After Tang Lou made preoperative preparations, he entered the operating room. As soon as he saw Tang Lou, Dr. Fei immediately gave up his position as the surgeon and asked for help with great respect: "Doctor Tang, you are finally here."

Tanglou nodded slightly and walked to the surgeon's position to observe the patient's condition.

Doctor Fei on the side also immediately cooperated and explained: "The patient has a typical great saphenous varicose vein. The main cause is his venous valve insufficiency, weak vein wall and venous return disorder caused by increased superficial vein pressure. In severe cases, reverse flow occurs."

flow."

"Moreover, the patient's occupation is a chef, which requires him to stand for long periods of time. In addition, obesity leads to increased abdominal pressure, which directly leads to increased intravenous blood pressure in the lower limbs."

After hearing Dr. Fei's explanation of the patient's condition, Tang Lou looked at the surface of the patient's lower limbs. It was indeed terrible to see.

The superficial veins of the patient's legs expanded tortuously like earthworms, and some venous stasis malnutrition, skin pigmentation, eczema, and venous ulcers even appeared locally.

Especially on the right leg, due to the slow blood flow in the lower limbs, the skin surface eventually bulges, the skin flakes fall off, and the pigment slowly accumulates, causing itching of the skin of the lower limbs, further causing edema of the lower limbs, and the skin has already ulcerated.

"So you performed a very routine high ligation and stripping of the great saphenous vein."

Tang Lou looked at the affected area and said.

"yes."

Dr. Fei was a little ashamed and confused. He clearly remembered that Director Wu had done this before, and he had done several of them. Why did he encounter a femoral artery injury today?

"Actually, I don't blame you for this surgery." Tang Lou looked at the wound and continued, "The first reason is that your surgical incision selection was inappropriate, the surgical field was not fully exposed, and the operating space was limited."

Hearing this, Dr. Fei was suddenly startled and glanced at Tanglou. He really thought that he was more familiar with the surgery this time, so he made the incision smaller and made it more difficult.

"Originally, this incision is not impossible, but you focused more on separating and dissecting the five branches. You happened to encounter that the patient's vein wall was weak and the patient was too obese. So after the vein ruptured during the operation, you blindly clamped

The clamp stopped the bleeding, which caused the artery to be damaged."

Tang Lou raised his head and glanced at Dr. Fei. The latter's pupils dilated, as if Tang Lou had seen through him.

He really wanted to show off in front of the interns. It was rare for him to perform an operation, so he pursued the ultimate dissection.

Who would have thought that he would be so unlucky to encounter a patient with weak vein walls and obesity, that he would be overturned.

"Alas, you will not live if you do it yourself."

Dr. Fei was filled with regret.

It had only been a few minutes since he came in. Tang Lou had deduced his entire surgical process just by observing the wounds and affected areas. Moreover, his analysis of the patient's condition was even better than his own, the surgeon who had studied for a long time before the surgery.

Go deep.

"Doctor Tang, you are so amazing."

Dr. Fei was filled with admiration, surprised and admired. Of course, his anxious heart also felt completely at ease.

"Then how to fix it next?"

Dr. Fei completely treated Tanglou as a superior doctor and asked for advice sincerely.

"If the defect is small, vascular sutures can be used to repair it in situ. After the operation, the femoral artery will be unobstructed and the pulse of the dorsalis pedis artery will be normal. It will be better and discharged after 10 days of hospitalization. But you did it a bit big this time. Look at the patient. The patient

The femoral artery was severely damaged and the defect area was large. It could only be repaired with an artificial blood vessel patch."

Tanglou analyzed it very professionally.

Hearing Tanglou's explanation, Dr. Fei had a cold sweat on his forehead. Although he had never done it, he knew how difficult it was to repair artificial blood vessel patches.

"Dr. Tang, how about we still perform artificial blood vessel replacement, which is too difficult..."

Dr. Fei was ashamed and sad. If Director Wu was here, he would definitely not be able to spare him. This was simply a medical accident. Fortunately, Dr. Tang came to the rescue, otherwise the patient would have had his limbs amputated or even died...

Doctor Fei was afraid for a while.

"It's okay, just patch it up, I can do it."

Tanglou did not use artificial blood vessel replacement, which is simpler but several times more expensive.

"Dr. Tang, thank you."

Dr. Fei, naturally knows that Dr. Tang is trying to minimize the consequences for himself. The difficulty of patch repair is several times that of artificial blood vessel replacement, but its advantages are also obvious. It has no side effects and is cheaper. After it is completed, it will be the same as without.

Happened generally.

...

...

In Director Shen Bingbing's office.

Mr. Mu put on a pair of reading glasses and read the information carefully. However, there seemed to be a light in his mind, but he couldn't catch it.

"What exactly is the disease?"

As he thought about it, Mr. Mu suddenly felt weak.

"Teacher, here you go, your favorite flavor."

Shen Bingbing peeled off a candy and handed it to Mr. Mu. The teacher had hypoglycemia, so whenever she went out with the teacher for meetings, consultations, ward rounds, etc., Shen Bingbing would always put a few candies in her pocket.

