The Godfather of Surgery

Yang Ping and Song Zimo could only drink apple cider vinegar, and the two brothers insisted on drinking vinegar like wine.

Dry!

Dry

Gululu is another cup.

Those who don't know the truth must think that this is the arrogance on the wine table.

Xu Zhiliang poured three glasses, but the momentum of drinking is admirable.

Zhang Lin will always say It's too bad, the last glass!, but he always won't pour it, as if he is short of the last glass.

Xiao Wu's face was not red, and his heart was not beating, as if he had just started.

Fatty Liang looked at his performance and was not very stable. He performed well today.

The new anesthesiologist, Dr. Wei, seemed a bit out of place, sitting beside him, submissive and very reserved.

Dr. Wei is a scalper type of person who only works and doesn't like to talk.

They drank two dozen beers.

Zhang Lin leaned on the back of the chair to rest. When the phone rang, his wife checked the post and immediately woke up.

Drink a glass or two, meaning, with Professor Yang, don't worry, I haven't finished the two glasses, there is still half left, be good. Teacher Zhang was extremely gentle, her waist was bent so much that it was almost on the ground, but she couldn't bear it. Live for a drink.

Here the fat man greeted the waiter, ignorant of current affairs and shouted: One more dozen.

Zhang Lin quickly covered the phone.

The fat man squinted his eyes: Look at your ugly face, you are so afraid of your wife. From now on, I will train my wife to be submissive.

The fat man touched the cup: Full up.

But I found that the cup was long gone, the cup, the cup.

There are relatively few opportunities to let go of drinking like this, and everyone usually eats as much as they can.

But today is different. The clinical trial of the external fixator of the spine is successful, which is a major event for Corey.

Except for the new Dr. Wei, other people participated a lot. Song Zimo and Xu Zhiliang were the backbones. Zhang Lin was in charge of data collection after the patients were admitted to the hospital. Xiao Wu was in charge of communicating with the patients and follow-up after discharge.

Everyone has a share of credit for this success, so everyone is very happy.

There is another reason, the fat man lost his love, and he was depressed and sad all day, and his brothers accompanied him crazy and crazy, venting the negative emotions in his heart.

After dinner, everyone dispersed.

Xiao Wu and Zhang Lin accompanied Fatty to go around the hospital. They decided not to go home, went to sleep in the department, and played a few games casually.

Yang Ping and Xiao Su took a walk around the hospital, the two families urged the marriage very hard, and they wanted to discuss the matter of marriage.

Parents are always like this, urging you to find a partner, then asking you to get married, and then encouraging you to have children.

Yang Ping and Xiao Su are not in a hurry, Xiao Su knows that Yang Ping will be busy with a new project now, and the marriage can be delayed for a while.

But people are in the rivers and lakes, and they can't help themselves.

——

In the morning, the weather was fine.

Yang Ping crossed the overpass and rushed to work in the hospital. This Saturday, the forum will broadcast live lectures at 9 o'clock.

Iron Triangle drank a little too much last night and was still washing in the duty room. Everyone had panda eyes. They must have been playing games very late last night.

Song Zimo and Xu Zhiliang arrived early, and they were preparing for the arrangement of the nine o'clock lecture.

The location is set in the demonstration classroom, where there is a camera facing the podium, and the lecture can be broadcast live.

One after another, people arrived at the doctor's office. These graduate students, training students and interns all came to attend the lectures.

Usually it is a trilogy of shift rounds.

But today is Saturday, there will be no major shifts, only the doctors and nurses on duty will change shifts privately.

There is no operation arranged, and the ward rounds are checked by each bed doctor individually.

Yang Ping asked the doctor on duty if there was anything special about the newly admitted patient. The doctor on duty said that a patient was admitted to the obstetrics and gynecology clinic in the afternoon.

Li Jun, male, 26 years old, had a distended abdomen for three months.

