Back in 2002 as a doctor

Page 932

The hemostatic forceps hit Director Zhang Shanchang on the forehead, and then flew out obliquely, but did not land in the sterile field.

"What the hell!" Zhou Congwen scolded.

"You... hit me?" Director Zhang Shanchang covered his forehead and looked at Zhou Congwen like a resentful woman.

"That's a sterile area." Zhou Congwen said coldly.

Director Zhang Shanchang suddenly realized what a stupid thing he had done, he was so ashamed, subconsciously wanted to hide his face and left.

However, in his heart he always remembered the imaging characteristics of Roujiamo or Devil's Eye, and these academic points that Director Zhang Shanchang firmly believed in were all crushed by a walnut.

"Why walnuts?" Director Zhang Shanchang murmured.

"Why not walnuts?" Zhou Congwen saw that this guy was no longer normal and had no seizures. He turned around and stepped off the stage, tearing off the sterile clothes.

"Impossible, it's very typical Roujiamo, how come it's not a stone." Director Zhang murmured.

"Ever studied in the Imperial Hospital?" Zhou Congwen asked with a smile.

"Professor Zhou, how do you know that?" Director Tan hurriedly came up to smooth things over. Director Zhang Shanchang was ashamed and thrown at home, completely losing the face of the First Hospital of the Medical University.

"Oh, usually Mr. Li's students would say Roujiamo, and the more formal term is Devil's Eye." Zhou Congwen smiled.

"Professor Zhou, when you said the stone was so big, were you joking or telling the truth?" Director Tan asked.

"Really." Zhou Congwen said, "However, the clinical findings are mainly small stones, and such large stones only exist in journal reports."

"Impossible, absolutely impossible, how can a stone of more than ten centimeters go down the intestinal tract?" Director Zhang Shanchang looked at Zhou Congwen and questioned.

"Have you heard of the tumbling phenomenon?" Zhou Congwen asked back.

"..." Director Zhang Shanchang was stunned, what was rolling?what phenomenon?What is Zhou Congwen talking about?

"Professor Zhou, can you explain in more detail?" Director Tan sighed inwardly. Director Zhang Shanchang was so stupid that he had taken out all the walnuts during an operation, and he is still entangled in what kind of Roujiamo.

Professor Zhou Congwen could see his mastery at a glance. Although Director Tan didn't approve of Director Zhang Shanchang's so-called mastery, he was even more unwilling to make a fool of himself all the time, so he quickly pulled Zhou Congwen to divert the conversation.

"Gallstone ileus was first described by Dr. Erasmus Bartholin in 1654 as a disease caused by the incarceration of gallstones in the gastrointestinal tract through a biliary-enteric fistula.

Because gallstones can "move freely" in different parts of the gastrointestinal tract - this is called the tumbling phenomenon"

"Gallstone ileus is more common in women, with a female to male ratio of 3.5:1.

Then there are elderly patients, especially those over 60 years old.

Other factors that contribute to gallstone ileus include a long history of gallstone disease, recurrent acute cholecystitis, and stones larger than 2 cm in diameter"

"The appearance of the characteristics of Roujiamo on the video does not mean that it is all gallstone intestinal obstruction. Mr. Li must have said it."

"!!!" Director Zhang Shanchang was at a loss when Zhou Congwen talked about Mr. Li.

Chapter 1604 Devil's Eye ([-])

"How do you know?" Director Zhang Shanchang subconsciously retorted.

Zhou Congwen smiled slightly, "When I was chatting with the boss and Mr. Li, I heard the old man talk about Roujiamo. The old man doesn't like the Western sayings, the devil's eye, this name is not easy to understand for the old man. Look, Roujiamo Mo, do you have a concept when you say it? Even if you haven’t eaten it.”

"..."

"..."

Everyone in the operating room was dumbfounded.

This is indeed the case, what Zhou Congwen said is also very vivid and easy to use, it doesn't seem like Director Zhang Shanchang used these two concepts to pretend to be forceful.

and!

Zhou Congwen didn't need to study at all, and the big tree behind him waved lightly, and to the doctors in the provincial capital, it was like a raging forest.

Mr. Huang is familiar with Mr. Li.

"The old man said that other factors that lead to gallstone ileus include long-term history of gallstone disease, recurrent acute cholecystitis, and stones larger than 2 cm in diameter. The so-called Roujiamo or the devil's eye has to be viewed dialectically."

