Chapter 1198: Chapter 935: Trouble Caused by a Fishbone_2 Chapter 1198: Chapter 935: Trouble Caused by a Fishbone_2 In this second-tier hospital, which is not very prominent, the dean picked up a treasure, imdiately entrusting Director Zhuo with establishing an independent Orthopedics departnt, with all resources being diverted to Director Zhuo’s direction. Originally, the hospital did not have an Orthopedics departnt, only a general surgery departnt and another surgical departnt, and there were only a few orthopedic patients.
Starting from nothing, Director Zhuo built the hospital’s Orthopedics departnt up to 120 beds, while Wu Siwen of the City People’s Hospital didn’t idle either, he successfully downsized the Orthopedics departnt from 120 beds to 60, and even then, those 60 beds were often not full, with the actual number of patients usually only being thirty-four.
The doctors at the City People’s Hospital with high professional titles did not include a single doctoral degree holder, and the few masters degrees they had were also part-ti. In contrast, Director Zhuo’s Orthopedics departnt brought in several doctors with doctoral and master’s degrees, greatly exceeding the dical team level of the City People’s Hospital.
The two hospitals were on the sa street, and it was quite unusual in the industry for the City People’s Hospital, a top-tier hospital, to be firmly outperford by a second-tier hospital.
Eventually, Wu Siwen and Dean Xie were both gone, and with Dean Chen taking office, he invited Director Zhuo to join the City People’s Hospital, considering that a second-tier hospital had limited scope after all.
The terms offered to Director Zhuo by Dean Chen were to be the head of Orthopedics and deputy dean, but Director Zhuo’s condition was that there would be no problem with him joining, as long as the City People’s Hospital ford a dical alliance with his second-tier hospital.
For the sake of Director Zhuo, Dean Chen agreed to the requirent, establishing a dical alliance between the City People’s Hospital and this second-tier hospital, with Director Zhuo serving as the Departnt Director for both.
Director Zhuo had a great respect for Yang Ping; he was just forty years old, in the pri of life, and he was very willing to cooperate with Yang Ping’s partnership. He knew how skilled Yang Ping was and was eager to learn from him; with such an opportunity now at hand, how could he not be pleased?
With Director Zhuo’s introduction, Yang Ping got a detailed understanding of the current situation of the Orthopedics departnt at the City People’s Hospital.
Yang Ping and Director Zhuo perford a spinal scoliosis surgery using the Yang-style osteotomy; Director Zhuo himself had also perford spinal scoliosis surgeries, so learning it was quite easy. After assisting in several surgeries and having so explanations, he should be able to master the technique fairly well.
In addition to teaching scoliosis surgery, Yang Ping personally showed him how to perform vertebral tumor surgeries and cervical surgeries, which are relatively difficult in Orthopedics. Especially Yang Ping’s new surgical techniques, if not taught in person by Yang Ping, Director Zhuo would take much longer to figure them out on his own. Director Zhuo was very grateful for Yang Ping’s selfless assistance.
Right after finishing a surgery, Yang Ping was in the changing room preparing to change clothes and leave, when he received a call from Dean Chen, ntioning that there was a difficulty in a surgery in the Thoracic Surgery Departnt Operating Room, and hoping Yang Ping could take a look. Dean Chen knew that Yang Ping at Sanbo Hospital now had the authority to perform any type of surgery and was considered an all-around surgical expert.
A Thoracic Surgery procedure? It must be a heart surgery. If there were real problems on the operating table, it would be a matter of life and death. Yang Ping dared not delay and went to check it out with Director Zhuo accompanying him.
Yang Ping was quite familiar with the Operating Rooms of the City People’s Hospital, and quickly, they arrived at the Thoracic Surgery Departnt Operating Room. The Departnt Director was Director Zhou Zhao, who was also a new appointnt by Dean Chen; after taking office, Chen replaced all previous departnt directors with young and promising doctors holding doctoral and master’s degrees.
Director Zhou Zhao, roughly the sa age as Director Zhuo, had not perford any significant surgeries over the years due to staying in the hospital, but being the only doctor with a doctoral degree in thoracic surgery, he was promoted by Dean Chen as the best of the short bunch.
“Professor Yang!”
Director Zhou’s forehead was sweaty, clearly from perspiration.
“What’s the situation?”
Yang Ping and Director Zhuo moved in to take a look.
Director Zhou stopped the surgery to personally explain the patient’s condition to Yang Ping, “A fish bone at the sternum location has penetrated the esophagus into the aorta, creating an aortoesophageal fistula; it’s clear on the CT scan, but after opening the chest, we can’t find the fish bone; it’s gone.”
Director Zhou summarized the dical history, presenting the most crucial information.
