Chapter 2022

"Hurry up! Is it a bit of public morality to chat with the doctor here? Have a good relationship. Talk in the pub after work. What are you talking about here?" Zheng Ren threw the shackles of morality on the family members of the patients.

They were stunned and calmed down.

The patient has a severe stomachache and is suffering from CT. It is precisely because of this that one CT is not enough and two more have to be done, which has aroused their dissatisfaction.

This noise is unconscious and accidental.

Being yelled twice, the anger and courage disappeared, and the whole person calmed down.

Coupled with Zhou Litao's good temper and constant explanation, they hurried into the house with the emergency surgeon to make a list.

Zhou Litao wiped his sweat and winked at Zheng Ren to take Zheng Ren into the duty room of the main engine.

But Zheng Ren didn't go. He went directly to the door of the emergency surgical consulting room and hurried.

The doctor flew to write the list, and the patient's family trotted away.

Seeing the disappearance of the patient's family members, Su Yun walked into the emergency surgical consulting room, thumbed up and said, "boss, your acting skills are good, very good."

Zheng Ren smiled. "Let's go and talk to President Zhou's duty room."

If the patient's family turns around and comes back, I'm afraid it will be bigger.

For such small frictions that are not medical disputes, Zheng Ren has rich experience.

After all, it's the inpatient manager of the emergency department. These small winds and waves are more common.

When he came to Zhou Litao's duty room, Zheng Ren was completely relaxed and sat in a chair with a smile.

"Mr. Zhou, you go up against him." Su Yun sat directly on the bed and said with a smile.

"How dare you." Zhou Litao said with a sad face. He knew Su Yun was joking, but the joke was not funny at all.

Everyone is a doctor. Knowing the embarrassment of the topic just now, they all consciously say new things.

"President Zhou, what's the patient's situation?" Su Yun asked, "free liver is usually found in childhood. How can the patient delay until now?"

"When the patient came, he asked about his medical history. It is said that he had intermittent abdominal pain since he was five or six years old, but he will be fine in a minute." Zhou Litao said, "I don't care at home. I think it's the little girl's body."

"Later, the patient got used to it. Every time when it hurts, it will be a little better when he lies on the right side."

"On the right side, this is the rhythm of returning the liver by posture."

"Almost. Every time I have a stomachache, I will find a bag. I can push it with my hand." Zhou Litao said.

This... Zheng Ren is helpless. The patient's heart is really big. He found such a big package on his stomach and didn't come to the hospital for examination?

No, it should be

Zheng Ren thought that Su Yun had asked, "haven't the patients come to the hospital for examination?"

"I said I checked it twice. After the abdominal pain was relieved, I checked it when I thought of it. Nothing happened. Finally, the patient gradually forgot about it."

I forgot,

Forget it!

"The patient's pain lasted a long time, the right lying position did not improve, and the upper abdominal mass was particularly large. Coupled with nausea and vomiting, the pain was severe, so he was afraid and called 120 ambulance to the hospital."

"After coming, I touched it. The patient had no tenderness in the abdomen and could touch a bag moving from right to left."

"What were you thinking about?" Su Yun asked.

"What can I consider without checking?" Zhou Litao smiled, "but I've thought about the deformities of the accessory spleen and liver."

"Is intestinal obstruction serious?" Zheng Ren asked.

"After listening, I can still hear bowel sounds, which are slightly weaker, about once a minute." Zhou Litao's physical examination is very detailed and beyond reproach.

"OK, then look at the film and send it directly to surgery." Zheng Ren said with a smile, "adult free liver is really rare. Terrier and auvray first reported it in 1897. Since then, there has been no decent summary, even few case reports."

"Well, as long as it's mainly children, under the age of 5." Su Yun added.

Zhou Litao knew that the two men in front of him sounded right, but they were also seen for the first time.

What is ability?

This is the ability.

It's a good memory to remember things in books. However, in clinical practice, it can be used, as if it has seen many cases. This is a big skill!

Some things, some people, can't refuse.

Zheng Ren called Dr. Liang and said that the examination was almost finished, and the film on the left position had been uploaded.

Turn on the computer and call up the patient's image data. It can be seen that the colon enters between the liver and diaphragm from the retrohepatic space.

The image is quite typical, and the free distance of the liver is about 10cm to the left compared with the film in the supine position.

This is the origin of palpable mass and intestinal obstruction.

There was no complete blockage, strangulation and necrosis. The patient's condition was in a controllable stage.

After watching the film, the film in the right lying position came through.

After changing the body position, you can see that the position of the liver moves obviously and returns directly to the original position.

However, the intestinal tract is compressed, and the film has some artifacts. It is estimated that the patient has obvious pain and agitation in the right lying position due to intestinal obstruction.

"OK, send the surgeon to prepare for emergency surgery." Zheng Ren, turn off the video data.

"Send liver and gall?"

Zheng Ren glanced at Su Yun and said with a smile, "you brother Yun said, send the liver and gallbladder and ask the gastrointestinal tract to go on stage together. First reset the gastrointestinal tract, and then fix the liver with the liver and gallbladder."

"Don't let me carry the pot." Su Yun said, "it's all you said. I never do anything that bothers people."

The disease is actually very simple, but we haven't seen it before. It's a little vague.

The liver cannot be fixed because of the abnormal development of the liver, such as too long, weak and lack of ligaments. When the patient stands upright, the liver moves down, the hepatic diaphragmatic space widens, and the colon is embedded in it, resulting in obstruction, followed by a series of clinical symptoms such as increased pain, nausea and vomiting.

"Mr. Zhou, let the surgeon accompany you." Zheng Ren told, "don't have anything on the road."

"OK." Zhou Litao stepped out of the duty system, called out the surgeon who was checking his body and gave him some instructions.

Subsequently, Zhou Litao went into the surgical emergency room to deal with the patients who had been examined before.

Zheng Ren came out with Zhou Litao with a smile. He glanced at the surgical office and immediately stopped.

"Boss?" Su Yun followed. Unexpectedly, he suddenly stopped and almost hit Zheng Ren's back.

Zheng Ren didn't speak. He hurried back to Zhou Litao's duty room and grabbed a white suit and put it on.

"What's your hysteria?" Su Yun stood at the door and asked him.

"Let President Zhou prepare nitroglycerin. Keep your voice down and don't put pressure on the patient." Zheng Ren said very seriously.