This time he felt the same feeling for a short time, but the shock Ji Xiang received was far greater than the time when Dahai performed the lengthening technique.

As for the pain, bleeding, infection, etc. that I experienced after circumcision, compared with what I felt this time, it was not enough.

So much so that Ji Xiang did not immediately take stock of his harvest.

Perhaps because the difficulty of empathy has increased, this time empathy gave Ji Xiang 30 surgery points.

But he was in a very bad mood and his eyes were full of blood.

I don't know how things will develop after I leave, Ji Xiang thought silently.

"Teacher." Ji Xiang pursed his lips and did not agree with the system NPC's statement.

"Doctor Xiao Ji, please tell me your analysis of this matter." The system NPC looked at Ji Xiang and asked calmly.

Although he knew that it was just an illusion, or a program, Ji Xiang remained calm for a long time.

Ji Xiang gradually calmed down after drinking half a bottle of glucose in the system NP1.

Looking at Ji Xiang quietly, the system NPC did not interrupt his thoughts.

"The fault in this matter lies with the surgeon who participated in the rescue three years ago, but the patient was so excited that it was wrong to hurt innocent people." Ji Xiang simply stated his judgment.

"The basic knowledge is still weak, so that your judgment on the whole thing is wrong." The system NPC shook his head.

"Huh?" Ji Xiang was startled when he heard the system NPC say this.

The patient's right kidney has disappeared. This thing is a sure thing. How could the system NPC say that!

Is his butt crooked? Even in the system space, his butt is still crooked?!

No wonder it is said that the butt determines the head, it turns out that is really the case.

Ji Xiang felt a little disdainful in his heart, and the young man's passion began to surge. Even if he had to offend this system NPC, who had profound moral knowledge and was extremely awesome, he had to stand on the side of justice and justice.

The system NPC did not laugh, but looked at Ji Xiang's expression seriously.

He seemed to have guessed what Ji Xiang was thinking.

This young man was like a little beast ready to challenge himself, completely forgetting the true purpose of coming to the system space this time.

The old man and the young man were silent, and the atmosphere in the system operating room was inexplicably awkward.

Three seconds later, the system NPC broke the suffocating silence.

"There is a type of disease called kidney autotomy, which is more common in tuberculosis patients." The system NPC waved his hand, and a light screen appeared in front of his eyes, and he began to tell Ji Xiang.

Ji Xiang frowned and cut off his kidney. He only had very little space to describe it in diagnosis and other courses.

Although Ji Xiang has memorized almost all the textbooks of his height with his superhuman memory, it is just boring memory and it is impossible to turn it into abilities.

"A large amount of calcium salts are deposited in renal tuberculosis lesions, resulting in extensive calcification of the entire kidney. The sonographic features of the disease are varying degrees of kidney damage and even calcification. When kidney function is completely lost, the ureter is completely occluded.

This condition is clinically called renal autotomy or putty kidney."

"Teacher, the patient has no history of tuberculosis." Ji Xiang tried to recall the memory when he felt the same way and defended.

The system NPC raised his deformed, chicken-paw-like right hand and pressed it.

"Kidney autotomy is a type of disease, and there is also a branch disease we call traumatic kidney autotomy."

"..."

These words were poured over his head like a basin of cold water, and the anger in Ji Xiang's heart was immediately extinguished.

Traumatic renal autotomy, as the name suggests, may cause kidney problems due to trauma.

Combining all the things he felt, Ji Xiang naturally thought of the words of the director of the Department of Urology, the purpose of coming to the system space, and the patient's emotions after knowing that he had been pinched.

The system NPC didn't care about Ji Xiang's feelings and continued to explain.

"The patient was diagnosed with liver rupture and renal contusion and laceration 3 years ago."

"Renal contusions and lacerations can be seen on CT scans with uneven density in the renal tissue, mold lakes, or cracks or hematomas and subcapsular hematomas in the renal parenchyma; enhanced CT can see it more clearly."

"Kidney contusion and laceration can lead to a series of complications such as hematuria. The simplest solution is to remove the kidney.

Due to the importance of the kidneys to humans, it is of course possible to avoid surgical removal as much as possible. Try to preserve the organs as much as possible. This is the clinical treatment guideline.

For those with persistent hematuria or external bleeding, the problem can be found on arteriography and highly selective embolization therapy can be performed, which means blocking the bleeding branch vessels, which not only stops the bleeding but also preserves the kidneys."

The system NPC began to tell Ji Xiang about kidney contusion and laceration, and then about kidney rupture.

Normally, Ji Xiang would definitely think that the system NPC was a bit nagging and did not go straight to the topic.

But this time he listened carefully and compared it with the knowledge he had learned in school.

“The fifth type of injury is renal vascular injury, which can be divided into two types.

The first is the rupture of the renal blood vessels, which can be one of the arteries and veins or both. This can also be regarded as a renal rupture, or a rupture of the renal pedicle. It is also a serious disease that will lead to death from massive bleeding if not operated quickly."

"The second one requires you to pay special attention to."

The system NPC reminded Ji Xiang in an emphatic tone.

