Chapter 1115: Surgical Perspective on How to View
He doesn’t talk much, and isn’t very good at it, but when he really needs to speak, each word he says definitely carries weight.
Fang Xueqing looked up to et Song Xueling’s earnest gaze in his brown eyes and unconsciously nodded.
The dical record was opened, and a few doctors gathered their heads around it, studying it.
The patients’ families outside were almost too impatient, demanding an explanation today.
“It’s a patient with a massive gastrointestinal hemorrhage,” Fang Xueqing pointed out a few key points on the dical record to two young doctors, “who arrived at our hospital’s ergency room three days ago during the day, with the main symptoms being hematesis and a large amount of bleeding. Hemostasis was achieved through a tri-lun dual-balloon tube compression, and after a blood transfusion, the condition sowhat stabilized. The ergency CT scan showed bleeding esophageal gastric varices and liver cirrhosis; portal hypertension was inevitable.”
“Due to lack of beds in the surgery departnt and the patient’s condition being sowhat stable with the patient’s family’s consent, he was first transferred to our internal dicine departnt for treatnt,” Dr. Ma continued, “Director Zhang perford endoscopic treatnt for esophageal gastric varices in our internal dicine unit the day before yesterday, injecting sclerotherapy agents and performing banding. Later, last night the patient suddenly beca very restless for unknown reasons. Vital signs were relatively stable, there was no rebleeding, consciousness was not lost, and examinations such as pupil reflex were all normal. The family was very anxious, constantly hoping to transfer to surgery for further surgical treatnt.”
Hearing Dr. Ma say this, it seems it is initially possible to rule out acute cerebral hemorrhage and cerebral embolism as causes of restlessness? There were also no signs of re-bleeding. Indeed, the patient’s manifestation of restlessness at this mont is sowhat perplexing.
Fang Xueqing tapped her finger on the dical record, feeling the patient’s unusual reaction was beyond her experience as a professor, temporarily baffling her. Turning her head, she asked Song Xueling, “Doctor Song, what do you think? Can this patient be transferred to surgery for an operation?”
Endoscopic treatnt completed the ergency hemostasis; if further radical treatnt is necessary, shunting procedures can be perford, including traditional surgery in the surgical departnt, or TIPS transjugular intrahepatic portosystemic shunting procedure, an interventional surgery.
Therefore, after a consultation by the surgical departnt, it was suggested that a radical surgery could be scheduled, asking the patient to wait as there was no indication for ergency surgery at the mont.
“Let Dr. Xie speak first,” said Song Xueling.
Insisting on having this female dical student speak first, what was Song Xueling thinking? Perplexed, Fang Xueqing could only look towards Xie Wanying and ask, “You aim to be a surgeon, how do you view this case from a surgical perspective?”
“Personally, I think the consultation report from the surgery departnt yesterday makes sense. The patient’s condition yesterday did not seem particularly urgent to require this esophageal gastric varices surgery,” said Xie Wanying, “Yes, the bleeding was controlled. Not only that, initially his hemoglobin was 97, which can only be considered mild anemia. I suspect the family exaggerated his condition by saying he vomited a significant amount of blood at ho. Because when he arrived at the ergency room, he was conscious, and the bleeding could not have been that significant. The endoscopic treatnt also did not experience significant bleeding.”
“What do you an?” Fang Xueqing and Dr. Ma picked up a deeper implication in her words.
Xie Wanying looked serious and said, “If the patient’s condition worsens, he may need to be transferred imdiately to surgery, and not just to general surgery, but to thoracic and cardiovascular surgery.”
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