The road to the rise of great doctors

Chapter 104 Hernia
In the ward, the afternoon sun shines in slantingly, adding a lot of warmth out of thin air.

In this ward, Liu Dong is seriously doing a physical examination for Zhang San. He is wearing disposable rubber gloves. Next to him are a dressing changing bowl and a pair of curved forceps. Inside the dressing changing bowl are povidone iodine and 3-4 Cotton ball, and a clean white gauze next to it.

After careful attempts, the patient named Zhang San's face was rosy, his face was covered with fine beads of sweat, and he also felt some pain locally.Phimosis is like this. The long-term narrowing of the outer orifice prevents the flow of urine and forms a lot of scales, which stimulates the inner layer of skin and causes repeated inflammation. The narrowing of the outer orifice will aggravate it to a certain extent.

After repeated attempts, it could not be liberated, so it was given up.

After this attempt, Zhang San saw Liu Dong's patience and seriousness, and couldn't help but feel a lot better.

He changed his previous unfamiliarity with strangers. When he talked to Liu Dong, he began to feel affectionate. It was as if Liu Dong had become his relative in an instant, and he couldn't wait to share all his thoughts. Say it all.

Liu Dong was a little helpless. After completing the task, he initially wanted to leave.But I couldn't resist such enthusiasm, so I stayed and chatted for a few words.

However, after looking at the time, Liu Dong thought again, "It's nothing important, why not increase your knowledge about inguinal hernia."

Liu Dong, who had changed his mind, felt that although he was not involved in the inguinal hernia surgery, it was the first time he encountered an example in clinical practice, so he inevitably became interested.

So, the two of them chatted about each other.After the atmosphere of the conversation gradually increased, Liu Dong proposed to give Zhang San another physical examination for inguinal hernia. Zhang San hesitated for a moment, after all, it was still a little painful just now, but when the atmosphere reached this point, he agreed.

An inguinal hernia is an organ or tissue in the abdominal cavity that protrudes outward through a passage.This channel can be congenitally weak or acquired.

Zhang San's inguinal hernia was acquired.The specific type is the most common type of inguinal hernia, indirect inguinal hernia, located on the left side.

At first, the protruding lump is relatively small and not painful. The only feeling is a slight swelling, which is especially obvious after standing for a long time or after activities, but it will become smaller or disappear on its own when you lie down.This was also the reason why he didn't come to see it in the first place.

However, as time went by, the protruding lump became larger and larger, and when it entered his lower pocket, he became a little embarrassed.

As the saying goes, "diseases should be kept hidden and medical treatment avoided."

"You stand first, I will check the body," Liu Dong and Zhang San said, and then started to check the body seriously.

"When standing, there is a mass in the left groin area. It is visible to the naked eye. It is soft and can be palpated by palpation. It is about 10 cm × 8 cm in size. Part of it goes into the pocket below. There is no pain when touched."

"Take off your shoes, lie on the bed, and bend your legs. I'll check on you again to see if you can return the money."

Zhang San followed Liu Dong's suggestion and lay on the bed. Liu Dong operated it gently, "You can return it, you cough... Well, press the inner ring mouth so that the lump does not protrude, and the outer ring expands significantly. After coughing, the outer ring The impact is obvious."

He continued the physical examination on both sides and found that the rest of the body was normal. "Okay, these two problems can be solved together during the surgery tomorrow."

After the physical examination, Liu Dong picked up the hand sanitizer beside the bed and disinfected his hands.

"Doctor Liu, why do you think I got this disease?" Zhang San asked quickly as he watched Liu Dong wash his hands and prepare to leave.

"Generally speaking, among the high-risk factors, long-term dysuria and long-term chronic cough are the most common. In your case, you also know that you have some difficulty in urinating. You are used to bulging your stomach and using abdominal pressure to urinate. In clinical practice, it is more likely to be benign prostatic hyperplasia. resulting in chronic dysuria, often in conjunction with an inguinal hernia.”

Liu Dong continued, "After surgery, the problem is solved. But you also know that most surgeries are safe, but among 1 people, there may be one unlucky person, so all risks must be explained clearly. When you encounter it, get over it.”

He raised his hand and looked at the time, and then said, "I have something to do in a while, so I will go and get busy. You should also go for a check-up soon."

Liu Dong left Zhang San's ward and went to take a look at the patients in his own group. He found that the basic conditions were all okay and there were no special circumstances.I also answered every patient or family member's questions one by one, and explained the meaning and treatment of the test results. I gained a lot of gratitude.

Back in the office, I looked at the busy figures beside me, well, none of the computers were free, but he didn't need them.

"Using the computer at the wrong peak can quickly complete what you need. Why snatch that computer from everyone at this moment!" Liu Dong smiled, then walked to the side of the conference table, picked up the "General Surgery Guide and Expert Consensus" 》, savor it carefully.

Textbooks are the first step for medical students to learn clinical knowledge. Mastering this knowledge will give them a preliminary understanding of diseases.But a disease only occupies 1-3 pages in surgery, and this knowledge is just the basics.

Guidelines and expert consensus are powerful tools for interns or residents to learn about diseases and clinical procedures.Here, there are more practical introductions, recommended examinations, recommended treatments, and information such as the level of evidence.For people with limited clinical experience, this is a magic weapon to help them deal with common situations.

Monographs have more knowledge. The epidemiology part can learn about the current incidence of this disease at home and abroad, whether there are similarities and differences between different ages and genders, who are high-risk groups, etc.; the pathology part reflects the disease. What is the essence of the disease? Pathology is usually the gold standard for the diagnosis of tumor diseases; clinical manifestations, laboratory tests and imaging tests reflect the statistical approximate manifestations of the disease and under what circumstances the disease needs to be considered.The treatment section will list in detail the treatment situations from the past, present, to the future being explored.Of course, most of it is about the past and present, and the future part usually doesn’t have many updates to the monograph.

The literature represents the latest research results.The review in the literature is a microcosm of the monograph.

At this time, Liu Dong was new to the general surgery department.

What he is reading is a guide and consensus compiled by experts in the field of general surgery. He wants to understand the content and purpose of medical orders and treatments through this.

Of course, because general surgical diseases are complex and some diseases develop rapidly, there are many guidelines and consensuses.This guide is just one of the guides.

(End of this chapter)