When doctors have a simulated operating room

Although the blood was a little cold, the nurses nearby kept warming it with their hands, trying to keep the temperature of the blood from being too cold.

Fortunately, the 600 ml of blood was useful.

After the transfusion, the patient's blood returned, the drug took effect, and the blood pressure also rose.

Chen Fang saw Zhang Yi staring at the examination sheet, and asked:

"Zhang Yi, what's the point here? Could it be that this person doesn't have esophageal cancer? But the mass and bleeding on the gastroscope are very clear."

Zhang Yi certainly knew that the gastroscope results showed clearly that there was indeed a mass in the esophagus.

But the problem is that the cause of this person's disease is below the mass!

He doesn't have esophageal cancer at all!

But...

The doctor in the gastroscopy room didn't continue to probe because he was worried about breaking the mass and causing heavy bleeding.

This problem was not discovered, which led to the misdiagnosis.

After looking at the patient for a while, seeing that the patient's condition had stabilized again, Zhang Yi hurriedly ordered:

"Ask the blood bank to transfer 600 ml of platelets and plasma, and then send the patient to the operating room quickly."

"Ah? How...how to send him to the operating room? Direct surgery to stop bleeding? But...but how to stop bleeding in this situation?"

Zhang Yi glanced at Chen Fang and said:

"I have a way."

Hiss!

Chen Fang: Okay, big brother, I worry too much!

The doctor of gastroenterology just came down and saw the emergency department sending the patient to the operating room.

"Hey, why did you send the patient away when we haven't seen him yet?"

The emergency nurse replied:

"Zhang Yi is here! He asked us to send the patient to the operating room."

Gastroenterologist: "Oh! You should have said it earlier. We made a wasted trip."

In the operating room.

Six hundred milliliters of blood were delivered.

It is a very dangerous behavior to perform blood transfusion and surgery at the same time.

But Zhang Yi still went on under pressure.

The gastroscopy doctor next to him felt a little nervous.

"Zhang... Assistant Zhang, can you go to the operating room with such severe vomiting blood?"

"Yes, just do your gastroscopy."

"Oh... OK!"

The lens was inserted into the mouth, and before it went in too deep, the entire narrow esophagus was seen, and there was a lot of blood inside.

After cleaning the lens and looking down again, the lump was indeed seen.

The damaged area of ​​the lump was not large at this time, which made the people in the operating room feel strange.

"The mass didn't bleed much. Could it be that there is something wrong with the esophagus? Could it be that it's a gastric ulcer that requires a blood transfusion, not a problem with the esophagus?"

Chen Fang shook his head and said, "But why is there a mass if there is nothing wrong with the esophagus? It must be esophageal cancer. Maybe the bleeding point is below this mass and we can't see it?"

Zhang Yi glanced at Chen Fang and said, "You are half right. The bleeding point is indeed below."

The gastroscopy doctor was confused: "What should I do now, Assistant Zhang? Should I continue to probe down? But what if it causes a larger area of ​​bleeding?"

Zhang Yi shook his head calmly: "No, bring the scalpel over. I want to make an incision on the chest."

"Ah?! No way, an esophageal cancer is bleeding, and you want to operate?"

"Do you want to operate to remove the bleeding section of the esophagus? Do an esophageal cardia anastomosis directly?"

"Don't make a fuss, just do what I say, or this person will die!"

Zhang Yi growled, and the operating room became quiet instantly.

OK, OK~

Listen to the boss~

Soon, Zhang Yi made a two-centimeter incision in the fifth intercostal space.

It was just big enough to put in the thoracoscope and other instruments.

Everyone watched Zhang Yi's operation and wanted to learn, but they didn't know what Zhang Yi was going to do.

If he wanted to install an artificial esophagus, he didn't tell anyone to get the equipment.

"Help hold the thoracoscope."

"Okay."

"Go inside, toward the heart, which is near the location of the esophageal mass in the gastroscope."

"Okay." Chen Fang was an assistant, and his hands were also very flexible.

Zhang Yi said while observing.

At this time, after the chest cavity was opened, everyone found that there was a lot of stuff inside!

There was actually blood in the chest cavity!

What's going on?

How could bleeding from esophageal cancer leak into the chest cavity on the heart side?

And the effusion inside had turned dark, and it was blood and inflammatory exudate at a glance, and it had been a month or two.

"Go deeper!"

"Okay!"

Now the people in the operating room understood that this patient might not just have simple esophageal cancer.

But there was another reason.

"Stop, don't move!"

When approaching the tumor, Zhang Yi asked Chen Fang to stop.

"Tweezers."

Zhang Yi used tweezers to gently pry open the surrounding tissues, and everyone found that blood flowed out with a slight movement!

"What's going on?"

Everyone was confused, only Zhang Yi said calmly:

"Rinse the surgical field."

"Tissue forceps."

After flushing, the field of vision became clearer.

Zhang Yi carefully exposed the outside of the esophageal tumor.

The esophageal tumor was not only swollen on the inner wall of the esophagus, but also on the outer wall.

The surgical field was not very clear, but when Zhang Yi lifted the tumor slightly.

At this time, everyone discovered!

The culprit of the bleeding was actually...

It was actually a fish bone! !

Oh my god! !

It turned out to be a fish bone after all this time!

Oh, I thought it was esophageal cancer!

"Give me the 15-cm hemostat."

Now that the problem has been exposed, it is easy to solve now.

First, clamp the thyroid artery branch and the carotid artery branch, the main blood supply vessels of the upper esophagus.

Then gently clamp out the fish bone that pierced the blood vessel.

As soon as it was clamped out, blood gushed out again.

In less than a few seconds, it covered the entire surgical field.

But fortunately, the upper artery was clamped, so the problem was not serious.

"Rinse, bring the bipolar electrocoagulation knife."

Chen Fang was very efficient. After cleaning the surgical field, he immediately handed over the electrocoagulation knife.

Zi~

Zi~

Zi~

The electrocoagulation knife can burn the blood vessels and seal the wound at the same time.

"Okay, the bleeding has stopped, and the effusion in the chest cavity can be cleaned."

Zhang Yi said as he loosened the hemostat clamping the upper artery.

Blood flow was restored, but there was no more bleeding at the place where the fish bone was stuck.

The operation was successful!

"Oh my god, Zhang Yi... you are amazing, how did you know the problem is here!"

Chen Fang looked at Zhang Yi with a puzzled but admiring look and asked.

This guy just stared at the examination list for a while, and he could see the reason? !

This is too amazing!

Zhang Yi looked at Chen Fang and smiled:

"Teacher Chen, do you know that this person has pneumonia?"

Chen Fang nodded: "I know, I saw it on the chest X-ray."

After saying that, Chen Fang immediately reacted!

"Fuck! I understand! Did you see from the chest X-ray that he was bleeding from a fish bone puncturing a blood vessel, not from esophageal cancer?!"

Zhang Yi nodded.

Chen Fang suddenly realized:

"Oh my god! Why didn't I think of it? That unprovoked inflammation can be seen. Blood and inflammatory exudate flowed into the chest cavity and caused lung infection, so pneumonia was found during the examination!"