Chapter 196 193. Reflection, Differential Diagnosis, Intra-abdominal Exploration(2/2)
It's not common connective tissue
This touch.
Kawei turned up the liver and exposed the gallbladder below. At the same time, he could also see many small blood vessels and lymphatic vessels that should not exist in the gallbladder triangle. This is the collateral circulation caused by the body in the case of portal vein obstruction of the liver, because
It looks like a sponge to the touch, so it is called sponge-like degeneration of the liver portal.
If this situation occurs, it means that the liver cells have been necrotic in large quantities and cirrhosis is a foregone conclusion.
There is no room for liver surgery, and even the anatomy of the gallbladder triangle has lost its meaning, because there are too many collateral circulations, and even Kawei cannot achieve 100% accuracy. Once the collateral circulation is damaged, it is bad
The coagulation function makes bleeding difficult to contain.
Questions one after another, why does not seem very serious cirrhosis cause such severe spongy-like degeneration of the liver hilar hilar?
The changes in the body will not lie, the liver is indeed no longer able to do it, it is certain that it is a decompensation period of cirrhosis, and the giant spleen, blood, and ascites can make sense. So the contradiction is transferred again, why is such a serious cirrhosis
Not obvious?
etc.
Suddenly a strange thought jumped into his mind.
Kavey stopped the movements in his hand and realized that he seemed to have missed a very important cause. Although it was almost impossible to see in the 21st century, it should have been in the 19th century.
No! Europe should not be affected by disaster. Has he been to Egypt?
Kavey never asked Fernan about his travel history, because from the beginning he determined that Fernan was alcohol and cirrhosis under the action of tumors. Too much consultation cannot change the fact of cirrhosis, and there is no examination.
Under the premise of means, Kawei will fall into an endless situation.
But it doesn’t make sense to worry about these things now. What he needs is a diagnosis.
The diagnosis was due to fecal examination, because bleeding in the upper gastrointestinal tract covered up bloody stools. Now there is no chance to do a microscopic examination, so I can only look for it from the organs.
"Come and help me dig out the mesenterology."
Kawei didn't expect that he would have a chance to have such surgery. He quickly put down the liver in his hand and instead set his target on his lower abdomen: "Catch out his intestines and turn it out, and move it lighter, I want it
Look at the blood vessels!”
The three assistants had no idea that Kawei had already thought and investigated a lot during this period, and had long given up on keeping up with Kawei. Even if he didn't understand the purpose of his doing so, he would obey unconditionally.
It is indeed difficult to check the intestines of the lower abdomen. Fortunately, the incision distance is sufficient, and it can still reveal the mesenteric plexus and its surrounding vascular plexus. [11]
Several people worked together to remove Fernan's intestines from his body and placed them on a clean gauze pad, then moved the intestinal tubes to the surroundings, exposing the internal blood vessels.
Kawei saw what he was looking for at a glance. The last time he saw it was more than 20 years ago, it was really a long time ago: "It's true here."
"What are we looking for?" Damirgaon was puzzled.
"Look at this carefully." Kawei pointed to the black lines in the mesenteric blood vessels, and finally clarified the cause of Fernan's history: "These are all bugs." [12]
Chapter completed!