Chapter 959： Secondary surgery

Helium, an abnormal anatomy formed by an organ or tissue in the human body leaving its normal anatomical position, through a weak point, defect or pore formed by congenital or acquired.

The sputum is a type of guilt, which refers to a disease state in which the visceral organs of the abdominal cavity move to the thoracic cavity through the ectopic of the diaphragm, and can be classified into traumatic sputum and non-traumatic sputum.

The most common non-traumatic sputum is esophageal hiatus hernia, thoracoabdominal hernia, parasternal hernia, and hernia. Esophageal hiatus hernia is the most common sputum in more than 90%, is the most common type of hernia.

Under normal circumstances, the esophageal hiatus will have the stomach and intestines appearing in the chest through the weak diaphragm.

The most serious complication is the incarceration of the hernia sac, and strangulated necrosis of the abdominal organs that break into the chest.

In this case, emergency surgery is generally required. If you don't have a long time, the gastrointestinal tract can still restore blood, which is the best.

Otherwise, a series of resections should be done to avoid more serious necrosis and complications such as toxic shock.

This is going to be terrible.

However, sputum is generally a cavity, such as the stomach, intestines, etc. will break into the chest. Like the liver, such a large piece of physical organs, rarely appear paralyzed.

This kind of surgery can be done by general surgery or thoracic surgery.

So when I heard the liver sputum, both Zheng Ren and Su Yun came to the interest, too rare to see.

What a shit’s $100,000 consultation fee was thrown away by the two in a flash.

Quickly came to the emergency department, the rescue room, the family of patients with a full house, and two medical staff in the field of private 120 are charging fees.

Seeing Zhou Litao is busy checking the body, Zheng Ren did not call him, but began to observe the patient.

The background in the patient system panel is bright red, which means the condition is very heavy.

Seventy-eight diagnoses of asymptomatic congenital sternal posterior sternoplasty, hernia repair, hepatic spasm, hypostatic pneumonia, pericardial effusion, etc. appeared in front of Zheng Ren.

After the sternum, Zheng Ren seems to have guessed something.

The abdominal organs protrude into the thoracic palpebral horn through the thoracic rib triangle, which is called the congenital sternal posterior iliac crest, also known as the posterior sternum, the parasternal scapula, the anterior lateral iliac crest or the hiatus hernia.

This kind of cockroach is relatively rare, accounting for 3% to 5% of cockroaches. Multiple chests on the right side, mainly respiratory and digestive symptoms.

However, the organs that break into the chest are still dominated by the gastrointestinal tract, and the liver is relatively rare.

Liver 疝 ... liver 疝 ... Zheng Ren condensed God thinking.

Su Yun has already gathered around the patient to see Zhou Litao check.

The little nurse in the emergency department is busy, feeling that someone is squeezing up, Liu Mei is upright, and if he is impatient, he will take the person away.

But when she saw Su Yun's moment, her face suddenly became red, and her hands didn't know where to put it. I don’t dare to look at it, I don’t dare to look at it, I want to see it, and I’m confused.

"What patient?" Su Yun asked softly.

"The postoperative patients from the nearby city hospitals have performed two operations, and now there is a right chest cavity." The little nurse didn't know much, but he knew how much to say, and he really didn't have any reservations.

After that, she felt a bit ashamed.

I know it is so good, it’s too wrong, oh~

"Su Yun, you are here." Zhou Litao heard someone talking around, and after checking the body, he turned back to see Su Yun.

"Call Yun Geer." Su Yunqi was on the ground, looking at the breast bottle, his mouth whispered.

"Cloud brother, closed drainage of the chest leads to a small amount of gas, and it is estimated that the lungs are still damaged." The little nurse added a sentence.

How was it so hot in April? She felt that her face mask could not be worn. The hot air sprayed from the gap of the mask as it breathed, raising the temperature of the entire face a lot.

It’s all this **** weather, the little nurse thought of it.

"Cui Lao is in the office." Zhou Litao held a clip in his hand and clipped a piece of A4 paper. He recorded the situation of many patients in his own way.

Su Yun asked him to call Yun Geer, Zhou Litao did not hear it, every freckle on the dark face expressed rejection.

He and his family said two words, arranged for an emergency department doctor to dispose of, and then Zheng Ren, Su Yun came to Cui Lao's office.

Knocking on the door and going in, Zhou Litao began to report the medical history.

Cui Lao did not say anything to Zheng Ren. He just looked at him and began to listen carefully to Zhou Litao’s report.

"The patient is a female, 55 years old. The local hospital diagnosed a congenital sternal posterior iliac crest.

The patient developed progressive dyspnea and palpitations at the event 8 months ago, aggravating for 2 months. He was hospitalized at a local hospital and treated with surgery.

Preoperative CT return: Intestinal contents in the thoracic cavity oppressed the middle and lower lobe of the right lung, resulting in atelectasis and mediastinal shift.

Here is the film before the patient's first surgery. ”

Said, Zhou Litao is very skilled to take a bag from the film bag and hand it to Cui Lao.

From the details, Zhou Litao is indeed a very capable emergency department in the hospital. Just a short period of understanding of the condition and physical examination, many situations are basically mastered. When Cui Lao reported, it was also methodical.

Zheng Ren said in his heart.

"Continue." Cui Lao did not watch the film, just faintly said.

"In the first operation, the median diameter of the mediastinum sternal defect was found to be 7 cm. Most of the intrusion included the small intestine and large intestine, as well as the greater omentum. The lung was found when the right lung was re-expanded after the hernia sac resection. Inflammatory blistering and spontaneous pneumothorax. Emergency chest examination in the emergency department, giving closed thoracic drainage."

Zhou Litao took the case copied by the patient's family, and Ma Li turned to the page of the surgical record, focusing on it.

"6 hours after surgery, closed drainage of the thoracic cavity led to a large amount of gas. The amount of gas was very large, and it was decided by the thoracic surgery that it was decided to open the chest for pulmonary blister repair."

"One week after surgery ~ www.novelhall.com ~ patients with sudden ventilatory disorders, acute liver function found transaminase increased. CT showed that the right lung re-compression, a substantial organ into the chest, suspected of the liver."

“The local doctor communicates with the patient's family and advises the patient to visit our hospital.”

After that, Zhou Litao put the medical record clip down and inserted the latest chest CT piece into the reader.

Zheng Ren’s unconscious left hand was placed on the right side of his arm, his right hand was squatting, his eyes narrowed and he began to read the film.

The patient's condition, Zhou Litao's story is very detailed. Two operations, one for thoracic surgery and one for general surgery.

After the operation, the patient's condition was not alleviated, but a more serious hepatic spasm occurred.

To be in emergency surgery, this is ok. But in the end, whether it is done in the chest or in the ordinary, the sense of proportion in the middle is very subtle.

The average doctor is not willing to take over the postoperative patients sent by the lower level hospital.

That means a lot of trouble.