This habit has gradually become a habit of hers since she was an intern.

"Bingbing." Mr. Mu held the candy in his mouth and touched his hand with very gentle eyes, "In a blink of an eye, the little girl who used to follow me is now the deputy director."

"Yes, I was scolded by the teacher a lot at that time."

Shen Bingbing peeled off a candy herself and put it in her mouth. Looking at Mr. Mu's gray hair and dull eyesight, she couldn't help but sigh.

"Yes, how many times have we been in the duty room together, studying medical records night after night."

Mr. Mu also leaned back on his chair, sighed, and then continued to read.

"Hey! This page of information seems a little different. These sets of data..."

Mr. Mu looked at this piece of paper, and suddenly, the light in his mind became concrete.

"Bingbing, I think I have found the cause of the patient's illness. No wonder, no wonder!"

Mr. Mu bit the candy in his mouth into pieces in excitement.

"real!"

Shen Bingbing also looked at the teacher excitedly.

"Kawasaki Syndrome!"

Mr. Mu flattened the paper in his hand and slammed the table.

"Kawasaki Syndrome?"

As the deputy chief specialist of pediatric surgery, Shen Bingbing had certainly heard of this extremely rare disease, but she had only heard of it and had never encountered this disease herself.

Kawasaki disease is the leading cause of acquired heart disease in children. It may cause children to suffer from cardiac infarction or even sudden death. It is a very cunning disease that is very good at disguise.

In the history of world medicine, Kawasaki disease is also an opponent that is not easily defeated. Since Dr. Tomisaku Kawasaki of Japan discovered the disease more than 40 years ago, there has been no specific examination that can help doctors diagnose that the patient has Kawasaki disease.

You must rely on the symptoms to see if at least five diagnostic conditions are met. In addition, patients may not have every symptom, so misdiagnosis or delayed diagnosis will inevitably occur.

And Xiao Yunyun is really a type of atypical Kawasaki disease with less than five diagnostic conditions.

The symptoms of Kawasaki disease in the first few days are not obviously different from those of a common cold. At first, there is a high fever of 39 or 40 degrees, and then the eyes are red. After a few days, the skin becomes rash, the mouth is red, chapped, and the tongue is red and swollen.

, symptoms such as bulging taste buds and the appearance of small particles on the surface of strawberries appear one after another. Most doctors can diagnose it as Kawasaki disease.

However, about 70% of children with Kawasaki disease initially experience a cold-like cough and runny nose, and about 50% of children have mild diarrhea, with symptoms similar to viral infection. In particular, Kawasaki disease causes an inflammatory reaction throughout the body, which inevitably makes anxious children

Parents are in a hurry to seek medical treatment, and even doctors misdirect or delay diagnosis.

For example, some young patients are taken to see a dermatologist by their family members because of a red rash on their body (which is also a reaction to inflammation of the blood vessels in the skin), or they are taken to an otolaryngologist for a fever. Because the eardrums are red, they are considered to have otitis media, and because the urine test

It is found that the number of white blood cells is high, proteinuria is found, and it is regarded as a urinary tract infection, or someone has stomach pain, gallbladder edema, and abnormal liver function, it is regarded as gastroenteritis caused by a cold.

There are also some children who were not told that it might be Kawasaki disease until the fever subsided one or two weeks after the fever, and they were about to be discharged from the hospital or seemed to be getting better after returning home. However, the tips of their fingers and toes had small patches of peeling skin, and they sought medical attention again.

disease.

The most feared coronary artery disease in Kawasaki disease is not the most obvious change during fever, but after the fever subsides, about 7 to 10 days after the fever, it slowly attacks the heart, and reaches its peak about two weeks after the fever.

Obviously, Xiao Yunyun now falls into this kind of situation, where coronary artery disease reaches its peak about two weeks after having a fever!

While Mr. Mu and Shen Bingbing were diagnosing the condition, Tang Lou also came out of the orthopedic surgery room and came to Shen Bingbing's office.

As soon as he entered the door, Tanglou asked urgently: "Director Shen, has Xiao Yunyun started treatment? Has he been given gamma globulin and aspirin treatment in time?"

Hearing Tang Lou's words, Shen Bingbing and Mr. Mu were slightly startled, and then Mr. Mu immediately reacted: "Did you record this piece of paper with different handwriting? So, you already knew that the patient had Kawasaki syndrome.

?”

"What paper? I knew it was Kawasaki disease."

Shen Bingbing looked doubtfully at Mr. Mu and the piece of paper in her hand that recorded special data, and suddenly looked at the record book that she had forgotten in a corner.

At this time, there was a sound of running outside Director Shen's office door. It was Shen Bingbing's resident doctor. As soon as he entered the door, he panted and said: "Director Shen, it's not good. Xiao Yunyun's condition suddenly took a turn for the worse. He's going to die soon."

Already."

"What?"

Shen Bingbing stood up immediately.

After all, Mr. Mu has a lot of experience, and he immediately thought of a possibility: "Oops, the diagnosis is still an hour late. If treated in time, it may be possible to save it, but beyond the critical point, traditional treatment methods are no longer effective."

It worked.”
Chapter completed!