White armor

Chapter 618: Eating handfuls of melon seed shells?
The feeling of the New Year is becoming weaker and weaker.

But after a busy year, Luo Hao finally had the opportunity to rest for a few days.

There are not many relatives at home and there is not much to say. After the New Year holiday, Luo Hao returned to the provincial capital in high spirits.

Luo Hao was satisfied that his first visit to Danizi's home was successful, and he finally understood something that had been bothering him.

Arriving at the department, Luo Hao changed into white clothes, put on his hairpin, and chatted with the doctors in the department.

Luo Hao was thinking about other things in his mind.

"Xiao Luo, Happy New Year." Chen Yan suddenly appeared at the office door.

Luo Hao stood up immediately, Erhei looked up, staring at Chen Yan with his green eyes, making Chen Yan a little scared.

In Chen Yan's mind, Erhei is like the terminator of the apocalypse. The key is that it is in dog form, which is more terrifying than human form.

"Director Chen, Happy New Year." Luo Hao went out to greet him.

Although he had called Chen Yan on New Year's Eve and was not lacking in etiquette, Luo Hao still went to greet Chen Yan enthusiastically.

"You're welcome. I came to see you to watch a movie." Chen Yan said directly without being polite to Luo Hao.

"Oh? What's wrong?"

"Look at this, can you solve it? If not, then surgery is the only option."

After hearing what Chen Yan said, Luo Hao immediately focused his attention, and all the previous polite greetings disappeared.

Chen Yan picked up two films and inserted them into the film viewer.

It was not filmed by our hospital, but by the provincial hospital.

Luo Hao first took a look at the hospital, then scanned the film.

Immediately, Luo Hao was stunned.

The patient's rectum showed obvious obstruction. The image showed a large mass of dense foreign matter completely blocking the intestinal cavity, which was tightly and full. The shape of the foreign matter was very special, with jagged edges but a certain regularity, showing a unique texture structure in the image. Luo Hao hugged his arms, leaned forward slightly, frowned unconsciously, and stared at the image on the film reader with a sharp gaze. He subconsciously tapped his elbow with his index finger, which was a small action he usually did when thinking about difficult cases.

"This density." Luo Hao muttered to himself and reached out to adjust the brightness of the film viewer.

As the light changed, the details of the foreign object appeared more clearly - it was not a uniform mass, but was composed of countless tiny, regularly shaped fragments tightly packed together, forming a strange mosaic-like pattern on the image.

What is even more puzzling is that there seems to be some kind of arrangement pattern between these fragments, as if they were deliberately stacked.

"It looks like a fecal stone. I don't understand why. I want you to take a look at it."

Chen Yan told the truth.

Luo Hao scanned the film, and various possible diagnoses flashed through his mind: fecal stone? Tumor?

Or some other foreign object?
But none of them quite fit the special performance in front of us.

He noticed that the bowel proximal to the obstruction was significantly dilated, whereas the distal part was completely collapsed, indicating that the obstruction had persisted for some time.

What puzzled him most was that the density of this foreign body was neither as uniform as a typical fecal stone, nor did it have the characteristics of invasive growth like a tumor.

"Senior brother, this looks a bit strange." Zhuang Yan asked.

"Well, Director Chen, what is the medical history?"

"Pumpkin seed shells." Chen Yan said.

"???"

"???"

Luo Hao and the rest of the medical team were stunned. Melon seed shells? Is Director Chen sure he's not kidding? How many melon seed shells would it take to block the rectum like this?

"It's Chinese New Year, and they said there were guests coming to our house, so the child stuffed handfuls of his favorite melon seeds into his mouth, and this is what happened." Chen Yan was also helpless.

"He's only 9 years old, so stingy." It was also the first time that Luo Hao encountered intestinal obstruction caused by melon seeds.

And the obstructed segment is still in the rectum.

"Brother, isn't crude fiber good for intestinal peristalsis?"

"It's nonsense to talk about the efficacy without considering the dosage." Luo Hao said, "I can give it a try. What are the conditions at home?"

"generally."

Yes, otherwise I wouldn’t treat these melon seeds so preciously.

But not really.

Luo Hao thought, it would be best not to have surgery on a 9-year-old child if possible.

"Let me try." Luo Hao crossed his arms and watched the movie. Chen Yan did not disturb him, but waited quietly beside him.

