1686 Boss Zheng, I missed you so much.
If it were not for the fact that he had followed the Department Director to perform surgery and saw the appendix being removed with his own eyes, he would have really suspected that it was an ectopic Appendix.
He didn’t know if boss Zheng in the imperial capital had ever performed an ectopic Appendix before. This was a life – threatening surgery. Once they could not find it, the sense of helplessness on the operating table was enough to make a person collapse.
He found the point of pain. There was only tenderness, no rebound pain, and no muscle tension.
Percussion was also very standard. However, there was nothing new. He did the same.
Auscultation …
After completing the physical examination, Zheng Ren helped the patient put on his clothes and turned to leave the ward.
“Boss Zheng, you …” Li Yong was a little nervous.
He saw that Zheng Ren’s expression was neither sad nor happy, as if victory was in his hands, but also as if he was at a loss.
“Inject 5ml of Meilan into the urinary catheter, and extract the seroperitoneum after 30 minutes.” Zheng Ren gave medical advice as he walked.
“Ah?” The young doctor was startled.
“If you can see blue liquid when you extract ascites, it proves that the bladder is ruptured. We think it might be caused by the rupture of the surgical scar many years ago.” Zheng Ren said as he walked.
“……”
“Boss Zheng, this …” The young doctor felt that it was a little unbelievable.
“Young man, the medical history and physical examination must be detailed and serious.
The medical record shows that the patient’s medical history collection, especially his previous medical history, was not detailed when he was admitted. For example, more than twenty years ago, the patient had a partial bladder resection due to a bladder blister, which led to the missed diagnosis and mistaken treatment of important diseases. ” Zheng Ren said very gently.
Although this young doctor was quite attentive, he had been working in a town – Level hospital for a long time, so he did not pay attention to many details. Zheng Ren was just giving a friendly reminder and did not berate him at all.
“During my first appendectomy, the pathological changes found during the operation did not match the diagnosis. The symptoms of Appendix inflammation were not typical, and the amount of fluid extracted was a little large. Did you consider if it was caused by other reasons?
He didn’t do any further investigation. As for whether there was a large amount of abdominal fluid during the operation, it was unknown. He guessed that there was a small amount of urine during the operation. But it didn’t attract the attention of the Sorcerer, or maybe you just thought urine was exuded. “
The doctor’s face was covered in sweat.
“Thirdly, the patient’s abdominal bloating was obviously aggravated after the use of the laxatives. I remember that you wrote this in your medical record. If you think about it one more step, you will know the truth. ” Zheng Ren said with a smile.
“There’s no problem with the patient’s kidney function. After using diuretics, especially 40mg of rapid urine, 500ml of urine will be discharged. However, the pale yellow urine that the ureter drew out did not increase, and that’s the biggest problem. “
“In summary, I think it’s a bladder rupture. He had to hurry up and do the Meilan experiment. If the blue liquid was drawn out through abdominal puncture, he would be transferred to the Department of Urology for surgery. The surgery isn’t that difficult. I’ll be done after I suture it. “
“Boss Zheng, really?” Li Yong was still in disbelief. He looked at Zheng Ren’s young face and felt a little lost.
“Eh? What’s real?” Zheng Ren didn’t understand. He had already explained it in such detail and thoroughly, why couldn’t he understand?
“I’ll go immediately. ” Seeing that Zheng Ren was about to leave, the doctor gathered his courage and asked,””Boss Zheng, can I … Can I leave you a WeChat message?”
“What?”
“I’ll perform a belly puncture in half an hour. I’ll report to you if there’s any blue liquid. ” The young doctor had an idea and found an excuse.
Zheng Ren smiled.
He took out his phone and showed the young doctor the QR code for WeChat. The two of them added each other on WeChat.
“You guys go ahead, I’ll go back to see old Liu.” Zheng Ren then left.
The medical treatment and surgical standards of Xilin town were indeed at the level of primary hospitals. It was simple and crude. The pain in the right lower abdomen was appendicitis, and he did not think about anything else.
He did not perform any differential diagnosis, and he did not deal with any abnormalities found during the operation. After the surgery … Sigh, I used rapid urine, but I didn’t urinate much. There’s no problem with my kidney. I didn’t even notice such an obvious point.
‘Forget it, it has nothing to do with me.’ Zheng Ren walked out of the ward area of the General Surgery Department and stopped thinking about it.
Zheng Ren no longer needed to use the system panel for such a small medical record. After reviewing the patient’s medical history, looking at the test results and course of disease records, one could basically come to a conclusion based on the clues.
It was obvious that the bladder had ruptured, so the seropertural fluid was just urine. Zheng Ren finally used the system panel of the big pig trotter as a reference and gave a definite answer.
As for the surgery, Zheng Ren had no interest in suturing the bladder.
Aside from needing to perform laparotomy, the difficulty of this type of surgery was not even comparable to appendectomy. Moreover, it was a little too much to go to the people’s Hospital of Xilin town to snatch a surgery from the Department of Urology.
After returning to the ward, he gossiped with Liu xuzhi about Li Yong’s wife’s condition. Liu xuzhi’s wife came in with a lunch box.
She had specially made hand – rolled noodles with hot soup for Zheng Ren, and the noodles were especially chewy.
“Boss Zheng, if I go to the capital, old Liu won’t be able to take care of my family. I’m going to find a small noodle shop to work.” Liu xuzhi’s lover said.
“I won ‘t. Don’t worry.” “In the entire country, there are less than five hundred people who can perform interventional surgeries better than old Liu,” Zheng Ren said with a smile.
500 was a huge number.
In fact, Zheng Ren wanted to say 100 yuan, but that was just TIPS. Considering all the factors, 500 was the standard.
As a doctor, to be able to rank in the top five hundred in the country, he was definitely at the level of a professor leading a team at a Provincial Hospital.
Old Liu’s wife was so worried that Liu xuzhi almost lost his life for 30000 Yuan.
It was quite ridiculous.
A handful of bitter tears.
Zheng Ren saw that Liu xuzhi and his wife were already prepared to fight to the death, so he didn’t try to persuade them. When they went to the capital, even if they had high standards, they would still have to work hard.
He could live by lying down … It seemed that he could now.
Tenured professors at Massachusetts General Hospital could enjoy life with a monthly salary of more than a hundred thousand dollars.
Tsk, tsk, he didn’t even realize that he would reach this stage so quickly.
Seeing that Liu xuzhi’s body was fine, Zheng Ren ate his noodles in big mouthfuls. He was prepared to ask Feng Xuhui to book a ticket after the meal and return to the capital as soon as possible.
The matter was already over now that Liu xuzhi had been brought back to Westwood.
After Lao Liu recuperated for a few days and brought his family to the capital, he would be able to carry out large – scale embolism surgery in the bottom of the stomach and the left gastric artery.
He would ask him for a few surgeries and see how much old Liu had mastered.
Zheng Ren already had some understanding of his talent. He was considered average, and the height that Liu xuzhi could reach in this life would probably not exceed su yunyanyi’s level.
However, as a person, he could not be compared to Su Yun, right? Zheng Ren laughed.
Old Liu probably wouldn’t be too bad. After all, he could even touch the threshold of TIPS surgery by himself, so he was much better than most people.
Before he could finish eating, a short, fat, and strong man knocked on the door and came in.
When he saw Zheng Ren, he immediately put on a flattering smile and extended his hands.””Boss Zheng, I’ve missed you so much!”