Come on, Dr. Wu

Chapter 407 Toothpick?

Donghai Airport.

In the end, Zhong Beibei was the only one who left, and the remaining seven people came to see her off.

At the moment of waving goodbye, the eight people realized that the show was really over and a month had really passed.

A page in life has really been turned.

So fast, so hard to accept.

Looking at the plane flying high, Cheng Shi and the others knew that no matter whether they left or stayed, there was one thing that remained unchanged.

That is their desire to reach the pinnacle of medicine and cure diseases and save lives.

After returning to the apartment, they were finally able to relax a little. The springs cannot be kept in a tense state all the time, and proper relaxation is also necessary.

After seeing Zhong Beibei off, they went out to sing and play, having a great time.

However, what they didn’t know was that while they were seeing them off, Wu Xiaofu was also waiting anxiously at the airport.

Qu Ying is coming back today. To be honest, the love between them is something that ordinary people cannot experience.

It has actually been just over a year since they started dating, but apart from the first one or two months together, they have been living apart for most of the time.

And it's an international relationship.

None of them had the time to travel back and forth between the two places, so the number of times they met later was even more limited, and even the top leader could count them.

The daily communication is actually just talking through video, but this kind of love can stand the test and become stronger. It is really as firm as a century.

But if you think about it carefully, this is the love between doctors.

So what if it’s not an international relationship?
Look at these doctors in the hospital, which one is not in an international relationship or even worse?

As a doctor in the First Affiliated Hospital, there is one word that is destined to run through your life, and that is - busy.

Whether it is an internist or a surgeon, the only difference is that internists can go home at night when they are not on duty, while surgeons can hardly go home.

It is said that seeing a surgeon is like being widowed in middle age. This is actually true. Wu Xiaofu doesn’t know about the others, but just the doctors in the department.

Once a surgery is scheduled, it must be completed on the same day. During this period, Chen Zhendong basically has to work until eleven or twelve o'clock every day. If there is an emergency, he has to work until the late night.

At this time, I didn't even want to take it home. I just slept in the hospital for one night and continued working the next day.

Chen Zhendong’s girlfriend is not in the same industry, but she has complained about him several times and has also quarreled with him several times.

This is not so bad. If he finds someone outside the industry, his significant other can still come to see him, and no matter how busy Chen Zhendong is, the two of them can still find time to meet.

If we really find someone in the same industry, then it will be over. Both of us will be busy, and it will be difficult for one of us to find time to rest, let alone find time for both of us to be free.

It is said that the most lasting romance is having a meal in the hospital cafeteria, and this is the love between doctors.

Being able to have a meal in the hospital cafeteria is their greatest luxury.

However, precisely because they both know the nature of their jobs, they can understand each other better. Of course, this is also on the premise that there are no children.

Therefore, we can find that doctors nowadays generally tell people to have children late. One person feels that they often stay up late and their body is not suitable for having children, or they are not prepared.

How to raise a child after giving birth is a huge problem for them.

"Xiaoying."

Wu Xiaofu stared at the opening, and the beautiful figure he had been thinking about appeared. Wu Xiaofu could no longer suppress his joy and shouted loudly.

Qu Ying had just come out and was looking around impatiently. When she heard Wu Xiaofu's voice, she became even more excited and ran out like a fly.

"Xiao Fu."

The two figures hugged each other tightly. People coming and going were no longer surprised. As young people, it was understandable that they hadn't seen each other for a long time. Thinking back to the past, they...

In the car, the two couldn't help but hug and kiss each other, and they didn't let go until Qu Ying was out of breath.

Along the way, the two expressed their longing for each other.

Things got even more intense after they got home. Wu Bin and the others knew that Qu Ying was coming back today, so they went to Wu Jinglüe with understanding.

It's a spacious house with a lot of potential.

Thinking that they would be getting engaged in two days, the two of them were even more excited.

Of course, after everything is over, we still have to go to work, as there are still two days before the holiday.

And before going to work, there is one more thing to deal with.

Wu Xiaofu sent a message to Jiang Bei, asking her and Cheng Shi to come to the hospital together. This made Jiang Bei, who had had so much fun yesterday and was planning to sleep in before looking for a job, a little confused. What could he want to talk to her about?

In the department.

Feng Lingling and the others were not puzzled as to why Jiang Bei came along. They knew their boss well and would not be willing to let go of talented people, let alone someone they had brought up personally.

In Ward F today, no matter how many doctors are added, there are not enough, so expanding the staff would be the best. However, not everyone can be recruited.

Now the team in the entire ward is very mature and works well together. No one wants a colleague who may disrupt the stability of the team to suddenly come in.

Therefore, Jiang Bei, who I have known about everything and have known for a month, is simply the best choice. In the department, no one would dislike this carefree, generous, physically fit, and resilient junior sister.

