2022 A rare free liver in an adult
“Hurry up! To chat with a doctor here, was there any public morality? If you’re on good terms, we can chat at the bar after work. What’s the point of talking here?” Zheng Ren threw the chains of morality on the patient’s family.
They were stunned for a moment before they calmed down.
The patient’s stomach hurt badly, and he was feeling uncomfortable at the CT scan. Because of this, one CT was not enough, and they had to do two more, which caused their dissatisfaction.
This kind of noise was unconscious and was considered an occasional event.
After being yelled at, his anger and courage disappeared, and he calmed down.
In addition, Zhou Litao had a good temper and kept explaining. They quickly went into the room with the emergency surgery department’s doctor to write the bill.
Zhou Litao wiped his sweat and gave Zheng Ren a look, wanting to bring him into the mainframe’s on-call room.
However, Zheng Ren did not go. He went straight to the door of the emergency department’s external consultation room and urged repeatedly.
The doctor quickly wrote the form and the patient’s family ran away.
When Su Yun saw that the patient’s family had disappeared, she walked into the emergency department’s consultation room, gave a thumbs up, and praised,”Boss, your acting skills are not bad. You deserve praise.”
Zheng Ren smiled.”Let’s go to chief Zhou’s office.”
If the patient’s family turned around for something, the situation would probably get worse.
Zheng Ren was very experienced in such small conflicts that could not be considered medical disputes.
After all, he was the chief resident of the emergency department, and he had seen a lot of such petty things.
When he arrived at Zhou Litao’s on-call room, Zheng Ren was completely relaxed and sat on the chair with a smile.
“Director Zhou, go up and fight him.” Su Yun sat on the bed and chuckled.
“I wouldn’t dare.” Zhou Li Tao said with a frown. He knew that Su Yun was joking, but it wasn’t funny at all.
They were all doctors, and they knew that the topic just now was awkward, so they all started talking about new things.
“General manager Zhou, what’s the situation with the patient?” “Detached livers are usually discovered during childhood. Why did the patient drag it out until now?” Su Yun asked.
“The patient asked for his medical history before he came. It’s said that he started to have intermittent abdominal pain when he was five or six years old, but he will recover in a while.” Zhou Litao said,”the family didn’t mind either. They thought that the young lady was weak.”
“Later on, the patient got used to it. Every time he felt pain, he would lie down on the right side, and it would be slightly better.”
“Right side. He’s using his position to suck in the liver.”
“Almost. Every time my stomach hurts, I’ll find a lump that can still be moved if I push it with my hand.” Zhou Litao said.
This … Zheng Ren was a little helpless. The patient was really generous. There was such a big bump on her stomach, and she didn’t even come to the hospital for a check?
No, it should be …
As Zheng Ren was thinking, Su Yun had already asked,””Has the patient not come to the hospital for a checkup?”
“He said that he had checked twice. Both times, after the abdominal pain was relieved, he remembered to check, and there was nothing wrong. In the end, the patient gradually forgot about this matter.”
He had forgotten.
He had forgotten!
“The patient’s pain lasted for a long time this time, and the right side of the patient’s body has not improved. The lump in the upper abdomen is particularly large. Plus, she vomited and was in intense pain, so she was scared and called the ambulance to send her to the hospital. “
“I touched the patient’s abdomen after I came here. There was no pain, and I could feel a bump that moved from right to left.”
“What were you thinking about at that time?” Su Yun asked.
“What can I consider if I don’t do a physical examination?” Zhou Litao smiled.”But I’ve thought about things like the Associate spleen and liver malformation.”
“Is the intestinal obstruction serious?” Zheng Ren asked.
“I did. I can still hear the rumbling of the intestines, but it’s a little weaker. It’s about one time per minute.” Zhou Litao’s physical examination was very detailed and irreproachable.
“Sure, let’s take a look at the scan then and send him to the surgery department.” Zheng Ren laughed and said,”it’s really rare to see an adult free liver.” Terrier and Auvray were first reported in 1897, and since then, there has been no decent summary, and there are few reports of individual cases. “
“Yes, as long as it’s a child, under five years old.” Su Yun added.
Zhou Litao knew that the two in front of him sounded very logical, but this was the first time they were seeing it.
What was ability?
This was a skill.
To be able to remember the contents of a book meant that he had a good memory. However, to be able to use it in clinical medicine as if he had seen it many times was a great skill!
There were some things and some people that one had to accept.
Zheng Ren gave professor Liang a call and told him that the examination was almost done, and the X-ray of the left side had been uploaded.
He turned on the computer and pulled up the patient’s X-ray image. He could see that the colon entered the space between the liver and the diaphragm from the space behind the liver.
The image was quite typical, and the distance between the liver and the patient’s CT scan was about 10 cm to the left.
This was the reason why the patient mentioned that he could touch the bag, and it was also the origin of intestinal obstruction.
It was not completely blocked, and there was no strangulation or necrosis. The patient’s condition was in the controllable stage.
After she finished looking at the X-ray, the X-ray from the right side of the bed was sent up.
After the position was changed, the liver’s position could be seen moving very clearly. It had returned to its original position.
However, the patient’s intestines were pressed, and there were some artifacts on the X-ray. It was estimated that the patient had obvious pain and restlessness when he was lying on the right side due to intestinal obstruction.
“Okay, send him to the surgery department to prepare for the emergency surgery.” Zheng Ren closed the video.
“Liver and gallbladder?”
Zheng Ren glanced at Su Yun and smiled.””Big brother Yun said that we’ll send the liver and gallbladder over, and we’ll get the stomach and intestines to go up together. We’ll perform gastrointestinal reduction first, then we’ll fix the liver with the liver and gallbladder. “
“Don’t make me the scapegoat. ” “You’re the one who said it,” Su Yun said.”I’ve never done things that torment people.”
The illness was actually very simple, but no one had seen it before, so they were a little vague.
It was due to the liver’s ligament being too long, thin, and lacking, causing the liver to be unable to be fixed. When the patient stood upright, the liver moved down, the gap between the liver and diaphragm widened, and the colon embedded in it would cause obstruction, which would then lead to a series of clinical symptoms such as increased pain, nausea, and vomiting.
“General manager Zhou, let the surgeon accompany you.” Zheng Ren warned,”don’t let anything happen to you on the way.”
“Alright,” he said. Zhou Litao walked out of the on-call system, called out the surgeon who was doing a physical examination, and gave him a few instructions.
After that, Zhou Litao walked into the emergency room to deal with the patient who had been examined.
Zheng Ren walked out with Zhou Litao with a smile. He took a glance at the outpatient consultation room and immediately stopped.
“Boss?” Su Yun followed behind, but he suddenly stopped and almost bumped into Zheng Ren’s back.
Zheng Ren didn’t say anything. He rushed back to Zhou Litao’s on-call room, grabbed a white coat, and put it on.
“What hysteria are you having?” Su Yun stood at the door and asked him.
“Ask general manager Zhou to prepare nitroglycerin. Lower your voice, don’t add pressure to the patient.” Zheng Ren said seriously.