332. Outpatient Clinic Records—[II]

Author: Hao Xifeng

332. Outpatient Clinic Records—[II]

"Herman, he is already dead. His blood pressure and heart rate are gone. He can't be saved!"

"."

"Herman!!!"

"But."

"I said forget it."

Herman looked at the patient who was no longer breathing, and helplessly let go of his hands: "He looked fine just now, but why suddenly he stopped?"

"This is the case for this kind of patient. The huge abdominal pressure has already caused circulatory failure. The liver, mesentery and omentum are all very ischemic." Kawei pointed to the liver and asked, "Even the portal vein has an embolism.

Do you know why?"

Everyone shook their heads.

"It's all air here," Kawei explained, "because when the stomach ruptures, the intragastric pressure drops sharply, the blood vessels suddenly expand, and a large amount of gas enters the stomach through the broken ends of the blood vessels, causing air embolism in the portal vein. The liver ischemia is too severe.

, even if he gets off the operating table, he will die from liver failure."

He has seen several cases of acute gastric dilatation combined with gastrointestinal rupture and food overflow. Even with the support of modern medical methods, the results of forced surgery are often very poor.

Like this patient, most patients will suffer severe hypotension and difficult-to-resuscitate cardiac arrest during surgery. Even if they survive the surgery well, they will die within 24 hours due to abdominal infection and prolonged circulatory ischemia.

After narrowly escaping death, the lucky ones who really make it through the gate of hell will say goodbye to their stomachs forever.

"If you are dead, you are dead. Surgery is not a panacea." Kawei took off his gloves and ran to wash his hands in the pool nearby. "If you have time to deal with this corpse, it is better to think about what to do next."

"Leave the rest to me." Saidi asked him to start washing his hands, and was no longer polite, and directly asked for the right to be the "chief surgeon", "Just in time to try the distal gastrectomy + gastrojejunostomy you just mentioned.

.”

"I'm afraid the anastomosis is not that easy to do because the stomach wall is too thin."

Kawei lifted up a piece of the stomach wall and said, "This is probably less than 5mm, and a large area of ​​the lower jejunum is necrotic. If you really want to practice, you can try the ileum or colon, but the effect is really not very good."

"It doesn't matter, I will continue practicing according to the previous surgical ideas."

Cediyo didn't care about these details. Being able to avoid the cadaver storage process and directly enter the practice stage is what every surgeon dreams of: "Why don't Dr. Carvey come with us?"

"As long as they accompany you, it's fine. I'm not interested in dead people."

Kawei shook his head and left the surgical theater.

It was already ten o'clock in the morning when we returned to the garden, and the scene became deserted as soon as we entered and left. It was because the visitor was too urgent, and Kawei forgot to take care of the follow-up matters. Perhaps considering the long operation time, all the original tables and chairs were

After moving away, the free sign was gone, and it was still the original garden that no one cared about.

But no matter how slim the hope is, there are always people who can persevere.

There were three of them, two men and one woman. They lined up very religiously at the original consultation position. When they saw Kawei appearing, they all smiled and stepped forward: "Dr. Kawei, you are out."

"The operation took a while and everyone else left?"

"It's all gone, we're the only ones keeping it."

"This is the number we got before."

If you can wait at the gate for more than an hour without seeing the results, there is a high probability that there is something wrong, and it is probably not for money. Free clinics are originally something Kawei did casually, so if they are scattered, let them be scattered.

.

"It's not convenient here. Come to the ward with me."

Patient G

"Well, actually I just want to ask you if you can perform an operation on me." The first girl in line was a little excited. After saying this, she remembered not to introduce herself, "By the way, my name is Laura, Laura.

Patty, Mr. Liben's friend, he should have mentioned me to you."

Kawei: Li Ben. Who is Li Ben?

Um, I kind of remembered. She was the LSP who was left behind by Mick, a big liar. We haven’t seen each other for a long time. How come we met such a beautiful girl and said we were friends?

A strange name + a familiar name that shouldn't appear here + something that has never happened before.

