When doctors have a simulated operating room

The patient was diagnosed with acute gastroenteritis.

"Use your eyes to see. First of all, I didn't see any shadows on the patient's CT film, which means it's not adhesion.

Secondly, there is no mass, so there should be no tumor.

It's not intestinal torsion, extra-abdominal hernia, intra-abdominal hernia or anything like that.

The only possibility is inflammation.

If the doctor who diagnosed acute gastroenteritis is not Director Li, then it should be a young doctor.

Found a little sign of inflammation, without considering other things, and immediately diagnosed acute gastroenteritis.

This is definitely wrong.

In fact, if you look closely, you will see this position, which is here."

Zhang Yi stretched out his hand and pointed near a section of the intestinal wall on the CT sheet.

"Director Gu, look carefully here. Do you feel that the intestinal wall is a little thickened? I suspect it is an embolism."

Gu Hongtao deliberately stretched his neck to look hard.

But this is an ordinary CT film, not an enhanced CT...

It is not easy to see clearly.

Then, Gu Hongtao looked at Zhang Yi in surprise.

This kid's eyesight is too good!

He can see this clearly? !

Then, Zhang Yi said:

"As for the cause of embolism, it can also be found.

Look at the electrocardiogram, the old lady has atrial fibrillation, right?

Look at the cholesterol, it is also high.

Dean Gu, you are also a medical student, so you naturally know that cholesterol cannot be the only one.

When it rises, the other ones will usually rise together.

If you don't believe it, you can check your blood lipids now.

So in summary, I suspect that the old lady has a thrombus.

And the location of the thrombus is just in the two atria.

The common thrombus in the atrium is the atrial appendage thrombus.

So, I boldly speculate.

It is the left atrial appendage thrombus or the right atrial appendage thrombus, which falls off during atrial fibrillation.

Do you see the thickening of the intestinal wall? I suspect that the thrombus that fell off fell here.

The expired milk that the old lady drank did have an impact.

But inflammation may only be the trigger.

The real cause of her intestinal obstruction is this thrombus!"

Zhang Yi finished speaking.

The surroundings fell into silence!

Several leaders and doctors around him looked at Zhang Yi with wide eyes.

Oh my goodness!

Why did this young man say it as if he had seen it with his own eyes? !

It just so happened that the results of the old lady's small intestine radiography came out.

Gu Hongtao took a look!

Oh my god!

It was really a strangulated intestinal obstruction!

And it did show embolism!

Gu Hongtao was shocked!

This young man was right!

At that moment, Gu Hongtao didn't have time to look at Zhang Yi again.

He immediately ordered:

"Hurry up to the operating room! Where are the family members? Where are the family members? Inform them that this patient needs surgery immediately!"

"Okay!"

Liao Zhu looked at Zhang Yi in shock and then hurried to do his work.

Only Wang Hao.

He looked at Zhang Yi with a surprised look on his face.

Then, he silently raised his thumb and spit out two words to Zhang Yi:

"Awesome!"

Zhang Yi looked at him calmly.

Later, he felt relieved when he saw the old lady being sent to the operating room.

Intestinal obstruction, especially intestinal obstruction caused by embolism.

It is best to have surgery as early as possible.

The longer you delay, the larger the necrosis area.

If too much intestinal tube is removed at that time, it will also affect the digestion and absorption function and may lead to short bowel syndrome.

Of course.

If this is the case, Zhang Yi has no choice.

If Zhang Yi hadn't found this old lady here today.

It is estimated that this family is still waiting in the outpatient clinic.

Or.

Because of the misdiagnosis of the laboratory department, it is not certain that the patient died in the emergency room.

Oh.

Sighing, Zhang Yi turned around to look for his uncle and aunt.

I forgot about it when I was busy just now.

Wang Hao caught up with him:

"Hey, little brother! Which hospital are you a resident in? You are quite impressive.

Many young doctors can't even make a diagnosis, but you can already read CT scans?"

"Tianhe People's Hospital, have you heard of it?"

Wang Hao thought for a while and asked:

"Tianhe? Is it the Tianhe in Yunnan Province?"

Zhang Yi nodded: "Yes."

Wang Hao showed a surprised expression again.

Tianhe People's Hospital should also be a tertiary hospital!

They actually let a resident intern be the assistant director!

Of course.

This assistant director looks pretty awesome.

The thickening of the intestinal wall that their Dean Gu couldn't see.

He actually saw it!

It shows that this young man is indeed extraordinary.

Zhang Yi, on the other side,

I saw Xu Changyuan and Tang Xiaohe on the bench in the hall.

I walked up to them immediately:

"Sorry, I got an occupational disease when I saw a patient just now. You must have waited for a long time."

Xu Changyuan smiled and waved his hand:

"What's the big deal? I'm so proud of my nephew being a doctor!"

"That's right. If Tingting's grades weren't average, I would have wanted her to study at a medical university."

Zhang Yi smiled and asked, "How many points did Tingting get in the last simulation?"

Tang Xiaohe shook her head helplessly: "More than 500, less than 520."

"If you work harder, you should be able to get in. If you can't get in from your own province, you can consider studying in other provinces. However, it still depends on what Tingting likes.

It's not a good thing to force her to learn something she doesn't want to learn."

The three chatted and walked home slowly.

At this time.

Yundu First People's Hospital, operating room.

Gu Hongtao performed the operation on intestinal obstruction.

This 65-year-old lady has been rushed to the operating table.

General anesthesia with intubation.

After opening the abdominal cavity, a small amount of exudate was found.

"Flush and suction."

Then, the obstructed intestine was found.

It turned out that most of the patient's small intestine and ascending colon were necrotic.

It had even begun to turn black.

Touching the terminal mesenteric artery with the hand found that the arterial pulsation had disappeared.

"No, it's completely necrotic, cut it off."

Before removing the suspected necrotic intestinal segment, the doctor will touch it and test it.

See if the intestine still responds to stimulation.

Or see if the artery still pulsates.

If there is none, it means that it is completely necrotic and can be removed.

"Ligate the small intestine end, ascending colon and part of the transverse colon end."

Ligate, and then clean out all the feces.

Then remove all the necrotic parts.

Then anastomose the remaining intestinal segments.

This old lady can only say that she was sent neither too late nor too early.

After the cut, there was about 2.5 meters of intestine left.

It might affect the digestion and absorption function.

But it can only be done this way.

After closing the abdomen, Gu Hongtao was still curious about a question.

He walked to the side of the removed intestine and observed it for a while.

Until he found the section of intestine with thickened long wall that the young man just mentioned.

Take a closer look.

Damn, there is really a blood clot inside!