zhang.

It's an honor to be a different person. But Zheng Ren knew how deep the water was, and he found it difficult.

Zheng Ren groaned slightly, and Cui Lao's gaze was like a whip on Zheng Ren's body.

"Then I'll throw bricks and lead the way and briefly talk about my opinion. Zheng Ren pondered for a moment and said politely, "If there is anything unexpected, please ask a few directors for guidance." ”

"The patient had a congenital retrosternal diaphragmatic hernia and was older in age, resulting in atrophy of the right diaphragm.

Moreover, due to the large size of the primary hernia and the long course of the disease, diaphragm dysfunction occurs after surgery, and the diaphragm function is further weakened and the surrounding tissues may be damaged due to the removal of the hernia sac in one piece during the operation. ”

"In summary, I think that the cause of the patient's liver hernia is due to congenital retrosternal hernia hernia sac resection, resulting in diaphragm tension hypertension, combined with pulmonary bullae, mechanical ventilation tension, and stretching resulting in a large tear of the right diaphragm. ”

"Surgical repair, preferably with a mesh to relieve local tension. Do we have any patches in our hospital?" Zheng Ren asked.

"Hmm. Director Zhang nodded and said, "The tear length, I estimate it to be 15c right, I agree with Boss Zheng's analysis." If this surgery is entered from the abdominal cavity, there is a liver obstruction, and it is difficult to have a surgical field, so it is recommended that the chest department open the chest for treatment, and we can come to the stage to assist. ”

Thoracotomy has been the most common invasive procedure for hernia surgery, especially since removal of the hernia sac is more appropriate. The morbidity and mortality rates after laparotomy are considered to be the highest, and Director Zhang's statement is not wrong.

But Zheng Ren hesitated for a moment, and finally remained silent.

"Xiao Zheng, what are you going to say?" Although Cui Lao was wearing reading glasses, he was aware of everything.

"I think Director Zhang is right, I think the key to the patient's surgery is the mesh. Zheng Ren said, "There is a high probability that the patient's diaphragm may atrophy, so because of the removal of the hernia sac, the tension is too high and it is torn." The mesh itself is more flexible than the diaphragm and can also fully relieve the tension of the diaphragm. ”

"With such a large patch, the operation is a bit difficult. Director Li of the chest department groaned and said.

The fastest update speed, hurry up and read the ..