The so-called pen holding style is to hold a scalpel like a fountain pen. Because the movement and strength of the knife holder mainly rely on the fingers, it has the characteristics of gentle force, flexible and accurate operation, and can control the movement of the knife finely. This method of holding the knife is generally used for short incisions and delicate surgeries, such as dissecting blood vessels, separating nerves, and Huang Guohui's next action: cutting the peritoneum.

At this time, Ichisuke, who was standing opposite Huang Guohui, had already used this time interval to complete the intermittent suturing of the skin surgical towel on the incision, and fixed the two ends of the surgical towel with two cloth towel pliers.

Seeing that Huang Guohui stopped observing the peritoneum and was about to proceed to the next operation, Yizhu stepped back and let go of the surgical field.

Huang Guohui stared at the peritoneum, held the scalpel with a pen, and gently swiped down with the blade of the knife, making a neat and perfect incision on the peritoneum. At the moment when the incision was cut, Huang Guohui clearly felt a small amount of gas escaping from the incision, but it was obviously not as much as he expected.

"Tissue scissors. Huang Guohui threw the scalpel into the tray and stretched out his hand again.

The instrument nurse hurriedly handed the tissue scissors to Huang Guohui.

Huang Guohui stretched the tissue scissors into the incision of the peritoneum, clicked twice, and the incision of the peritoneum was doubled, and then took the saline gauze handed over by the instrument nurse and applied it to protect the incision, and then fixed the peritoneum on the saline gauze with toothed curved vascular forceps, and finally fixed the two ends of the saline gauze with cloth towel forceps.

After doing all this, he shouted "pull the hook".

Ichisuke, who had already been prepared, took two thyroid retractors and put them into the incision, and as soon as he used both hands, the incision expanded to both sides, and Fan Leilei's abdominal cavity was fully exposed.

Zhang Xiangyang didn't care what Huang Guohui thought, and walked to the operating table, almost shoulder to shoulder with Huang Guohui's assistant, looking down at the abdominal cavity.

There was only a light layer of grass-yellow fluid in the abdominal cavity, which was obviously non-purulent, and no feces were seen, and there was no obvious odor.

At this time, Zhang Xiangyang couldn't help but let out a long breath. At this time, although Fan Leilei's small intestine has not been examined, it can almost be said that Fan Leilei's small intestine has no extensive necrosis.

Why is this so?

Huang Guohui obviously couldn't figure it out. He suppressed the confusion in his heart and gave the order: "Suck the oozing!"

The hand-washing nurse handed the disposable suction tube connected to the negative pressure suction device to the second assistant, who held the suction tube and began to suck up the fluid in the abdominal cavity. Soon, the grass-yellow liquid in the abdominal cavity was sucked out, and the scale on the liquid bottle scale on the vacuum suction device showed an exudate of 80 ml.

After the exudate was sucked up, Fan Leilei's small intestine was exposed to Huang Guohui and Zhang Xiangyang's field of vision. It is evident that although the small intestine exposed by the incision is somewhat distended, it has a slightly darker pink appearance, which is no different from the color of the normal small intestine.

Logically speaking, as Huang Guohui as a doctor, he should be happy for the patient to see this scene. But when I glanced at the X-ray abdominal radiograph on the light box opposite the operating table, I couldn't help but whisper in confusion, "It shouldn't be!"

What is the reason why the actual situation of Fan Leilei's small intestine is so different from the results of X-ray abdominal radiographs? What's more, Fan Leilei himself also shows vomiting, abdominal distention, no bowel movements, and other typical characteristics of intestinal obstruction patients!

Huang Guohui decided to conduct a segment-by-section examination of the small intestine.

He put his hand into the incision, hooked a section of Fan Leilei's small intestine, and gently pressed his fingers, so Fan Leilei's intestine was lifted to the outside of the incision. When he explored the length of nearly 50 centimeters, he finally found that a part of the intestinal tube in the abdominal cavity was not slightly dark pink, but showed a gray color, about one centimeter to two centimeters in length.

