Everyone continued to listen, and a doctor nodded: This patientâs injury isnât easy to retrospectively analyze. Direct injuries are always easier to scrutinize than indirect ones. Indirect injuries are like hidden landmines, extremely difficult to unearth.
"Reviewing the patientâs previous records of simple hospital transfer medical history, combined with postoperative lung CT films, the blood pneumothorax at the time is estimated to have caused two-thirds shrinkage of the left lung, pushing the heart, major blood vessels, and main bronchus to the right side within the mediastinum. Clinically common parallel displacement does not cause significant damage to the patientâs heart."
Thatâs correct, indeed, a blood pneumothorax rarely harms the heart. The heart is double-protected by the pericardium, and its position is relatively central in the body. When a person is hit, unless itâs a penetrating injury, it is generally unlikely to hit squarely in a direct center direction. Therefore, this situation is rarely seen clinically, and the lack of clinical data led doctors at the Provincial Peopleâs Hospital to initially underestimate the cardiac damage in the patient.
Doctors here received Xiao Shugangâs medical records and had similar doubts. How Xiao Shugangâs heart was damaged seems somewhat mysterious. If this puzzle isnât solved, how could surgery be planned? Like Fu Xinhengâs initial standpoint, surgery cannot proceed under unclear circumstances; the threshold has to be grasped first.
Is there someone trying to grasp this threshold now? Can it be grasped?
All the doctors present listened earnestly, listening further.
Du Yeqingâs pen tapped into the palm of his hand. He would shout "stop" if he heard even the slightest hint of academic error, no matter who the person might be. Wrong is wrong.
Pan Shihuaâs eyes caught the point from the surgeons for Student Xie, nervously continued to support Student Xie by saying: "According to the above deduction, it can only be that other accidental events occurred during the heartâs parallel displacement. Considering the patientâs injury and subsequent constraints by local medical conditions, several emergency hospital transfers were necessitated, increasing the likelihood of such accidents. Midway vehicle jolting led to a certain angle of twist during heart displacement, followed by a secondary impact. The heart rotated eight to ten degrees to the left, with the impact force from the patientâs right side to the left side with a central chest wall angle of approximately five degrees; the injured sites corresponded with two lesions shown on CT films. Using IVUS inspection to further seek corroborating evidence might indicate the necessity for coronary artery bypass surgery."
"Wait a minute," Du Yeqing raised his hand with the pen, calling a halt.
"Bring the CT films over," Shim Youhuan turned and called on someone below to bring the films.
Evidently, their line of thought couldnât keep up with Student Xieâs rapid deductions.
After the films were delivered, a group of doctors gathered their heads together to study whether Student Xieâs words made sense.
Previously insisting on conservative approaches, Du Yeqing, with the CT films in hand, didnât continue to argue about weighing priorities anymore.
"Whatâs this?" Kang Mingzhu questioned.
It was exactly what Tan Kelin hit upon.
If the surgery must proceed, the necessity must outweigh the risk. Earlier, Cao Yong and Tao Zhijie were proving the necessity of the surgery. Xie Wanyingâs words further argue for the necessity of the surgery initially, followed by suggestions on how to lower the surgical risk.
Tan Kelin, as Student Xieâs surgical enlightenment teacher, taught her surgical fundamentals thoroughly.
Teacher Tan, who doesnât favor mentoring, is indeed a truly good teacher.