After a few minutes, Luo Hao took down the film and said, "Meng, go and communicate with the patient's family."

"Is there anything we should pay attention to?" Meng Liangren asked.

"I won't go into details about routine rectal ruptures and the need for emergency surgery. In general, the more serious the case, the better. That's all."

Gone?

Meng Liangren and Chen Yan were both stunned.

What Luo Hao meant was that the probability of success of the operation was extremely high, which meant that it could be solved through endoscopy.

Or, on a dsa machine?

Meng Liangren did not ask, but turned around and began to write the preoperative instructions. He planned to show it to Luo Hao after he finished writing, and then say anything else.

Professor Luo thinks it’s okay, but he shouldn’t take it seriously and must try his best.

"Xiao Luo, how do we do it?"

"There's nothing I can do. I'll just use pliers to dig it out bit by bit."

“Colonoscopy?”

"Yeah." Luo Hao nodded.

"I asked Director Shi, and he said colonoscopy is very difficult." Chen Yan shrugged and spread his hands.

"It is indeed difficult. What the director said is true." Luo Hao said, "Be patient and take it step by step. It's okay. I'm here for you."

Chen Yan twisted his beard and tilted his head slightly, but then smiled, "Okay, then I'll take the patient to the endoscopy room and give the preoperative instructions. After Lao Meng finishes writing it, he'll give it to my boss, and he'll tell the patient's family."

Meng Liangren breathed a sigh of relief. Director Chen was truly a considerate person.

Luo Hao didn't hesitate to send Chen Yan away and then sat next to Meng Liangren to read the preoperative instructions he had written.

"Xiao Zhuang, have you been working out recently? I see you've lost weight." Luo Hao didn't feel nervous and chatted with Zhuang Yan.

"Is that so?" Zhuang Yan suddenly felt that her hard work was not in vain.

Gain three pounds during every festive season!

But after a year, I ate dog food every day and exercised, and I actually lost five pounds! A full five pounds! !

Zhuang Yan already had tears in her eyes.

"Well, indeed, do you consume enough carbohydrates every day?" Luo Hao asked casually, "If you don't consume enough carbohydrates, it may make you stupid."

"I know this, so I drink after practice."

"???"

"???"

"Wine is a liquid carbohydrate with zero oil, salt and fat. It is highly palatable and quickly absorbed. It not only provides energy to the body but also makes people happy. It is a mental nitrogen pump for fitness."

"..."

Luo Hao knew that Zhuang Yan was talking nonsense. She couldn't drink. Two bottles of beer mixed with diuretics would be too much.

"In order to achieve a balanced diet, we should consume a variety of carbohydrates, such as single-grain liquor, multi-grain liquor, and sauce-flavored liquor..."

"Wait!" Luo Hao interrupted Zhuang Yan, "Xiao Zhuang, who told you this?"

"My Father."

It turns out that he is not someone from the gym, but Dean Zhuang?
Luo Hao was a little confused.

"It's Chinese New Year, my dad rarely drinks, but this year he keeps going out to drink."

"When my mother came back and told him about it, he kept saying these things, and my ears are now callused."

"Oh, stop it." Luo Hao said with a smile, "What about you?"

"I'm fine. The dog food that Senior Brother ordered is nutritionally balanced. I had a blood test a few days ago and it showed I was not lacking any nutrients."

"Does your dad also work out?"

"He just plays table tennis and does some exercise. If he really wants to work out, he can't even lift a barbell."

Luo Hao smiled. Although Dean Zhuang was in poor health, his condition was not as bad as Zhuang Yan said.

"You guys go ahead and do your work. I'm going to go see a patient." Seeing that Meng Liangren had almost finished writing and that it was in line with his own ideas, Luo Hao got up and left.

The hospital manager laughed when he saw Luo Hao leaving, "Professor Luo is becoming more and more like a leader now."

"What's the matter?" Zhuang Yan felt that what the resident manager said didn't seem to be good, so she asked.

"The biggest cost of work is communication cost. The leader never speaks directly, he makes you guess."

"Not only do you have to guess what the words mean, you also have to guess the eyes, the micro-expressions, and why they said that. If you don't want to guess, just ask directly..."

The resident boss was talking, and then he saw a figure at the door and immediately shut his mouth.

