The Godfather of Surgery
Chapter 510 Poor little guy
Yang Ping sat down at Li Zehui's desk, and Marshall handed over the medical records. Yang Ping didn't look at the paper records, but looked at the video pictures first.
This is a public office. In order to facilitate the exchange of information, every doctor has a desk equipped with computers, printers and electronic screens for reading films.
On another floor, some of their doctors also have individual offices, and most of the time, they prefer to stay here to work.
The doctors in the office gathered around and stood around, wondering if an orthopedic surgeon was really proficient in cardiac surgery.
The quality of the electronic reading screen is very good, the image is very clear, and the influence of reflection has been eliminated.
"Doctor Yang, can you interpret this patient's heart ultrasound in detail?" Dodge also stood behind him at some point.
Li Ze will glance at this senior brother, is this a test for his guests?
There are many categories of pictures tiled on the electronic screen, such as ordinary X-rays, cardiac catheterization, color Doppler ultrasound, and CT three-dimensional reconstruction.
Yang Ping's mouse hovered over the category of cardiac color ultrasound pictures, and clicked to open the picture inside, which was the dynamic echocardiogram of the video.
The right heart, great vessels, central mediastinum, and lungs on both sides are all clearly displayed.
Interpreting ultrasound images of the heart requires a very high professional level. Many thoracic surgeons cannot understand such images and can only rely on professional ultrasound doctors to interpret them.
But top cardiac surgeons often perform ultrasounds on their patients and interpret the images themselves.
This echocardiogram was done jointly by Dodge and Li Zehui, and the image quality is very high.
Yang Ping pointed to the image and said: "This is a rare dextrocardia. To be precise, all its thoracic and abdominal organs are heterotopic. On the basis of dextrocardia, the poor little guy is still Combined with congenital heart malformation - tetralogy of Fallot, ventricular septal defect, pulmonary artery stenosis, aortic overriding, right ventricular hypertrophy."
Yang Ping pointed out the locations and degrees of the deformities one by one, and then explained the basis for the judgment.
This is a mirror-reversed heart, and it is very difficult to identify these deformities.
"There is a mass under the aorta, which blocks the flow of blood. It is probably a rhabdomyoma. It is located in a very dangerous position. The blood cannot pass through here, and it will form a vortex. If you want to open the chest cavity and remove it, It is impossible to perfectly correct the deformity of the heart and great vessels. Here, there are still adhesions, blurred anatomy, and dysplasia of the vessel wall, which will become a major obstacle to the operation. The quality of the image is not good. Do a cardiac ultrasound."
Yang Ping's interpretation was very good, not at all like an orthopedic doctor crossing the border, and the last sentence aroused the discussion of the doctor next to him.
This is an ultrasound performed by Dr. Dodge himself. Could there be a problem?
"Doctor Yang, can you give me a reason why you need to redo the ultrasound of the heart?" A doctor couldn't help asking.
In fact, Yang Ping was just telling the truth without any intention of offense. He had no idea who performed the echocardiogram.
Since someone asked this question, Yang Ping explained: "This ultrasound does not take into account the particularity of the anatomy, and still adopts conventional methods to collect pictures. Many important information are missed, and the advantages of ultrasound are not brought into play. It is completely unsupportable. Surgical decision making."
"Well, I really want to see Dr. Yang do a color ultrasound again." Dodge continued.
Li Zehui glanced at Dodge again. This East Coast American has a very arrogant personality and often looks down on others.
However, as long as he does not embarrass the guests, Li Zehui will not stop the normal discussion.
Surgery, especially cardiac surgery, requires long-term accumulation, which no one can overcome, not even a genius.
Dodge thought that Li Zehui had given Yang Ping the information in advance, which is why Yang Ping interpreted the echocardiogram so clearly and calmly.
Because Dodge himself, together with Li Zehui at the time, spent several days in order to judge this case, and it took a comprehensive examination to figure it out. And it's kind of unbelievable that he was able to get so much information with an echocardiogram.
How could he judge all of this with color Doppler ultrasound?
Afterwards, Yang Ping also interpreted the rest of the pictures, from deep to shallow, with clear logic, which is refreshing. But it didn't impress this East Coast American, whose stubbornness was beyond the imagination of ordinary people.
"In this case, if he is operated on hastily, he is doomed to fail. Using conventional surgical methods, whether it is the resection of the tumor or the deformity correction of tetralogy of Fallot, will undoubtedly speed up his death. We You can only succeed if you come up with something unique." Yang Ping let go of the mouse, raised his head and said to Li Zehui.
"Then—what shall we do?"
Professor Li didn't understand exactly what uniqueness was referring to.
Yang Ping thought for a while and said, "Let's see the patient first."
Under the leadership of Marshall, everyone came to a separate ward.
Considering the little guy's low immunity, Li Ze arranged for him this single room with negative pressure isolation function.
