WHEN THE DOCTOR USES A HACK

Chapter 798: Chapter 798: Deadlocked!

The strength that erupts during a seizure is still quite considerable.

It took the combined effort of three or four people to finally get the elderly man under control!

Before long, the effects of the sedative also began to take hold.

The patient’s side quieted down.

However, this did not mean that he was safe.

Here, one of the doctors from Group Two was incessantly briefing on the patient’s condition.

“Patient, male, 72 years old, in the recovery phase after a major gastrectomy, cause of seizures unknown, with a history of hypertension, diabetes… oral medicine…”

Hearing the patient’s details, Hou Rong’s expression darkened.

The patient had a history of hypertension, but at this moment his blood pressure was only below 80mmHg, which meant it was difficult for such blood pressure to provide the blood supply that the patient needed.

The human body has a tolerance function for many situations.

Some people’s blood pressure can reach 170, 180 without feeling the slightest discomfort, while some people’s blood sugar can exceed 33.3 without showing any abnormalities.

This is because the body has already tolerated this abnormal environment.

So at this time, after the patient’s systolic pressure had dropped to only 80, he was already in shock!

Here, after stabilizing the patient’s condition, Hou Rong hurriedly transferred him to the operating room to complete the esophageal repair surgery in time, for at this moment, definitely, a large amount of blood would have entered the thoracic cavity due to the esophageal rupture.

Stop bleeding!

Repair the esophagus and trachea.

Clear the blood in the thoracic cavity to prevent further infection.

That was what needed to be done at the moment.

Meanwhile, Hou Rong was still incessantly pondering one question, why did the patient have a seizure?

What exactly was the cause?

But now, the situation was urgent, and there was no time to delay.

The patient had stomach cancer before, could it be brain metastasis?

Thinking this, Hou Rong could not help but feel a headache coming on.

At this point, Chen Cang said, “Director Hou, could it be a brain hemorrhage?”

This remark suddenly woke Hou Rong up.

Right! Could it be a brain hemorrhage, given the patient’s history of hypertension?

Doing a CT scan was definitely too late now; just taking the time for a CT could mean losing his life — that would certainly be inappropriate.

Thinking this, Hou Rong performed a check for meningeal irritation signs, and indeed!

Positive!

Of course, a positive meningeal irritation sign did not mean it was definitely a brain hemorrhage, but it was possible.

However, right now, the patient had to undergo surgery, otherwise, forget about a brain hemorrhage, ischemia would be the direct cause of death!

Here, the Blood Transfusion Department had already completed the blood dispatch, sending it directly.

A group of people pushed the patient straight to the operating room.

Chen Cang also followed right along.

After all, it was related to his own mission; he could not be indifferent.

Moreover, Chen Cang felt that this patient seemed not as simple as imagined.

After anesthesia, the surgery began.

Once an incision was made in the neck, everything such as the esophagus, trachea, and nerves… promptly came into everyone’s view.

But precisely because of this, the horrifying state of the neck area was somewhat shocking to those present!

The patient’s esophagus was damaged in many places, with irregular wounds, and the condition of the entire esophagus was poor!

Generally, the success of treating an esophageal perforation depends on the location of the puncture, the size of the tear, the timing of the diagnosis, and whether the treatment measures are appropriate.

And this elderly man’s situation was obviously very poor!

Not only were there numerous tears, but the damage was also irregular, and if it were not for the timely arrival at the emergency center, once it surpassed 12 hours, there would basically be no point in treating it!

Hou Rong also couldn’t help feeling some regret.

At this point, the possibility of the patient being cured was already low enough.

During the time after the patient’s onset of the disease, accompanied by epileptic seizures, oral secretions must have been swallowed into the stomach. Such secretions, full of bacteria, entering the mediastinum or thoracic cavity through the tears, would worsen the infection!

“Broad-spectrum antibiotics!”

“High dosage!”

Hou Rong kept issuing medical orders; at this time, transfusion and fluid replenishment were carried out simultaneously while electrolyte disturbances were being corrected, and the patient’s condition had stabilized.

At this moment, what was needed was to separate the esophagus and carry out repairs.

The patient’s surgical incision was on the anterior edge of the left sternocleidomastoid muscle, exposing the thyroid in the process.

Hou Rong carefully severed the omohyoid muscle.

Then he freed the middle thyroid vein.

By retracting the thyroid and the carotid sheath on either side, he freed the esophagus!

The perforation site was too obvious; it could be seen without searching for it.

Fortunately, the trachea was not damaged. Otherwise, the surgery would have been even more troublesome.

Next was the repair of the esophagus.

But!

It was at this time that a difficult problem arose before everyone.

There were too many ruptured locations, and they were irregular; it was definitely not possible to sew them up with absorbable sutures directly.

How should it be repaired?

To remove and then anastomose the ends?

That was completely unrealistic because the patient himself had gastric cancer and had undergone a subtotal gastrectomy, so there wasn’t enough length in the digestive tract.

It was simply not possible to remove and then sew it back together.

But without removal, a forced anastomosis was even more dangerous.

After a forced anastomosis, most would even develop reflux esophagitis, anastomotic fistula, and so on.

Seeing the inflammatory appearance around the rupture site, Hou Rong hesitated.

What to do?

The surgery had reached this point, and it was no longer possible to proceed.

Hou Rong quickly said to a nurse beside him, “Call Director Yu and Director Chang, the head of team three.”

Director Chang was a big shot in thoracic surgery, and Hou Rong could only pin his hopes on them at this time.

Esophageal rupture and an inability to operate, suturing was simply not possible, and anastomosis also wasn’t feasible.

At this moment, several doctors from team two also started to feel restless.

Emergencies often encounter these situations because there is no time for adequate preparation for urgent surgeries, and such emergencies require discussion in the operating theater!

Yu Yonggang and Chang Xiong arrived in the operating room before long.

Looking at the patient’s condition, the three fell into silence.

Hou Rong couldn’t help asking, “Is it feasible to use an autologous colon segment to replace the esophagus?”

Using autologous stomach and colon and other abdominal organs to replace the esophagus is still the most common method today.

Chang Xiong shook his head emphatically, “No!”

“He’s already had a subtotal gastrectomy, and after looking at the imagery, sacrificing more of the digestive tract is too great a blow to the patient’s digestive system. The surgery also comes with many complications, and the patient is already post-gastric cancer surgery. In such a case, the postoperative quality would be too poor, even … the basic digestive function couldn’t be maintained.”

At this time, Yu Yonggang, holding a pair of forceps while carefully separating neck tissue, suddenly said, “Is it possible to reconstruct and repair the cervical esophagus using a sternocleidomastoid myocutaneous flap?”

As soon as this statement was made, the eyes of those around brightened up!

This was a good idea!

However, Chang Xiong carefully examined the myocutaneous flap of the sternocleidomastoid, then frowned and said, “It is possible, but … that would bring up the issue of blood supply, and in the long run, it would definitely lead to the formation of scar tissue, causing esophageal wall contracture, and the chance of success for the next surgery would be practically non-existent!”

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