My medical skills are a billion points

Xiao Chu hurriedly received patients.

The patient was a man in his fifties.

Mainly right lower quadrant pain, for two days.

Gao Yingjun checked first.

When he pressed his finger on the man's lower right abdomen, the position of Mai's point, the man frowned in pain.

"Ah, doctor, it hurts!"

"Deep tenderness at McBurney's point, it may be acute appendicitis, I think further imaging examination should be done, plus routine blood test!"

Gao Yingjun finished checking and said.

"Xiao Chu, what's your opinion?"

Of course Xiao Chu had a different opinion.

This man was not acute appendicitis at all, but right lower quadrant pain caused by testicular cancer.

But he couldn't say it directly.

However, according to Gao Yingjun's examination, it can also be found out that this man is finally testicular cancer.

So now, there is no need for Xiao Chu's reminder.

So Xiao Chu nodded pretendingly, and said, "Just do what you said, just do the inspection!"

More than an hour later, Gao Yingjun walked into the doctor's office with the man's examination report, somewhat dumbfounded.

He handed the report to Xiao Chu and said, "I thought this patient had acute appendicitis, but I didn't expect it to be testicular cancer!"

Xiao Chu took the report, looked at it for a while, and said, "He has pain in the lower right abdomen, prepare for surgery! Talk to your family about the condition."

"Okay, I'll let the family members sign."

After talking for more than an hour, Gao Yingjun finally got through the work of the family members.

Soon, the man was pushed into the operating room, ready to undergo cancer resection.

This time, it was Xiao Chu who took the lead.

Because Gao Yingjun doesn't know how to do this operation, he can only help, Wang Panpan is the second assistant.

After the patient is anesthetized, everything is ready for work.

Xiao Chu started the operation.

About half an hour later, Xiao Chu removed the patient's cancerous ointment pills.

Xiao Chu looked at the shape of the cancerous ointment pill, and said, "It is likely to be a stromal tumor, but it still needs to be sent for pathological examination to confirm."

"Ok!"

However, as soon as he finished speaking, the monitor sounded a rapid alarm.

Moreover, the patient's blood pressure began to drop, and tachycardia appeared.

Gao Yingjun hurriedly said: "I didn't see the bleeding point, what's going on?"

Wang Panpan also said: "The electrocardiogram is normal, so it should not be a heart problem."

The anesthesiologist, who has been closely observing the monitor, also said: "The blood oxygen saturation is normal, not a pulmonary embolism."

Gao Yingjun looked at the monitor again, frowning.

"It must be an adverse reaction to the anesthetic."

Chapter 306

The anesthetist hurriedly said: "It can't be an adverse reaction of the anesthetic, dopamine has been used to constrict blood vessels, and the amount of fluid replacement has also been increased.

But blood pressure is still dropping.There must be blood on him. "

The anesthetist has checked the conditions of the instruments.

He didn't think it was an adverse reaction of anesthesia at all, and he didn't want to take the blame for it.

Gao Yingjun said uncertainly: "During the ligation of the spermatic cord, this phenomenon has not yet occurred, so there should be no more bleeding spots, right?"

Wang Panpan thought for a while and said, "Could it be the vagus nerve that ruptured the nerve, and the stimulation caused the blood pressure to drop?"

Gao Yingjun shook his head, but he didn't agree with her statement.

"If it was vagus nerve stimulation, the drop in blood pressure should have responded to epinephrine. But now the anesthesiologist has used epinephrine, but there is no response. So it must not be a matter of vagus nerve stimulation."

The current instrument monitoring is normal in all aspects, but the blood pressure has been dropping.

But I can't find the bleeding point, which is really a headache.

But under normal circumstances, the patient's blood pressure has been falling, and it is generally caused by bleeding.

Of course, there are many reasons for shock.

There are cardiogenic shock, septic shock and hypovolemic shock, many types.

After all, this patient is undergoing surgery, so the first choice is to consider, or shock caused by bleeding.

But the problem is, Gao Yingjun and Wang Panpan stared wide-eyed, but they couldn't find any obvious bleeding point.

Wang Panpan hesitated and said, "Isn't it sepsis?"

Gao Yingjun immediately shook his head.

"Impossible, the operation is not finished yet, where did the sepsis come from? Even if it is infected, it cannot be so fast."

Just when everyone was discussing urgently.

The anesthesiologist hurriedly said: "You have to come up with treatment measures as soon as possible, the patient's blood pressure is only 60/30mmHg, and I'm giving him a blood transfusion, even with booster drugs.

If the blood pressure keeps dropping like this, the heartbeat will stop. "

If the state of shock is not corrected, death is 100%.

If a patient dies on the operating table, it is a taboo for any doctor.

