Chapter 571 Young Man

Yang Ping and Song Zimo could only drink apple cider vinegar, and the two brothers drank vinegar to the point of wine.

"Cheers!"

"Cheers"

Gulp another cup.

Those who don't know the truth must think that this is the heroic spirit at the wine table.

Xu Zhiliang fell after three cups, but his drinking spirit is admirable.

Zhang Lin always says "No more, last cup!", but he never falls, as if he is just one cup away.

Xiaowu's face is not red, his heart is not beating, as if he just started.

Liang Pangzi's performance is not very stable, but he performed well today.

The new anesthesiologist, Dr. Wei, seems a bit out of place. He sits next to him, submissive and very restrained.

Dr. Wei is a scalper type of person, who only works and doesn't like to talk.

They drank two dozen beers.

Zhang Lin leaned back on the chair to rest, and when the phone rang, his wife checked on him, and he woke up immediately.

"Have one or two cups, just for the sake of showing it, with Professor Yang. Don't worry, I haven't finished both cups yet, there's still half left, okay." Teacher Zhang was extremely gentle, her waist was bent almost to the ground, but she couldn't help but snort.

The fat man here called the waiter and shouted without knowing the situation: Another dozen.

Zhang Lin quickly covered his phone.

The fat man squinted his eyes: "Look at your bear-like appearance, you are so afraid of your wife, I will teach my wife to obey you in the future."

The fat man touched the cup: "Fill it up."

But he found that the cup had disappeared long ago, the cup, the cup.

There are relatively few opportunities to drink so freely, and usually everyone eats just enough.

But today is different, the clinical trial of the spinal external fixator was successful, which is a big event in the department.

In addition to the new doctor Wei, other people participated a lot. Song Zimo and Xu Zhiliang are the backbones, Zhang Lin is responsible for collecting patient data after admission, Xiaowu is responsible for communicating with patients and follow-up after discharge.

Everyone has contributed to this success, so everyone is very happy.

There is another reason. Fatty was heartbroken and depressed all day, so his brothers went crazy with him to vent their negative emotions.

After dinner, everyone dispersed.

Xiaowu and Zhang Lin accompanied Fatty to walk around the hospital. They decided not to go home, but to sleep in the department and play a few games.

Yang Ping and Xiao Su took a walk around the hospital. The two families urged them to get married, and they had to discuss marriage.

Parents are always like this, urging you to find a partner, then get married, and then encourage you to have children.

Yang Ping and Xiao Su were not in a hurry. Xiao Su knew that Yang Ping was busy with a new project now, so marriage could be delayed.

But people are in the rivers and lakes, and they can't help themselves.

——

In the morning, the weather was very good.

Yang Ping crossed the overpass and rushed to the hospital to work. Today is Saturday, and he will give a live lecture at the forum at nine o'clock.

The "iron triangle" drank a little too much last night and was still washing in the duty room. Everyone had panda eyes. They must have played games very late last night.

Song Zimo and Xu Zhiliang arrived very early. They were preparing for the nine o'clock lecture.

The location is set up in the demonstration room, where there is a camera facing the podium, and lectures can be broadcast live.

People gradually arrived at the doctor's office. These graduate students, regular trainees and interns all came to listen to the lecture.

Usually, the three steps of handover, ward rounds and surgery are performed.

But today is Saturday, and there is no big handover. Only the doctors and nurses on duty will hand over the shift privately.

No surgery was scheduled, and each doctor in charge of the bed will check his own patients individually.

Yang Ping asked the doctor on duty if there were any special new patients. The doctor on duty said that a patient was admitted to the general surgery clinic in the afternoon.

Li Jun, male, 26 years old, had a bulging abdomen for three months.

Physical examination can touch the lower abdominal mass, which is solid, with clear boundaries, mild tenderness, moderate ascites, sensory disturbance of the perineum and perianal skin, and disappearance of anal reflexes.

Auxiliary examinations include color Doppler ultrasound and MRI.

"Take a look at the film!"

Yang Ping said.

Magnetic resonance imaging and color Doppler ultrasound are performed in the outpatient clinic. Generally, the pictures are printed on the screen first for everyone to analyze. This is not only to familiarize with the information of the new patients, but also to cultivate the doctor's independent thinking ability.

After a simple analysis, the results of the imaging examination were printed out.

In fact, experienced clinicians have a higher ability to interpret X-rays, CT and MRI images than radiologists, because they can often combine images with surgical findings.

Junior doctors rely heavily on the diagnosis of radiologists.

However, color ultrasound is an exception. Most surgeons do not have the ability to interpret color ultrasound and can only rely on reports. Moreover, the images on the color ultrasound report are only symbolic, unlike X-rays, which can be interpreted directly.

"A mass in the abdomen? Is it a mass? I can clearly see the teeth and spine, as well as other bones."

"Is it written wrong in the medical record? Is it a female?"

