A family member kicked when he raised his foot, and the obstetrician reacted quickly and dodged sideways, but the hand holding the flat car had to be released.

"As long as I've been here, you'll be responsible if something happens!" said the old lady with a shrill finger pointing at the obstetrician's nose, "You're shirking your responsibility!

"......" Zheng Ren was speechless.

"Don't send it away, it's still too late to disembowel. The time you are talking about is not good at all!" The obstetrician did not struggle with the old lady and tried to grab the flat car, but was pushed away by another person.

Seeing the elevator arrive, the flat car was pushed into the elevator, and the hustle and bustle at the door of the operating room gradually quieted down.

But that's just the beginning.

Seeing that the dissuasion was ineffective, the obstetrician immediately called the director and the medical office, and while explaining the situation, he hurriedly went downstairs to change clothes.

Yes, this is just the beginning. More troublesome things are yet to come.

The obstetrician and Zheng Ren walked face to face, Zheng Ren dodged a way, watching her leave in a hurry, very helpless.

If you don't believe the statement of a large tertiary hospital, you have to go to a private hospital or an underground black clinic to deliver the baby. The child has already developed symptoms of unstable fetal heartbeat and will have to wait a few hours for it to regenerate......

It sounds ridiculous, but it's the truth.

Zheng Ren shook his head, there are some things that cannot be solved with medical technology and high level.

However, Zheng Ren has a force in his heart, this kind of thing is definitely not something that he can solve by himself, he can only look at it.

He found the second-hand that Su Yun said, opened the closed door, and walked in.

"Boss, what's going on outside?" Su Yun stood in the assistant's position, and a very old advanced doctor was pushed aside by him.

"What's the situation with the pericardium?" Zheng Ren didn't answer Su Yun's words, but asked rhetorically.

"Gas-liquid pericardium, rare. Su Yun said with a smile.

Zheng Ren's heart moved, is the gas and liquid pericardium, why didn't the system diagnose it?

He glanced at the patient, and the last item in the system panel was the diagnosis of the gas-liquid pericardium.

This is......

The patient is so lucky!, Zheng Ren thought.

Pericardial effusion is common, but traumatic conditions are dangerous. Zheng Ren has encountered it a few times in Haicheng, and he wants to open his chest in an emergency and dissect his heart bag to relieve pressure under direct vision.

Pneumopericardium, on the other hand, is uncommon. Traumatic pneumothorax with pericardial rupture without damage to the large vessels is a plausible source of pneumopericardium.

Then there is the side injury caused by anesthesia intubation and mechanical ventilation.

Zheng Ren knew that when he was in the emergency department, there was no diagnosis of gas-liquid pericardium in the system panel, but there was one on the operating table, which may be caused by mechanical ventilation.

"Did you do it?" asked Jung-in.

"In the diaphragm, the tension is particularly high. ”

"Boss Zheng, here. Fang Lin put down the needle holder in his hand and looked back and smiled.

Zheng Ren didn't speak to Fang Lin, he leaned over and glanced at the operation area.

The diaphragm atrophy is more obvious, and my previous judgment is still very accurate.

The right diaphragm has been sutured with the help of a patch, and judging by the tension, there should be no problem.

Fang Lin's surgery is still good, and the total hospitalization level of 912 is a little higher than that of the director of Haicheng First Hospital.

"Explore the alveoli, mediastinum, pericardium. Zheng Ren said in a deep voice.

"The alveoli in the lower lobe of the right lung closed during the second thoracotomy. Su Yun said.

"Look it up, or there is no way to explain it if you have pericardial gas. Zheng Rendao.

Su Yun touched the pericardium with hemostatic forceps, hesitated for a moment, and said, "The pressure on the pericardium is greater than just now." ”

As he spoke, he didn't hesitate, picked up the knife, and cut directly through the pericardium.

If this happens off-stage or during transport, the patient is exposed to extremely dangerous conditions. But on the operating table, a pericardial incision and decompression could not be simpler.

Fang Lin didn't say anything to Zheng Ren, and began to do pericardial fenestration, and the reduced pericardium was sent for pathological examination, and a part of the pericardial effusion was extracted with a syringe and sent for relevant examinations.

The amount of pericardial effusion is about 700L, and the color is clear, which excludes the possibility of bloody pericardial effusion.

Normally, it's time to flush the ribcage and the surgery is coming to an end.

However, when the chest cavity was flushed, a small amount of gas was found to have escaped.

Fang Lin and Su Yun searched for a while on the stage, and finally found a problem in the mediastinum.

A small sinus tract is formed between the trachea and the pericardium, and strangely enough, there is also a passage leading to the thoracic cavity.

The patient had a small amount of pneumothorax during transport, which can be explained by this. Because the patient is weak and has insufficient lung ventilation, there is no large amount of air-fluid pericardium.

However, during anesthesia, with mechanical ventilation, the patient's ventilation volume increases, and a part of the gas enters the pericardial cavity, forming a gas-liquid pericardium.

There is nothing special about the condition, at least it seems that this is the case for Zheng Ren. But this patient ...... One operation after another, as if facing the Grim Reaper who disappeared in the coming of death.

Such a complex hernia finally led to the appearance of a gas-liquid pericardium, and Zheng Ren said that it was the first time he had seen it.

Even in the vast number of medical journals and papers, there is no mention of related cases.

However, it is good to find the problem, and the next operation is not difficult, but it is to remove the sinus tract and eliminate hidden dangers.

"Boss Zheng, this patient's life is really big. Repeatedly flushed the chest cavity, found no problem, and when he was about to close his chest, Fang Lin sighed with emotion.

"It's okay, hurry up and close your chest. Su Yun clamped the ribs on both sides with the closure, and began to tighten the screws to close the closure.

Sutures are the most basic, but Su Yun seems to have not had chest surgery for a long time, and he won't let go of this opportunity for surgery. The person studying next to him looked helpless, but he couldn't say anything yet.

Fortunately, there are a lot of 912 surgeries, and if you want to do them, there is always no shortage of surgeries.

The biggest problem with coming here is that the body can't keep up. If every operation is done, all events can be on the operating table except for eating and sleeping.

Eliminate hidden dangers, and the atmosphere is relaxed. There was talk and laughter, and the anesthesiologist told Su Yun and Fang Lin about the mothers who had just given birth.

Everyone unanimously judged that there was a high probability that something would happen. This kind of thing, one corpse and two lives, that obstetrician will be in big trouble.

"When I was an intern, I met a family member who told the doctor that if it was a girl, the right fallopian tube of the mother would be ligated by the way. Su Yun sneered.

"Uh...... Why?" Zheng Ren paused for a moment.

Is the fallopian tube on one side closed when it is closed?

"Because men are left, women are right. Su Yun said: "If you close the right fallopian tube, you will be able to give birth to a boy next time." ”

"......" Zheng Ren was speechless.

Although I have been clinical for so many years, when I encounter similar patients and cases, I still have a very ridiculous idea.

……

……

Diaphragmatic hernia complicated by air-fluid pericardium, mentioned in a case report in New England magazine, is a patient in Argentina.