My medical path

Chapter 29 Emergency Surgery
In the operating room, the patient is anesthetized and lying on the operating bed.

In addition to hands and feet, there were multiple wounds on the chest and abdomen, so general anesthesia was performed.

Coincidentally, the anesthetist was still Wang Ruoyun, together with Lu Shiqing, today's surgery team gathered again.

Wang Ruoyun's eyes lit up when he saw Chen Bo walking in.

The unpleasantness of having dinner with girlfriends ended by emergency surgery has also been alleviated a lot.

Because there are also wounds in the chest and abdomen, multidisciplinary surgery is required.

From the thoracic surgery department is Huang Daguang, the deputy chief physician.

The person from the general surgery department turned out to be the attending physician Luo Hao whom Chen Bo met during his consultation.

"Meet you again." Luo Hao greeted Chen Bo happily when he entered the operating room.

Huang Daguang, who followed behind, just nodded and found a seat to sit.

Luo Hao, the patient who was transferred after Chen Bo's consultation that day, was followed up continuously.

Facts have proved that Chen Bo's judgment is correct.

No symptoms of shock appeared after that patient.

Although there is still the possibility of bleeding within a week or two, the most dangerous time has passed.

For a doctor who is not engaged in general surgery, to be able to make such an accurate judgment, he can still stick to his own judgment even when his on-line doctors have already reached a conclusion.

From this point alone, Chen Bo's theoretical foundation is very solid.

And he has full confidence in the judgment of the disease, so Luo Hao admires Chen Bo very much.

The world of doctors is the same as other technical jobs, and those who are capable are respected.

The folk customs in Jiangcheng County are quite tough.

This patient was eating supper at the night market and saw a beautiful girl standing in the open space on the phone, and when she became lustful, she groped her butt.

The girl didn't cry, make trouble, or howl when her butt was touched, but calmly dialed another call.

As a result, 2 minutes later, a few people got out of a van, rushed to the rear trunk of the car, brushed and pulled out a few knives.

It turned out to be a tragedy. Last second, I was still lamenting that this girl's buttocks are really flexible, and now she is lying on the operating bed honestly.

Of course, the calm sister and the gangsters were also taken in by the police station.

Most patients with stab wounds have stories, and their performances are completely different.

Chen Bo remembered a patient he had taken over.

An aunt who is almost 50 years old also staged a full-scale martial arts with her neighbors because of neighbor relationship problems.

As a result, the neighbor slashed dozens of knives, one of which fell on the face.

Although none of the vital parts were injured, they were already dying of shock when they arrived at the hospital.

Who knew that when he was sent to the hospital bed, the first thing he said when he saw Chen Bo was not to ask Chen Bo to save his life, but to hold Chen Bo's hand tightly and say something that made Chen Bo dumbfounded——

"Doctor, please save my face!"

.........

In this kind of combined surgery, each major is generally responsible for its own work.

Huang Daguang from the Department of Thoracic Surgery is in charge of the chest, and Luo Hao from the Department of General Surgery is in charge of the abdomen.

Chen Bo was naturally responsible for the rest of the hands and feet.

They each brought a helper, and Chen Bo's helper was Pang Minghui, because he was on duty today.

Here comes the problem again. After dividing the respective areas of responsibility, it becomes a matter for several people to consider who will do it first.

Generally speaking, the life-threatening part is done first.

For example, if you stabbed the heart with a knife, if there is still a chance, the heart must be the first problem to be dealt with.

Another example is when a knife wounds organs such as the liver and kidneys, the bleeding is also rushing, and these parts are also given priority in order to save lives.

As for the problem of Chen Bo's hands and feet, as long as it is not the damage of the opening of the large blood vessels, it is generally ranked behind.

This patient had nearly ten large and small incisions in the chest and abdomen area alone.

I also saw the X-ray taken before the operation. In addition to the wound seen on the skin, there was a left pneumothorax and pneumoperitoneum at the same time, and a lot of fluid in the chest cavity and abdominal cavity could be seen.

Normally, Qi is in the lungs and intestines.

Now that there is gas outside these normal parts, it means that the lungs and intestines are ruptured.

Moreover, there was a lot of fluid in the chest and abdomen, judging from the bleeding of the blood vessels or organs in the lungs and abdominal cavity after injury.

The patient was in shock when he came, and now he can appear in the operating room only through blood transfusion.

Therefore, according to the normal operation arrangement, the wounds in the chest and abdomen should be treated first.

At present, exploratory surgery in large hospitals can basically be performed minimally invasively under endoscopy, but a small place like Jiangcheng County People's Hospital obviously does not have such conditions.

So now the chest and abdomen need to be explored at the same time, so we have to consider who will do it first, or whether to open the chest and abdomen at the same time.

As for Chen Bo, no one is giving priority to it for the time being.

In terms of thoracotomy, a large opening between the ribs must be opened and forced open to expose the lungs below.

Because the lung is the main respiratory organ, an artificial lung is required during the operation. Not only is the operation complicated, but the operation trauma is also great.

For the abdomen, a large incision is made on the midline of the abdomen, the stomach is cut open, and the organs and intestines are carefully inspected. The trauma is not minor.

After Chen Bo arrived in the operating room, he started the scan to check the patients, and he did see the accumulation of air and fluid in the chest and abdomen.

But after careful inspection, it was found that the lung was indeed poked a small hole, but the blood vessel was not injured!
There is an opening in the stomach where the abdomen is located, and the gas and blood in the abdominal cavity may come from this opening.

But the question arises, where does the blood in the chest come from?Chen Bo was full of doubts.

After careful inspection, Chen Bo found the answer.

Diaphragm!

If it wasn't for Chen Bo's current powerful system, according to conventional inspection methods, even if he checked this location, he might not be able to find it.

Through the system, Chen Bo could clearly see that there was a one-centimeter tear on the left diaphragm, and now the incision was bleeding profusely.

At the same time, Chen Bo also saw a skin wound of about one centimeter on the patient's left side under the ribs. This wound is easy to miss if you don't look carefully.

Seeing this situation, a dynamic picture took shape in Chen Bo's mind:

A knife at least ten centimeters long and one centimeter wide pierced the patient's left side under the ribs, passed obliquely upwards through the stomach, continued to pass through the diaphragm, and then pierced the left lung after entering the chest cavity!

At this time, Chen Bo didn't know whether it was the patient's luck or the guy who used the knife was highly skilled.

When the knife pierced in, it happened to avoid both the spleen behind the stomach and the heart next to the lungs!

So now the situation is clear, the hemorrhage in the chest cavity is not from the lungs, but from the diaphragm!

The lung was stabbed with a small wound, but a small amount of pneumothorax does not need to be treated.

Because small wounds in the lung can heal on their own, if the pneumothorax increases, at most, a closed drainage will be placed, and there is no need for thoracotomy at all!
And the wound in the diaphragm only needs to be repaired from the abdomen.

This discovery lifted Chen Bo's spirit.

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(End of this chapter)