Chen Cang looked at the medical records and various test reports in his hand, and thought of the numerous appendix operations, he suddenly frowned slightly.
"The patient is only 12 years old, with metastatic right lower quadrant pain with nausea and vomiting for 2 days, fever for one day, abdominal pain from the umbilical cord, 24 hours later transferred to the right lower quadrant, showing persistent pain, paroxysmal aggravation, previous physical examination, no history of similar diseases Examination ... the abdominal muscles are tense, the right lower abdomen has toothache, rebound pain, obvious Myers points, the bowel sounds are weakened, the psoas muscle sign is positive, the colonic inflation test is positive, and the obturator muscle test is negative ... "
Appendicitis is no problem!
But ... Cang Cang still had some doubts.
Suspected urethral stones?
But there is no stone disease?
Is it ...
沧 Cang Cang thought of a peculiar appendicitis!
At this time, the anesthesiologist came in to prepare for anesthesia. It was Liu Jian, an old acquaintance.
However, today is the game. Liu Jian just nodded slightly, didn't talk much, and was ready to anesthesia.
Chen Cang quickly stopped and said, "Liu, wait a minute, I will check again."
健 Liu Jian hesitated a little, but stopped.
Cang Cang walked to the boy. The boy was obviously a little nervous. When he saw Chen Cang coming, he was at a loss, and closed his eyes.
Chen Cang said, "I'll touch your stomach for a while and tell me if it hurts."
After speaking, Chen Cang started his right hand from the umbilicus and touched clockwise ...
"It hurts!"
As soon as I pressed it, the boy frowned and shouted.
Chen Cang nodded and continued to change positions!
After a few minutes, Chen Cang had an idea in his heart.
应该 This should be a rare case: "Extraperitoneal appendicitis!"
This kind of case is extremely rare. It is caused by the abnormal evolution of the cecum during the embryonic period, and the incidence is only 2% -8%.
If this kind of extraperitoneal appendicitis is not treated in time, the inflammation can easily spread and accumulate surrounding organs such as ureters, kidneys, and large pelvic vessels, causing extremely serious complications.
Simply put, this disease is a bit tricky!
But this is how it is for others.
I have no pressure on Chen Cang.
Xun turned to Liu Jian and said, "Liu Brother is fine."
健 Liu Jian nodded in doubt: "This appendix?"
沧 Cang Chen said lightly: "It should be ectopic appendicitis, but also extraperitoneal ectopic appendicitis!"
Liu Jian frowned immediately.
Because epiperitoneal appendicitis is very difficult to diagnose before surgery, it is often found during exploration.
Therefore, this disease often causes major problems due to insufficient preparation of the operator.
Liu Jian asked carefully, "Are you sure?"
Cang Cang nodded!
Liu Jian also had a heart when he was anesthetized. After all ... he remembered that he had heard the teacher when he was in school in Kyoto and had never seen it before.
At this time, several people in the office at this time saw the picture on the big screen and laughed and discussed. As for the score, everyone had their own opinions, but it did not hinder the communication between each other.
"No. 1 is very skilled? The technique is very precise, the boy is OK!"
"No. 2 is OK, but there is still a little gap between No. 1's grasp of the appendix."
"Oh? Why didn't No. 3 start! Why ... this 咋 is on medical examination?"
Sure enough, after the man finished speaking, others also paid attention to the number three.
Because everyone has already started surgery at this moment, No. 1 has found the appendix and is ready to be removed.
And No. 3 has not started yet!
Look at the layman, it must be a verdict!
But several veterans are field-tested veterans. When they saw this battle, the first reaction was to pick up the medical records of patients in operating room No. 3.
A few people raised their hands and it seemed that nothing was different.
This is a typical appendicitis?
思 Liu Siqi naturally recognized that No. 3 was Chen Cang. He had a good opinion of Chen Cang, and even ... when he saw Chen Cang, he wanted to score an ultra-low score!
I then took advantage of Chen Cang.
Of course, this is just an idea.
In fact, he has been following Chen Cang since he came in, but ... he was curious when he saw that he would not be operated for a long time, and would not even be anesthetized by an anesthetist.
