Chapter 2157 Good Intentions to Do Bad Things (Leader Deadwood VIP Plus 1)

"Does menstruation affect pneumothorax? Or is pneumothorax related to menstruation?" Su Yun looked at Zheng Ren suspiciously.

Zheng Ren was also in a daze.

There is such a saying about menstrual pneumothorax, but most of them are related to endometriosis. But if it's endometriosis...

Zheng Ren froze for a moment, could it be menstrual pneumothorax? !

This disease is so rare that Zheng Ren didn't think about it at all.

"Boss, if it's endometriosis, the pneumothorax will be on the right side, and menstrual attacks will occur, but...Old Shao, the patient has had 7 surgeries, how many times have they been performed on the left and right sides?" Su Yun asked.

"4 times on the left side and 3 times on the right side." Shao Jinghe replied immediately.

"That shouldn't be the case." Su Yun frowned and said in a low voice.

He didn't know what to do, subconsciously, he couldn't say for sure that it was a spontaneous pneumothorax caused by endometriosis.

Zheng Ren stood up abruptly, went to the viewer again, and looked at the video.

Shao Jinghe was dumbfounded, he looked at Fang Lin with blank eyes, at a loss.

Fang Lin has never encountered this kind of disease. Although he knows about menstrual pneumothorax, he can't even take the exam.

If any examiner asks a question to test this, it is estimated that he will be hit with a pneumothorax.

"The endometrium migrates to the pleura and the surface of the lungs, and sheds when menstruation comes. Because the pleura is very thin, it is prone to damage, causing air to enter the pleural cavity from the lungs, forming a pneumothorax, and symptoms," Zheng Ren said. , while thinking.

It seems to be talking to himself, and it seems to be talking to a certain existence in the dark.

"The diaphragm is fine."

"Well, it might be a problem with the diaphragm." Zheng Ren looked at the film, "Generally, pneumothorax during menstruation is accompanied by diaphragm damage..."

After finishing speaking, he rested his chin and asked, "Old Shao, if I understand correctly, you just said that every time a patient suffers from a pneumothorax is a menstrual period, and then the menstrual period is still very long and the amount is relatively large. Is that right?" .”

Shao Jinghe nodded again and again.

Although he didn't know what this boss Xiao Zheng was thinking at all, he could still answer the most basic questions.

"Uh..." Fang Lin didn't watch the film, but looked at Boss Zheng, a little speechless.

"Diagnosis of menstrual pneumothorax." Zheng Ren said with certainty, "There are four diagnostic criteria."

"..." Fang Lin looked at Boss Zheng in astonishment. Could it be that he misheard what he just said?

"First, spontaneous rupture of bullae."

"Secondly, uneven uterine contractions during the menstrual period cause gas to enter the uterine cavity and enter the abdominal cavity through the fallopian tubes. At this time, the ectopic endometrium that occludes the micropores of the diaphragm falls off, the passage of the diaphragm opens, and the gas enters the chest cavity to cause the disease."

"Third, ectopic endometrial shedding on the visceral pleura leads to air leak in the lung."

"Fourth, prostaglandin-induced bronchiolar constriction or alveolar rupture by a one-way valve mechanism due to bronchiolar endometriosis."

Zheng Ren started to talk one, two, three, four, five again, not only Shao Jinghe, but even Fang Lin was confused.

"There is endometriosis, and the diagnosis is menstrual pneumothorax, which meets criteria 1 and 3." Zheng Ren said.

"But..." Shao Jinghe wanted to say something, but he didn't say it in the end.

"There is a problem with the diaphragm." Su Yun added, "It's a small gap, and only when the abdominal pressure increases will there be a small gap, causing the endometrium to reappear."

"again……"

"Going further, it falls directly on the lungs. Finally, it erodes and breaks the visceral pleura during the menstrual period, resulting in continuous spontaneous pneumothorax."

"Yes." Zheng Ren nodded, "Old Shao, did you observe the diaphragm during the operation?"

"without……"

Shao Jinghe was in a daze, undergoing pneumothorax surgery, whoever observes the diaphragm for nothing.

"Well, during the operation, single-chamber ventilation is used. Carefully find the position of the diaphragm, and there may be a small tear. Forget it, it is better to pressurize through the laparoscope. When the pressure is high, the gas can be seen entering the chest cavity."

"Boss Zheng, Brother Yun, let's go up and have a look together?" Fang Lin was uncertain.

"It's as if you don't have second-line professors." Su Yun spouted casually.

That being said, it is absolutely impossible for him not to appear on stage. Such a rare menstrual pneumothorax, if you don't go up and take a look, Su Yun will have to fight Fang Lin desperately.

There is no problem with the patient's fasting time, and the surgery is on the bill. There was still half an hour of preparation time before the operation, so Zheng Ren and Su Yun went directly to the operating room.

"Boss, it is said that the muscles of the diaphragm are very developed, and there are very few problems. Is it a congenital problem?" Su Yun asked.

"It's possible, just go up and have a look." Zheng Ren said, "Repair the diaphragm, and take chorion-releasing hormone treatment after the operation. It should be cured soon."

Su Yun suddenly remembered something. He looked at Shao Jinghe and asked, "Did all the pathology after the previous surgery be done?"

"..."

In a word, Shao Jinghe was dumbfounded.

It is said that all the excised things should be sent for pathological examination, for example, the appendix may have malignant transformation in 1-2 out of 1,000.

Because the cycle of pathological diagnosis is long and the cost is too expensive for some families, many people refuse to do pathological examination.

Doctors, especially those in lower-level hospitals, rarely force patients to undergo pathological examinations. The patients who came to 912 did not talk about it with their families at all. It is only natural to have a pathological examination after surgery.

This is a difference between small local hospitals and the top tertiary hospitals in the imperial capital.

This patient had a spontaneous pneumothorax, the diagnosis was clear, and there were basically no problems with the bullae cut out during the operation.

At least Su Yun has never seen it.

It is estimated that Shao Jing and Dr. Shao also thought about it in the same way. Judging from his appearance, he should not have undergone a pathological examination.

Sure enough, Shao Jinghe said embarrassingly, "I didn't do it."

"Old Shao, your work is too careless." Su Yun said contemptuously, "If you do it once, even if it is only once, this will never happen. You..."

"Brother Yun, that's not the case." Shao Jinghe was about to cry, and quickly said: "The patient's family is not very rich, and I didn't dare to use titanium clips during the operation. They were all stitched by hand. The return of the pathology is also a— —I don’t think it’s meaningful if it matches the changes of bullae.”

Zheng Ren sighed and shook his head slightly.

That's it for the inspection, it's unlikely that something went wrong. But once there is a problem, such as the current situation, it may cause misdiagnosis and missed diagnosis.

This is the standard good intentions to do bad things.

But having said that, even if Shao Jinghe did a pathological examination and the specimens were sent to the pathology department, the doctor there would probably go crazy.

The pathological examination of the bullae conformed to the endometrium under the microscope, and no one in the local hospital dared to diagnose it.

At that time, I will take the pathological slides to the higher-level hospital for a diagnosis, and it will still be a toss.

It is already very good for grass-roots hospitals to correctly diagnose and treat common diseases.

As for rare diseases, there is not a single case in ten or twenty years, even if you have learned a dragon-slaying stunt, it is useless.

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