Surgery Godfather
Chapter 1199 - 936: Where is he hiding?

Chapter 1199: Chapter 936: Where is he hiding?

This patient is an acquaintance of Director Zhou, and City People’s Hospital is currently in the process of reestablishing its brand. If they can’t even resolve a fishbone issue, it will severely affect the establishment of the brand.

Although the fishbone is indeed troublesome, the patient doesn’t think so; having a chest opened and still not finding a fishbone, what kind of level is that?

These are still minor issues. If the fishbone stays in the blood vessels and isn’t removed, it’s a hazard no matter where it locates, extremely dangerous, causing unpredictable and uncontrollable bleeding, infection, embolism, and more. If it enters the brain, then craniotomy would be needed, which could even lead to intracranial infection.

"Should we use the C-Arm machine again?"

Director Zhou whispered a reminder. They had already used the C-Arm, but hadn’t found anything. Perhaps Professor Yang would discover something new.

"Bring all the X-rays you’ve taken just now for me to see."

After all, using X-rays with a C-Arm involves ionizing radiation, and too much exposure isn’t good. Yang Ping decided to first review the X-rays they had taken before. If necessary to check for any missing details, additional imaging could be taken later.

The doctors observing below immediately adjusted the screen of the C-Arm for Yang Ping to see and pulled up the recently taken images.

There was no need for additional images, as they had X-rays from head to toe, both anterior and lateral views. Yang Ping leaned in closely and inspected them, but didn’t find any traces of the fishbone.

Fishbones are bony, with a density similar to human bone tissue, so they appear as thin, needle-like structures on X-rays, which are relatively conspicuous except for areas obscured by bone.

The areas obscured by bone are not many, such as inside the skull, vertebral canal, or the rib areas of the thorax, and so on.

Hence, the usefulness of the C-Arm is limited due to its blind spots. At this point, it became necessary to use surface ultrasound to compensate for the limitations of the C-Arm. The combination of both machines basically allows for no hiding place for the fishbone, as they can cover each other’s blind spots.

"Let’s first repair the damage to the esophagus and aorta, then scan with the ultrasound," decided Yang Ping, opting to try the surface ultrasound.

The only available methods currently are the X-ray C-Arm and surface ultrasound. As for a CT scan, it would require ending the surgery, transporting the patient to the CT room, and returning for a second surgery to remove the fishbone. During this transporting and waiting time, the fishbone could likely shift again.

They aimed to resolve the issue in one surgery if possible, and if not, it would be left to a subsequent operation.

Director Zhou and his assistant were repairing the injuries to the aorta and esophagus. The puncture caused by the fishbone was very small, currently manifesting as a hematoma under the outer membrane of the aorta. They needed to open the membrane and clear the hematoma to see the tiny puncture. The esophagus was similar, though the hematoma wasn’t as clear.

The puncture in the aorta was right at the aortic arch, where blood pressure is extremely high. At any moment, blood could squirt out of the small hole, then tear the blood vessel, causing massive hemorrhage and death. Even without massive bleeding, it could still easily lead to aortic dissection, which is also extremely dangerous, with the patient at constant risk of death.

Moreover, blood could enter the esophagus through the aortic-esophageal fistula, causing the patient to vomit blood. Inhaled vomited blood could lead to suffocation death.

In any case, this hole must be repaired, else it’s a lethal ticking time bomb.

As Director Zhou and his assistant repaired the openings in the aorta and esophagus, the patrolling nurse prepared the ultrasound machine and a sterile ultrasound probe.

After Director Zhou finished the repairs to the aorta and esophagus, Yang Ping decided to scan the surgical area and its surrounding sterile zone with the sterile ultrasound probe, mainly focusing on the aorta and esophagus in this region.

It’s quite unlikely that the fishbone is hiding in other nearby parts. If it’s just nearby, then the C-Arm X-ray should have easily detected it since the surgical area is now open, without significant obstruction by the sternum. Even if the posterior ribs were obstructing, Director Zhou had used many oblique angles earlier to minimize obstruction by the ribs during his imaging of this region.

Following the physiological rules of the human body, the fishbone would definitely be carried farther along the blood flow direction and must be lodged somewhere, unable to turn back. Hence, conducting a carpet-like search along the direction of blood flow, theoretically, it’s certain to be found. It just depends on whether the doctor’s ultrasound recognition skills are up to the task.

If it’s not found in the surgical area or the nearby sterile zone, then they should close the chest. They can’t keep the chest cavity open indefinitely. After closing the chest, they would then explore other areas. Yang Ping instructed Director Zhou, "Let’s close the chest. After closing, we will explore other areas."

The fishbone wasn’t found in the surgical area, adding to Director Zhou’s anxiety. The patient had only reluctantly agreed to the surgery, and now they couldn’t find the fishbone after opening the chest - this was not easy to explain.

If they find it later, well and good, but if they don’t find the fishbone, they would have to explain a lot to the patient’s family after the surgery. And this issue would still not be resolved; the search for the fishbone would definitely continue, and after the patient rests for a few days, a second surgery would be inevitable.

With anxiety, Director Zhou mechanically proceeded with his assistant to close the chest, given that he wasn’t experienced in handling major surgeries.

In recent years, the Thoracic Surgery Department of the City People’s Hospital hadn’t conducted any significant surgeries, and he hadn’t had opportunities to go out and learn more, so how could he improve.

At this moment, the more Director Zhou thought, the more restless and upset he became. In this state, he and his assistant completed the chest closure, waiting for Yang Ping’s next instructions.

Search the lightnovelworld.cc website on Google to access chapters of novels early and in the highest quality.