Hernia is an abnormal anatomy formed by a certain organ or tissue in the human body leaving its normal anatomical position and entering another part through weak points, defects or pores formed by congenital or acquired weaknesses.

Diaphragmatic hernia is a type of internal hernia, which refers to the disease state in which the abdominal cavity and other organs move into the chest cavity through the diaphragm muscle. It can be divided into traumatic diaphragmatic hernia and non-traumatic diaphragmatic hernia.

The most common non-traumatic diaphragmatic hernia are hiatal hernia, hiatal hernia, parasternal hernia and diaphragmatic abdomen. hiatal hernia is the most common diaphragmatic hernia, which is more than 90% of the most common hernia.

Generally speaking, hiatal hernia of the esophageal hernia will have a stomach, and the intestines appear in the chest through the weak diaphragm.

The most serious complication is the incarceration of the hernia sac, and the abdominal organs hernia hernia appear to have strangular necrosis.

In this case, emergency surgery is generally required. If the gastrointestinal tract can recover blood circulation, it is the best.

Otherwise, a series of resections should be performed to avoid more serious necrosis and complications such as infection and toxic shock.

This will be fatal.

However, diaphragmatic hernia usually occurs when the stomach, intestine and other hollow organs will hernia into the chest cavity. For example, the liver, such a large substantial organ, there will be few hernia.

This kind of surgery can be done by general surgery or thoracic surgery.

So when I heard of liver hernia, both Zheng Ren and Su Yun became interested. It was so rare that I went to take a look.

What a bullshit $100,000 consultation fee, the two of them were thrown behind them in an instant.

I quickly arrived at the emergency department. The emergency room was filled with the family of patients and two other private medical staff from other places were charging fees.

Seeing that Zhou Litao was busy checking his body, Zheng Ren did not call him, but began to observe the patient.

The background in the patient's system panel is bright red, which means the condition is very serious.

Seven or eight diagnoses such as asymptomatic congenital posterior sternum hernia, diaphragmatic hernia repair surgery, liver hernia, pericardial effusion, etc., appeared in front of Zheng Ren.

Zheng Ren seemed to have guessed something about the diaphragmatic hernia behind the sternum.

The abdominal organ protrudes into the cardiac diaphragm of the thoracic cavity through the triangular thoracic rib, which is called congenital posterior sternum hernia, also known as posterior sternum hernia, parasternal hernia, anterior lateral hernia or hiatal hernia.

This type of hernia is relatively rare, accounting for 3% to 5% of diaphragmatic hernia. It is common on the right chest cavity, mainly respiratory and digestive symptoms.

However, the organs herniated into the chest cavity are still mainly gastrointestinal tract, and the liver is relatively rare.

Liver hernia...Liver hernia...Zheng Ren concentrated and thought.

Su Yun had already come to the patient and watched Zhou Litao have checked his body.

The young nurse in the emergency department was busy and felt someone rushing up. She raised her eyebrows and turned around and was impatient to drive the person away.

But the moment she saw Su Yun, her face turned red and she didn't know where to put her hands. She didn't dare to look at it, and she wanted to look at it, and she was so entangled.

"What patient?" Su Yun asked gently.

"The postoperative patient sent by a nearby city hospital has undergone two surgeries, and now the right chest cavity occupies space." The young nurse doesn't know much, but she knows how much she says, and she really doesn't have any reservations.

After saying that, she felt a little ashamed.

I know very little, this is so wrong, oh oh ~

"Su Yun, you are here." Zhou Litao heard someone talking around him. After checking his body, he turned around and saw that it was Su Yun.

"Call Yun Ge'er." Su Yun squatted on the ground, looked at the chest bottle, and said in a low voice.

"Brother Yun, the closed chest drainage leads to a small amount of gas, and it is estimated that there is still a damaged lung." The young nurse added.

Why was it so hot in April? She felt that the mask with a hot face could not be worn. The heat sprayed from the gaps in the mask as she breathed, increasing the temperature of the entire face a lot.

It was all this damn weather, the little nurse thought to herself.

"Old Cui is in the office." Zhou Litao held a clip in his hand, with a stack of A4 paper on it, and recorded the situation of many patients in his own way.

Zhou Litao said that Su Yun asked him to call Yun Ge'er as if he hadn't heard it. Every freckle on his dark face expressed his rejection.

He said a few words to his family and arranged for an emergency department doctor to deal with it. Then he and Zheng Ren and Su Yun came to Cui's office.

Knocked at the door and went in, and Zhou Litao began to report his medical history.

Mr. Cui didn't say anything to Zheng Ren, but just glanced at him and began to listen to Zhou Litao's report seriously.

"The patient is a female, 55 years old, and the local hospital diagnosed it with a congenital posterior sternum hernia.

The patient developed progressive dyspnea and palpitations during activity 8 months ago, which aggravated for 2 months. He was hospitalized in a local hospital and was treated with surgical treatment.

Preoperative T-return: Intestinal contents in the thoracic cavity compress the middle and lower lobes of the right lung, resulting in atelectasis and mediastinal deviation.

This is the film before the patient's first surgery.”

As he said that, Zhou Litao skillfully took out a bag from the film bag and handed it to Mr. Cui.

Judging from the details, Zhou Litao is indeed a very capable emergency department hospitalization officer. He only understands the condition and physical examination in a short time, and has basically mastered many situations. He also reported to Mr. Cui in an orderly manner.

Zheng Ren praised in his heart.

"Continue." Mr. Cui did not watch the movie, but just said lightly.

"The first operation was found that the median diameter of the mediastinal sternum defect was 7m during the operation, and most of the hernia included the small intestine, large intestine, and the large omentum. When the right lung was reopened after the hernia sac was re-excerpted, emphysema and spontaneous pneumothorax were found. The thoracic consultation was conducted on the emergency table and closed drainage was given."

Zhou Litao took the case copied by the patient's family and quickly turned to the page of the surgical record, picking the key points.

"6 hours after the operation, the closed drainage of the chest cavity led to a large amount of gas. The gas volume was very large. After consultation by the thoracic surgery, it was decided to go on stage for the second time to open the chest and perform the repair of the lung blister."

"One week after the operation, the patient had a sudden ventilation disorder and urgently checked the liver function and found an increase in aminotransferase.t showed that the right lung compressed again, and there was a substantial organ entering the chest cavity. It was suspected that it was the liver."

"The local doctor communicates with the patient's family and recommends that the patient go to our hospital for treatment."

After saying that, Zhou Litao put down the medical record clip and inserted the most recent breast T-piece on the film viewer.

Zheng Ren unconsciously put his left hand on his right armpit, held his cheek with his right hand, narrowed his eyes slightly, and began to read the film.

Zhou Litao talked about the patient's condition in detail. Two surgeries were performed, one was a thoracic surgery and the other was a general surgery.

The patient's condition after the operation not only did not relieve it, but instead suffered more serious liver hernia.

This is certain if you need emergency surgery. But whether it is a thoracic or a general external surgery, the sense of proportion in the middle is very subtle.

Ordinary doctors are unwilling to take over postoperative patients sent by lower-level hospitals.
Chapter completed!