The Surgeon's Studio

"Menstruation period has an impact on pneumothorax? Or is it related to your period?" Su Yun looked at Zheng Ren in confusion.

Zheng Ren was also in a daze.

There was such a saying for menstruating pneumothorax, but most of it was related to ectopic transplantation. However, if it was ectopic transplantation ...

Zheng Ren was stunned for a moment. 'Is it menstruating pneumothorax?'

This illness was so rare that Zheng Ren had not even thought about it.

"Boss, if it's endometrosis, right pneumothorax will be the main cause, and it will act up during her period, but ... Old Yan, the patient has had seven operations, how many times has she had surgery on both sides?" Su Yun asked.

"Four times on the left, three times on the right." Shao Jinghe immediately replied.

"I don't think so." Su Yun furrowed her brows and said in a low voice.

He was not confident, so he subconsciously dared not say with certainty that it was spontaneous pneumothorax caused by Empress Dowager.

Zheng Ren suddenly stood up and went to the film reader to look at the image.

Shao Jinghe was dumbfounded upon hearing that. He looked at Fang Lin in a daze and was at a loss.

Fang Lin had never encountered such an illness before. Even though he knew that he had chest tightness during his period, he did not even know how to take a test for that.

If any examiner were to set this question, he would probably be struck with a chest cavity.

"The uterus lining moves to the pleura and the surface of the lung to grow, and it falls off when the period comes. Because the pleura is very thin, it's easy to be damaged, causing air to enter the pleura cavity from the lungs, forming pneumothorax and causing symptoms. " Zheng Ren thought as he spoke.

It seemed like he was talking to himself, but it also seemed like he was conversing with a certain existence in the dark.

"My diaphragm is fine."

"Yes, it might be a problem with the diaphragm." Zheng Ren looked at the film and said,"generally, menestathroplasty is accompanied by abdominal muscle damage ..."

After that, he asked,"old Yan, if I'm not mistaken, you just said that the patient has a period every time he has pneumothorax. The latter period is long and the amount is relatively large. Is that right?"

Shao Jinghe nodded repeatedly.

Although he had no idea what little boss Zheng was thinking, he could still answer the most basic questions.

"Uh ..." Fang Lin did not look at the X-ray. Instead, he looked at boss Zheng and was slightly speechless.

"It's diagnosed as menstruating pneumothorax," Zheng Ren said with certainty,"there are four criteria for diagnosis."

"..." Fang Lin looked at boss Zheng in astonishment. 'Did I mishear what he said earlier?'

"First, the spontaneous rupture of the pulmonary buffaloes."

"Second, irregular contractions during the menstruation period will cause the gas to enter the uterus and enter the abdominal cavity through the fallopian tube. At this time, the ectopic uterus lining that blocks the diaphragm pore will fall off, and the diaphragm channel will open. The disease will occur when the gas enters the chest."

"Third, the loss of the ectopic uterus lining on the pleura leads to air leakage in the lungs."

"Fourth, pulmonary alveolus rupture caused by the bronchi contraction caused by epinephrine or the unidirectional valve mechanism caused by the bronchi endometrum.

Zheng Ren began to narrate in detail again. Not only Shao Jinghe, but even Fang Lin was confused as well.

"There's endometrum, and he's been diagnosed with menstruating aichest. He meets the first and third criteria. " Zheng Ren said.

"But ..." Shao Jinghe wanted to say something, but he did not say it in the end.

"There's a problem with the diaphragm. " Su Yun added,"it's a very small tear. Only when the abdominal pressure increases will there be a small gap, causing the uterus to have an abnormal position again."

"Again ..."

"If it goes further, it will directly fall on the lungs. Finally, during the physiological period, it eroded the visceral pleura, leading to spontaneous pneumothorax that constantly occurred. "

"Yes." Zheng Ren nodded."Zou, did you observe the diaphragm during the surgery?"

"No..."

Shao Jinghe was at a loss. It was a pneumothorax surgery. Why would anyone observe the diaphragm for no reason?

"Hmm, during the surgery, use single-chamber ventilation and look carefully for the position of the diaphragm. There's probably a small tear. Forget it, I'll just apply pressure using a laparoscope. If the pressure is high, we can see gas entering the chest cavity. "

"Boss Zheng, Brother Yun, shall we go up and take a look?" Fang Lin felt uncertain in his heart.

"You're speaking as if you don't have a second-string team professor. " Su Yun casually retorted.

Although that was what he said, it was absolutely impossible for him not to go on stage. Su Yun would fight Fang Lin to the death if she did not take a look at the rare period and chest tightness.

It was not a problem for the patient to be prohibited from drinking or drinking water, so he requested for surgery. There was still half an hour of preparation time before the operation, so Zheng Ren and Su Yun went straight to the operating theater.

"Boss, the diaphragm muscles are very developed, so it's rare for there to be problems. Is it a congenital problem?" Su Yun asked.

"It's possible. We'll know once we go up and take a look." Zheng Ren said,"repair the diaphragm. After the surgery, she will need to take Chrysalis-releasing hormone therapy. She should be fine soon."

Su Yun suddenly thought of something. He looked at Shao Jinghe and asked,""Have you done the postsurgical pathology for all the previous surgeries?"

“……”

Shao Jinghe was dumbfounded by her question.

By right, all the things that were cut off should be sent for pathological examination. For example, the appendix, which might have a malignant change in one or two out of a thousand.

Due to the long period of pathological diagnosis, the cost was expensive for some families, so many people refused to do a pathological examination.

Doctors, especially those from lower-ranked hospitals, would rarely force patients to do pathological examinations. Meanwhile, the patient who came to 912 hospital did not tell the patient's family about this at all. It was only right for him to do a pathological examination after the surgery.

This was the difference between a small local hospital and a top class tertiary Grade A hospital in the capital.

The patient had spontaneous pneumothorax, and the diagnosis was very clear. There was basically no problem with the pulmonary blister removed during the surgery.

At least, Su Yun had never seen one before.

Shao Jing and doctor Yan probably thought the same way. It seemed that he had not done a pathological examination.

Sure enough, Shao Jinghe said embarrassedly,""I didn't do it."

"Old Yan, you're not being meticulous with your work." Su Yun said in disdain,"if we did it once, even if it was only once, this would not have happened." You're ..."

"Brother Yun, it's not like that." Shao Jinghe was on the verge of tears as he hurriedly said,""The patient's family isn't very rich, so I didn't even dare to use titanium clips during the surgery. I had to suture by hand. The pathology report also says that there's only a red mist that matches the change of lung bumple. I don't think it makes any sense. "

Zheng Ren sighed and shook his head.

That was how the inspection was like. The possibility of a problem appearing was not high. However, once there was a problem, such as the current situation, it could cause misdiagnosis and missed diagnosis.

This was the standard case of doing bad things with good intentions.

But then again, even if Shao Jinghe did a pathological examination and sent the sample to the pathology Department, the doctor there would probably go crazy.

The pathological examination of the pulmonary blister was in line with the situation of the endometrum under a microscope, and no one in the local hospital dared to make a diagnosis.

At that time, it would still be a hassle to take the pathological section to a high-class hospital for a diagnosis.

It was already very good for primary hospitals to be able to make the correct diagnosis and treatment for common diseases.

As for rare diseases, they would not come across one case in ten or twenty years. Even if they learned a set of dragon-slaying skills, it would be useless.

……

……

(Looking for a heart to heart competition, looking for monthly votes.)