Chapter 1715: 1656 Spoon in the Esophagus

Subdural hematoma bleeding is slow; early clinical symptoms are not obvious, or even absent, resulting in missed early diagnosis and treatment time.

When clinical symptoms appear, the hematoma has already formed for a relatively long time, mainly presenting as atypical symptoms such as chronic intracranial hypertension and cerebral ischemia.

Da Liu had no external injury; Zheng Ren considered it the result of long-term heavy drinking causing vascular regression, fragility, increased permeability, and chronic leakage, which was triggered, aggravated, and worsened by emotional agitation.

It is estimated that after his younger brother came, he also didn't say anything nice to him. One blow after another, Da Liu finally couldn't hold up.

This person is somewhat pitiful.

But pitiful people always have hateful aspects; Zheng Ren also didn't know how to talk about this matter. Da Liu's current situation is largely due to his own actions.

Having nothing to do with himself, he might as well set it aside; Zheng Ren gave a wry smile, thinking to himself.

"Boss Zheng, a few days ago the students at Capital Medical University felt nauseous and vomited; what was the final diagnosis?" Zhou Litao then asked.

"My consideration is mass hysteria." Zheng Ren said.

Su Yun and Zhou Litao were doubtful about this diagnosis. After all, hysteria has no clear substantive changes, no evidence can be produced, and its credibility has therefore dropped considerably.

"Boss Zheng, I have a case I resolved a couple of days ago; take a look." Zhou Litao set aside the mass hysteria and began to show off.

"Huh? What disease?" Upon hearing Zhou Litao's words, Zheng Ren immediately became interested.

"A spoon was taken out of the esophagus." Zhou Litao gave a hehe smile, full of pride.

Esophagus…… spoon……

"Come, I kept one image. The spoon patient also said he didn't want it, so I kept it." Zhou Litao said.

Esophageal foreign bodies refer to foreign objects such as small animal bones, tuberous foods like peach pits, sweet potato chunks, corn cobs, etc., as well as children's toys, iron wires, fishhooks, plastic products, etc., that become lodged in the esophagus.

Zheng Ren recalled a case report about a man who swallowed forty knives, which remained in his esophagus.

That seems a bit exaggerated; Zheng Ren didn't really believe it. Forty knives—could it be a magic trick? If they could be easily removed, it would become a sword-swallowing act.

Seeing that Zhou Litao was not busy, he brought Zheng Ren and Su Yun to his duty room.

He installed a plastic hook on the side of the cabinet, on which hung several dozen film packets.

After finding the film, he handed it to Zheng Ren. Zhou Litao said: "The patient came in after an argument while eating dinner at night, got punched in the chest, and subsequently experienced chest tightness, nausea, etc."

"Just take an image and you can see it." Su Yun said.

Zheng Ren took out the film and looked at it against the window.

The film showed a very clear image of a spoon in the esophagus, with no sign of an esophageal diverticulum or similar.

It is really hard to imagine how the spoon ended up lodged in the esophagus.

It is probably relatively large, unable to pass through the cardia into the stomach, so it wandered in the esophagus and eventually became fibrotic.

"Tsk, that big." Su Yun looked at the film and exclaimed.

"Indeed." Zhou Litao took out a plastic bag containing a spoon about 10 centimeters long, its surface covered with food residue and pus-like matter.

"You didn't even wash it." Su Yun said.

"Looking at it this way, it's even more eye-catching." Zhou Litao laughed: "If it were washed clean, the kids would doubt whether this really happened. Am I just buying a spoon to trick people, or is it genuine? Even if we had the image back then, it wouldn't be very credible."

What Zhou Litao said made sense; this guy has always been thinking about giving lectures to the students at the Medical University Affiliated Hospital in the future.

I also don't know where he finally puts all the miscellaneous junk he collects.

According to Su Yun, this is a case of hoarding tendency.

This is an illness; it needs treatment.

"How was it taken out?" Zheng Ren asked.

"Sent to the endoscopy suite; Director Luo removed it with a gastroscope." Zhou Litao said: "Director Luo also said that if you were there, the patient might sustain even less injury."

Zheng Ren smiled.

It's just removing an esophageal foreign body; no matter who does it, the injury definitely won't be significant.

A spoon is relatively uncommon; esophageal foreign bodies in adults are usually things like dentures.

At night, forgetting to remove dentures, one swallows them while sleeping. After waking, some careless people don't feel the dentures in the esophagus; they just think they forgot where they put their dentures.

In the end, this results in an esophageal foreign body.

"That big, taking it out must be quite a hassle." Zheng Ren remarked.

"With general anesthesia, that's how we managed to take it out. At the time, the thoracic department was on standby; if the endoscopy failed, we were prepared to perform a thoracotomy."

What Zhou Litao said was correct; making all kinds of preparations to avoid problems.

If one method doesn't work, switch to another. This is also why, at 912, if we changed to a local hospital, we would likely have to perform a thoracotomy and esophageal resection.

However, cutting the esophagus to remove a foreign object is a very troublesome, high-risk surgery.

Unlike removing a subcutaneous lipoma, postoperative complications may include local ischemia, wound non-healing, leading to possible thoracic infection, pulmonary infection, lung abscess, or empyema.

Being able to remove it with an endoscope is the best.

After looking at the film and then at the retrieved spoon, seeing Zhou Litao carefully put the spoon away, Zheng Ren thought he was quite an interesting person.

However, once he has a family, I don't know whether his partner will be able to accept these things.

After chatting a few more sentences, Zhou Litao received a phone call from the doctor who sent Da Liu for examination.

Cranial CT showed that Da Liu was diagnosed with an acute subdural hematoma in the right frontal-temporal lobe; he was immediately transferred to surgery for craniotomy and hematoma evacuation.

Craniotomy surgery, although risky, is absolutely considered a "minor" procedure in neurosurgery.

As long as it is detected early and treated early, the possibility of postoperative coma or long-term bedridden state is not large.

"I'll go take a look at neurosurgery." Su Yun glanced at Zheng Ren and asked: "You don't want to go, do you?"

Zheng Ren nodded.

He is instinctively resistant to patients with messy household affairs; as long as the illness is treated, that's fine, but the heart condition…

Forget it; better to leave it to Su Yun to handle.

Leaving the emergency department, the two went their separate ways.

Su Yun went to neurosurgery, while Zheng Ren directly returned to the intervention department.

Sitting in the sunlight, Zheng Ren again dove into the System Library to read books. Although Zheng Ren almost had photographic memory, the System Library's update volume was too large; new journals came one after another, and Zheng Ren simply could not finish reading them.

After a while, Xie Yiren sent a message asking what to eat for Evening.

In the Evening, Qin Tang also said they would treat guests; as for what exactly the matter was, Zheng Ren didn't know.

Flipping through their phone, Zheng Ren suddenly felt a stir in their heart.

The little boy with cancer's account, I haven't looked at it for a long time; I don't know how he is now.

Opening the account, I saw the little boy's avatar was lit, but his signature hadn't been updated, remaining from nearly a month ago.