Ji Xiang and Dr. Meng talked about speculation. They went to the emergency department every four days to have sex. At night, they accompanied Meng Qingfei on duty, helped sew wounds and check the patients.

Time flies, and half a month has passed.

"Xiao Ji!" Director Liu walked out of the office and stood at the door and shouted loudly.

"Here, Director." Ji Xiang opened the door with his elbow wearing disposable gloves and probed out of the pharmacy, "What instruct the Director."

"Come on, change the dressings quickly, let's go for a consultation."

"Okay." Ji Xiang responded and turned around and quickly explained the precautions to the patient after the circumcision surgery that had been performed on the weekend.

The circumcision he performed was quite good, with almost no postoperative complications, and the explanation was detailed, so the patient felt less fear.

"Okay, just come to me in three days to change the dressings." Ji Xiang took off his gloves and said to the patient.

"Doctor, go to the outpatient clinic or come here?"

"Just come here. You have to register when you go to the outpatient clinic. Just change the medicine, it's not worth it." Ji Xiang said.

Turning around and going out, Ji Xiang bowed and smiled, "Sorry, Director."

"What's wrong with me?" Director Liu laughed and scolded, "Changing the medicine is serious. Don't be so hypocritical, learn more."

As he said that, Director Liu glanced at Ji Xiang.

"Director." Ji Xiang felt a little guilty.

"Is the disposal fee confiscated for changing the dressings to the patient?" Director Liu asked Youyou.

"..." Ji Xiang sighed in his heart, but was discovered by Director Liu.

"Your patients should change the medicine by themselves. If you don't take it, it doesn't matter." Director Liu suddenly smiled sly, "But don't let the head nurse know, the housekeeper is too long-winded."

"ah?"

"The performance of the department, hey! It's a joke when you tell it. While you're curing the disease and saving the patient, you're also performing performance appraisal. Do you think it's very divided?"

“Some.”

"If you don't talk about this, it's hard to be a doctor now, mainly because of schizophrenia."

"Director, what kind of patient is consulting?" Ji Xiang smiled and asked immediately.

"The patient was admitted to the hospital for femoral vein thrombosis in the lower limb, and the thrombolysis treatment was not good. He was preparing to intervene in the catheterization and thrombolysis. He had a CT scan before the operation and found something was wrong. I just looked at the video on the computer and always felt something was wrong."

Director Liu said while walking.

"What's wrong?"

"Well, I don't think it's a tumor, but I can't tell what it is." Director Liu said, "The kidney substance is gone. It should be a renal cyst, but this thing is too big, I dare not recognize it."

"How old?" Ji Xiang asked curiously.

"I guess 5,000ml of water is found inside, and the solid layer is like a piece of paper." Director Liu said in confusion, "It cannot be said that renal cysts are very common. I have seen more than ten centimeters and twenty centimeters, but the kidney cysts are

Press into a piece of paper…”

Ji Xiang didn't say anything and accompanied Director Liu to continue walking towards the gastroenterology department.

The kidneys were pressed into a piece of paper, which sounded strange. The reason why Ji Xiang didn't talk much was because he wanted to read the patient's information.

I didn't even watch the movie, why should I talk too much?

When he came to the vascular surgery department, Director Liu first came to him. He asked the patient's image data and inserted it on the video reader to look.

Although the hospital's systems have been fully electronicized and can watch movies with a computer, Director Liu is older and is more accustomed to watching movies on the video viewer.

Ji Xiang stood behind Director Liu and watched with him.

There is a huge mass on the left abdomen of the patient, with about 7 vertebrae in length and width exceeding the midline of the abdomen.

If this thing had not been told by the density that Ji Xiang was a "water sac", anyone would have suspected it was a tumor.

But such a large "water cyst" doesn't look like a renal cyst.

Ji Xiang's ability to read films is not high. He just passed the standard line. After reading it carefully, he went to see the medical record.

The system NPC is not easy to do. Although he rarely tests himself, if he asks him or her questions, if he can't answer it... Ji Xiang feels too embarrassing.

It has to be said that the medical records were written by the internal physician, which were detailed enough, and although the patient's admission time was short, all the rewrites were written.

If it is a surgical patient, even the patient admitted to ICU may not be able to write the surgical record before being discharged from the hospital.

After writing it down, Ji Xiang came to the system space.

"Teacher, the cyst is very big." Ji Xiang and the system NPC said after reporting.

"It's not a cyst, or it's not an ordinary cyst." The system NPC said, "It should be huge hydronephrosis."

"Teacher, the water that has no kidneys?"

"Yes." The system NPC nodded, "Generally, when hydronephrosis is discovered, the kidneys will be retained more or less. It may not function, but it can be seen on the image."

"But huge hydronephrosis..."

"Teacher, why is the name of this disease so strange?" Ji Xiang asked.

"It's just very huge, and there's nothing to describe." System NPC said, "In 1939, Dr. Stirling first proposed the concept of huge hydronephrosis.

That is to say, the amount of water accumulation in the assembly system exceeds 1,000 ml, and the imaging manifests itself as water accumulation reaches or exceeds the midline of the abdomen, occupying half of the abdominal cavity, or the length of the water accumulation exceeds 5 spine lengths."

"But now, 1,000ml of water accumulation in clinical practice is no longer huge. I have seen patients with more than 5,000ml."

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"This one has at least 5,000ml."

"Yes, but the patient has no discomfort. It is rare to come to the hospital until complications occur. Vein thrombosis in the lower limbs is formed by the huge hydronephrosis of the lower vena cava, which causes the return flow to be blocked and the blood flow rate is reduced."

"It's rare, it's normal that your director hasn't seen it before."

"The principle is the same as hydronephrosis. The causes include stenosis of the ureteral junction of the renal pelvis, vestoureter reflux, giant ureter and posterior urethra valves, etc. Among them, 80% of the patients are caused by stenosis of the ureteral junction of the renal pelvis."

"As for treatment..." As he said that, the system NPC paused.

"Stenosis site loosening surgery?"

"This can be done with general hydronephrosis, but the kidney on one side of the huge hydronephrosis has no function anymore. If it is retained, it will not be worth the cost and it will need to be surgically removed."

Ji Xiang nodded.

"Don't underestimate this surgery." The system NPC said, "The surgery for huge hydronephrosis is quite difficult to do. Although the concept was proposed in 1939, laparoscopic surgery was carried out in the last century, and laparoscopic surgery could be used to do huge hydronephrosis.

, It was not reported until 1991."

"Why, teacher."

"Because of the long time, the dorsal membrane and peritoneum of the kidneys are fused and local anatomical tissue changes, making the operation difficult to complete with laparoscopy."

"If it's an open abdominal surgery, it can be a little easier."

"Doctor Xiaoji."

"At." Ji Xiang replied immediately.

He was a little worried and guessed whether the system NPC had to experience it himself and empathize.

"Train the surgery directly. You see I have an operation and then try it myself a few times." The system NPC said, "You can only understand why the surgery is difficult after you have done it yourself."

"Don't you have to empathize?" Ji Xiang asked.

"The patient didn't feel anything before he found a venous thrombosis. What's the point of trying?" said the system NPC. "If the surgery fails, you can try it."
Chapter completed!