Auto chess in the operating room

Chapter 99 Laparoscopy in sight

Cheng Jian is an experienced old expert. He was only in the blind spot before. After Tang Lou's reminder and the suspicion of portal phlebitis, it is natural that the various information of the patient became less messy and the evidence was automatically organized.

I took the materials organized by Qingping, and looked through them carefully.

In the acute inflammatory phase of purulent portal phlebitis, purulent lesions may involve the main portal vein and its branches, the involved vein segment is difficult to identify, the vein is closed and swollen, the lumen is obviously enlarged, the thinned part of the vessel wall is intermittently bulged, and the venous intima is ruptured , the formation of fresh thrombus of varying degrees can be seen, and the adventitia is mostly exuded by cellulose.

Therefore, through CT, it is possible to observe extensive enlargement of the portal vein system and intraluminal thrombus formation.

Before, because too many other classic symptoms interfered with the line of sight, now analyzing the CT examination again, Cheng Jian really saw the extremely hidden portal vein system expansion and intracavitary embolus formation, combined with the patient's intra-abdominal infection lesions, and Qingping's emphatically proposed In the presence of sepsis, the diagnosis of acute suppurative portophlebitis is not difficult.

"Yes, yes, Tang Lou, you are really talented in diagnosis. How did you discover such a secret symptom?"

Cheng Jian put down the documents and looked at the Tanglou.

Tang Lou was stared at with hairs on his back, and scratched his head: "It may be because my clinical experience is relatively shallow. For many classic symptoms, I don't respond instinctively to various common diseases like experts. Instead, I put aside these most obvious symptoms. After checking the data, the cases that can be published in journals are relatively rare and special, and there are some accidents."

Cheng Jian nodded. Tang Lou said that it made him think deeply. In many cases, due to the long-term diagnosis, he developed an instinctive reaction. For some initial symptoms, he immediately thought of classic symptoms, and he was complacent, but lost the feeling of walking on thin ice when he was young. , carefully.

Empiricism and fixed thinking are sometimes the source of relying on the old and selling the old, so remember!

"Tang Lou, you are doing very well, I will inform Qingping immediately."

Tang Lou hastily added: "Director Cheng, don't say I proposed this matter. After all, I am an intern now, and Dr. Qing has arranged ten appendicitis operations for me. If he finds out that I did not prepare well, Instead, I was studying this patient, and I had to be punished."

"He dares!"

Cheng Jian scowled, instinctively protecting his calf.

But thinking about it, Tang Lou was right to think about it. After all, it is very taboo to report to a higher level in the workplace.

"Okay, I see. You go back and prepare for the appendicitis operation."

"Oh~"

Cheng Jian sorted out the information and was about to call Qingping, but after thinking about it, he stopped Tang Lou.

"Tang Lou, these ten appendicitis operations are done well, and I will go back and conduct random checks during the period. If they are completed well, I have discussed with Dr. Qingping, and I will directly arrange for you to undergo laparoscopic appendectomy."

"Really?"

Tang Lou was overjoyed, the laparoscopic technique has been upgraded to a higher level, and his current two-star appendectomy is enough to handle it.

[Ding, new task, rapid growth: complete ten appendicitis resections, the cure rate is 100%, and there is no postoperative infection.Every time a reward gold coin 2 is completed, the reward card library is automatically refreshed once]

"Don't be too happy too early. You have to complete all of them and the patient's prognosis is good before you can be the chief surgeon for laparoscopic appendectomy. If there is a small problem with one of them, start from the pull hook again, and give me every one. handle it seriously!"

Cheng Jian said seriously, after all, surgery is very serious, it concerns the patient's life, so it should not be rushed and treated as a trifling matter.

"Director Cheng, don't worry."

Tang Lou nodded, as if he was determined to win, and the standard given by the system could be even higher.

"By the way, during these ten operations, Tian Linsheng can be properly arranged to help, and rewarded for closing the abdomen and suturing. One person cannot perform the operation, and you need to train a good assistant. In the future, Tian Linsheng will cooperate with you. I will cooperate with you. Qingping informed."

Cheng Jian also reminded that after all, Ma En is already a resident doctor in the department, and his status is inappropriate.Wang Daquan was too flexible, and Cheng Jian didn't like it too much. Tian Linsheng was a good candidate both in terms of qualifications and personality.

Cheng Jian has a sense of his old father's hard work in cultivating power for his heirs.

"understood."

Tang Lou's eyes lit up, he naturally understood Cheng Jian's good intentions.

"Director Cheng, your coffee is quite fragrant, but it's a bit bitter and doesn't quench your thirst."

"roll!"

Looking at the back of Tang Lou getting out, Cheng Jian smiled: "Young people are awesome."

He took another sip of coffee, tasted it, and cursed again: "Your vision is much worse than mine."

While Tang Lou and Cheng Jian were discussing the condition, Ma En and Wang Daquan went to test the patient's various data again according to the time point.

