I can see health

Chapter 424 Lu Chen, don't fall behind!

Xiao Shikang also understood the seriousness of the matter, and immediately contacted the CT room, and then communicated with the patient's family about the condition.

"Our family is here for atrial fibrillation ablation. Why are there so many problems suddenly?"

The patient's family member was a middle-aged woman. She was confused by what Xiao Shikang said, and most of them didn't understand. She could only understand one sentence. The patient's condition suddenly became very complicated!
"It's not that there are so many problems after the operation." Xiao Shikang patiently explained, "We thought that the patient had so many problems before the operation, but we just discovered them during the operation!"

"Then what should we do next?" The middle-aged woman frowned.

"Immediately go out for an examination. Only after the diagnosis can be made for the next step of diagnosis and treatment." Xiao Shikang said.

"Don't you have a suspect diagnosis now?"

"Considering the rupture and hemorrhage of the liver occupying space, as for the cause of the pericardial effusion, we don't know yet." Xiao Shikang paused.

"Liver occupying space, liver cancer?" The middle-aged woman was taken aback. She knew some medicine, but it was only superficial.

"Not sure yet." Xiao Shikang shook his head.

"Then, well, let's go out for a checkup." The middle-aged woman compromised.

……

With the consent of the patient's family, Xiao Shikang immediately sent a doctor out to accompany the examination.

And Lu Chen stayed in the catheterization room, continuing to read the patient's medical records.

The patient's current information is not perfect, only the recent medical history, as for the past history, it is very vague.

"That's right! The patient should have been taking anticoagulant drugs!" A flash of light flashed in Lu Chen's mind.

The patient is now undergoing ablation of atrial fibrillation.

Patients with atrial fibrillation require long-term anticoagulation, warfarin or Xarelto.

The side effect of anticoagulants is bleeding!

Is it because of long-term anticoagulation that the patient has hemorrhage in each serous cavity?

Just after Lu Chen thought about it, the CT room sent back a message that the patient's abdominal CT was done.

Xiao Shikang immediately found a free computer, turned on the computer imaging system, and called up the abdominal CT image.

CT results showed that there were two cystic low-density shadows in the left lobe of the patient's liver, with small flakes of hemorrhage and thin-walled enhancement. In the arterial phase, there was obvious enhancement of small intramural nodules, and in the portal venous phase and delayed phase, the supportive enhancement was equivalent to the liver parenchyma. There was no enhancement in the cystic content, and the adjacent gastric cavity was compressed.

The diagnosis given by the doctor in the CT room was hepatic cyst with hemorrhage, but tumor metastasis was not ruled out!

Seeing this, Lu Chen already had an idea in his heart.

The diagnosis of the doctor in the CT room is only based on the abdominal CT.

But the real clinical diagnosis is not just relying on a CT film.

Xiao Shikang frowned after reading the patient's image, "It seems that a hepatic cyst is ruptured and bleeding!"

However, Lu Chen shook his head, "I think it looks like liver cancer that has metastasized and bleeds. The tumor not only metastasized to the liver, but also metastasized to the pericardium. Otherwise, the source of the pericardial effusion cannot be explained. In addition, the patient took oral anticoagulants, may also be involved in the development of the disease."

After listening to Lu Chen's explanation, Xiao Shikang was also taken aback.

Such an explanation is not unreasonable!
However, what surprised Xiao Shikang the most was Lu Chen's clinical thinking mode.

In addition to his excellent ability in interventional surgery, he did not expect that his ability in clinical diagnosis and treatment is also excellent!
"Well, it makes sense. However, the most important task right now is to stop the bleeding!" Xiao Shikang said.

Lu Chen nodded slightly.

Now what caused the liver rupture and bleeding is not important anymore.

Although the patient's current symptoms are not serious, they may develop further at any time.

The two negative signs of the health value on his head just confirmed this state.