It is not wrong to speak ill of others behind their backs, but you must not let anyone catch you. Once upon a time, a doctor was talking about Dean Jin behind his back during a meeting, but he did not expect that his back was facing the door. Dean Jin happened to go to the department that day and happened to hear him "talking nonsense".

As a result, it became awkward.

Sure enough, the resident manager was right to be cautious, and Shen Zizai walked in.

"Happy New Year." Shen Zizai greeted.

"Director, Happy New Year."

Today is the last day of the holiday, and I haven't been back to work as usual, but I can already admit patients. I just didn't expect Shen Zizai to come.

"There is a patient, please admit him." Shen Zizai said.

"Okay!"

When the resident manager met the director, he didn't say much nonsense and agreed very straightforwardly.

Shen Zizai glanced at him and said, "Where's Xiao Luo? I just heard him talking."

"Director, we just had a patient with intestinal obstruction in the gastrointestinal surgery department. I'd like to ask my senior brother if he can perform endoscopic treatment."

"Chen Yan is really good at ordering people around." Shen Zizai said with a smile.

He seemed to be in a good mood, quite good.

"Director, what did you do during the New Year? Why do you seem so happy?" Zhuang Yan asked.

"Hey, my son's test results before the Chinese New Year were pretty good. I went to talk to his teacher during the Chinese New Year, and he said that based on the speed at which his grades were improving, he might be able to get into Union Medical College."

"Congratulations!!!" Zhuang Yan said with a smile.

"If I could get into Peking Union Medical College... forget it, the score is too high. I'd better go to our medical university. If he gets in, Xiao Luo will have half the credit." Shen Zizai couldn't help laughing and was happy from the inside out.

"You guys are busy, Xiao Luo went to the gastrointestinal department?"

"Ah."

"I'll go take a look, chat for a while and then go home." Shen Zizai said, "The patient is a student with uterine fibroids. She wants to have surgery during the winter vacation. She should be the first one in the queue after the New Year so as not to delay her schooling."

After giving the instructions, Shen Zizai walked away happily with his hands behind his back.

The hospital manager heaved a sigh of relief. Fortunately, he was alert, otherwise he would not be able to survive this year if the director caught him saying bad things about his boss behind his back during the New Year.

Even though it was just a joke and everyone knew it was a joke, it's not good.

Not long after, the hospital manager's phone rang. He answered the call and told the person on the other end the location of the ward.

This is normal, and the patient only has uterine fibroids, a minor illness.

What really gives hospitalization a headache are patients who are coughing up blood. During embolization, if the blood vessels supplying the spinal cord are accidentally blocked, causing the patient to become paralyzed, that is really a splitting headache.

Meng Liangren was still revising the preoperative summary word by word. The New Year should bring a new look, and he didn't want the first patient to have a problem, no matter how lightly Professor Luo said it.

"Dong Dong Dong~"

There was a knock on the door.

Zhuang Yan tilted her head and was stunned for a moment.

A man in his thirties with a dark face stood at the door.

Most of the patients in the interventional department are liver disease patients, so it is normal for them to have a dark complexion, but… the man was wearing a pair of low-waisted tights.

Zhuang Yan has never worn this kind of pants. Only the hosts of short videos that contain borderline content would wear them.

And like the female blogger, he wore low-waisted tights that revealed the strap of his underwear.

Not only that, there is a succubus tattooed on her lower abdomen.

Maybe because she is too fat, the succubus looks chubby and a little funny.

"Hello." The man in low-waisted tights said politely.

The resident boss was also stunned. He looked the man in low-waisted tights up and down, but did not stare at him. Instead, he let him in.

The man in the low-waisted tight pants didn't seem to care about the surprised look of the hospital manager. He was very polite and said, "I'll go through the hospitalization procedures."

"Who?" the resident manager asked immediately.

"My little master."

"???"

"???"

The hospital manager was stunned for a moment, and Zhuang Yan was also stunned. Little Master? Did I hear it wrong?

What kind of drama is this? Why is it so outrageous?

She was wearing low-waisted tights, fancy underwear, and a succubus on her belly. With this outfit, she would be blocked if she did a live broadcast on the short video platform.

But this big brother came to the hospital dressed openly, and didn't feel shy at all and didn't mention his little master.

Emmm.