The patient's expenses are all paid by the Red Cross, so there is no money problem.
The little guy was lying on the bed, wrapped in a hospital baby wrap, he was too small, lying on the bed, not like a six-month-old baby, with oxygen pipes connected to his nostrils and infusion tubes connected to his body.
In the corner, a man squatted on the ground, his eyes were a little dull, and he looked like an Arab.
"This is the father of the child!" Professor Li introduced the man in the corner.
"Does he understand English?"
Yang Ping asked.
Professor Li shook his head: "He is mute, but he has good hearing and understands Arabic. This lady can help translate."
An Asian lady stepped forward and said she could translate.
Yang Ping looked at this man slightly. He was very thin, like a person who had been starving for a long time. His body was covered with gauze in many places, and there was a thick callus on the tiger's mouth on his right hand. The right side of his wide T-shirt was a little open, and the collarbone There is also traces of a broad cocoon.
This person should have held a gun and fought a war, Yang Ping felt this way.
"He and his wife came from Yemen with their children. He crossed the war zone, crossed the desert, then sneaked across the border and entered Saudi Arabia. His wife was shot and killed while crossing the war zone. Not very good." Professor Li said in a sympathetic tone.
Yang Ping stretched out his hand: "Hi, I'm a doctor from China, maybe I can help this little guy."
The lady translator immediately translated Yang Ping's words, and he seemed to understand. He immediately stood up from the ground, wiped his hands on his body a few times, and then shook hands with Yang Ping. He seemed very nervous when shaking hands.
"It's okay, I'm a doctor." Yang Ping comforted him.
The man just nodded and said nothing.
"Let me take a look, I'll check him now, okay?"
The man nodded, and then walked to the bed to undo the wrapping. His movements were very gentle and skilled, more skilled than the average young mother. He made an inaudible sound from his throat, as if he was coaxing a child.
When the scarf was fully opened, Yang Ping was extremely shocked by the scene in front of him.
The child's body is very thin, really skinny, like a baby's skeleton covered with a layer of skin.
If it is not a doctor, seeing this scene will definitely feel extremely uncomfortable.
People who live in a peaceful and comfortable environment will never see such a baby, that is a skeleton.
poor guy!
His lips were blue-purple, and he squinted his eyes, not knowing what kind of danger he was in.
Perhaps human beings are born with compassion for the same kind. Facing this strange little guy, Yang Ping's eyes were foggy, a little blurred, and his heart ached.
He tried his best to adjust himself to stabilize his emotions, and then approached the bed, rubbing his hands constantly to generate heat.
The collarbone, sternum, ribs, pelvis, limbs, every bone is clear, the limbs are like a small dry wood, even if he takes a breath, he will worry about breaking his bones.
In the abdomen, the peristaltic waves of the intestines are clearly visible, it is just under the skin, and the spine can be easily touched from the abdomen.
Professor Li handed over the stethoscope, a stethoscope specially used for auscultation of babies. Yang Ping was careful and moved extremely gently, fearing that a little force would break his bones, and put the stethoscope on his right chest, where the heart was.
The second heart sound of the pulmonary valve was significantly weakened, there was a systolic ejection murmur at the left sternal border, and the blood flow of the left ventricle hit the tumor, making a rattling sound.
However, faint moist rales were heard in both lungs, indicating that he already had a lung infection.
During the auscultation, suddenly, the child's eyes opened, looking at Yang Ping, staring at him all the time, he seemed to be begging, please help me.
Yang Ping took a deep breath, took off the stethoscope and handed it to Li Zehui, and then completed some physical examinations.
After completing the physical examination, Yang Ping indicated to the man that he could wrap the child in a towel. The man lowered his head and wrapped the towel silently. He smiled at the awakened child.
Li Zehui said calmly: "After his wife died, the child had no breast milk, and there was no milk powder at all in the war zone and desert. He crushed some rough food and mixed it with cold water to feed the child. The helicopter of the Red Cross found him at the border. At that time, there was only half a jug of water beside him. The water was already stinking with some food debris mixed in, and he still had several festering gunshot wounds on his body. He handed a note to the Red Cross, saying Bring your child here for medical treatment."
It's hard to imagine how he insisted on coming to this hospital with his children.
"Have you seen him in Yemen?" Yang Ping asked.
"Yes, that's the Red Cross Hospital. He and his wife came to me with their children. I can't do anything. That hospital doesn't have the conditions to do this kind of surgery. It can only do some trauma surgery. I wrote him the address here and I I told him that I would come here every month. Unexpectedly, he really found here. I have no reason to give up—" Li Zehui talked about the patient's background, deeply moved.
"Can it be operated?" Li Zehui looked expectantly.
Yang Ping looked at the child's father again, and he squatted back to the corner, but kept looking here, as if he was waiting for some news.
"I'll try."
Yang Ping replied.
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