Gao Yingjun had tried his best, but he couldn't find out what caused the shock, so he had no choice but to turn his attention to Xiao Chu.

Now Xiao Chu is a god in his mind, the god who diagnoses and handles any difficult operations.

If there is a situation that Xiao Chu cannot solve, then this person must be hopeless.

"Xiao Chu, the patient's blood pressure keeps dropping, what's going on?"

At first, Xiao Chu didn't understand why the patient's blood pressure suddenly dropped.

And he also looked for the bleeding point in detail, but he did not find it.

Seeing the expectant eyes of Wang Panpan and Gao Yingjun, Xiao Chu quickly recalled his operation process.

Suddenly, an inspiration flashed in my mind.

Found the reason!

He lifted off the sterile towel that had been placed on the patient.

Sure enough, a bruise was found on the patient's waist.

The patient was not injured, where did the bruising come from?

Generally, the skin is blue and purple, which means that there is subcutaneous bleeding.

Xiao Chu pointed to the bruises on the patient's waist and said:

"Look, there are bruises and bruises on his waist, which means that he has internal bleeding, and it is retroperitoneal bleeding.

My guess is that the pill artery may have retracted into the pelvis. Although it is rare, it is definitely possible. "

It is extremely rare for the pill artery to retract into the pelvis, but it is not absolutely uncommon.

What's more, just now Xiao Chu spent [-] points to look at it with his ability, and it was indeed the bleeding caused by the arterial retraction of the ointment pill.

This kind of extremely rare situation made him encounter it, and it was indeed a bit of a shame.

Fortunately, he has extremely rich clinical experience, not to mention he has cheats on him.

Any difficult situation cannot escape his eyes.

Hearing what Xiao Chu said, Gao Yingjun's eyes widened instantly.

"The pill artery retracts, can't it? This kind of rare situation, let us encounter it?"

"Did we get lucky today?"

But Wang Panpan was stunned.

She will never do this operation.

The reason why he came to the stage was just to gain experience, to be the second assistant, to pull the hook, and at most to sew a skin or something at the end.

She didn't know anything about the arterial retraction of the pill that Xiao Chu and Gao Yingjun mentioned.

He could only stare at the two of them with big ignorant eyes.

Xiao Chu said: "Do you think we still have a choice?"

As Xiao Chu said, he picked up a scalpel and cut a laparotomy in the patient's abdomen.

As soon as the abdominal cavity was cut open, a gust of blood gushed out.

"I'm going! Sure enough, the testicular artery is retracted and bleeding."

Gao Yingjun was stunned for a moment, and then burst into foul language.

"Damn it, Xiao Chu, our luck is unbelievable, I think we should buy lottery tickets after the surgery.

This kind of thing that I have only heard about before, I actually saw it with my own eyes.Should I say lucky, or lucky? "

After some searching, Xiao Chu quickly found the pill artery that retracted into the pelvis.

After the arteries were ligated with plaster pills, the patient's blood pressure stopped dropping immediately.

Then start to rise slowly.

Gao Yingjun started to flatter Xiao Chu.

"After all, Director Xiao, as long as you act, any problem will be solved!"

Suddenly, Gao Yingjun became serious.

"Xiao Chu, you are too handsome, it's easy to make us lazy!"

Of course Xiao Chu heard the joke in Gao Yingjun's words.

He didn't answer, but was doing abdominal closure and suturing on the patient in a leisurely manner.

But Wang Panpan took it seriously, and immediately asked: "Mr. Gao, isn't it a good thing that Mr. Xiao is good? How could you become lazy?"

Gao Yingjun took the scissors, cut the thread, and then said: "Because Xiao Chu is so good, we are prone to become dependent, and we will let him solve any difficult diseases.

As time goes by, we will develop the habit of completely relying on Xiao Chu, won't we become lazy? "

After tying a knot, Xiao Chu said angrily: "I think you just don't want to do surgery, so don't make any excuses."

Talking and laughing, this man's operation has been completed.

After recovering from anesthesia, he was sent out of the operating room and sent to the intensive care unit.

Xiao Chu's principle is that as long as he has undergone a second-level or higher operation, he should be placed in the intensive care unit as much as possible after the operation.

Because nurses in the intensive care unit closely observe patients 24 hours a day.

Once there is a problem, it can be found at any time.

Therefore, it is necessary for postoperative patients to enter the intensive care unit for 24 hours of observation.

Xiao Chu washed his hands and put on his white coat again.

I took out my phone to check the time, and found a notification in the group of directors of the hospital department.

"There will be a meeting in the conference room at three o'clock in the afternoon, about the honor of the hospital!"

Chapter 307 Foreign body in the stomach, to take or not to take?