When Jiang Bei arrived at the department, she really wanted to ask Wu Xiaofu why he asked her to come. She had been guessing all along, and had all kinds of speculations and possibilities in her mind. She felt uneasy and uncomfortable.

She also thought that Wu Xiaofu might be planning to find a hospital for her or even keep her because she did not leave Donghai. However, she felt that it was impossible. How could she be so confident?

But my heart is beating so fast. Once people have an idea, they can't control their thoughts.

But after entering the hospital, Jiang Bei could no longer control herself.

"Xiao Jiang, you're here just in time. Bed seven is bleeding. Go check it out."

"Xiao Jiang, I have an operation today. Please help me arrange for these two to be discharged from the hospital."

……

Jiang Bei was really confused. She really wanted to say to these older brothers and sisters, "Do you know that the show is over? She is going to leave the hospital."

But seeing that no one else gave her the chance to refuse, Jiang Bei had no choice but to do it. At most she would just work for a day for nothing, as long as the hospital didn't kick her out.

In fact, it would be fine for her to work for free. As long as she could stay here, work with Wu Xiaofu and learn things, she felt that she was still making a profit.

But now that I’m busy, I don’t have much chance to ask Wu Xiaofu about anything.

After the morning meeting, she went to the ward rounds and went straight to the surgery. She couldn't catch Wu Xiaofu until Wu Xiaofu asked her to come down to eat the surgery meal. She didn't see Wu Xiaofu until then. The surgery meal ordering in the hospital is not so strict. You can order more. Although there are only five people in the surgery, it is not a problem if you want to bring one or two for the on-duty person.

No one would say anything. A surgical meal with a meal price of thirty yuan is not that bad and is still acceptable.

"Boss."

Jiang Bei was a little excited thinking that she finally had the chance to ask Wu Xiaofu, but Wu Xiaofu simply gestured with his chopsticks.

"Well, here you are. Sit down and eat. Then I will go into surgery with you later."

Ah!
Jiang Bei was too busy talking. She had to go into surgery and who knew when Wu Xiaofu would be required to do it. The most important thing was to eat quickly, so she just ate her meal.

Wu Xiaofu ate very quickly. "I'll go first, you come over later."

Jiang Bei quickly shoveled down the last bite and gulped down a mouthful of water, "I'm ready now."

On the operating table.

This is a female patient, only 32 years old, who came to the hospital mainly because of "pain and discomfort in the right upper abdomen for 10 days".

This patient is quite informative. Two years ago, the patient was found to have foreign body in the liver and had a history of liver abscess.

When encountering such patients, the hospital generally recommends surgery for the patients. Liver abscesses are okay and can be treated with medication, but foreign bodies in the liver cannot be treated with medication.

If this thing is not removed surgically, it will become a disaster sooner or later, especially some foreign bodies with great hidden dangers. However, no one is willing to do surgery, and the patient requested conservative treatment at the time.

Fortunately, the patient's symptoms improved after conservative treatment, which made the patient have no plans for further surgical operation.

Two years passed like this. During this time, the patient followed the principle of "out of sight, out of mind" and did not have a follow-up check-up.

Until 10 days ago, the patient suddenly experienced pain and discomfort in the right upper abdomen without obvious cause. The pain was persistent, dull, and there was no nausea or vomiting. Two days later, he even developed a fever. In fact, foreign body in the liver has always been a concern for the patient.

After these symptoms appeared, the patient immediately associated them with foreign body in the liver.

Not daring to delay, the patient rushed to the hospital, where he was treated by Wu Xiaofu.

After a physical examination, the body temperature had reached 38.5℃, which was a high fever. There was mild tenderness in the right upper abdomen and percussion pain in the liver area. A mass could be felt on the right chest wall, which was soft and obviously tender.

Based on the patient's medical history, Wu Xiaofu told the patient that this time he had no choice but to do it.

Even if the patient is unwilling in his heart, he has to obey after hearing this.

The patient had previous auxiliary examinations from two years ago. Ultrasound showed: foreign body in liver S6 (similar to the shape of a toothpick) and surrounding inflammatory lesions.

CT three-dimensional reconstruction suggested: foreign body and abscess formation in the liver.

After Wu Xiaofu admitted the patient to the hospital, he arranged a new examination for the patient. The upper abdominal CT+ enhancement showed: a needle-shaped high-density shadow from the inner lower part of liver S6 obliquely outward and upward through the liver capsule to the abdominal wall, and abnormal manifestations of the surrounding liver tissue and abdominal wall. It was considered that there was a foreign body in the liver and it penetrated the capsule to the abdominal wall. There was an inflammatory reaction in the liver tissue around the foreign body and localized inflammatory granulation tissue and abdominal wall soft tissue infection and abscess formation. The foreign body was shaped like a toothpick. Please combine it with clinical practice.

