I'm really an intern

Chapter 476 Two Ways, Life or Death

What a magical feeling.

The director of the imaging department turned his head to look beside him. Zhang Tianyang stood upright and looked at him calmly.

So the director of the imaging department was a little depressed.

Obviously he is the authority, and the person who is being questioned and about to be tried should be the one next to him.

But why, he was so calm, but he was a little nervous?

"Cough cough!"

Coughing twice, the director of the imaging department suppressed the uneasiness in his heart and regained the initiative.

He looked around, and in the eyes of everyone, he opened his mouth slowly.

"The results of the film review he just said are correct."

"I knew it!"

Before all the white coats could react, Zhao Tianwang, who had already been impatient, slapped his thigh suddenly, pointed at Zhang Tianyang, and spewed wildly——

"I know the result of what you said, brat"

Halfway through the speech, he suddenly reacted.

wait!

Just now, the director of the imaging department said that the result of this brat was wrong or right?

Seems to be right?

But how could it be right!

Zhao Tianwang was suddenly stuck on the spot.

"Cough cough."

The chief director of the Department of Urology, who was a step behind, glanced at Zhao Tianwang and spoke slowly.

"What Dr. Zhao means is that we already knew that Dr. Zhang was right. Dr. Zhao and I are very optimistic about Xiao Zhang."

That's it!

The excitement of eating melons just rose in the hearts of the white coats, and their enthusiasm was instantly extinguished.

Looking at Zhao Tianwang Zhaocha again, he saw that his mouth was not closed yet, and the muscles on his face trembled slightly.

"Doctor Zhao, sit down, the doctors in our own department should protect, but don't be so excited."

The chief director of the urology department gave Zhao Tianwang a leisurely hand, then turned to look at the white coats around him.

"Okay, the patient is still waiting in the emergency department, let's ask the director of the imaging department to tell us about the imaging results!"

A group of white coats really regained their spirits, and turned their eyes to the director of the imaging department again.

Zhao Tianwang was dragged to sit down by the director of the Urology Department, the muscles on his face still trembling, he could only take a deep breath, forced himself to stare at the medical records in his hand, and stopped looking at Zhang Tianyang.

Zhang Tianyang seemed to have a sense of it, and glanced here, then turned his gaze back, and focused on listening to the director of the imaging department.

"The result in the brief introduction of the medical record is correct, but it is relatively brief. Now let me explain it to you in detail."

The director of the Imaging Department pointed to the screen and began to analyze it bit by bit.

"There are indeed multiple nodular shadows in the lungs. Considering infiltrative pulmonary tuberculosis, mainly proliferative foci, it may be the active stage of pulmonary tuberculosis.

Diffuse increased lung shadow, considered as traumatic wet lung.The left thorax collapsed and multiple rib fractures were considered fresh lesions.

A small amount of pleural effusion on the left side without atelectasis.The esophagus is obviously dilated in the mediastinum, which may be caused by cardia compression. "

"There was no damage to the liver in the abdomen, and no clear abnormalities were found in the portal vein, bile duct, gallbladder, portal vein, and splenic vein.

There is no clear and complete structure of the left kidney. The left retroperitoneum occupies a huge space, and blood can be seen around it. It is considered that the left kidney has changed after trauma and lost its original structure.

Right kidney atrophy, hydrops, suspicious stones.The inferior vena cava and aorta were compressed and displaced, and the superior mesenteric artery was compressed and deformed. "

The overall result is not far from what Zhang Tianyang wrote in the medical record, but the details are much more detailed.

While listening, the faces of the white coats present gradually became serious.

"After completing the CT examination, the patient has contacted the interventional department and was sent to the interventional operating room."

Zhang Tianyang opened his mouth and directed everyone's attention to the interventional doctor.

The director of the imaging department who had just summed up the imaging results had no exposure at all, but his face was serious, and he also set his sights on the interventional surgeon.

The patient's obviously swollen abdomen, the sudden drop in hemoglobin, and the results of imaging studies clearly pointed to a term—hemorrhage.

And it's bleeding badly.

What is not clear now is the location of the bleeding.

At this time, the first thing that comes to mind is the intervention department.

"What is the situation now? Can the bleeding artery be found? Can embolization be performed?"

The chief director of the Department of Urology frowned and stared at the interventional doctor.

The doctor who intervened in the department looked a little young. Although he was definitely older than Zhang Tianyang, he probably wasn't much older.

At this time, the sudden coldness became the focus of everyone, and his voice trembled uncontrollably.

"The guide wire was put in 2 minutes ago, I'll ask again!"

After saying that, he quickly took out the phone, his fingertips trembling slightly.

"Then ask the thoracic surgeon for consultation first."

The chief director of the Department of Urology advanced the consultation, "How is the patient's chest condition now?"

"There was no clear bleeding in the patient's thoracic cavity, and it was considered to be pleural adhesions. Currently, the multiple fractures of the left rib are fresh lesions, but no displacement has been seen, so we can not deal with it for now."

Although the patient is currently in critical condition, the thoracic surgery department they are in charge of is not in a hurry, and the thoracic surgeon who was named looks a little relaxed.

But the face of the head of the urology department was not at all relaxed.

"At present, the patient's abdominal tension is extremely high. It is considered that the huge hydronephrosis of the left kidney ruptured to the formation of intrarenal and perirenal hemorrhage and hematoma. At present, the retroperitoneum is in a state of extremely high pressure, resulting in pressure on the right kidney and abdominal organs."

But looking at the patient's high bulging stomach, one can imagine how serious the hematoma inside is.

The abdominal visceral hypertension can lead to organ dysfunction, abdominal compartment syndrome, and also cause serious consequences such as ischemia, multiple organ dysfunction and even necrosis.

Zhang Tianyang also frowned, his expression serious.

Patients now have two options.

If the interventional department can find the bleeding artery of the patient and successfully embolize it, then things will be easy.

The patient looks very serious at the moment, but it is actually because the disease progresses too fast.

If it can be successfully embolized and the bleeding can be stopped, then in fact, the next thing to be solved is the bloody effusion currently gathering in the patient's abdominal cavity.

Whether it is conservative treatment to wait for absorption, or paracentesis to put a part of the effusion every day, it can be done slowly.

But Zhang Tianyang thought about his expression carefully, and felt that the chance of the patient going this way was not high.

In case the bleeding vessel cannot be found during the intervention, or cannot be successfully embolized, the bleeding still exists.

Then, the patient can only undergo emergency surgery.

Surgical exploration, hemostasis, and possibly resection of the left kidney with no normal anatomical structure, decompression and other treatments.

But the patient's current condition

Zhang Tianyang frowns.

At this time, the interventional doctor who had been contacting his superior suddenly raised his head.

"The results from the intervention room came out!"

"On the DSA image, 4 arteries were seen, 3 of which were clearly located, 2 of which were the right renal artery and the mesenteric artery, and 1 was suspected to be the left renal artery, but the development was incomplete.

It is uncertain whether this artery is the source of active bleeding, so

The artery cannot be embolized at this time."

The voice of the interventional doctor became smaller and smaller.

The face of the head of the urology department became increasingly ugly.

Zhang Tianyang took a deep breath, and his heart sank slowly.

really!

　Push this book~

　　"Shenhao starts from real-name authentication", the author, this is life.

　　An An certified, the author is a scumbag!

　　go scold him

　　

　

(End of this chapter)