Chapter 1167

"Dangdang ~" Zheng Ren knocked on the door of the consulting room. Hearing Cui's voice inside, he pushed the door in.

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

"Well, as soon as I stepped down, I came directly." Zheng Ren smiled and walked over.

"It's bad not to eat. At my age, you'll feel bad." Cui Lao said, pointed to the film and asked, "tell me, what do you think."

Zheng Ren was silent.

In front of the film, the image is incredible. A broken glass bottle is in the rectum, with a tip stabbing the rectum, and the bone surface at the lower end of the sciatic bone is damaged, especially at the pubic symphysis. The bone surface is eroded and the degree of damage is about 90%.

The sharp part of the bottle reaches the middle gluteal muscle backward, surrounded by organic tissue, diffuse inflammatory lesions occur in the perirectal area where the foreign body is located, and disuse steatosis occurs in the muscle of the right lower limb.

Zheng Ren sees a lot of rectal foreign bodies in the emergency department. What wine bottles, steel pipes, * * * and mousse bottles are the most.

But generally, they went directly to the hospital and took it out. Except for a little embarrassment, it was nothing.

The current case is different.

Severe inflammatory changes, bone wear and erosion at the pubic symphysis, and the surrounding adhesive tissue mean that the foreign body has not been removed for a long time.

Is this abuse? Or something else?

Zheng Ren's eyebrows wrinkled unconsciously.

"The patient began to describe the medical history, but later learned under Xiao Zhou's repeated inquiry that he stuffed a beer bottle into his rectum when he drank too much and played with his girlfriend five years ago. Because he was embarrassed and the patient was introverted, he didn't come to the hospital to take out the foreign body at that time." Cui Lao slowly talked about the patient's medical history while watching the film.

Er... As soon as Zheng rennaohai outlined the picture of the injury at that time, he felt very strange.

Introverted? I didn't see it.

But this has nothing to do with Zheng Ren. What he wants to consider is how the patient should be treated. As for answering Cui Lao's words, Zheng Ren didn't realize that the atmosphere in the consulting room was not so embarrassing.

Unknowingly, his left hand had reached under his right armpit, his right hand held his cheek and stared at the X-ray film.

Cui Lao was not angry because Zheng Ren didn't speak. He continued to introduce his condition.

"The patient complained of claudication for 1 month and weakness of the right lower limb. It was considered that it was caused by the change of disuse fat. This visit was due to fecal incontinence and watery stool. He came to our emergency hospital."

"What about the patient?" Zheng Ren asked.

"I'm going to do CT of lower abdomen and pelvis. I think the patient should undergo surgical treatment, and the treatment is very difficult. It's better to check in detail." Cui Lao said, "Xiao Zheng, look at this X-ray. Do you have any idea about the operation?"

"Like radical resection of rectal cancer, double operation, colon and anus should be open. When they recover better, they can do the second stage operation." Zheng Rendao.

Old Cui nodded slightly, which was what he could think of.

It's just the difficulty of the operation. It's definitely not so simple that a few words can describe it.

The time of rectal foreign body is too long, so that the foreign body is highly organized and wrapped in the body. If you want to clean it thoroughly, you will certainly lose a lot of blood.

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

Once the operation is slightly rough, there will even be a large area of bleeding, but there is no possibility of bleeding vessels.

To coagulate all capillaries with electric burn, postoperative healing and rebleeding have become a big problem.

The operation should be particularly meticulous and requires very high manipulation.

Zheng Ren's brain began to run at high speed, analyzed X-rays, carried out three-dimensional reconstruction, and judged the direction of blood vessels, capillary branches and related tissue positions.

Even with the passive skills of reconstruction, Zheng Ren still feels that the operation of this patient is very difficult and has almost reached the horizon.

With the passage of time, Zheng Ren rebuilt repeatedly in his mind, trying to find a reasonable way to enter. To minimize damage, but also to achieve the goal. But even with Zheng Ren's ability, it is difficult to solve this problem in a short time.

Soon, Zhou Litao knocked at the door, "old Cui, the patient came back from CT just now."

Cui nodded, stood up and said, "Xiao Zheng, let's go to see eye patients."

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

Accompanied Cui Lao to the emergency room, the patient was lying on the flat car. He is a young man. He looks young, just 23 or 4 years old.

He was accompanied by a girl, wearing a plain Plaid Dress, shawl hair, simple and clean.

"Li Mingchao, isn't he?" Old Cui asked.

"Doctor, I won't die." The young man was lying on the flat car with a frightened face.

"Check your body first, and then send it to gastrointestinal surgery. Xiao Zhou, call gastrointestinal surgery and reserve an emergency bed." Cui didn't answer the patient's questions, but said to Zhou Litao.

"Doctor, are you all right?" The girl also asked anxiously.

"How can it be all right." Zheng Rendang said faintly between Cui Lao and the girl, "how did you get such a heavy injury?"

"...." the girl concluded. She was timid, embarrassed and tangled, and her tears fell down.

Zheng Ren was speechless. At this time, the girl's cry made him helpless.

"Are you from DIDU, or do you work here?" Zheng Ren asked.

"Work here after college." The boy said.

"Are you married?"

"No."

"Inform your family and hurry up." Zheng Ren said, "my condition is very serious. I have to have a big operation."

"Don't..." the boy said with pain, "I... that... Surgery signature, can let my girlfriend come."

"Such a high-risk operation requires immediate relatives. You are not married and can't sign. No doctor dares to do this kind of operation." Zheng Rendao.

Just watched the film, Zheng Ren had a basic judgment on his condition. Even if you operate on the stage, there will be a lot of bleeding during the operation.

It's entirely possible to say you can't stand down.

"Doctor..."

"If you don't sign, no one dares to have an operation. If you don't have an operation, you won't be fine for another five years." Zheng Ren said firmly.

Suddenly, the patient and his girlfriend were in a panic.

They were silent. Zheng Ren looked at Cui's physical examination. The patient's physical examination sent a letter. The abdomen was flat and soft, without tenderness and rebound pain. Digital rectal examination showed that the tension of perianal fistula and anal sphincter decreased significantly, and the lower end of foreign body could be obviously touched.

Zheng Ren sighed and shook his head slightly.

……

Note: the case comes from the International Journal of surgery case reports mu? Dr. cahit ozbilgin reports. It's really tiring to look up the data from the case mentioned by senior brother.