Grade three involves rupture of the splenic hilum, and grade four is the most serious when the spleen is severely fragmented, and it is necessary to consider removing the entire spleen.
The reason why Dr. Zhou was so surprised was that he had already explained when the child came to the county hospital that the surgery department here was not equipped to perform surgery on infants and young children and no doctor could do it.
"We can only send him to a higher-level hospital." Doctor Zhou said hurriedly to Xie Wanying, Nie Jiamin and others, and asked the nurse to call the nearest hospital in the city that could accept the child.
Seeing that Dr. Zhou might not understand what Teacher Nie meant, Xie Wanying helped her teacher to explain: "Dr. Zhou, don't send the child to the city hospital. Teacher Nie's idea is that the child must be operated on in the operating room here because there is not enough time to send him to the city hospital."
Doctor Zhou was so anxious that he jumped up and down. He said to her, "Don't you know? I told you before, didn't I? No one is willing to do it. Give the patient a blood transfusion first. Give her more blood transfusions. Try to save her life and send her to the city hospital. There are doctors there to perform surgery on her. It will take about two hours to get her there."
"Two hours is too late. Her splenic hilum ruptured and she was bleeding profusely," said Xie Wanying.
Her words caught Nie Jiamin's attention. Turning his head, Nie Jiamin looked at her with a gleam in his eyes: thinking of the simple report from the ultrasound doctor just now, how could she hear that the spleen hilum was ruptured, unless she could understand the ultrasound images herself like him.
"No, no." Doctor Zhou insisted on his opinion. It was obvious that he was very afraid that the child would die on the operating table. He expressed strong displeasure to Xie Wanying, "I see that you are just a student and have never seen a patient like this. I have seen many similar patients. Some are more serious than hers. They can be safely sent to the city for surgery."
"It's much more serious than hers. If she doesn't have an abdominal exploration to stop the bleeding as soon as possible, the amount of blood loss will be unimaginable. She is an infant."
...
...
Doctor Zhou was extremely surprised after hearing her words: "Where did you come to this conclusion?"
"The splenic hilum is ruptured, the splenic artery and splenic vein are ruptured, and if you percuss her abdomen again, you will hear mobile dullness," said Xie Wanying.
In terms of abdominal shifting dullness, adults have close to 1000 ml of peritoneal effusion, and infants and young children are definitely in a worse condition. Dr. Zhou was speechless: "This..." He thought she was listing data, so he had to produce relevant data to refute her.
Someone laughed out loud.
Dr. Zhou turned around and saw the taciturn expert, Mr. Nie, smiling.
Some people are good at speaking and they are sophistry, while others are good at speaking and they are strong. The laughter that Nie Jiamin couldn't suppress in her throat was undoubtedly the latter, seeing that such an upright person was good at speaking and they were able to make people smile from the bottom of their hearts.
Hearing the teacher's laughter, Xie Wanying stopped talking for a while. She thought that she seemed to have said too much and was showing off in front of the teacher.
The student didn't say anything, so Nie Jiamin quickly said, "Perform abdominal puncture. If the diagnosis is clear, send him to the operating room."
"But, but the surgeon——" Doctor Zhou blinked at the expert from the capital: Expert, please don't embarrass us, even if you are from the National Association, you can't do anything wrong. No one can force them to go to the operating table.
Teacher Nie was being modest, but Dr. Zhou didn't realize it.
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