What are you doing?
Is he skeptical of the disease?
impossible!
Is the hospital still unable to distinguish between an appendix surgery?
So, at the beginning, Liu Siqi took the copied medical records over and over again three or four times, but the templates came and went back and forth, what's different there!
这 Is this Chen Cang only suture the tendon? He overestimated himself?
思 Liu Siqi couldn't help but doubt Chen Cang's heart.
Twenty-five judges plus one Hao Xuliang all picked up their medical records to investigate carefully.
看了 I looked at everything from the medical record to the test to the abdominal color Doppler ultrasound, but I didn't see what happened!
Even Hao Xuliang felt a little embarrassed. After all, Chen Cang was the real one. The person with a good name was fortunate that he didn't say it, otherwise ... it would be shameful.
A few people turned the medical records inside and out without gaining anything.
Suddenly, Liu Siqi, who read the medical records five or six times, suddenly grasped a detail!
That is, the patient's symptoms are similar to urinary stones!
B ultrasound shows no signs of stones
This……
Liu Siqi suddenly stunned!
外 Extraperitoneal appendix? ? ?
After thinking of this idea, Liu Siqi suddenly realized.
At this time, the people around seemed to give up and started shaking their heads.
Liu Siqi saw this and said with some excitement: "Everyone said, is there any possibility of this patient with an extraperitoneal appendix ?!"
As soon as this word came out, the people around them frowned suddenly.
At this time, Chen Cang has begun to move!
刀 This knife is very light and shallow. It seems simple, but it just cuts the belly ...
Chen Cang has to be careful. If it is an extraperitoneal appendix, it is best to be careful not to cause inflammation to spread.
The incision is small, 4 cm.
This is considered by Chen Cang. Too small incisions are prone to errors, but 4cm, not too big or small, is enough for Chen Cang!
After I cut it, a stench came!
沧 Cang Cang's eyes suddenly appeared a red arrow, he suddenly froze!
The system still has this function? Help yourself find the lesion?
Chen Cang took a look according to the position, and she really saw a crimson appendix. At this time, he was already congested and swollen, and even purulent fluid leaked out around him.
[Extraperitoneal suppurative appendicitis, lv29, leader strange! Features: High concealment, easy to spread inflammation. Tip: Handle with care and do not act recklessly. 】
It really is extraperitoneal suppurative appendicitis!
Also, this is a big guy!
Level 29, the leader is blamed!
Will killing an artifact if killed?
沧 Cang Cang couldn't help but feel a little surprised ~ www.novelhall.com ~ After all, it was diagnosed and discovered by myself, and it was nothing more than a happy doctor.
At this time, the office is silent!
Everyone held their breath and stared at the scene in the third operating room.
Is this too fake?
Is this acting?
Hundreds of appendix operations may not have such a thing, I met them today, and ... it seems that this doctor has diagnosed it?
how can that be!
Several old experts frowned!
Suddenly, a man couldn't help but asked, "How does he know it is an extraperitoneal ectopic appendix? Such an ectopic appendix is difficult to diagnose ..."
With a bang, everyone's voice was spoken!
Hao Xuliang was also stunned in the place, his eyes were full of wonder, thinking, this kid is also unlucky?
I even met such a weird thing!
思 Liu Siqi didn't know what to say. It turned out to be extraperitoneal appendicitis. Fortunately, he didn't act so recklessly. Otherwise ... the inflammatory spread would not be conducive to later recovery.
The people around me looked at Liu Siqi, eyes full of curiosity.
Finally, some people couldn't help asking: "Lao Liu ... are you asking?"
思 Liu Siqi glared angrily: "You are the mop! Why am I holding it!"
The man was not upset and smiled: "How did you find that this might be an extraperitoneal appendix?"
思 Liu Siqi sneered, pointing at the medical record: "Nature is based on strength! The so-called book is read a hundred times for its own sake ... you just have to think about the medical record carefully, look at it more naturally ...
Everyone saw that Liu Siqi had installed such a deep B and looked at each other. After three seconds, they still couldn't hold back: "Speak people!"