Chapter 2021 Rare Adult Free Liver (Monthly Ticket 64500 Plus More × 129)

"Hurry up! Chatting with the doctor here, is there any sense of public morality? If you have a good relationship, you can chat in the tavern after get off work. What are you talking about here?" Zheng Ren threw the shackles of morality on the patient's family members.

They froze for a moment and calmed down.

The patient had a severe stomachache and was feeling uncomfortable on the CT side. Because of this, one CT was not enough, and two more were needed, which aroused their dissatisfaction.

This noise is unconscious and is an accidental event.

After being yelled at twice, the anger and courage disappeared, and the whole person calmed down.

In addition, Zhou Litao had a good temper and kept explaining, so they hurried into the room with the emergency surgery doctor to make a bill.

Zhou Litao wiped off his sweat and winked at Zheng Ren, wanting to take Zheng Ren into the host's duty room.

But Zheng Ren didn't go, he walked directly to the door of the emergency surgery clinic, urging him repeatedly.

The doctor quickly issued the order, and the patient's family members ran away.

Seeing the disappearance of the patient's family members, Su Yun walked into the emergency surgery clinic, gave a thumbs up, and praised: "Boss, your acting skills are pretty good, very good."

Zheng Ren smiled, "Come on, let's go to Mr. Zhou's duty room and talk."

If the patient's family members have something to do and come back, I'm afraid the matter will be bigger.

Zheng Ren has rich experience in such small frictions that are not considered medical disputes.

After all, he is the chief resident of the emergency department, and I have seen many such small incidents.

When he came to Zhou Litao's duty room, Zheng Ren completely relaxed and sat on the chair with a smile.

"Mr. Zhou, go up and beat him up." Su Yun sat down on the bed and said with a smile.

"How dare you." Zhou Litao said with a sad face. He knew that Su Yun was joking, but the joke was not funny at all.

Everyone is a doctor, knowing the embarrassment of the topic just now, and consciously talking about new things.

"Mr. Zhou, what's the condition of the patient?" Su Yun asked, "The free liver is usually found in childhood, how did the patient drag it so far?"

"The patient asked about his medical history when he came here. It is said that he has had intermittent abdominal pain since he was five or six years old, but it will heal after a while." Zhou Litao said, "The family didn't care about it, thinking that the little girl was weak."

"Later, the patient got used to it. Every time he felt pain, lying on the right side would make it a little better."

"The right side, this is the rhythm of returning the liver by posture."

"Almost, every time I have a stomachache, I will find a lump, which can still move with a push." ​​Zhou Litao said.

This... Zheng Ren felt helpless. The patient is also really big-hearted. He found such a big lump on his stomach, but he didn't come to the hospital for an examination?

No, it should be...

As Zheng Ren was thinking, Su Yun had already asked, "Has the patient not been to the hospital for examination?"

"It is said that I checked it twice, and I checked it when I remembered it after the abdominal pain relieved. There was nothing wrong with it. In the end, the patient gradually forgot about it."

forgot

Forget it!

"The patient suffered from pain for a long time this time, and the right side position did not improve. The mass in the upper abdomen was particularly large. In addition to nausea and vomiting, the pain was severe, so he was afraid, and called the 120 ambulance to the hospital."

"After I came here, I touched it. There was no pain in the patient's abdomen. I could feel a mass moving from right to left."

"What were you thinking about?" Su Yun asked.

"If I don't do the examination, what can I think about." Zhou Litao smiled, "But I still have to think about the secondary spleen and liver abnormalities."

"Is the intestinal obstruction serious?" Zheng Ren asked.

"I listened, and I can still hear bowel sounds, but they are slightly weaker, about 1 sound per minute." Zhou Litao's physical examination was very detailed and beyond reproach.

"Okay, let's watch the film and send it directly to the surgeon." Zheng Ren said with a smile: "Adult free liver is really rare. It was first reported by Terrier and Auvray in 1897, and there has been no decent summary since then. There are very few case reports.”

"Well, as long as the children are the main ones, those under the age of 5." Su Yun added.

Zhou Litao knew that the two people in front of him sounded very logical, but this was the first time he saw them.

What is it?

That's the thing.

If you can remember things from books, you have a good memory. But in clinical practice, it can be used, as if I have seen many cases, this is a great skill!

Some things, some people, can't accept it.

Zheng Ren called Dr. Liang, who said that the examination was almost finished, and the film of the left side had been uploaded.

Turn on the computer and call up the patient's image data. It can be seen that the colon enters between the liver and the diaphragm from the posthepatic space.

The image is quite typical, and the distance of the liver dislodging is about 10cm to the left compared with the supine position film.

This is the origin of the palpable mass in the patient's self-report, and also the origin of intestinal obstruction.

There was no complete blockage, strangulation, or necrosis, and the patient's condition was in a controllable stage.

After watching the film, the film of lying on the right side came through.

After changing the position, you can see that the position of the liver has moved obviously, and it directly returns to the original position.

However, the intestinal tract is under pressure, and there are some artifacts in the film. It is estimated that the patient has obvious pain and restlessness when lying on the right side due to intestinal obstruction.

"Okay, let's send it to the surgeon for emergency surgery." Zheng Ren turned off the video data.

"Send liver and gallbladder?"

Zheng Ren glanced at Su Yun, and said with a smile: "You brother Yun said, send the liver and gallbladder, and ask the stomach and intestines to come on stage together. First, the stomach and intestines will reset the intestinal tract, and then the liver and gallbladder will fix the liver."

"Don't let me take the blame." Su Yun said: "You said it all. I never do things that make people upset."

This disease is actually very simple, it's just that everyone has never seen it, and it's all a bit vague.

The liver cannot be fixed due to abnormal development such as excessively long, weak, or absent ligaments of the liver. When the patient is upright, the liver moves down, the space between the liver and diaphragm widens, and the colon is embedded in it to cause obstruction, followed by a series of clinical symptoms such as aggravated pain, nausea, and vomiting.

"President Zhou, let the surgeon accompany you." Zheng Ren warned, "Don't let anything happen on the way."

"Okay." Zhou Litao stepped out of the duty system, called out the surgeon who was doing a physical examination, and gave some instructions.

Afterwards, Zhou Litao walked into the surgical emergency room to deal with the patients who were undergoing examinations before.

Zheng Ren followed Zhou Litao out with a smile. He glanced at the surgery room and stopped immediately.

"Boss?" Su Yun followed, but he stopped suddenly and almost bumped into Zheng Ren's back.

Zheng Ren didn't speak, and hurried back to Zhou Litao's duty room, grabbed a white suit and put it on.

"What hysteria do you have?" Su Yun asked him standing at the door.

"Let President Zhou prepare nitroglycerin, keep your voice down, and don't add pressure to the patient." Zheng Ren said seriously.