Physical examination revealed a palpable mass in the lower abdomen, solid, with clear boundaries, mild tenderness, moderate ascites, perineal and perianal skin sensory disturbances, and loss of anal reflexes.

Auxiliary examinations include color Doppler ultrasound and MRI.

The patient was admitted from the obstetrics and gynecology department? Yang Ping felt strange.

Doctors are often referred to the wrong department, but very few men are referred to the obstetrics and gynecology department. Even if a man has a distended abdomen, the first thing he thinks of is tumor, not pregnancy.

It's not that Yang Ping is curious, but that the doctor wants to make the diagnosis and treatment process clear.

This is called medical history. Only by clarifying the medical history can a real diagnosis be made, especially for intractable diseases.

I don't know either. The doctor in charge of the bed was a little confused, and he was also thinking about what men think about obstetrics and gynecology.

Watch the film!

Yang Ping just mentioned it in passing, and didn't go into this reason.

What the outpatient clinic does is MRI and color Doppler ultrasound. Generally, the pictures are printed on the screen for everyone to analyze. This is not only to familiarize themselves with the information of new patients, but also to cultivate doctors' independent thinking ability.

After a brief analysis, everyone will print out the results of the image inspection.

In fact, the interpretation ability of experienced clinicians on X-rays, CT and MRI images is higher than that of radiologists, because he can often combine images with surgical findings.

And junior doctors rely heavily on the diagnosis of radiologists.

But color Doppler ultrasound is an exception. Most surgeons do not have the ability to interpret color doppler ultrasound and can only rely on the report, and the pictures on the color doppler ultrasound report are only symbolic, unlike X-rays, which can be interpreted directly.

A mass in the abdomen? Is it a mass? You can clearly see the teeth, the spine, and other bones.

Is it a mistake in the medical record? Is it a woman?

fetus?

Everyone's first reaction is, apart from the fetus, how can there be a spine?

Some people questioned that he got the wrong gender, which angered the doctor on duty. He defended his reputation: I did a detailed physical examination, and the genitals are male.

The overtones, those who suspect that I wrote the wrong medical records, shut up and don't stir up trouble.

At this time, there were more and more people, and everyone gathered around the electronic film reading screen. Song Zimo, Xu Zhiliang, Zhang Lin, Xiao Wu and Fatty also washed up and had breakfast.

Drinking is still not good, after one night, after washing, Yang Ping can still smell their wine.

Fortunately, it's Saturday, and everyone is resting, so it doesn't matter much.

Zoom in, is that the spine?

Why is it a bit like a spine.

Is there a CT?

No, I asked the admission director of the Department of Obstetrics and Gynecology, and she said that she was afraid of misdiagnosis, so she dared not do CT. The doctor on duty is more serious and deserves praise.

That is to say, at that time, the obstetrician and gynecologist were afraid that this was the fetus, so they did not dare to do CT and chose MRI.

MRI has no ionizing radiation, while CT ionizing radiation is relatively large.

Everyone discussed for a long time, and the doctor on duty just didn't release the diagnosis like a trick.

The main spine is difficult for everyone, all the tumors in the brain, how can there be a long spine.

Even teratomas are mostly teeth, hair, nerves, bone and fat, etc.

I have never seen or heard of such an obvious spine.

Everyone was anxious, afraid that Professor Yang would ask questions later, and hated the doctor on duty to death, who would not be able to beat him to death, and refused to make a diagnosis.

The doctor on duty slowly released the patient's diagnosis: pelvic teratoma with sacral nerve injury.

Yang Ping narrowed his eyes slightly, looking at the image on the screen.

It is more common to have teeth, hair, and irregular bone in teratoma, but it is really rare to have a spine in it.

It is better to see the patient first, clinicians, contacting patients in person, this is a necessary principle.

It was only past seven, and Yang Ping decided to go see the patient.

The patient looks fair and clean, with exquisite facial features and excellent looks, with a kind of feminine beauty of today's niche.

