Chapter 2819

Soon, Su Yun passed all the received images to Zheng Ren.

Just a few films and test sheets, but we can see that the old man's physical condition is really very poor, and his condition is very difficult.

Ion disorder was quite serious at the time of admission, and now it has basically returned to normal, but combined with the image, the operation is not done in words.

Zenker diverticulum is a kind of pharyngeal esophageal diverticulum, which is different from ordinary esophageal diverticulum. In 1874, German pathologist Zenker made correct analysis and observation on pharyngeal esophageal diverticulum, so it was named Zenker diverticulum.

Pharyngeal esophageal diverticulum accounts for about 60% of esophageal diverticulum, especially in patients aged 50 ~ 80 years.

This pharyngeal esophageal diverticulum at the pharyngeal esophageal junction is Zenker diverticulum. Its occurrence is related to the dyskinesia of pharyngeal esophageal muscle, the increase of pressure in esophageal cavity caused by achalasia of circumpharyngeal muscle, and the weakness of the anatomical structure of this local muscle.

There is no doubt about the diagnosis. Gastroscopy has proved that what this old patient needs is not diagnosis and differential diagnosis, but treatment.

"Boss, I think all the indicators are maintained well, and there is the possibility of surgery. But it is only possible. It is more likely to be unable to stand down. It is difficult for this body to resist the impact of surgery and anesthesia." Su Yun said after reading the test sheet.

"I'll think about it." Zheng Ren put down his cell phone and looked at the neon flashing distance, thinking about the patient's situation.

The old man was 84 years old. He found progressive dysphagia 6 years ago and was diagnosed as Zenker diverticulum. At that time, because of his age, the patient's family decided to refuse surgical treatment after discussion.

That was six years ago. They refused at that time, let alone now.

Before admission, the elderly could only eat a half stream diet with intermittent vomiting.

After admission, upper gastrointestinal angiography showed that there was a huge diverticulum on the right wall of the esophagus from the neck to the upper chest, and the lower end reached the level of carina, about 10cm × The size is 6cm, the width of the base of the diverticulum is about 7cm, and the ridge between the diverticulum and the thoracic esophagus is about 3cm long.

Chest CT scan showed that the pharyngeal esophageal diverticulum located in the chest compressed and narrowed the trachea and esophagus.

Electronic gastroscopy showed a huge diverticulum on the right wall of the esophagus 16 ~ 23cm away from the incisor. The mucosa of the diverticulum wall was obviously congested, and the esophageal cavity was compressed and narrowed into an intermittently open hole shape. Gastroscopy could not pass through.

"Because the diverticulum base is in the cervical esophagus and upper thoracic esophagus, neither the cervical incision nor the thoracic incision can completely expose the diverticulum base, so there is no way to completely remove the diverticulum." Zheng Ren recalled it and said to Su Yun.

"Yes." Su Yun frowned. "The diverticulum is too big for diverticulum suspension. At this age, it must be impossible to do the operation of combined neck and chest incision."

"Well, certainly not. If the incision is combined, I'm afraid I can't get out of the ICU even if I can step down. It's estimated that the handsome house also thinks so. It's reasonable for the patient's family members to refuse treatment." Zheng Ren mused.

The car then went silent. Zhou Chunyong felt quite embarrassed. Boss Zheng and Su Yun were meditating, and he didn't want or dare to disturb their ideas.

In silence, Zheng Ren got off the bus and went into the private room with Zhou Chunyong. He asked the waiter, "do you have a pen and paper, please?"

"Er... Yes, sir. Just a moment." The waiter was very polite and went to get the paper and pen.

"Boss, do you have an idea?" Su Yun asked.

"It's a little vague, but it's not very clear. Let me draw it for you." Zheng Ren simply didn't come to the table. He sat directly on the sofa next to him, put his elbows on his knees, narrowed his eyes slightly, and looked at the tea table in front of him.

"What are they?" President Bao whispered to Zhou Chunyong.

"I told boss Zheng about Peng's love. It was just a chat. I didn't expect boss Zheng to take it seriously." Zhou Chunyong said helplessly.

"Can there be a way?" Director Bao asked in disbelief.

"I don't know. Have a look." Although Zhou Chunyong saw that boss Zheng had done countless difficult operations, he still refused to believe it.

The old man lives in Shuaifu. Xiehe is known as the last stop in the domestic medical industry. Shuaifu is the point with the strongest technical force. There is no way there. Boss Zheng should and can't solve the problem like flying fairy outside the sky.

Do you want to do it by intervention? Zhou Chunyong suddenly thought of such a possibility. Bullet embolism. Boss Zheng took the bullet out by intervention. This idea is like a fairy flying outside the sky. Now I think it's amazing.

It is also possible that you can't guess boss Zheng with your own level. Zhou Chunyong knelt early in front of boss Zheng and knelt quite thoroughly.

The waiter brought up the pen and paper, and Zheng Ren immediately began to draw a sketch. Zhou Chunyong looks down from a distance. It is a schematic diagram of human anatomy of neck and chest. Although it is only a sketch, the shape is realistic, and the 3D three-dimensional structure is clearly displayed with shadows.

Boss Zheng and Su Yun began to talk about the idea of surgery. President Bao was particularly helpless.

Normally, sitting here, whether out of politeness or dignity, should be fully respected. Come up to chat, talk and laugh. During a meal, everyone has a deeper understanding of each other. It's not convenient to do things in the future.

This is the most basic idea. It seems that as long as there is a little EQ, it will do so.

However, boss Zheng and Su Yun didn't look at themselves. They were chatting enthusiastically and quarreled occasionally. It was very intense.

"Dean Bao, boss Zheng has such a temper." Zhou Chunyong sighed and said, "why don't we order first?"

"Wait a minute." Although Bao Longtao was a little angry, he couldn't tell the problem. Even if he thinks that his family has given up treatment, he doesn't have to think about these things at all, but it's not easy to interrupt.

In fact, it doesn't matter whether you want to or not. Even if you interrupt boss Zheng, you have to take care of yourself. It is said that boss Zheng has strong combat effectiveness. He really dares to hit people when he crosses his eyes in emergency rescue.

No, no, Bao Longtao shook his head, "wait a minute."

He found a place to sit down, took out his mobile phone and opened a small group. When he saw the news in the group, his expression was dim.

"The two old people discussed it and have been discharged automatically." Bao Longtao said, "I'm going back to my hometown."

"Er..." Zhou Chunyong looked at boss Zheng and Su Yun, who were discussing the hot topic, and his heart was mixed.

Is their discussion meaningful? It makes no sense at all.

Chinese people pay attention to returning to their roots. Many people have to go back to their hometown when they die, especially the elderly.

"Dean Bao, where is your hometown?"

"On the other side of the Fen River, it's time to drive." Bao Longtao said softly, "I'm still preparing the car. It's estimated that I'll leave early tomorrow morning and arrive in the evening. Let's go and see the old man again tomorrow."