"Dangdangdang~" Zheng Ren knocked lightly on the door of the consultation room, heard the voice of Cui Lao inside, and pushed the door in.

"Xiao Zheng, come so early. Cui Lao was concentrating on studying an X-ray film and pushed his glasses.

"Well, as soon as I got off the stage, I came over directly. Zheng Ren smiled heartily and leaned over.

"It's not good not to skip meals, and at my age, you'll be uncomfortable. After Cui Lao finished speaking, he pointed to the film and asked, "Tell me, what do you think." ”

Jung Ren was silent.

The film in front of me is incredible. A broken glass bottle in the rectum, there is a tip to puncture the rectum, the lower end of the ischial bone is damaged, especially the pubic symphysis, the bone surface is eroded, the degree of damage is about 90%.

The sharp part of the bottle reaches the gluteus medius posteriorly, surrounded by organic tissue, and diffuse inflammatory lesions occur in the perirectal area where the foreign body is located, and apraxia steatosis occurs in the muscles of the right lower extremity.

Rectal foreign bodies, Zheng Ren has seen a lot in the emergency department, what wine bottles, steel pipes, ***, and mousse bottles are the most.

But I usually go directly to the hospital at that time, and I take it out and take it out, except for a little embarrassment, it's nothing.

The case in front of me is different.

Severe inflammation and abrasion and erosion of bone at the pubic symphysis, as well as surrounding adhesions, mean that the foreign body has not been removed for a long time.

Is this abuse? Or is it something else?

Zheng Ren's brow furrowed unconsciously.

The patient began to recount the unknown medical history, but later learned after repeated questioning by Xiao Zhou that he had stuffed a beer bottle into his rectum five years ago when he and his girlfriend had drunk too much and were playing. Because I was embarrassed and the patient was more introverted, I didn't come to the hospital to remove the foreign body at that time. Cui Lao watched the film and slowly talked about the patient's medical history.

Belch...... As soon as Zheng Ren sketched the picture of his injury at that time in his mind, he felt extremely weird.

Are you introverted? I don't see it.

But this has nothing to do with Zheng Ren, what he has to think about is how to treat the patient. As for answering Cui Lao's words, which made the atmosphere in the consultation room less awkward, Zheng Ren didn't realize it at all.

Before I knew it, my left hand had reached out to my right armpit, and my right hand was on my cheek, staring at the X-ray.

Cui Lao was not annoyed by Zheng Ren's lack of speech, and he continued to introduce his condition.

"The patient complained of claudication for 1 month and weakness in the right lower extremity, which is thought to be due to apraxia fat changes. This visit was due to fecal incontinence and watery stools, and I came to our hospital for emergency treatment. ”

"What about the patient?" asked Zheng Ren.

"I went for a CT scan of the lower abdomen and pelvis. I think that the patient should undergo surgery, and the treatment is very difficult, so it is better to have a detailed examination. Cui Lao said: "Xiao Zheng, do you have any thoughts about surgery when you look at this X-ray?"

"It is like radical rectal cancer surgery, the colon and anus should be left blank, and the recovery is better, and then the second-stage surgery will be done. Zheng Rendao.

Cui Lao bowed slightly, this is also what he can think of.

It's just that the difficulty of the operation is definitely not so simple and can be described in a few words.

The patient has a foreign body in the rectum for so long that the foreign body is highly organized, enveloped, and if it is to be cleaned up thoroughly, it will definitely lose a lot of blood.

This operation is a great test of the operator's surgical skills.

Once the surgery is a little rougher, there may even be a large area of bleeding but no bleeding vessel can be found.

All the capillaries had to be coagulated with electrocautery, and postoperative healing and rebleeding became a big problem.

The surgery must be very delicate, and the requirements for manipulation are extremely high.

Zheng Ren's brain began to work at high speed, analyzing X-rays, performing 3D reconstructions, and determining the direction of blood vessels, capillary branches, and the location of related body tissues.

Even with the passive skill of reconstruction, Zheng Ren still felt that the difficulty of this patient's operation was so great that it had almost reached the sky.

As time passed, Zheng Ren reconstructed it repeatedly in his mind, trying to find a reasonable path to enter as much as possible. It is necessary to minimize the damage and achieve the goal. However, even with Zheng Ren's ability, it is difficult to solve this problem in a short period of time.

Soon, Zhou Litao knocked on the door, "Old Cui, the patient came back from a CT scan just now." ”

Cui Lao nodded, stood up and said, "Xiao Zheng, let's go see the patient." ”

Zheng Ren looked at the X-ray, and the glass bottle in his rectum looked so dazzling.

Accompanied Cui Lao to the emergency room, the patient was lying on his stomach on the flat car. It's a young man, and he doesn't look very old, just 23 or 4 years old.

There was a girl beside him, wearing a plain plaid dress and shawl hair, simple and clean.

"Li Mingchao, huh. Cui Lao asked.

"Doctor, I'm not going to die. The young man was lying on the flat car, looking terrified.

"First the physical examination, then the gastrointestinal surgeon. Xiao Zhou, make a phone call to inform the Department of Gastrointestinal Surgery to reserve an emergency bed. Cui Lao did not answer the patient's question, but said to Zhou Litao.

"Doctor, it's okay. The girl asked anxiously.

"How can it be okay. Zheng Ren stood between Cui Lao and the girl, and said lightly, "Why did you come here with such a serious injury?"

"......" the girl concluded, she was a little timid, a little embarrassed, a little entangled, and tears crackled down.

Zheng Ren was speechless, and the girl's crying made him helpless.

"Are you from the imperial capital, or do you work here?" asked Zheng Ren.

"I worked here after graduating from university. The boy said.

"Are you married?"

"No, I don't. ”

"Inform the family, hurry up. Zheng Ren said: "The condition is very serious, and a big operation is required." ”

"Don't ......," said the boy, enduring the pain, "I...... That one...... Surgery signed, can let my girlfriend come. ”

"For such a high-risk operation, you have to have an immediate family member. You're not married, you can't sign, and no doctor dares to do this kind of surgery. Zheng Rendao.

Just watched the film, Zheng Ren has a basic judgment of the condition. Even if you do it yourself, there will be a lot of bleeding during the operation.

It is entirely possible to say that he will not come to the stage.

"Doctor......

"No one dares to have surgery without signing. Without surgery, you won't be able to survive for another five years. Zheng Ren said firmly.

All of a sudden, the patient and his girlfriend were in a panic.

They fell silent, Zheng Ren looked at Cui Lao's physical examination, and the patient's physical examination sent a letter that the abdomen was flat and soft, no tenderness, and no rebound pain. Digital rectal examination of perianal fistula and anal sphincter tension is significantly reduced, and the lower end of the foreign body can be clearly palpated.

This is a trouble, Zheng Ren sighed and shook his head slightly.

……

Note: Case taken from the International Journal of Surgery Case Reports by Dr. Ozbilgina. Listening to the case mentioned by my senior brother, I was really tired of looking for information.