Ji Xiang nodded and looked at the light screen. His brain was divided into several different threads. While thinking about the emotions of the patient, himself, and the doctor in the CT room when he felt the same, he listened attentively to the teachings of the system NPC.

"With renal artery contusion, the main problem will appear on the blood vessels. The patient was sent to the operating table during emergency treatment and underwent laparotomy. It was found that the shape of the kidneys had not changed and there was no indication for surgery."

"Even if we had a CT scan in the emergency department, we wouldn't find any problems."

"Teacher, what if we do a 64-slice CT, the kind that uses medicine?" Ji Xiang asked.

"It doesn't matter whether emergency patients can give you time to do this kind of examination. Even if you do it, there is a high probability that there will be no diagnosis."

"..." Ji Xiang was speechless.

"Injury to the renal artery causes the intima of the blood vessel to become rough, causing changes in fluid dynamics, which can easily lead to the gradual formation of thrombus.

From incomplete to complete occlusion of the renal artery; it may occur as quickly as a few hours after the injury, or as slowly as ten days or even dozens of days after the injury.”

"Let me ask you." The system NPC looked into Ji Xiang's eyes.

Ji Xiang was a little panicked by those bright and transparent eyes.

He already understood what the system NPC meant. Although it was not very clear, he knew that he had made a huge mistake in the process of empathizing with others.

"If the rescue is successful, how long will it take for the trauma patient to be discharged from the hospital?"

"10-14 days, as long as there are no infections or other accidents." Ji Xiang replied.

"Yes." The system NPC nodded, "The patient is fine with a simple post-operative review. Will you prescribe a more expensive imaging examination for the patient?"

"Won't."

Ji Xiang answered seriously.

"Yes." The system NPC said, "This is a secondary disease. The doctor is experienced and tells the patient to go to the outpatient clinic for a checkup one month after discharge to see if there are any changes in the kidneys.

But they have almost recovered, and most patients will forget about it after they are discharged from the hospital."

Ji Xiang breathed a sigh of relief. As for the complicated emotions in his heart, even he himself couldn't explain clearly.

“After renal artery contusion, the most serious situation is that the injured side of the kidney completely loses blood supply, and of course it will gradually undergo ischemic atrophy.

Some people have also called it "sterile necrosis".

The tissue with normal kidney structure gradually disappears due to ischemia and necrosis, and is replaced by connective tissue similar to the surrounding tissue, which cannot be seen at all on CT."

"In other words, the patient's right kidney was not cut off, but it became necrotic due to an extremely rare renal artery contusion that led to traumatic renal autotomy?" Ji Xiang found this logic difficult to accept.

The system NPC nodded.

Ji Xiang was silent.

He still had something to say in his heart, but he didn't say it out loud.

"Are you saying that the doctor still has the responsibility?" The system NPC seemed to be a god, seeing through Ji Xiang's heart and asked calmly.

"Yes." Ji Xiang didn't hide it, nodded and replied.

"Let me give you an example." The system NPC said seriously, "Our hospital's neurosurgery department once treated a patient like this - a car accident injury, a very slight scratch, and the patient was wearing a seat belt."

"You know about the trauma?"

Ji Xiang was startled. The system NPC said it was simple, but he probably only knew a little bit, and he would not understand anything more.

Trauma patients will basically choose to be hospitalized if they have insurance or if the other party is fully responsible.

Firstly, just in case, and secondly, it is also good to have a full physical examination.

"The patient is a young female. After being hospitalized for 6 days, all examinations were normal and she was ready to be discharged the next day. After the doctor on duty came off the stage for emergency surgery that day, he saw the patient getting up at night to go to the bathroom. Everything was normal."

"But less than an hour later, the nurse took over the shift late at night and found that the patient was incontinent and did not respond to calls."

"!!!" Ji Xiang was stunned.

"It's already too late to call the doctor over at this time." The system NPC sighed, "The probability of the carotid artery intima being torn off is one in 50,000, causing a large number of emboli in the blood vessels of the patient's head, and eventually blocking the brain stem, so Died 19 days later.”

"!!!"

"These two cases are somewhat similar." The system NPC brought the topic back, "You are right to think that if the doctor is high-level, it can be prevented early, but that requires a doctor of my level."

Having said this, the system NPC paused.

"The probability is one in 50,000. How many similar patients do you think there are in the country?"

Ji Xiang no longer paid attention to the words of the system NPC "Versailles". He frowned and asked, "Teacher, if it is discovered early, is there any way to treat it?"

"That's something you only think about after your urology skill reaches level 9." The system NPC said, "Now let me ask you, do you know the secret of the focus of the director of urology?"

The reason why he did not pay attention to patients with partial nephrectomy, which is extremely difficult and has many postoperative complications, but specifically asked to pay attention to a patient with renal contusion, appeared in front of Ji Xiang.

He knew that the director of the Department of Urology would definitely not pay attention to all renal contusions. Instead, he vaguely guessed that this patient might have a problem based on his difficult clinical experience. He needed to observe more and communicate with the patient and the patient's family to avoid accidents.

This is full of clinical experience.

Ji Xiang did not nod, but began to ask the system NPC some questions that he did not understand yet.
Chapter completed!