Chapter 1199: 1167 Aged Old Bottle (28500 extra chapters ×14 seeking monthly tickets)

"Knock knock knock~" Zheng Ren lightly knocked on the consultation room's door, hearing Cui Lao's voice inside, he pushed the door and entered.

"Little Zheng, you came so early." Cui Lao was intently studying an X-ray film, pushing his glasses.

"Hmm, just got off shift, I came straight over." Zheng Ren said with a simple smile, moving closer.

"Not eating is not good; at my age, you'll suffer." After saying that, Cui Lao pointed at the film and asked, "Tell me, what do you see?"

Zheng Ren remained silent.

The image before him was extraordinary. A shattered glass bottle lay in the rectum, its sharp end injuring the rectum; the bone surface at the lower end of the ischium was also damaged, especially the pubic symphysis, where the bone surface was eroded, damage about 90%.

The sharp part of the bottle extended backward to the gluteus medius, surrounded by organizing tissue; the rectal area around the foreign body showed diffuse inflammatory changes, and the muscles of the right lower limb underwent disuse-related fatty degeneration.

Rectal foreign bodies—Zheng Ren sees many in the Emergency Department: wine bottles, steel pipes, ***, and moss bottles are the most common.

Usually they come to the hospital right away, have it removed, and aside from being a bit embarrassed, there's nothing else.

But this case is different.

The severe inflammatory changes, wear and erosion of the bone at the pubic symphysis, and the surrounding adhesions indicate that this foreign body has not been removed for a long time.

Is this abuse? Or something else?

Zheng Ren's brow furrowed unconsciously.

"The patient initially gave an unclear history, but after repeated questioning by Zhou Litao, we learned that five years ago, he and his girlfriend, drunk and playing, inserted a beer bottle into his rectum. Because he was embarrassed and rather introverted, he didn't come to the hospital to have it removed at the time." Cui Lao said this while looking at the film, slowly recounting the patient's history.

Uh…… As Zheng Ren imagined the scene of injury in his mind, he felt it was extraordinarily bizarre.

"Introverted personality?" I couldn't tell.

But this has nothing to do with Zheng Ren; he was thinking about how to treat the patient. As for answering Cui Lao's question to ease the awkward atmosphere in the consultation room, Zheng Ren didn't realize it at all.

Unconsciously, his left hand reached to his right armpit, his right hand supported his chin, and he stared intently at the X-ray.

Cui Lao wasn't annoyed by Zheng Ren's silence; he continued to explain the condition.

"The patient reports limping for one month, weakness in the right lower limb, which we consider due to disuse-related fatty changes. This visit is due to fecal incontinence, watery stool, coming to our hospital's Emergency Department."

"Where is the patient?" Zheng Ren asked.

"He went for a lower abdomen and pelvic CT. I think the patient should undergo surgical treatment, and the difficulty is great, so more detailed examination is better." Cui Lao said: "Zheng Ren, look at this X-ray—any thoughts on the surgery?"

"Like a rectal cancer radical resection, with two surgeons, the colon and anus must be exteriorized, wait for recovery, then do a second-stage operation." Zheng Ren said.

Cui Lao nodded slightly; that was also what he could think of.

But the difficulty of the surgery absolutely cannot be described in just a few simple words.

The patient's rectal foreign body has been there too long, so it has become highly organized and encapsulated in the body; to completely clear it will definitely cause massive bleeding.

This surgery poses a great test of the surgeon's surgical skill.

If the surgery is even slightly rough, there could be widespread oozing with no identifiable bleeding vessel.

Using electrocautery to coagulate all capillaries makes postoperative healing and re‑bleeding a major problem.

The surgery must be exceptionally meticulous, with extremely high technical demands.

Zheng Ren's brain began to work at high speed, analyzing the X‑ray, performing a 3D reconstruction, and determining the vessel pathways, capillary branches, and the locations of related bodily tissues.

Even with the passive reconstruction skill, Zheng Ren still felt the patient's surgical difficulty was immense, almost reaching the heavens.

Time ticked by second by second; Zheng Ren repeatedly reconstructed in his mind, trying to find a reasonable entry path with minimal damage while still achieving the goal. Yet even with Zheng Ren's ability, it was very hard to solve this problem in a short time.

Soon, Zhou Litao knocked on the door: "Cui Lao, that patient's CT has come back."

Cui Lao nodded, stood up and said: "Zheng Ren, let's go look at the patient."

Zheng Ren looked at that X‑ray; the glass bottle in the rectum appeared glaringly obvious.

Accompanying Cui Lao to the Emergency Resuscitation Room, the patient lay prone on the stretcher. He was a young man, appearing no older than about twenty‑three or twenty‑four.

Beside him was a girl wearing a plain‑checkered dress, shoulder‑length hair, simple and clean.

"Li Mingchao, right?" Cui Lao asked.

"Doctor, I won't die, will I?" the young man lay on the stretcher, his face full of panic.

"First examine him, then send him to Gastroenterology Surgery. Zhou Litao, call to notify Gastroenterology Surgery and reserve an Emergency Department bed." Cui Lao did not answer the patient's question, but spoke to Zhou Litao.

"Doctor, is everything okay?" the girl also asked anxiously.

Zheng Ren stepped between Cui Lao and the girl, saying lightly, "With such a serious injury, why did you come only now?"

"……" the girl replied, she was a bit timid, a bit embarrassed, a bit conflicted, and tears pattered down.

Zheng Ren was speechless; at that moment the girl's crying left him helpless.

"Are you from the capital, or do you work here?" Zheng Ren asked.

"After graduating from university, I work here." the boy said.

"Are you married?"

"No."

"Notify your families and hurry over." Zheng Ren said: "The condition is serious; a major surgery is needed."

"Don't……" the boy said through pain, "I…… that…… the surgery signature, can my girlfriend sign?"

"With such high‑risk surgery, only immediate family can sign. You're not married, so you can't sign, and no doctor would dare perform this operation." Zheng Ren said.

After just looking at the film, Zheng Ren had a basic judgment of the condition. Even if he himself performed the operation, there would be a lot of bleeding during surgery.

Not being able to come down from the operating table is entirely possible.

"Doctor……"

"Without a signature, no one will dare to operate. Without surgery, you definitely won't be able to go another five years without trouble." Zheng Ren said firmly.

In an instant, the patient and his girlfriend fell into panic.

They fell silent; Zheng Ren watched Cui Lao examine the body. The patient's abdomen was soft, non‑tender, with no rebound pain. A rectal exam showed perianal tags, and the anal sphincter tension was markedly decreased, allowing the lower end of the foreign body to be palpated.

This whole affair, Zheng Ren sighed and shook his head slightly.

……

Note: The case comes from Dr. Ozbilgina's report in the International Journal of Surgery Case Reports. Looking up the materials is really exhausting.