Even Lao Meng temporarily put down his work and looked back at the man in low-waisted tights.

Meng Liangren seemed to have suffered a critical blow and quickly turned his head around to busy himself with the work in his hands.

He was afraid that if he looked at it for a few more seconds, he would not be able to pull his eye out, and Professor Luo was still waiting for surgery.

Meng Liangren knows what is more important.

“I didn’t hear what you just said.” The resident manager looked apologetic and expressed his respect for the man in the low-waisted leggings.

It's not easy to be so open and frank, and the hospital manager couldn't help but be convinced.

"My little master needs to be hospitalized for surgery. We went to the outpatient clinic before the Lunar New Year and registered with Director Shen Zizai."

The man in low-waisted leggings spoke clearly.

"..." The resident manager highly suspected that Director Shen did not see this person at all.

"I contacted Director Shen and asked us to come and complete the hospitalization procedures today." The man in low-waisted tights continued.

"What medical insurance?" The hospital manager, like Meng Liangren, didn't dare to look at him any more and sat in front of the computer to prepare an admission form for him.

If there is content about infectious diseases before the operation, you should definitely prescribe as much as possible and check it out without getting tired of it.

"Little master." The man in low-waisted tights shouted.

A girl about 1.6 meters tall with ordinary looks walked in.

She didn't have the confidence to think she was a princess, but she didn't care about everyone's eyes. She was just afraid of the operation.

Encouraged by the man in low-waisted leggings, the patient began to go through the hospitalization procedures, constantly asking the hospital manager whether the operation would be painful or not.

The hospital manager never expected that the first patient he would receive at the beginning of the year would be someone with such a forbidden love affair.

Meng Liangren hurried to make revisions, printed out the document, and hurried out with it.

"Old Meng, wait for me." Zhuang Yan also ran out, covering her heart with her hand, and let out a long sigh, "Oh my god, they have such strong tastes."

"Uh, I haven't seen it either."

"A few years ago, someone was crawling on the ground without clothes. It was speculated that it was the master's game." Zhuang Yan and Meng Liangren are familiar with each other and dare to say anything.

Meng Liangren got a splitting headache whenever he recalled the man in low-waisted tight pants.

"Is it the part of the legendary play?" Meng Liangren asked.

"Yes! I highly suspect that hospitalization and surgery are part of their play."

"The object is reversed."

"Who knows what they'll do? Didn't you see the succubus tattooed on that guy's belly? When I was in college, I went to Sanya and saw a few girls with spades tattooed on their ankles at the beach. My dad wouldn't let me get close to them."

Meng Liangren thought of some legends, but they were just legends and he didn’t know much about them.

The most outrageous thing was that his former colleague was having a 4i relationship with a girl. Even so, Meng Liangren had to go back and look up information for a long time before he could figure out what was going on.

Meng Liangren attributed this kind of people to being bored.

When they arrived at the gastrointestinal surgery department, Meng Liangren showed the preoperative instructions to Luo Hao. Luo Hao did not take it lightly and after reading it carefully, he handed it to the resident chief of the gastrointestinal surgery department.

"Xiao Luo, how do you perform the operation?" Chen Yan asked Luo Hao, twirling his beard.

"Just do it little by little. The adhesions aren't particularly severe. It's mainly because the obstruction is too hard. If it doesn't work, you'll have to use a grinding drill."

"A grinding drill?"

"It's a device for thrombus drilling in the Department of Cardiovascular Medicine. It's a little expensive."

Chen Yan immediately remembered that during the Chinese New Year, the director of the Department of Cardiology sent a message to the doctors’ group about the successful application of a new technology in surgery.

No wonder Professor Xiao Luo asked the patient about his family conditions at that time. It turned out that he was thinking about that thing.

The recyclable interventional consumables for internal medicine are very thin. Even if a drill can grind through the obstructing feces, it seems that it is impossible.

Although he had doubts in his heart, Chen Yan did not say anything, but prepared to take a closer look.

In fact, it is not difficult for the young patient to choose surgery. It is just because he is too young, so it is best to avoid surgery to avoid unnecessary trouble in his future life.

Chen Yan called the patient's family and explained the situation. The patient's family cooperated and knew why the doctor did not want to perform surgery.

The communication went smoothly, and Chen Yan was particularly curious about what Professor Xiao Luo would do.