Now the diagnosis was completely clear: it was foreign body in the liver with infection.

After Wu Xiaofu communicated with Peng Xia, he scheduled the surgery for today.

Some foreign bodies in the abdominal cavity do not require treatment, but intervention is required in most cases, especially foreign bodies in the liver. Not to mention the important organs, the foreign body is not small and is a sharp object.

This time, the symptoms were caused by piercing the abdominal wall. What if the large blood vessels in the abdominal cavity were pierced? The consequences cannot be underestimated.

So, Wu Xiaofu did not dare to delay and directly arranged the surgery for Monday. The foreign body in the liver was already active and it might pierce the blood vessels any day. It is better to have the surgery as early as possible.

The operation is not difficult. It is just "liver foreign body removal + abdominal wall abscess incision and drainage" after laparoscopic exploration.

The operation proceeded step by step.

"Jiang Bei, if you don't plan to go back, then stay in Donghai to develop?"

Hearing Wu Xiaofu's question, Jiang Bei nodded quickly, "Yes, I like it here, I want to stay here to work, there are more patients here, which will allow me to grow faster."

Wu Xiaofu nodded when he heard this. "Well, I've seen your performance over the past month. If you want, you can stay in the department, but it's just a department contract. If you want a hospital contract or something, you still have to work hard on your own."

"real!"

Jiang Bei was really surprised at this time. She didn't expect that she would really be retained by Wu Xiaofu. As for the technical employment contract, she didn't care about it at all. She was already thinking about working for nothing, so what was the technical employment contract?

"Thank you, boss."

Seeing Jiang Bei's expression, Wu Xiaofu also smiled.

"If you really decide to stay, you have to work harder in the future."

"Yes sir."

"Out."

As they were talking, the operation reached a critical moment. Under the laparoscope, a toothpick appeared in everyone's field of vision. As expected, just as the examination suggested, the culprit was indeed a toothpick.

"Jiang Bei, I'll give you this case to report tomorrow."

Report the case! Jiang Bei did not refuse and nodded quickly. This is the tradition of District F. When encountering interesting cases, they must share them at the morning meeting.

This patient came when Wu Xiaofu was in the outpatient clinic. Jiang Bei was also there at the time and was quite familiar with the case.

Now that I have followed the operation, I already have a plan in my mind.

"Combined with clinical history, ultrasound examination and CT examination, the diagnosis of intrahepatic foreign body combined with surrounding tissue infection was basically clear.

When the patient came to the hospital for the first time for an ultrasound examination, the foreign body was considered to be a toothpick. At that time, the ultrasound department used the toothpick for in vitro experiments for the sake of accuracy, and compared it with the foreign body in the liver under ultrasound. The size and shape were basically the same.

This case is quite rare. When the patient was first treated 2 years ago, the foreign body was located in the liver parenchyma, but there was no obvious break in the liver capsule at both ends of the liver at that time.

At that time, we began to wonder: 'Where did this foreign object come from?'
The patient herself couldn't explain it clearly at the time. After all, she wouldn't swallow a toothpick for no reason.

Two years later, the foreign body slowly broke through the liver capsule and migrated to the chest wall, forming a chest wall abscess.

According to the literature we have read, foreign bodies in the liver are generally sharp objects, the most common of which are fish bones, followed by toothpicks.

The most common site for foreign bodies to invade the liver is the left liver (adjacent to the gastric antrum). In this case, the foreign body was located in the lower segment of the right posterior lobe of the liver (S6). The foreign body was likely to have pierced the liver tissue from the wall of the ascending colon.

The patient's clinical manifestations are mainly gastrointestinal perforation and infectious lesions caused by foreign bodies in the liver, such as fever, upper abdominal pain, and intrahepatic abscess.

The main ultrasound manifestations of foreign bodies in the liver are: (1) Foreign bodies generally appear as "fishbone-shaped" or "toothpick-shaped" strong or high echoes, with or without acoustic shadows. Foreign bodies may be located entirely or partially in the liver parenchyma. (2) Infectious lesions caused by foreign bodies: generally manifested as a mixed mass centered on the foreign body, with anechoic and weak echoic areas visible in the mass. CDFI: The edge of the mass is rich in blood supply.

If foreign bodies are found in the liver, surgical treatment is the first choice, and anti-infection treatment is actively performed. "

perfect!

Jiang Bei couldn't help but give herself a thumbs up after silently preparing the draft in her mind. She found that she was in a particularly good state today. Such a case report was easy for her to handle. After returning, she could add the medical records and it would be done.

(End of this chapter)