This was the first time the two of them had met since the incident with the dropped envelope and Xiao Yazhi's surgery.
Xie Wanying's attention is focused on the patients.
The heart rate was 126 beats per minute and the blood pressure was a little low. I guess there were signs of intestinal incarceration, Xie Wanying speculated.
Soon, Dr. Liu Chengran arrived at the hospital.
"Bring the CT film." Liu Chengran walked into the operating room and gave the order.
Various preoperative patient information was submitted.
Liu Chengran checked the patient's information and asked Xie Wanying: "Tell me, what is the condition of this patient?"
The emergency department teacher's interrogation at night was very tense. Xie Wanying quickly expressed her understanding of the case: "The preliminary diagnosis is paraduodenal hernia PDH. This disease is very easy to misdiagnose or miss, so when the patient's symptoms were not obvious before, he was treated by internal medicine in other hospitals but it was not discovered. This time, the patient's symptoms worsened due to strenuous exercise after a full meal and could not be relieved by medication. The family members urgently sent the patient to our hospital for emergency help. After a CT scan, there were no major obstacles to diagnosis. Paraduodenal hernia is divided into left and right. Judging from the CT results today, this patient should have had it on the left side, with the jejunum entering the Landzert recess. On the CT scan, you can see a slightly obvious cystic intestinal loop between the pancreas and stomach in the upper abdomen."
"How do you think this operation can be performed?" Liu Chengran continued to ask her.
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"The patient has symptoms of intestinal obstruction and vomiting. Intestinal torsion and intestinal strangulation and necrosis cannot be ruled out. The digestive endoscope cannot be inserted, so a laparotomy is needed. An incision is made along the midline of the abdomen, the intestines in the hernia sac are taken out and corrected, and the hernia ring is closed. I hope the intestines have not ruptured or necrotized, otherwise it is peritonitis. The patient has no symptoms of peritonitis for the time being, so this operation should be performed as soon as possible."
Hearing her answer quickly and steadily, Liu Chengran was sure that Tan Kelin's order could be carried out, and ordered: "You do it."
What did the teacher say? It was so sudden that the students were unable to react.
Liu Chengran waved his hand and said, "Go wash your hands. You will be the lead surgeon for this surgery tonight."
Li Qi'an took a deep breath: What?! Didn't I hear that the surgical student was trying to perform an appendectomy operation?
Appendicitis? If laparotomy is performed for appendicitis, it is basically severe diffuse peritonitis. Even the attending physicians may not be able to save such patients. Elective appendicitis surgeries are now all laparoscopic, so where is the opportunity for interns? It is best for interns to learn to do traditional laparotomy first to lay a solid foundation, and then do laparoscopy.
Now there is such an opportunity to give it to the interns to try. There will be no next store after this one.
This operation is not necessarily more difficult than the appendicitis surgery that interns used to practice. In fact, appendicitis surgery was quite difficult in the past. Some interns would spend a long time just to find the appendix. For surgical interns, how to quickly find the lesion after opening the abdomen is a threshold. Interns need to have the thinking experience to connect the imaging film with the actual anatomical position of the various organs in the patient's abdomen.
You can take it for granted in your mind, but it is another matter when it comes to actual operation. Otherwise, why do seniors often say that juniors have high expectations but low skills? They can talk very well, but when they put their hands into practice, they are all rubbish.
"Didn't you do this with your teacher Sun?" Liu Chengran said to the students.
Teacher Sun had previously performed an operation on a case where a paraduodenal hernia was discovered and the hernia was treated at the same time. She was an assistant at the time and was fortunate to be involved in the operation. She had an impression of it and was quite clear about the steps of the operation.
"Do!"
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