Almost all of these patients are of unknown origin!

Not to mention signing, even the family members don’t know where it is.

This means that no one will pay, and if an accident occurs later, the hospital will be almost 100% responsible...

but,

Subsequently, government staff appeared on the scene and issued a written document, requiring the hospital to provide full treatment and all costs and consequences would be borne by the government.

Only then did the hospital dare to officially carry out rescue operations, surgeries, etc.

This side of Linhai No.1 Hospital,

Xu Qiu was in charge of a patient with small intestinal perforation and rupture.

Routine surgical procedures require strict preoperative preparations such as water and electrolyte balance control, blood volume, and anti-infection.

But at this time, I couldn't care about so much. If I didn't carry out the operation, it would be a dead end.

…

Continuous epidural anesthesia.

Supine position.

"The operation begins."

Xu Qiu picked up the scalpel and made an abdominal incision.

Preoperative examination revealed that the patient's small intestine had perforation, rupture, and some intestinal hematoma and necrosis.

At present, in addition to repair surgery, part of the intestine must be removed.

"Hook."

After the laparotomy is completed, the instruments are used to open the surgical field.

Xu Qiu began to explore the entire abdominal cavity.

"Get ready, I'm going to investigate." Xu Qiu reminded.

Touching the intestines with hands can easily cause patients to vomit in response to stress.

One must always be wary of suffocation - this is a professional habit developed by surgeons.

Although the patient may not have chyme in his stomach.

"Ready!" the anesthesiologist stood ready.

Xu Qiu nodded, and then started to explore in order.

Starting from the duodenojejunal flexure, from top to bottom.

From the ligament of Treitz to the terminal ileum and cecum of the right lower quadrant.

Xu Qiu's movements were very fast.

However, it is unambiguous and accurately marks the locations of intestinal loop hematoma, mesenteric hematoma, seromuscular injury, intestinal rupture, etc.

The damaged area was quickly clamped with intestinal forceps to prevent continued contamination of the abdominal cavity.

After the exploration, a complete surgical plan appeared in Xu Qiu's mind.

However, just before the operation officially started, he was suddenly stunned.

Something's wrong!

He quickly investigated again.

At this time, the assistant was a little confused as to what was happening!

Xu Qiu's voice sounded again: "This is... an ectopic pancreas."

He was a little surprised.

It was not discovered during the previous examination that this patient not only had a general problem, but also a rare ectopic pancreas!

Just at the edge of the small intestine mesentery and the wall of the small intestine, there was an exophytic mass of 6*5*4cm with a soft texture and protruding into the intestinal lumen.

Those who are not experienced may mistake this for a hernia sac.

However, this is actually an ectopic pancreas!

The so-called ectopic pancreas is also called the vagus pancreas.

This is isolated pancreatic tissue outside the normal pancreatic anatomy.ъìqυgΕtv.℃ǒΜ

This is a congenital malformation, the cause of which has not yet been identified, and the prevalence is only about 0.2%.

In this patient's case, it was between the stomach and duodenum.

"Looking at it this way, the obstruction is actually caused by the ectopic pancreas!"

Ectopic pancreas can easily induce intussusception and intestinal obstruction. Clinically, many patients with this disease are hospitalized due to intussusception and incomplete obstruction.

Fortunately, Xu Qiu discovered it in advance.

Otherwise, after the small intestine operation, it is found that the patient still has obstruction!

Who would have thought that the patient actually had an ectopic pancreas hidden in his body!

…

"continue."

This unexpected discovery did not affect Xu Qiu's surgical progress.

It's just one more resection.

He looked inside the patient's abdomen again.

The intestinal mucosa was severely damaged and torn apart piece by piece, like a thin layer of paper.

The muscle layer is also exposed.

The only good news is that the mucosa was not damaged and there was no herniation.

"3-0 does not absorb the line."

Xu Qiu dropped stitches one after another, and made interrupted sutures along the horizontal axis of the serosa edge to retract the mucous membrane.

"Dr. Xu, why don't you suture longitudinally?" The assistant was puzzled.

Xu Qiu didn't even raise his head: "Longitudinal suturing will cause the inner diameter of the intestine to shrink and cause stenosis."

This is a problem that even the most skilled doctors cannot avoid.

Clinically, many doctors may choose longitudinal suturing.

Because it's simple.

Horizontal suturing requires adjusting the suture at any time according to the shape of the small intestine, and constantly changing the suture strength to control the entire tension. Once it fails, you have to start over.

Therefore, unless there is complete certainty, the doctor will choose the safer longitudinal suture.

After all, if there is a slight stenosis, it will not affect anything, but if it cannot be sutured, it will be a huge surgical accident.

…

"Scalpel."

After completing the repair of the serosal damage, Xu Qiu began to remove the hematoma on the intestinal wall.

This step requires incision of the serosa.

While cleaning the entire layer, check for any holes.

Make a transverse incision and suture in situ.

If the hematoma is large, the supply blood vessels will be directly found and ligated, followed by intestinal resection and anastomosis.

"There are 13 piercings in total." The assistant counted them one by one, with a shocked expression on his face.

Too much!

With so many perforations, do they really need to be repaired?

Is there any need to repair it?

On the operating table, Xu Qiu's expression remained unchanged after hearing this number. He just said calmly: "Continue."

He began to repair them one by one.

The tear is smaller than half of the intestinal tube and has neat edges. This is the easiest type.

Xu Qiu lifted the break in the intestinal wall and pulled it to both sides of the intestinal tube.

Keep it perpendicular to the longitudinal axis of the intestine.

Then, perform double-layer suturing.

The inner layer is the intestinal wall, and the outer layer is the seromuscular layer.

The assistant was stunned for a moment.
To be continued...