The system takes me for surgery

Chapter 382: Small Mesenteric Lymphoma

Meimei said: "Yo, you are really not loyal enough. Not everyone knows this, but you still keep it secret with me."

"You mean heart surgery?" Li Zhengping asked.

"It's not about this, it's still secretive."

"I don't know either. Director Xie mentioned it in the morning, so I know. Otherwise, you can ask the young man in our department."

Anesthesiologist Meimei asked, "Is that so?"

Liang Yi nodded and said, "Our director just said it this morning."

"Your old Xie usually looks like a jerk, but I didn't expect to be very active in doing this."

"Yeah, I didn't think of that either."

"I heard that he has a big back, mainly because he wants to have a pacemaker implanted."

"You also know that our emergency department is notoriously low, and it takes a lot of effort to do this." Li Zhengping laughed at himself.

"Director, don't be harsh with your words. If you say this, we have to downgrade our anesthesia. I heard that this time, the pacemaker of the source power has come in, and the cost is about [-]% lower than the previous one, so Several surgical departments wanted to do it, and finally your department got it, I didn't expect that you, Lao Xie, have a lot of skills."

Source power pacemaker?Isn't this the heart that Ouyang Ping'an mentioned earlier that the program itself has loopholes and may be illegally invaded by hackers? Liang Yi thought about it while pulling the hook.

"So that's what happened. We Meimei really have antennas and know everything."

"No, don't make me angry, I'm just a second-rate information dealer." Anesthesiologist Meimei said.

Li Zhengping said: "Anyway, I'm not a leader. The leader plans what to do. We, as younger brothers, just follow. To be a worker, to be a worker, we must have self-knowledge."

Meimei was spinning a pen in her hand, and said with a smile: "Director Li looks like an old antique, and he can play tricks."

While speaking, the abdominal cavity has been opened.

Liang Yi was stunned for a moment, thinking that he had read wrongly, because the consultation and physical examination were all done by Li Zhengping, and he was rushed to the operating room immediately after the emergency diagnosis. He was only in charge of abdominal puncture, so he had only a half-knowledge about the patient's specific situation.

Li Zhengping's investigation found that his complexion changed drastically, and it was far from the digestive tract perforation he had judged before.

There was about 1 500 mL of light yellow turbid fluid in the abdominal cavity, with flocs, no abnormalities in the liver, gallbladder, pancreas, and spleen, the proximal jejunum was obviously dilated, and a mass of about 7 cmX8 cmX7 cm was seen at the root of the mesentery of the jejunum. There is omentum and pus moss-like material.

This should not be it!

If I had been more careful during the physical examination, it would not be difficult to find the mass in the left middle abdomen of the patient. Even if the patient had obvious tenderness, rebound tenderness, and tense abdominal muscles, as long as the patient cooperates, the mass of 7 cmX8 cmX7 cm in the abdomen is still easy to touch Yes, and the patient is not obese.

His face became a little embarrassed, and he said: "Surgery really knows people, faces, and faces. When I didn't open it, I thought he was Lin Chiling, but I didn't expect to know it was Song Xiaobao when I opened it. Not to mention beauty and ugliness, even men and women. distinguish."

The anesthesiologist Meimei came over on tiptoe and said, "Director Li, your medical records need to be overhauled. This is not a perforation of the digestive tract."

"Yeah, the old driver overturned in the gutter, I'm a shame."

Li Zhengping continued to peel, and found that some masses and omentum were purple-black, and they could not be separated from the jejunal adhesion about 170 cm away from Qu's ligament.

Liang Yi let go of the suction device in his hand, and used his fingers to help him bluntly peel it off. He found that the proximal jejunum was obviously dilated, and the middle section of the transverse colon was also adhered to the mass. trend.

This enteritis is not common!After stepping down, I have to check it out!

Li Zhengping told Liang Yi: "Actually, our doctors still rely too much on auxiliary departments. I haven't avoided this problem myself."

Liang Yi nodded.

Li Zhengping said: "According to the B-ultrasound examination, there was a large amount of fluid in the abdominal cavity, but there were no other positive findings, and a light yellow turbid fluid was extracted from the puncture, so it is suspected to be perforation of the digestive tract."

"Clinical changes are ever-changing, so surgeons need to be prepared to overturn all plans at any time and make temporary plans." Liang Yi said.

He nodded and said, "You are very enlightened."

Li Zhengping said: "This may be small mesenteric lymphoma."

Liang Yi clamped a piece of tissue with hemostatic forceps, and said, "Although it's all purple and black, this seems to be a lesion caused by inflammation, not quite like lymphoma, and the other small piece should be lymphoma."

"The lesions caused by inflammation generally don't show such a dark purple color, and this one looks hideous, so it's not a good thing at first sight."

Both of them discussed it based on their own judgment, but the final result was the same, that is, to completely clean it up.

A piece of tissue was taken from the two questionable parts for pathological examination. Pathological examination plays a very important role in modern medicine.

Pathological diagnosis is the gold standard for judging whether it is a tumor or whether it is benign or malignant. In addition, it is also of unshakable importance in treatment.

Taking lung cancer as an example, whether it is adenocarcinoma or squamous cell carcinoma has a great impact on medication and treatment strategies.The current pathological diagnosis has added biomarkers at the molecular level - genetic testing and immunohistochemistry, which are important for predicting the response to medication, especially targeted drugs and immunotherapy drugs.

In addition, pathological examination can also evaluate the degree of tumor development, that is, the growth site of the tumor, the degree of infiltration, whether there is metastasis to regional lymph nodes, and whether there is distant metastasis, that is, to determine the pathological stage of the tumor.

It is not an exaggeration to say that a doctor in the pathological examination department can also be said to be a doctor's doctor.

Li Zhengping resected the tumor and part of the jejunum, and then performed end-to-end jejunum anastomosis.Anti-infection and nutritional support were given after the operation, and the recovery went smoothly. The patient's symptoms of abdominal pain and fever disappeared soon.

It is necessary to remove all abnormal tissues after the surgery opens the abdomen, but before the results of the pathological examination come out, the surgeon has no idea.

This is also the reason why surgeons are under a lot of pressure, because before the operation, be careful that the operation will be completely different from what you expected. After the operation, the pressure will be even greater, and you will worry about whether you made a wrong cut or the malignant tumor was not completely removed.

The time waiting for the pathology report is difficult.

Three days later, the pathological examination report came out, and Director Li Zhengping went to get it in person, and talked with the pathology department for half an hour.

Liang Yi was helping Xie Tianmu make the shift schedule and calculate the night meal fee. Li Zhengping patted him on the shoulder and said, "Liang Yi, stop for a while, the college student's pathology report is out."

Liang Yi stopped what he was doing, turned around and asked, "Director, how are you doing?"

"It's about the same as you expected." Li Zhengping said.