I really don't want to be a doctor

Chapter 187 Intestinal Rupture
The patient is unfortunate,

But also lucky.

after all,

At this time, patients do not have a large demand for the operating room.

Wait another hour or two,

Patients with the same disease may not have such good conditions.

at least until now,
There is room in the operating room,
Blood still has blood.

Therefore,
time!

They should try to save time!
Leaving Yang Le in the emergency department to help, Yu Wenxing rushed to the operating room with the patient on his back.

Deng Liming has been waiting,
Quickly glanced at the patient, and said to Yu Wenxing, "Call Liu Xuejun and ask him to come up."

Yu Wenxing nodded and took out the phone.

There are two ways to treat liver rupture, the first is non-surgical treatment,

The conditions for non-surgical treatment are more stringent,

The patient's overall condition is required to be good,

And this patient's blood pressure continued to drop, and now the systolic blood pressure has reached 68mmHg.
There is no condition for non-surgical treatment.

The second is surgical treatment.
The principle of surgical treatment is to completely stop bleeding and remove devitalized tissue to save lives.

This requires that the liver must be exposed as much as possible.

Two people cannot perform this kind of surgery.

Therefore,
Deng Liming asked Yu Wenxing to call Liu Xuejun to come up.

"Will you do it?"

The scene of Yu Wenxing suturing his spleen is still vivid in my mind.

After Deng Liming drew the line, he suddenly looked up at Yu Wenxing.

"If it only requires suturing, I can; if it requires liver resection, I may just have to try."

Yu Wenxing pondered for two seconds, then replied.

Although now he really wants to contribute his strength,

But he will not be brave enough to do surgery that he can't do at all,

Surgical treatment of liver rupture can be roughly divided into three types. The first one is suture repair, but it is mostly used in sharp instrument injuries such as stab wounds, and the tear must be less than 3cm.

This patient was not injured by a sharp instrument, but by a blunt instrument. His liver was injured by a falling wardrobe. In this case, the damage to the liver is generally relatively large, and it is very difficult to directly repair it with suturing.

The second is liver resection, which requires familiarity with the distribution of various blood vessels and bile ducts in the liver. After all, liver resection is not a simple resection, but suture ligation is required, and accidental ligation must be avoided.
Yu Wenxing knew that his understanding of the liver was not very deep.
but,

If Deng Liming is also on stage, Yu Wenxing is confident to give it a try.

The third is stuffing.

Packing is basically a helpless move. It is generally used in cases of extremely severe liver damage. If suturing and ligation cannot be completed, gauze and hemostatic sponge can only be used for packing.

As for whether it can stop the bleeding,

It can only be left to God's will.

"Okay, it's up to you, I believe in you."

Deng Liming originally wanted to come by himself,

But think about it,

Yu Wenxing's level of spleen repair is countless times higher than his own, which at least shows that he has a very high degree of mastery of sutures.

"Row."

Liu Xuejun came soon.

The three of them washed their hands,

The peritoneum was opened.

This patient was really lucky,
Only a tear was visible on the surface of the liver.
Although there was slight bleeding in other places, after treatment with gauze, the bleeding began to decrease significantly.

"Sew."

Deng Liming said.

"kindness."

The depth of the crack was about 25mm and the length was about 4cm. Yu Wenxing used four stitches.

After the bleeding was completely stopped and the abdomen was closed, the patient's blood pressure slowly rose, and the three of them had no time to breathe a sigh of relief, and quickly ran back to the emergency department.

Emergency Department,
We need people so much.

The trauma caused by the earthquake is exploding rapidly.

For general surgery,
Rupture of the spleen is the most common, and rupture of the liver is much rarer.

And the patient who worried Yu Wenxing the most,
Still here.

Closed abdominal trauma with rupture of the bowel lumen.

Intestinal rupture is definitely one of the most serious abdominal injuries.

after all,

The intestinal tract is mostly covered by the greater omentum, and the cushion of the greater omentum is still damaged, which shows that the injury suffered by this patient is really serious.

The large incision made by laparotomy, when the stomach was pulled open, blood gushed out.

My blood pressure started to drop instantly.

"Blood transfusion! Transfuse two units of blood first!"

There was not enough blood in stock, and Deng Liming didn't dare to lose too much blindly.

A small bag of blood was transfused in,
The second channel starts to infuse low molecular weight dextran,
This is a blood substitute.

"Autologous blood collection!"

Yu Wenxing whispered.

Autologous blood collection is absolutely necessary at this time to process the patient's bleeding and reinfuse it.

This has been prepared before the operation.
The drainage tube guides the large gushing blood into the autologous blood collector, which can be reinfused into the injured person's body after treatment.

"Go for it faster."

Deng Liming said in a deep voice, and began to move.

He was very impatient,
But also very calm.

After cleaning up the accumulated blood in the abdominal cavity, Deng Liming began to search.

He didn't check the intestines for the first time,
Although the liver and spleen have been judged to be free of bleeding under B-ultrasound, the stomach needs to be checked again.

liver,

spleen,

pancreas.

When the pancreas was detected, Deng Liming's face turned pale again.

The head of the pancreas is damaged.

Injury to the pancreas is extremely difficult to manage,
After all, the pancreas is also an extremely important organ of the human body and can secrete a variety of hormones.

Such as:
Trypsin, insulin, etc.

If the pancreas is damaged,

Pancreatitis is prone to occur after surgery.

The mortality rate of severe pancreatitis is extremely high.

"I'll sew here later, it should be fine."

Yu Wenxing said, looking at the pancreatic head that was bleeding a little.

Deng Liming nodded,
This position is indeed the best choice for Yu Wenxing to sew,

He has already experienced Yu Wenxing's mattress suture technique once, so he doesn't need to worry about it.

continue to explore,

The bleeding point of the right colon was easily found.

Deng Liming hesitated as he looked at the colon that was about to tear.

In fact, the treatment principles of intestinal rupture and intestinal perforation are almost the same.

If the rupture is not obvious, it only needs to be repaired.

After all, the intestinal cavity is much larger than the common hepatic duct, so it is not difficult to suture directly.
This is also an operation that almost all doctors who have worked in general surgery for several years can complete.

And if the rupture of the intestinal cavity is very obvious,

Then you have to cut the intestine directly.

Can.
Deng Liming hesitated,
This patient was only 43 years old. At this age, it was too cruel to cut off the right colon directly.

"Can you sew?"

Deng Liming raised his head and glanced at Yu Wenxing.

Yu Wenxing was also silent,

Sutures are definitely the best option for this patient with a ruptured intestine.

Although the human intestine is very long, cutting off part of it directly will not have a fatal effect on the human body,

but,

can not cut,
Definitely not better.

but,
in this patient.
Yu Wenxing looked at the colon that was about to rupture, and shook his head with some difficulty.

this patient,

It is extremely difficult to sew,
and,

The stitching effect is not necessarily very good.

The blood supply to this section of the colon has been almost completely destroyed. If the intestine is sutured, the blood vessels will have to be sutured.
The mesenteric vessels are very thin,
Yu Wenxing was confident that he did not have the skills to suture the mesenteric artery.

"Okay, let's cut it."

Deng Liming sighed, cursed the benevolence of a woman secretly, picked up the hemostat, and began to clamp the intestinal cavity.

The end result is gratifying,

It took two hours to get off the stage safely for the patient.

However, this is still an unbearable pain for the patient.

Right hemicolectomy!

There are bound to be unforeseen consequences for the future.

(End of this chapter)