Chapter 2022： Rare adult free liver

You hurry! Chatting with the doctor here, is there any point of public morality? Good relationship, get off work, talk to the pub, what to do here. "Zheng Ren's hand threw the moral shackles on the patient's family.

They snorted and calmed down.

The patient's stomach hurts so badly that it is uncomfortable on the CT side. Because of this, a CT is not enough, and two more, it has caused their dissatisfaction.

This kind of noise is unconscious and belongs to incidental events.

Being shackled by two people, the anger and courage disappeared, and the whole person calmed down.

In addition, Zhou Litao's temper is very good, and he constantly explains that they havetened to the doctors of the emergency department and drilled into the house to open the list.

Zhou Litao wiped a sweat and gave Zheng Ren a look. He wanted to bring Zheng Renjin to the duty room of the host.

However, Zheng Ren did not go, he went directly to the door of the emergency surgery clinic, and rushed.

The doctor flew the general billing list, and the patient's family left and ran away.

Su Yun saw the patient's family disappeared, walked into the emergency department, and put up his thumb. He said: "Boss, acting is good, quite good."

Zheng Ren smiled and said, "Go, go to the weekly duty room."

If the patient's family has something to turn back, I am afraid that things will be even bigger.

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

After all, it is the total hospitalization of the emergency department. These small winds and waves are much more.

Came to Zhou Litao's duty room, Zheng Ren was completely relaxed, sitting in a chair with a smile.

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

"Which dare." Zhou Litao said with a grumpy face, he knew that Su Yun was joking, but this joke is not funny at all.

Everyone is a doctor, knowing the embarrassment of the topic, and consciously saying something new.

“Zhou Zong, what is the patient?” Su Yun asked: “Free liver, which is usually found in childhood, how has the patient been dragged to the present?”

"When the patient came, I asked about the medical history. It is said that there was intermittent abdominal pain from the age of five or six, but it would be good for a while." Zhou Litao said, "There is no concern in the family, and it is considered that the little girl is physically weak."

"The patient will get used to it later. When it hurts, the right side will be slightly better."

"On the right side, this is the rhythm of keeping the liver back by position."

"Almost, every time you have a stomachache, you will find a mass that can be moved by hand." Zhou Litao said.

This... Zheng Ren has some helplessness. The patient is really a big heart. I found such a large mass on my stomach. I still haven’t come to the hospital for examination.

No, it should be...

Zheng Ren thought, Su Yun had already asked: "Is the patient not checked at the hospital?"

"It is said that it has been checked twice. It is all after the abdominal pain is relieved. I will check it. There is nothing wrong with it. Finally, the patient will gradually forget this."

Forgot,

Forgot!

"The patient had a long time of pain, and the right lateral position did not improve. The upper abdomen was particularly large. With nausea and vomiting, the pain was severe, so I was afraid, and called 120 ambulances to the hospital."

"I touched it after coming. The patient's abdomen has no tenderness and can touch a mass that moves from right to left."

"What did you think about at the time?" Su Yun asked.

"If I don't check, I can think about it." Zhou Litao smiled. "But the spleen and liver malformation are still pondering."

"Is the intestinal obstruction not heavy?" Zheng Ren asked.

"I listened, but I can hear the bowel sounds, which is slightly weaker, about 1 time per minute." Zhou Litao's physical examination is very detailed and blameless.

"Well, then take a look at the film and send it directly to the surgery." Zheng Ren said with a smile: "The adult free liver is rare. In 1897, Terrier and Auvray reported for the first time. Since then, there has been no decent summary. Even the case reports are few."

"Well, as long as the child is the main, under 5 years old." Su Yun added a sentence.

Zhou Litao knows that the two heads in front of him are the ones who are listening, but they are the first to see them.

What is the ability?

This is the ability.

Things in the book can be remembered, this is a good memory. However, in the clinical, you can use it, just like how many cases you have seen, this is the big skill!

Some things, some people, can't take it.

Zheng Ren gave Dr. Liang a phone call. The face said that the check was almost finished, and the film on the left side was uploaded.

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

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

This is the origin of the mass that the patient can feel the self-report, and it is also the origin of the intestinal obstruction.

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

After watching the film, the film on the right side of the film was passed up.

After changing the position, you can see that the liver position is moving very clearly and return directly to the original part.

However, the intestines are under pressure, and there are some artifacts in the film. It is estimated that the patient has obvious pain and agitation when the patient is in the right lateral position because of intestinal obstruction.

"Well send the surgery to the emergency surgery." Zheng Ren turned off the image data.

"Send the liver and gallbladder?"

Zheng Ren glanced at Su Yun and said with a smile: "You said Yun Geer, sent the liver and gallbladder, called the gastrointestinal tract together. First, the gastrointestinal tract is done, then the liver and gallbladder fix the liver."

"Don't let me back." Su Yundao: "It's all you said, tossing people, I never do."

The disease is actually very simple, but everyone has not seen it, and it is somewhat vague.

The ligaments caused by the liver are too long, weak, and lack of developmental abnormalities, so that the liver cannot be fixed. When the patient is upright, the liver moves down, the hepatic spasm gap widens, and the colon is embedded with obstruction, followed by a series of clinical symptoms such as increased pain, nausea, and vomiting.

"Zhou, let the surgeon go with him." Zheng Ren said, "Don't go out on the road."

"Good." Zhou Litao stepped out of the duty system and called out the surgeon who was checking the body and slammed a few words.

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

Zheng Ren smiled with Zhou Litao. He glanced at the surgical office and immediately stopped.

"Boss?" Su Yun followed behind, but he did not expect that he suddenly stopped, almost hit Zheng Ren's back.

Zheng Ren did not speak, and hurriedly rushed back to Zhou Litao's duty room and grabbed a white suit.

"What troubles do you have?" Su Yun stood at the door and asked him.

"Let Zhou always prepare nitroglycerin, whisper, don't add pressure to patients." Zheng Ren said very seriously.

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