The drill bit is too small and too fine.

The diameter of the left coronary artery is 0.2-0.75cm, while that of the rectum is 2-5cm, a difference of many times.

On the way to the endoscopy room, Chen Yan hesitated to speak several times. Luo Hao smiled and said, "Director Chen, there is actually no skill in using an endoscope. It's just a matter of practice."

"Water mill?"

"Just do it little by little. The outside will be very hard, but the inside will be better. Because this operation is dirty, you have been doing this for a lifetime, so you must have encountered similar situations before."

“……”Chen Yan nodded.

"By the way, ask the hygienist in your department to change clothes." Luo Hao was a little embarrassed. "It's just after the Chinese New Year, and the endoscopy room hasn't opened yet. We made the room a mess, with feces all over the floor. It's not good."

"Okay." Chen Yan also knew that the endoscopy room would send at most two nurses to work overtime.

The patient's abdominal pressure is very high, and feces may burst out at that time.

It is not necessarily feces, it is more appropriate to call it intestinal contents. Because it has been held back for too long, once a channel is opened, the intestinal contents will spray out.

By that time, the walls will be sprayed all over and Chen Yan will definitely not clean it up. Even if Luo Hao is the doctor invited for consultation, he will not clean it up either.

Operation……

Gastrointestinal surgery is just like a dung collector, Chen Yan thought. But today's job is more difficult than usual. Usually, when performing surgery, there is always a chance to relieve stress first.

"We perform a lot of this type of surgery in our interventional department," Luo Hao explained.

Chen Yan smiled, twirling his beard.

Some cancers are late-stage, and intestinal obstruction caused by tumor compression requires intestinal stenting under the interventional department. The abdominal pressure of patients with more severe obstruction is indeed high, similar to the situation of the little patient in front of us.

Indeed, the interventional department looks clean, but once you get involved in this area, you will face the same difficulties as gastrointestinal surgery.

Change clothes and go for surgery.

Luo Hao did not ask for anesthesia, but first comforted the little patient and asked him to cooperate as much as possible.

The colonoscope was inserted, almost touching the anus, and a wooden stick-like fecal obstruction was seen. Luo Hao took a look and saw melon seeds embedded in it, just like the cut cakes sold outside.

Chen Yan is knowledgeable and has seen all kinds of strange things, so he doesn't take it seriously.

However, Zhuang Yan had been following behind Luo Hao, looking at the stool formed by the melon seeds with curiosity.

Luo Hao moved after seeing the feces, but found that the feces was blocked in his rectum like a stone. He seemed to hear the sound of the pliers hitting the feces.

It was too hard. Luo Hao could only ask the endoscopy assistant to open the grinder.

This is the first time that a grinder has been used in intestinal obstruction.

In terms of the hardness of the outer shell, Luo Hao felt that it was comparable to a blood clot, so he hoped that the inside would be softer.

The grinder was put in and started grinding. A piece of melon seed shell was ground and flew out, which could be seen clearly under the camera.

It was not until this moment that Chen Yan understood what Luo Hao meant - the hard work of grinding.

It would probably take more than an hour to grind such a large piece of feces, even if Professor Luo Haoluo had the latest grinder in his hand.

Luo Hao carefully ground open the outer shell of the dung. He held his breath and concentrated, feeling the subtle sensation from the grinder with his fingers.

It seemed like it was soft inside, and Luo Hao breathed a sigh of relief.

Instead of grinding through the dung, he first ground off the outer shell layer by layer.

Then Luo Hao began to take out the melon seeds patiently little by little with pliers.

"Senior Brother, let me do it!" Zhuang Yan volunteered.

Luo Hao frowned, turned around and glanced at Zhuang Yan.

Zhuang Yan was stunned. What was that look in senior brother's eyes? Why did he feel so serious?

Did I make any mistakes? It seems not.

"Xiao Zhuang, why don't you go back first?" Luo Hao said.

"Yes, Xiaozhuang, you go back first." Chen Yan also said on the side.

"???"

"This is just the beginning. When the outside opens, the pressure inside will be higher and it will spray out."

"..."

Zhuang Yan was so busy looking at the pieces of feces that looked like sliced ​​cakes that she completely forgot about the embarrassing scene in the helicopter when she was rescuing a patient poisoned by paraquat.

(End of this chapter)