The patient's family members were kicked out directly, and the eyes of the two were blazing.

"What is going on in this tenement building? Who made him promise the patient that the cause of the disease has been found?"

"That's right, what the hell is this guy doing to make the two of us look like garbage."

Wang Daquan still remembers the sentence of the patient's uncle, "Whether you two can do it or not, if you don't know, you will ask the superior doctor for instructions."If you look at Dr. Tang, you can see the cause as soon as you come.Get out now!

Let your superior doctor or Dr. Tang come and talk to me!
Even the patient's mother was on the sidelines: she was not as good-looking as Dr. Tang, and her speech was not as nice as Dr. Tang's.
Ma En and Wang Daquan were in a panic. While looking for Qingping, they reorganized their words and denounced Tang Lou for deceiving the patient. Now the patient has given a time limit of half a day, and if he does not give a clear treatment plan, he will make a fuss.

It seems that something big is about to happen!
The two soon found Qing Ping in the general surgery office. Dr. Qing was on the phone with Cheng Jian.

"Really, okay, I'll implement it right away."

Qingping suddenly relaxed, and he was in a good mood, seeing Wang Daquan and Ma En rushing back full of shame and indignation.

Just as Ma En was about to sue, he heard Dr. Qing say: "Director Cheng has basically found the cause of the disease. He suspects it is suppurative portal phlebitis. The possibility is nine out of ten. You came just in time. Let's go to the ward right away. I'll go check it out myself. If diagnosed, start treatment immediately."

Ma En and Wang Daquan looked at each other in disbelief, and when they were about to sue Tang Lou, they all held back.

He was even more surprised. This didn't mean that Tang Lou knew that Director Cheng had found out about his illness earlier than Dr. Qing.

In other words, after thinking about it, the two of them felt sour.

At this time, Tang Lou also returned to the office from Cheng Jian.

Looking at Qingping and the others: "Doctor Qing, the cause of the appendicitis patient's high fever has been found. I just met Director Cheng and told me that it was suppurative portal phlebitis."

"Well. As expected of Director Cheng, the veteran will be the top three. I am still checking the direction with Ma En and the others, so I feel more at ease now."

Qingping is in a good mood. Last night he didn't sleep all night. He was investigating and sorting out all kinds of information, but he only determined two broad directions. He just gave the information to Director Cheng for a long time, and he found such a deep suppuration. Portal phlebitis, had to take.

"We all have to learn from Director Cheng. We have rich experience and sharp vision. We are too far behind."

Qingping sighed again.

Both Wang Daquan and Ma En agreed very much, but Tang Lou's expression was indifferent, without much admiration.

Tian Linsheng, who was still knocking over the medical records, also stopped, his eyes full of envy, when will he be able to be like Director Cheng, and intractable diseases will be wiped out with a snap of his fingers!
Qingping directly arranged: "Ma En, Wang Daquan and you go to the ward with me. Tang Lou, you and Tian Linsheng continue to prepare for appendicitis surgery, and there will be one tomorrow morning."

Tang Lou thought for a while: "Doctor Qing, I still have ten appendicitis operations in the future, and the volume is huge. Can Tian Linsheng be responsible for closing the abdomen and suturing it?"

Qingping thought of Li Chengjian's entrustment on the previous phone call: "You are the chief surgeon, and you will arrange everything."

"Really?"

Tian Linsheng bounced up from the chair, excited, rubbing his hands, with an expression of recognizing a good master.

That's the help you've been dreaming of!

Ma En and Wang Daquan were also very surprised. Isn't this Tang Lou clearly cultivating his younger brother?

Wang Daquan was deep in his thoughts, and looked at Ma En beside him, and suddenly felt a kind of resentment that he was unkind to others.

According to the present situation, Director Cheng told Tang Lou in advance about the patient's condition without even telling Qingping.

Everyone can think that Tang Lou will rise to the sky in the future, and naturally it is not comparable to a resident doctor like Ma En who has no background and mediocre talents.

Don't say it's Ma En, no way, I will not even be as good as Tian Linsheng in the future.

An absurd picture appeared in Wang Daquan's mind:

Cheng Jian is like the founding ancestor of a sect, Qingping is the senior brother, and Tang Lou is the most beloved closed disciple who married the ancestor's precious daughter.

According to seniority, Ma En is the eldest disciple of Senior Brother Qingping, so he is Ma En's disciple.

Disciple's disciple, isn't that the grandson of the great king!

Now that Tian Linsheng is Tang Lou's founding disciple, wouldn't he want to call him Master Tian Linsheng?

Oh shit, I'm a generation shorter.

Thinking about the future scene, Tian Linsheng: Wang Daquan, from now on we will talk about our own business, I will call you brother, you will call me uncle

Wang Daquan suddenly felt that life was hopeless.
(End of this chapter)