But the color of his face was very poor, and he felt like a chronic disease.

Accompanied by the bed was a sunny boy, tall and big, wearing a fashionable T-shirt, with some strange tattoos on his arms, and tapes on his fingers.

After Yang Ping asked about the medical history, there was no obvious discrepancy with the records in the medical records.

The patient has always felt that the lower abdomen is bloated, but he is not concerned. The lower abdomen began to swell slightly three months ago. At that time, he thought that he lacked exercise and had a small belly.

Until the stomach was getting bigger and bigger, they had a color ultrasound at the local hospital. The two felt that the local hospital was not up to standard, so they went across provinces to Nandu Sanbo Hospital for medical treatment.

Who are you to him?

Yang Ping asked Sunshine Boy.

Patient Li Jun looked sideways at the sunny boy, as if he had no idea.

I'm his cousin, is it serious?

The sunny boy was a little nervous.

I'll talk to you in detail later.

Yang Ping felt that he should have a good talk with them. The tumor oppressed the sacral nerve and grew into the sacral foramen and into the sacral canal. It was quite difficult to completely remove it.

Moreover, the physical examination showed that the anal area has sensory disturbance, and the bowel movement is a little out of control.

Did the outpatient doctor explain the treatment plan to you at that time?

The patient, Li Jun, remained silent for a while, and the boy Sunshine helped to answer: I didn't explain anything, I just said that I was considering teratoma, and I wanted to go to your department for surgery, and said that this teratoma is a bit strange, why does it still have a well-developed spine? Never seen a teratoma like this before.

It's really a bit complicated. Close the door and I'll check it for you. Yang Ping took the gloves from Song Zimo.

Although the door was closed, there was a large circle of trainees and interns around, all of whom were eager to study.

It's a bit embarrassing even for boys.

It's okay, we are a teaching hospital, this is a normal thing.

Indeed, while enjoying the superb medical technology of the teaching hospital, we must also remember that it is a teaching hospital, and we must be prepared to accept onlookers. If there are no cases for the interns to observe, these interns will never grow up.

it's okay no problem!

The sunny boy stroked the patient's forehead to comfort him.

The patient lay down first, and then lay on his stomach, his pants were completely taken off, and the diapers tied inside were also untied.

There is no wrong gender in the medical record. This time it can be confirmed, and everyone will have no doubts.

Yang Ping checked the skin sensation one by one, and found that the doctor on duty was very accurate, and the perineum and perianal skin felt impaired, and the anal reflex could not be elicited.

Is there any problem with urination and defecation?

I often don't know it, and the stool and urine come out.

So he wears diapers.

That is, the sacral nerve root has been severely compressed.

These interns can see more clearly after they are seated. The crowd is a bit crowded, and some are eager to come to check the anal radiation.

Everyone can check the muscle strength of the sarcomere, the feeling of the dermatome, especially the anal reflex, and everyone can experience it.

No way, when encountering a classic case, let the intern do it yourself and experience it for yourself.

Everyone is eager to try it, and has already held a pointed percussion hammer in their hands. They will use this sharp thorn to stimulate the anal mucosa of the patient to observe whether the anus shrinks.

Sometimes for the sake of preparation, stretch out the index finger, apply lubricant paraffin oil, put the index finger into the patient's anus, and feel whether there is any contraction.

Everyone line up, don't squeeze! Come one by one!

Zhang Lin maintained the order, and then demonstrated by himself how to check the anal reflex.

Although the sunny boy was very upset, he just hid it in his heart and didn't raise any objections.

I'll talk to you guys about the illness later!

It is true that the condition is a bit complicated. Even if the tumor is resected, the nerves may not recover after the operation, the perineum and perianal skin will be numb, like a piece of dead skin, and there will be incontinence, and the stool and urine will flow out unconsciously.

The sunny boy's face looked gloomy, and he agreed.