The Surgeon's Studio

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"Dang, dang, dang ..." Zheng Ren knocked on the door of the consultation room lightly. He pushed the door open and entered after hearing cui Lao's voice. "Little Zheng, you're early." Cui Lao was focused on an X – ray film as he adjusted his glasses. "Yeah, I just got off the stage and came straight over." Zheng Ren laughed and leaned over. "It's not good to not eat. At my age, you'll suffer. " Cui Lao pointed at the film and asked,"Tell me, what do you think?" Zheng Ren was silent. The image in the x – ray before his eyes was beyond imagination. There was a broken glass bottle in the rectum with a sharp tip that had stabbed the ischioid bone. The bone surface below the rectum was damaged, especially at the sacrum, where the bone surface was eroded. The degree of damage was about 90%. The sharp part of the bottle reached the gluteus maximus and was surrounded by organic tissue. The rectum where the foreign body was located had a spreading inflammatory lesion, and the right lower limb muscle had lost use adipose degeneration. Zheng Ren had seen a lot of rectal foreign matter in the emergency department, and most of them were wine bottles, steel pipes, massage sticks, and mousse bottles. However, they usually went straight to the hospital and took it out. Other than being a little embarrassed, there was nothing much. The case in front of him was different. Severe inflammation changes, the wear and erosion of the bone at the pubis joint, and the surrounding adhered tissue meant that the foreign object had not been removed for a long time. Was this abuse? Or something else? Zheng Ren's brows furrowed unknowingly. "At first, the patient's medical history was unclear, but after repeated questioning from Xiao Zhou, he learned that five years ago, when he was having fun with his girlfriend, he stuffed a beer bottle into his rectum. The patient was rather introverted, so she didn't come to the hospital to remove the foreign object because she was embarrassed. " Cui Lao looked at the x – ray as he slowly explained the patient's medical history. Uh ... Zheng Ren felt extremely strange when he pictured the scene of his injury. Introverted? I can't tell. However, this had nothing to do with Zheng Ren. He had to consider how to treat the patient. Zheng Ren didn't realize that his answer to cui Lao had made the atmosphere less awkward. Unconsciously, his left hand had reached under his right armpit, and his right hand was supporting his chin as he looked at the X – ray scan with rapt attention. Cui Lao didn't get angry at Zheng Ren's silence and continued to explain the patient's condition. "The patient has been limping for one month and his right lower limb is weak. It is considered to be caused by a change in used fat. This time, he came to our hospital's emergency department for treatment because of urinary incontinence and aquatic feces. " "Where's the patient?" Zheng Ren asked. "He's going to do a CT scan of the lower abdomen and pelvis. I think that the patient should undergo surgical treatment, and the treatment will be very difficult, so it's better to have a more detailed examination. " "Lil 'Zheng, do you have any thoughts on the surgery after you look at this X – ray scan?" cui Lao asked. "It'll be like a radical surgery for rectal cancer. The surgeon will need to leave both his colon and anus empty. When he recovers a little, he'll have to undergo the second stage of surgery. " Zheng Ren said. Cui Lao nodded slightly. This was what he had thought of. However, the difficulty of the surgery was definitely not something that could be described with a few simple words. The foreign body in the patient's rectum had been there for too long, and it had been highly mechanized and wrapped in the body. If he wanted to completely remove it, he would definitely lose a lot of blood. This surgery was a great test of the surgeon's surgical skills. If the surgery was a little rough, there was even the possibility of blood oozing out in a large area without the bleeding vessel being found. The need to use electric burner to coagulate all the capillaries was a big problem in postoperative healing and bleeding again. The surgery had to be especially meticulous, and the requirements for the technique were extremely high. Zheng Ren's brain started working at high speed. He analyzed the X – ray scan and carried out a three – dimensional reconstruction. He also judged the direction of the blood vessels, the branches of the capillaries, and the position of the relevant body tissue. Even with the passive skill of reconstruction, Zheng Ren still felt that the difficulty of this patient's surgery had almost reached the sky. As time passed by, Zheng Ren reconstructed his thoughts repeatedly in his mind, trying to find a reasonable path to enter. The damage had to be minimal, and the goal had to be achieved. However, even with Zheng Ren's ability, it would be difficult to solve this problem in a short time. Very quickly, Zhou Litao knocked on the door."Cui Lao, the patient just now came back from a CT scan." Cui Lao nodded and stood up."Little Zheng, let's go and see the patient." Zheng Ren looked at the X – ray film. The glass bottle in the rectum was so glaring. He accompanied cui Lao to the emergency resuscitation room, where the patient was lying on the Gurney. It was a young man who didn't look too old, about 23 or 24 years old. He was accompanied by a girl, who was wearing a plain plaid dress and had shoulder – Length hair. She looked simple and clean. "Li mingchao, right?" Cui Lao asked. "Doctor, I won't die, right?" The young man lay on the Gurney with a terrified expression. "Do a physical examination first, then send him to the gastrointestinal surgery department. Young Zhou, make a call to inform the gastrointestinal surgery department to reserve emergency beds. " Cui Lao didn't answer the patient's question but spoke to Zhou Litao. "Doctor, are you alright?" The girl also asked anxiously. "How can I be fine?" Zheng Ren stood between cui Lao and the girl and said calmly,"you're injured so badly. Why are you only here now?" "..." The girl came to a conclusion. She was a little timid, a little embarrassed, and a little conflicted. Tears fell down her face. Zheng Ren was speechless. The girl's crying made him feel helpless. "Are you people from the capital or do you work here?" Zheng Ren asked. "I started working here after I graduated from University." The boy said. "Are you two married?" "No, I haven 't." "Inform the family to hurry up and come over." "His condition is very serious, and he needs to undergo a major surgery," Zheng Ren said. "Don't ..." The boy endured the pain and said,"I ... That ... Sign the surgery papers. I can get my girlfriend to come." "Such a high – risk surgery requires immediate family members. You're not married, so you can't sign it. No doctor would dare to perform such an operation. " Zheng Ren said. Zheng Ren had a basic judgment of the patient's condition after looking at the x – ray. Even if he performed the surgery himself, there would be a lot of bleeding during the surgery. It was completely possible to say that he was embarrassed. "Doctor ..." "No one would dare to perform the surgery without the signature. If you don't receive the surgery, you definitely won't be able to last for another five years without any problems. " Zheng Ren said firmly. All of a sudden, the patient and his girlfriend fell into a panic. They fell silent. Zheng Ren looked at cui Lao's physical examination. The patient's abdomen was flat and soft, and there was no tactile pain or rebound pain. The tension of the anal sphincter and the anal sphincter in the rectal examination was significantly reduced, and the lower end of the foreign object could be clearly touched. Zheng Ren sighed and shook his head slightly. …… [Note: This case is from the International Journal of Surgical Case Reports, which was published by doctor Mu peaks CAAT ozbilkin.] After listening to his senior brother's case, it was really tiring to search for information.