The system takes me for surgery

Chapter 286: Dig Me A Pit

After the dean called Hongzhi to inquire about the situation, his face became a little ugly, full of worry, because the status of this couple was unusual, and if something happened here, it would not be explained clearly.

When Dr. Huang in the emergency department said that multi-department cooperation was needed, the dean Xiang Hongzhi immediately agreed.

Cai Yulan gave the patient Cai Yulan an enhanced CT scan of the whole abdomen, which indicated ascites and pelvic hematoma.

Huge hematoma in the right retroperitoneum reached around the right kidney, thrombus was seen in the inferior vena cava, right common iliac vein, and internal and external iliac vein at the level of the renal hilus;

Vascular ultrasonography of the extremities revealed deep vein thrombosis in the right popliteal vein; tumor markers were all within the normal range.

Please consult with various relevant departments, including orthopedics and diagnostics.

Hu Yaoguo, the orthopedic department, saw that Liang Yi had also come, and said, "Why is there such a big fight today?"

Liang Yi said: "I heard that he is the leader of Jiangzhou City."

"No wonder, you kid is quite well informed." Hu Yaoguo said.

Zhou Aimin of the diagnostic department saw that the general surgery, interventional, endocrinology, gynecology, and orthopedic departments were all in place, and he couldn't help feeling a little uneasy. At this moment, for the diagnostic department, his responsibilities and obligations were highlighted. The diagnostic department is supposed to draw a conclusion for this highly comprehensive disease, and then let the clinician execute it according to his diagnosis.

If any accidents are found during the process, the doctors in the diagnostic department have an inescapable responsibility.Because he should have the ability to think macroscopically and consider all kinds of details. This is the meaning of the existence of the diagnostic department.

Liang Yi walked over to say hello, "Brother Min, you're here."

Seeing Liang Yi coming, Zhou Aimin breathed a sigh of relief, because at least there was an agreement, and he was not fighting alone.

The directors of each department sat down and saw Liang Yi sitting next to Director Zhou Aimin of the Diagnostic Department.

If it was placed half a year ago, everyone would have been very surprised, but six months ago, Liang Yi was active in the affiliated hospital as if he had been born out of nowhere. What he has done and his skills have already impressed everyone very deeply.

The directors of each department began to put forward their own opinions: but everyone's proposals were very cautious.

The opinions of general surgery and gynecology are almost the same as yesterday.

The opinions of the interventional department and the hematology department made everyone more vigilant about this operation.

Interventional consultation opinion: CT showed thrombus-like changes in the inferior vena cava at the level of the renal hilus and the right common iliac veins and internal and external iliac veins. At present, the patient's current active bleeding still persists, and surgical exploration is required to confirm the diagnosis.Considering the existence of deep vein thrombosis, there is a risk of pulmonary embolism at any time, and anticoagulant and thrombolytic therapy cannot be performed during surgical exploration to avoid intraoperative bleeding, so an inferior vena cava filter should be placed to prevent the occurrence of pulmonary embolism.

Hematology consultation opinion: disseminated intravascular coagulation may occur.

Hu Yaoguo, Department of Orthopedics, said: "Although the force was not large, I still think that the possibility of bleeding caused by trauma cannot be ruled out, and the site should be close to the sacroiliac site."

After they finished speaking, each director shook his head and said that this patient may need to be transferred to another hospital because the condition is too complicated, and what we are currently considering is only what we think of and there may be some unknown factors.And now without surgery, we simply cannot make a specific judgment, which is a huge risk for patients.

The dean looked at Zhou Aimin to Hongzhi and said, "What do you think?"

Zhou Aimin read the patient's treatment information several times, carefully considered his own diagnosis, stood up,

He said: "CT showed pelvic hematoma and iliac vein thrombosis, and the tumor markers were normal. Although it is not a typical manifestation of malignant tumors, it cannot be ruled out that the hematoma is formed by spontaneous rupture and bleeding of the tumor. The deep vein thrombosis may be a long-term phenomenon. Diabetes causes blood hypercoagulation, which is induced by stress. At present, the continuous insulin pumping into the blood vessels has been controlled to 8.7 mmol/L, and the operation is relatively safe. Active surgical exploration should be made to confirm the diagnosis and stop bleeding at the same time.”

The dean asked Hongzhi: "Director Zhou, you mean that this operation is necessary and feasible, right?"

Zhou Aimin nodded and said, "I think this patient has many underlying diseases and is not suitable for long-distance transfer. The operation should be performed sooner rather than later."

The dean Xiang Hongzhi looked at Liang Yi and asked, "What do you think?"

All the doctors who consulted looked at Liang Yi. If it was in the past, everyone would definitely think that Liang Yi walked through the back door behind him to get such attention from the dean.

But now it is different, Liang Yi has done too many things that have impressed the older generation directors of the affiliated hospital, and they are looking forward to Liang Yi's answer.

Liang Yi stood up and said: "I have the same opinion as Director Hu of the Orthopedics Department and the Director of the Diagnostic Department. The tumor markers reported no abnormalities, so there was no obvious evidence of gastrointestinal tumors. I think there are two reasons for hematoma and thrombosis in the lower abdomen:

One is caused by the spontaneous rupture of gynecological tumors; the other may be caused by the rupture of the iliac vessels themselves.I am more inclined to the latter, but regardless of the diagnosis, transfer is a negative option, and surgical exploration should be performed to stop the bleeding immediately. "

Everyone has doubts about Liang Yi's iliac vessel injury, because iliac vein rupture is very rare, the onset is rapid, and the mortality rate is as high as 23%.

At present, although the patient has a small amount of bleeding, the amount of bleeding has not yet reached the level of iliac vessel rupture.

Hu Yaoguo, Department of Orthopedics, took a closer look at the CT, nodded and said, "It seems that the iliac vessels are very likely to be injured."

The dean looked at Liang Yi and Hu Yaoguo to Hongzhi, and said, "Since we have the preliminary diagnosis results, then you general surgery department and orthopedics department will arrange this operation. The other directors will stay on standby until the operation is safely off the operating table." , cell phones are not allowed to be turned on silent."

Everyone nodded, knowing that the dean deliberately said such words, they knew the importance of the matter.

Afterwards, Liang Yi discussed the operation with Hu Yaoguo, director of the orthopedics department.

Liang Yi said: "Director, I'm sorry to drag you into trouble."

Hu Yaoguo said with a smile: "Have you ever given me peace of mind, kid? No, do you often dig holes for me to jump in?"

"Although the imaging studies look a little blurry, but based on its physical signs and the judgment of its anatomical location, I think it should be correct."

"Do surgery with you kid. Not only will you put on my black hat, but it may also interrupt your dean's career." Hu Yaoguo shook his head and said helplessly.

"It's just that the patients came to the door by themselves, and I didn't recruit patients. How can you say that about me?" Liang Yi said.

In the evening, the inferior vena cava was punctured through the jugular vein, and a filter was placed above the opening of the inferior vena cava and the renal vein. The operation went smoothly.