Yang Ping had thought it was so kind of heart surgery, but it turned out to be a procedure to remove a fish bone; he imdiately went to the light box to review the CT scan while Director Zhuo brought him the dical files.
A fish bone entering the aorta is extrely dangerous and can easily lead to major bleeding. But now, not finding the fish bone after opening the chest ans that despite such a major surgery, the problem wasn’t completely resolved, and the patient and family mbers were surely not understanding, making the situation quite troubleso.
Sotis a small fish bone can be quite difficult to handle.
“Can you see the fistula on the aorta and esophagus?” Yang Ping asked.
Director Zhou replied, “The fistula is visible. Should I first repair the fistula on the esophagus and aorta and leave the fish bone aside for now?”
Since they couldn’t find it, there was nothing they could do; they couldn’t let the patient lie on the operating table indefinitely.
Yang Ping could indeed see a fish bone from the CT images, about two centiters long, slantingly embedded in the esophagus and aorta. The position was clear on the CT scan images, located right behind the sternum.
The fistula was found, but the fish bone had disappeared, indicating that it had moved. Displacent of fish bones and foreign bodies is very common. After a CT scan, movents such as handling and breathing can all cause the fish bone to shift.
If the fish bone moved within a local area, it wouldn’t be too difficult, but what they feared was the fish bone entering the aorta and then moving with the blood circulation. Such movent over a long distance was incredibly difficult to pinpoint.
In the operating room, there was an X-ray C-arm machine, typically used by orthopedics. Other departnts like urological surgery also frequently use it for procedures such as removing urinary stones. The Thoracic Surgery Departnt rarely used the X-ray C-arm machine; it was probably brought in temporarily from the Orthopedics Operating Room for assistance, yet even with the C-arm machine, they couldn’t locate the fish bone.
At this ti, it was difficult to proceed without getting on the operating table. Yang Ping reviewed the dical record: the patient, 52 years old, had accidentally swallowed a fish bone at a dinner party 10 days prior. By swallowing rice balls, he had managed to push down the fish bone. As he felt no foreign object sensation afterwards, he thought he was fine. However, five days later, he began to experience vague pain behind his chest. He went to the City People’s Hospital thinking it was angina and underwent several cardiovascular tests, but there was no evidence of myocardial ischemia or infarction.
When the patient ntioned to the doctors about swallowing a fish bone a few days earlier, the doctors imdiately considered the possibility that the fish bone might be stuck in the esophagus. An ergency chest CT scan was done and indeed revealed a thin fish bone; it wasn’t just stuck in the esophagus, but had penetrated it and entered the aorta behind, aning it had skewered from the esophagus into the aorta—a very dangerous situation. If the aorta had torn, there would have been severe bleeding, threatening the patient’s life.
The doctors suggested that the patient undergo an ergency thoracotomy to remove the fish bone. This procedure had to be done through an open chest surgery; using an esophagoscope was not advisable as it could worsen the damage to the esophagus and aorta. Moreover, if pulling out the fish bone caused a massive hemorrhage in the aorta, there wouldn’t be enough ti to open the chest, and repairs to the esophagus and aorta couldn’t be done under esophagoscopy.
For a single fish bone, a major surgery like a thoracotomy was required; the patient and the family didn’t quite understand but reluctantly agreed after listening to the doctors’ analysis. Now the patient was lying on the operating table with his chest opened, but the fish bone couldn’t be found. What were they to do?
As Director Zhou was anxiously contemplating, Yang Ping had already decided to step in, “How about I get on the operating table and help you take a look?”
“Then I shall have to trouble Professor Yang!”
Director Zhou was profoundly grateful. Professor Yang was the VIP Dean Chen had invited to help enhance the dical standards at the People’s Hospital. Improving dical standards encompassed many aspects, including training talents, leading surgeries, and handling so tough challenges.
A doctor imdiately took Yang Ping to wash his hands, and he scrubbed in for surgery.
He carefully examined the esophagus and aorta’s fistula, and in combination with the CT images of the fish bone, it was very likely that the bone had entered the aorta and moved away with the blood circulation.
Yet Yang Ping still conducted a ticulous search around the center of the fistulas and did not find the fish bone.
“I’m afraid it has entered the aorta and moved away with the blood flow; we need to track it step by step along the direction of the blood circulation,” Yang Ping deduced.
Director Zhou imdiately felt overwheld. If this were the case, where could they possibly look? The aorta had nurous branches, and the fish bone could have gone to any organ.
Even with a great effort to locate it, it could have moved again by then, and in the process of cutting up the blood vessels, they might end up finding nothing at all.
This one fish bone was causing such an ordeal, sothing Director Zhou was encountering for the very first ti.
The other doctors and nurses, thinking of all the fish they had eaten over the years, felt an almost miraculous sense of relief from disaster.
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