……

The patient did not return to the catheterization laboratory of the cardiology department, but was sent directly to the surgical operating room.

Liver rupture and bleeding is still in the development stage, so stop it in time!

Otherwise, once hemorrhage causes shock, the operation will be too late.

This little episode in the catheterization room did not affect the normal progress of other operations.

However, Lu Chen did not have a single operation all day.

Today is his second day in the cath lab.

The number of operations is still zero!
Although there were many electrophysiological surgeries, these two surgeries were arranged for Lu Chen.

In the following time, Lu Chen followed Xiao Shikang and observed several other operations.

"Don't worry, there's another surgery tomorrow." Xiao Shikang smiled, "We can get started tomorrow."

"Yeah." Lu Chen nodded, he was not in a hurry, surgery should be of high quality.

Otherwise, even ten ordinary surgeries may not be worth one difficult surgeries.

……

Four p.m.

There was news from the operating room.

The patient's bleeding has stopped, and the preliminary diagnosis is tumor metastasis!
This result made Xiao Shikang a little scared!

The preoperative abdominal CT examination only reported a suspicious liver cyst.

Hepatic cysts are benign. As long as the size does not compress the surrounding tissues and the location is not dangerous, they generally do not need to be treated.

Even the abdominal CT of the abdominal examination during the operation is considered to be a benign hepatic cyst with ruptured bleeding.

However, what surprised everyone was that a quick pathological section turned out to be a malignant tumor!
"Lu Chen, thanks to you for discovering the abnormality." Xiao Shikang said with lingering fear, "If the ablation operation is performed on the patient in such a muddle-headed manner, the follow-up matter will be even more troublesome."

Atrial fibrillation does not affect the patient's life expectancy.

But after the operation, the risk of bleeding is increased, and the rupture and bleeding of the patient may progress faster!

Lu Chen was also a little lucky. Fortunately, when he was looking at the contrast images, he saw this small-medium amount of pericardial effusion.

If he just let it go in such a muddleheaded way, then the current situation would be different!
……

At 05:30 in the afternoon, I finally got off work.

Lu Chen rejected Yao Jie's request to share a meal and returned to his hotel.

It's been a long time since I went to the clinic, and Lu Chen was really not used to coming to the catheterization room suddenly.

However, after going through the somewhat thrilling diagnosis and treatment process today, Lu Chen felt his heart beating.

This long-lost enthusiasm is incomparable to simple surgery!
Surgery, of course, pays attention to the technical ability of doctors.

However, the process of diagnosing and treating patients emphasizes the rigorous "detective" thinking, inferring from every doubtful point in the medical records, and finally discovering the final diagnosis of the patient, and treating the patient in time to cure the patient.

While Lu Chen was thinking, Min Xiaobo called.

"Hey, Lu Chen, how many surgeries have you had in the past two days?"

Min Xiaobo got straight to the point.

"Ahem." Lu Chen coughed in embarrassment, "Not one."

"Ah?" Min Xiaobo was surprised, "Why don't you have one? We are in the second stage of assessment. The number of operations is also an important indicator. I asked other people, and it seems that they have at least two. Surgery."

Lu Chen smiled helplessly, he didn't explain too much.

Originally, he also had two surgeries, but due to his own reasons, both surgeries were cancelled.

"I've already made four sets, you have to hurry up too!"

"No hurry, there will be a chance later." Lu Chen said.

"Hey, among the thirteen of us, half of them can pass the second-stage assessment and get a certificate of completion, that would be great." Min Xiaobo said, "Everyone is working hard, Lu Chen, don't fall behind ah!"

"Well, thank you Bo Ge for your reminder." Lu Chen smiled.

"That's it for now, hang up."

After hanging up the phone, Lu Chen let out a long sigh of relief.

In the next less than a month, he really has to work hard.

Then, with a thought, he entered the virtual space of the system again to perform a simulated operation of electrophysiological intervention.

(End of this chapter)