Chapter 2159

"Does menstruation affect pneumothorax? Or is pneumothorax related to menstruation?" Su Yun looked at Zheng Ren suspiciously.

Zheng Ren is also in a daze.

Menstrual pneumothorax has this statement, but most of them are related to endometriosis. But if endometriosis

Zheng renleng, is it menstrual pneumothorax?!

The disease was so rare that Zheng Ren didn't even think about it.

"Boss, if endometriosis occurs, it will mainly be right pneumothorax, which will occur during menstruation, but... Lao Shao, the patient has 7 operations, and how many times are there on both sides?" Su Yun asked.

"4 times on the left and 3 times on the right." Shao Jinghe immediately replied.

"That shouldn't be." Su Yun frowned and whispered.

He had no bottom in his heart. Subconsciously, he was not sure that it was spontaneous pneumothorax caused by endometriosis.

Zheng Ren suddenly stood up, came to the front of the film reader and looked at the image.

Shao Jinghe was silly. He looked at Fang Lin with his eyebrows and eyes, at a loss.

Fang Lin has never encountered this disease. Although he knows about pneumothorax during menstruation, he can't even take the exam.

If any examiner gives a question to test this, it is estimated that he will be punched out of his chest.

"The endometrium migrates to the pleura and lung surface for growth, and falls off when menstruation comes. Because the pleura is very thin, it is easy to be damaged, resulting in air entering the pleural cavity from the lungs, forming pneumothorax and symptoms." Zheng Ren said and thought.

It's like talking to yourself, or talking to someone in the dark.

"The diaphragm is fine."

"Well, it could be the diaphragm." Zheng Ren looked at the film, "generally, pneumothorax during menstruation is accompanied by diaphragm damage..."

With that, he held his cheek and asked, "Lao Shao, if I understand correctly, what you just said is that every time a patient commits pneumothorax is a menstrual period, and then the menstrual period is still very long and the amount is relatively large, isn't it?"

Shao Jinghe nodded repeatedly.

Although he had no idea what the boss Xiao Zheng was thinking, he could still answer the most basic questions.

"Er..." Fang Lin didn't watch the film, but looked at boss Zheng, some speechless.

"Diagnosis of menstrual pneumothorax." Zheng Ren definitely said, "there are four diagnostic criteria."

"..." Fang Lin looked at boss Zheng in amazement. Did he hear what he just said wrong?

"First, the spontaneous rupture of pulmonary bullae."

"Second, the uneven uterine contraction during the menstrual period promotes the gas to enter the uterine cavity and enter the abdominal cavity through the fallopian tube. At this time, the ectopic endometrium blocking the diaphragm micropores falls off, the diaphragm channel is open, and the gas enters the thoracic cavity."

"Third, the ectopic endometrium on the visceral pleura falls off, resulting in lung leakage."

"Fourth, bronchiolar contraction caused by prostaglandins or alveolar rupture caused by unidirectional valve mechanism caused by bronchiolar endometriosis."

Zheng Ren began to talk again, not only Shao Jinghe, but also Fang Lin.

"Endometriosis, diagnosed as menstrual pneumothorax, in line with 1 and 3 criteria." Zheng Rendao.

"But..." Shao Jinghe wanted to say something, but he didn't say it in the end.

"There's a problem with the diaphragm." Su Yun added, "a small crack, only when the abdominal pressure increases, there will be a small gap, resulting in endometriosis again."

"Again..."

"Go further and fall directly on the lungs. Finally, it erodes the visceral pleura in physiological period, resulting in continuous spontaneous pneumothorax."

"Yes." Zheng Ren nodded, "Lao Shao, have you ever observed the diaphragm during your operation?"

"No..."

Shao Jinghe is at a loss. He has pneumothorax surgery. Who can observe what the diaphragm does if he has nothing to do.

"Well, during the operation, one chamber ventilation. Look carefully for the location of the diaphragm. It is estimated that there is a small crack. Forget it, it's still laparoscopic to pressurize. When the pressure is high, gas can be seen in the chest."

"Boss Zheng, Brother Yun, let's go up and have a look?" Fang Lin had no idea.

"It's like you don't have a second-line professor." Su Yun gushed.

That's what I said, but it's absolutely impossible to keep him off the stage. With such a rare menstrual pneumothorax, Su Yun has to work hard with Fang Lin without looking up.

The patient's fasting time was no problem. He put forward the list for surgery. There was still half an hour to prepare before the operation. Zheng Ren and Su Yun went directly to the operating room.

"Boss, normally the diaphragm muscles are very developed, and there are few problems. Is it a congenital problem?" Su Yun asked.

"It's possible. Just go up and have a look." Zheng Rendao, "repair the diaphragm, and take chorionic releasing hormone treatment after operation. It should get better soon."

Su Yun suddenly remembered something. He looked at Shao Jinghe and asked, "have you done the previous surgery and postoperative pathology?"

“……”

In a word, Shao Jinghe was silly.

Normally, all the cut things should be sent for pathological examination, such as the appendix. There may be 1-2 malignant changes in 1000.

Because the period of pathological diagnosis is long and the cost is expensive for some families, many refuse to do pathological examination.

Doctors, especially doctors in lower level hospitals, rarely force patients to do pathological examination. The patients who came to 912 didn't tell their families about it at all. It was natural to have a pathological examination after operation.

This is a difference between the local small hospitals and the top three first-class hospitals in DIDU.

This patient is a spontaneous pneumothorax. The diagnosis is very clear. There is no problem with the pulmonary bullae cut off during the operation.

At least Su Yun hasn't seen it.

It is estimated that Shao Jing and Dr. Shao also think so. It seems that he hasn't done pathological examination.

Sure enough, Shao Jinghe said, "I didn't do it."

"Lao Shao, your work is too careless." Su Yun said contemptuously, "if you do it once, even if it's only once, it won't happen. You..."

"Brother Yun, it's not like that." Shao Jinghe was about to cry and hurriedly said, "the patient's family is not very rich. I didn't dare to use titanium clips during the operation. They were sutured by hand. The pathology also paid off -- it is consistent with the change of pulmonary bullae. I don't think it makes any sense."

Zheng Ren sighed and shook his head slightly.

The inspection is like this. There is little possibility of problems. But once there is a problem, such as the current situation, it may cause misdiagnosis and missed diagnosis.

This is the standard good intention to do bad things.

But then again, even if Shao Jinghe did a pathological examination and sent the specimen to the pathology department, it is estimated that the doctor on that side is crazy.

The pathological examination of pulmonary bullae was consistent with the microscopic condition of endometrium, and no one dared to diagnose it in local hospitals.

At that time, take the pathological section to the superior hospital for diagnosis. It's still a toss.

It is very good that grass-roots hospitals can correctly diagnose and treat common diseases.

As for rare diseases, there is no case in ten or twenty years. Even learning the unique skill of killing dragons is useless.

……

……

(ask for comparison and monthly ticket.)