"Fetus?"

Everyone's first reaction was, how could there be a spine except for a fetus?

Some people questioned that he had made a mistake in gender, which made the doctor on duty anxious. He defended his reputation: "I did a detailed physical examination and it was a male."

The hidden meaning is that those who suspect that I wrote the wrong medical record should shut up and stop fanning the flames.

At this time, more and more people gathered around the electronic reading screen. Song Zimo, Xu Zhiliang, Zhang Lin, Xiaowu and Fatty also finished washing up and had breakfast.

Drinking is still not good. After a night, after washing up, Yang Ping could still smell their alcohol.

Fortunately, it was Saturday and everyone was resting, so it didn't matter much.

"Zoom in, is that the spine?"

"Why does it look a bit like a spine?"

"Do you have a CT scan?"

"No, I asked the director of the admissions department of the general surgery department and he didn't dare to do CT." The doctor on duty is more serious and deserves praise.

In this way, the general surgeon at that time was afraid that this was really a fetus, so he did not dare to do CT and chose MRI.

NMR does not have ionizing radiation, while CT has relatively large ionizing radiation.

Everyone discussed it for a long time, but the doctor on duty acted like he was lying and refused to release the diagnosis.

The main thing that troubles everyone is the vertebra. Among all the tumors in our minds, there is no vertebrae.

Even teratomas are mostly teeth, hair, nerves, bone, fat, etc.

I have never seen or heard of such an obvious spine.

Everyone is anxious, afraid that Professor Yang will ask questions later, and they hate the doctor on duty. He won't give you a diagnosis even if he can't beat you to death.

The doctor on duty slowly announced the patient's diagnosis: pelvic teratoma combined with sacral nerve damage.

Yang Ping narrowed his eyes slightly and looked at the images on the screen.

Teratomas with teeth, hair, and irregular bone fragments are more common, but those with a spine in them are indeed rare.

It’s better to see the patients first, clinicians, and have personal contact with patients. This is a necessary principle.

It was only around seven o'clock when Yang Ping decided to go see the patient.

The patient's complexion was very dark, and he felt like he was suffering from a chronic disease.

Accompanying the bedside was a sunny boy, tall and tall, wearing a fashionable T-shirt, with some strange tattoos on his arms, and tape wrapped around his fingers.

After Yang Ping asked about the medical history, there was no obvious discrepancy with what was recorded in the medical records.

The patient had always felt a bulging feeling in his lower abdomen, but he didn't pay attention to it. Three months ago, his lower abdomen began to bulge slightly. At that time, he thought he had a belly due to lack of exercise.

Until their belly got bigger and bigger, they went to the local hospital for a color ultrasound. They felt that the local hospital was not good enough, so they went across the province to seek medical treatment at Nandu Sanbo Hospital.

"Who are you to him?"

Yang Ping asked the sunshine boy.

"I'm his cousin, is it serious?"

The sunshine boy replied.

"I'll talk to you in detail later."

Yang Ping felt that he should have a good talk with them. The tumor was compressing the sacral nerves and growing into the sacral foramen and the sacral canal. It would be difficult to completely remove it.

Moreover, the physical examination showed that the anus area had sensory impairment and the bowel movements were somewhat uncontrollable.

"Did the outpatient doctor explain the treatment plan to you at that time?"

The patient Li Jun remained silent. Sunshine Boy helped to answer: "I didn't explain anything. I just said that I was considering teratoma and wanted to go to your department for surgery. He also said that this teratoma is a bit strange. How come there is still a well-developed spine?" Never seen this type of teratoma."

"It's indeed a bit complicated. Close the door and I want to check it for you." Yang Ping took the gloves from Song Zimo.

Although the door is closed, there is a large circle of trainees and interns surrounding it, all of them are eager to learn. There is no way, this is a teaching hospital, and some special or classic cases are easy to be watched by interns.

Even boys are a little embarrassed.

"It's okay, we are a teaching hospital, this is normal."

It is also true that while enjoying the superb medical technology of a teaching hospital, it is a teaching hospital and must be mentally prepared to be watched. If there are no cases for interns to observe, these interns will never be able to grow.

"it's okay no problem!"

Sunny Boy comforts the patient.

Yang Ping checked the skin sensation one dermatome after another and found that the physical examination by the doctor on duty was very accurate. The skin sensation in the perineum and perianal area was impaired, and the anal reflex could not be elicited.

"Do you have any problems with defecation or defecation?"

"Often without knowing it, stool and urine come out."

So he wears a diaper.

That is to say, the sacral nerve root has been severely compressed.

"I'll discuss the condition with you alone later!"

It is true that the condition is a bit complicated. Even if the tumor is removed, the nerves may not be restored after the operation. The perineal and perianal skin will be numb, like a piece of dead skin, and there will also be incontinence, with stool and urine flowing out unknowingly.

This is an obvious sign of fecal incontinence.