"Hou Quanhai, open your stomach and check!" The Bluetooth headset on Hou Quanhai's ear came from Jiang Yan'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.

"Sucker!" Hou Quanhai said to Fan Yu 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 tear in the middle of this 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 this spleen! A ruptured splenic artery and a splenic vein were also seen, and blood was still pouring out.

Seeing this, Hou Quanhai'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, Hou Quanhai 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. Direct excision? Or is it an excised part? Or patching?

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

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

"Although the spleen did not appear completely shattered, this penetrating wound was too large and deep, and there was almost a high probability that it would have to be completely removed!" Jiang Yan immediately judged how to deal with it.

"Although the wound is quite large, as long as the bleeding stops and stitches up, can it be saved?" Hou Quanhai tried to ask.

"It's hard, it's so hard! Because the spleen is relatively brittle, it is difficult to suture, and even if it is sutured well, it is easy to have a second bleeding. Generally speaking, if the thickness of the spleen is more than 2 cm, it is generally selected to be partially or completely resected! Jiang Yan shook his head and explained.

"2 cm through thickness isn't that very big?" Hou Quanhai 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 few examples of such successes! Even if you are a master, there is only a half-percent chance. ”

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

Just when she was about to instruct Hou Quanhai on how to stop the bleeding quickly, Director Min Wen ran in sweating profusely!

"Director Jiang, where is the patient?" The door director gasped.

"Inside the operating room! By the way, why did you get here so soon? Did you hear that your house is a fifteen-minute drive from here? Jiang Yan 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 come over quickly!" The door director 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, Hou Quanhai is opening the patient's abdomen inside, and you still have to come for the excision operation." Jiang Yan said quickly.

"I'll go!" The door director walked to the operating room neatly.

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

"Door Chief." Hou Quanhai was quite big in the Bluetooth headset just now, and the conversation outside.

"Hmm." The door director glanced at Hou Quanhai and nodded.

He took a quick look and found that Hou Quanhai had only opened his abdomen to check the injury, and had not yet started the operation. He felt that Hou Quanhai should not be able to perform this tertiary operation, and it was estimated that Jiang Yan outside would direct him to open his abdomen and shorten the time as much as possible!

"It's been a lot of bloodshed, isn't it? Now we have to stop the bleeding! The door director said, stretched out his hands and took it in.

Hou Quanhai only saw that the director of the door pinched the spleen pedicle with his right hand with his index finger and thumb, and together with his left hand, he held the entire spleen out of the incision.

"Take a large gauze pad to fill the spleen bed!" The door director said to Hou Quanhai.

"Okay." Hou Quanhai 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!

Fan Yu on the side also had an expression as if he had seen a ghost, and obviously he also found out.

The blood was still bleeding just now!

At this time, the director of the door seemed to have noticed the shocked expressions of these two people, so he smiled and said, "In the face of this kind of massive bleeding of the 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!" Hou Quanhai nodded admiringly, worthy of being the director of the emergency department, this hemostatic method 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 the door director took a closer look and sighed helplessly.

Hearing this, Hou Quanhai frowned, the judgment of the door director and Jiang Yan was still the same, it could only be a total excision!

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, 3000 points will be awarded! ”

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

"Director, can you try stitching it up? What if, what if it can be brought back to life? This patient has no spleen at such a young age, what can I do in the future~" Hou Quanhai 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 ability of pneumococci is weakened. In other words, the spleen is also a filter of blood throughout the body, which can remove pathogens mixed into the blood and cells that have decayed by themselves.

The spleen is also an important base for various immune cells to live, proliferate, and respond to immune effects and produce immune effector substances (such as antibodies, etc.). The spleen also produces immunoactive cells and plays an immune role, 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 prone to occur after cutting the spleen! That is, cancer!

If the patient is forty or fifty years old, Hou Quanhai certainly does not want to take risks and supports the removal of the spleen! After all, even if it is possible in the future, it is possible to get a tumor, and it will be a matter of seventy or eighty years old, and it doesn't 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!