This is it, Huang Guohui couldn't help but be shocked, and he was ready to pull out this small intestine for examination. When he put his fingers into the incision and touched this part of the small intestine, he immediately noticed that something was wrong. It is evident that there is a sharp object at both ends stuck in the middle of this part of the discolored small intestine.

What is this thing?

Huang Guohui carefully lifted the small intestine from the incision, and with the help of the bright light, he finally recognized what the two sharp objects were.

It turned out to be an unusually sharp jujube kernel with two ends! Its two sharp ends pierced the intestinal wall of Fan Leilei's small intestine respectively, and just like that, it lay across Fan Leilei's small intestine, blocking both ends of the intestine.

Zhang Xiangyang looked at the jujube pit stuck in the middle of the intestine and couldn't help but smile dumbly. I really didn't expect that the culprit that confused him and Huang Guohui, the two major surgical masters, was this small jujube pit.

If this jujube pit completely punctures the intestine, then a large amount of gas and feces must enter the abdominal cavity, followed by adhesion and inflammation of the abdominal tissue, which will cause acute peritonitis, extensive necrosis of the small intestine and other consequences.

But Fan Leilei, the child's luck, is that after the two ends of the jujube kernel pierced both sides of the intestinal wall, the two ends of the jujube kernel just blocked the holes on both sides of the intestinal wall.

Therefore, when X-rays are performed, the characteristic features of generalized necrosis of the small intestine, such as distended bowel and distended abdominal pneumatosis, will appear. In fact, because the contents of the small intestine such as food residues and feces did not have time to enter the abdominal cavity, Fan Leilei's abdominal cavity was not inflammatory, but because the intestine was blocked by the jujube pit, there were symptoms of intestinal obstruction.

Of course, Fan Leilei's luck also has limits. If it weren't for the college student named Ren Jiangchi who discovered Fan Leilei's intestinal obstruction in time, with the delay of time, Fan Leilei's small intestine that was punctured and blocked by the jujube core would inevitably be necrotic and develop into acute peritonitis and extensive necrosis of the small intestine.

Huang Guohui obviously figured out the strangeness at this time, he shook his head with a wry smile, and said: "Old director, you said that I have seventeen or eighteen years of experience on the operating table outside my children, how could I never have imagined that I would be made so big by a small jujube pit!"

It would not be an exaggeration to describe his mistake as a big heel. If it weren't for Ren Jiangchi standing up and singing against them and persuading Tian Guifen to agree to the laparotomy and exploration operation, then Fan Leilei's child's life would be tied here.

"Director Huang, don't blame yourself too much! I've been engaged in surgery for more than 40 years, didn't I misdiagnose it today?" Zhang Xiangyang comforted, "This also reminds us not to be too conceited in the future, and we must live to learn from all the time!"

"You can't be too conceited!" Huang Guohui nodded, his brows furrowed, "But I still feel a little evil." We can't figure out the problem with the X-ray machine, can the college student named Ren Jiangchi really be able to get the pulse number out? He said that Fan Leilei has intestinal obstruction, even if he said before, but he can accurately judge that Fan Leilei is just a simple intestinal obstruction, and the necrosis of the small intestine will not exceed two centimeters, which is too evil, right? When did the diagnosis level of traditional Chinese medicine advance to such a point?

"Yes, I can't figure it out either, it's really too evil!" Zhang Xiangyang shook his head again and again, as a famous Chinese medicine black, he couldn't understand such a result.

"Okay, let's not talk about this, I'm ready for the next operation!" Huang Guohui turned around and said to the nurse: "You go outside to inform Fan Leilei's family, saying that after laparotomy, Fan Leilei is only intestinal obstruction and simple intestinal perforation caused by a foreign body, and our next step is to remove the foreign body and perform a simple small intestine repair operation." ”