Kawei felt strange at first and didn't know how to reply to her, but his magical brain connected these elements with the note he received yesterday.

Could it be that she is the person mentioned in the note?

At this time, considering the existence of Alphonse, it makes sense that Li Benzang showed his head and tail. Since the background was complicated, Kawei did not say it directly. He just greeted the liar who had been looking for him: "Oh, thank you for waiting until

Now, by the way, where is Li himself?"

"I don't know where he went." Laura looked uncertain, "Dr. Kawei, are you willing to accept mine?"

Kawei was not in a hurry to answer, but wanted to confirm her basic situation first: "Which side is it?"

"The left side." Laura unconsciously blocked the left side of her chest with her left hand and said helplessly, "In order not to attract attention, I put a lot of sponges and fabrics in it. In fact, if you look closely, it will look a little unnatural.

It feels weird.”

"When was the surgery performed?"

"Two years ago, Professor Cediyo was the surgeon."

"Did you even cut off the muscles inside?"

"I'm not sure. The operation took an hour, and now it feels a little sunken."

Kawei did a simple palpation through his clothes and continued to ask: "Are there any swelling, pain or lumps now?"

“No.” Laura was a little worried when she saw him asking questions, “Will you accept me?”

"No problem, but the operation requires some preparation time, and you have to stay in the ward for at least two weeks." Kawei warned, "Because I need to evaluate the healing of the incision after the operation. If there is a problem, I must solve it as soon as possible.

Otherwise, the entire operation will be in vain."

As long as you work hard enough, you can bring Laura at least 500 francs in income in two weeks, and the subsidy given by Carvey will definitely not be comparable.

But when I think about the things that disappeared on my body can grow back, the small loss in money is not so important: "No problem, I have thought about it, let alone two weeks, I will live there even for a month."

"Well."

Kawei took out a stack of notes from his pocket, scrawled two lines of words on it, tore it off and handed it to her: "Take this piece of paper to the next ward, give it to the nurse there, and say I asked you to go

of."

"oh oh."

Laura happily accepted the note, but her feet did not move, and her eyes kept glancing at Kavi's pockets.

Seeing that she hadn't left, Kawei remembered something, then took out his wallet and handed over 100 francs: "I need to do a comprehensive examination before the operation, because the reconstruction requires muscle and skin measurements."

"no problem."

"The best thing is that the operation is successful. If problems such as incision ulceration occur due to our problems, we will provide free treatment and give an additional 200 francs as compensation."

"Okay, okay, thank you."

Patient H, male, 56 years old

"What's wrong?"

The man passed Laura, looked at the stool, hesitated for a while, then held the table with both hands, and sat down slowly: "I'm sorry, doctor, my butt hurts. I can't sit down too fast. If I'm too fast."

As soon as he finished speaking, he stood up as if he were sitting on a nail: "I think I'd better stand. The stool is too small to sit on."

"A lump in my butt? Is it hemorrhoids?"

"It should be considered a lump. It was right next to the gang door at the beginning."

"In the beginning? Now?"

"Now it's more like a full water bladder, a little soft, but still very painful."

"It seems like it's been a long time."

"It's been more than a week."

"Do you have a fever?"

"It was a bit like it at first, but now I don't know."

"Okay, come with me." Kawei pointed to the examination room nearby and asked the nurse for some gauze and linen gloves. "Come here, take off your pants and let me see."

The examination is actually not difficult. A little palpation can diagnose an abscess around the penis. The specificity is very high. The location is on the left side of the vaginal opening. The pain is very obvious when touched, and the scope is not small. It has spread to the rear and right rear.

What's more serious, and the main reason why he is willing to come to the doctor this time, is that the abscess has broken. It may be due to pressure, but it is more likely to be caused by the friction of the pants.

"When did it break?"

"Last night. Be gentle, it hurts too much."

"Have you ever squeezed yourself?"

"No, hiss. I don't dare to touch it, it hurts too much!"
To be continued...