"With no history of recent episodes of biliary colic, jaundice, or acute cholecystitis, the diagnosis of gallstone ileus is unlikely."

"Mr. Li's main intention is to remind the doctors in the medical technology department to pay attention not to rely solely on imaging studies to make a diagnosis."

Zhou Congwen's words made Director Zhang even more ashamed.

Director Ji stood in the position of the surgeon and sewed up the incisional intestine. He already had awe and fear for this young world's number one surgeon in his heart.

It's not just that the surgery is done well.

Although Zhou Congwen's surgery is good, you can't tell just by the "simple" surgery in front of you, but Zhou Congwen's basic knowledge is really solid, and Director Ji is ashamed.

Knowledge related to theory is even easier to come by, and it is solid to the extreme.

It even gave people the illusion that it was Mr. Huang who was teaching in the operating room, not Zhou Congwen, a young boy, talking here.

"Therefore, doctors tend to be preconceived when making clinical judgments, and it is difficult to consider intestinal obstruction caused by other foreign body incarceration."

"But walnuts are not common, the key is how it gets down." Director Zhang Shanchang argued.

"Usually ingested fruit stones pass through the gastrointestinal tract without complications, but occasionally they may cause small bowel obstruction.

The reason for the latter may be the incarceration directly caused by the core, or the formation of secondary gastrointestinal stones.The most common site of incarceration is the narrowest part of the ileum lumen, which is about 50-75 cm away from the ileocecal valve. Other obstruction sites include the pylorus, duodenum, colon, and rectum. "

"Although it is not common, it would be better if the patient in front of me, Director Zhang, could ask about the medical history and have more clinical experience." Zhou Congwen said with a slight smile.

Director Tan looked at the young Zhou Congwen waving the big stick of clinical experience, hitting Director Shanchang's head one after another, and felt a little inexplicable joy.

Shouldn't an old director like Director Zhang Shanchang be qualified to say that?

Now everything is reversed.

"Professor Zhou." Director Tan said with a smile, "Thanks for your hard work, shall we change clothes?"

"Okay." Zhou Congwen smiled, and glanced at Director Zhang Shanchang, "Director Zhang, you need to improve your film-watching skills. It's best to combine it with clinical practice, especially the differential diagnosis of similar rare diseases."

"..." Director Zhang was at a loss for Zhou Congwen's direct ridicule.

It is said to be ridicule, but it has the feeling of Chunchun's teaching; but when Chunchun's teaching is listened carefully, it is full of ridicule and ridicule.

"Elder Li dare not diagnose gallstone ileus just based on the Roujiamo sign," Zhou Congwen said with a smile.

"Then what should we do?" Director Zhang Shanchang was a little confused, he took himself as a student in a trance, and asked proactively.

"The clinical manifestations caused by fruit stone incarceration are similar to those of gallstone ileus. However, Rigler's triad can be seen on abdominal plain films of patients with gallstone ileus - intestinal dilatation, biliary pneumatosis, and ectopic gallstones, while fruit stone incarceration is not cause pneumobilia."

"So, it's not just a Roujiamo sign or seeing the devil's eye that can be diagnosed." Zhou Congwen's voice became farther and farther away, and by the time he finished speaking, Ren and Director Tan had left the operating room.

Director Zhang Shanchang stood there with a dazed expression on his face, his forehead had already started to turn red, and Zhou Congwen hit the hemostat forcefully very hard.

Seeing Zhou Congwen and Director Tan leave, the itinerant nurse probed out after a few seconds to take a look, and closed the door of the operating room before letting out a sigh of relief.

She picked up the hemostatic forceps, looked at Director Zhang Shanchang who was still in a state of confusion, "Director Shanchang, what are you... are you arguing with Professor Zhou?"

"..." Director Zhang Shanchang burst into tears, why couldn't he say a few words.

But when the rebuttal came to the extreme, Director Zhang Shanchang felt that no matter what he said, no matter how he said it, it was absurd and embarrassing.

"That's right, Professor Zhou has already taken out the walnuts." Director Ji added, "Director Shanchang, you too, want to grab walnuts when you reach out, which means that Professor Zhou has a good temper. If someone else... My words immediately turned my face."

Director Zhang Shanchang was extremely ashamed when he heard Director Ji talk about the pain.

Although he is the director of the medical technology department, he also knows that he should not move around in the operating room, and the most basic concept of asepsis is still necessary.

I was a little surprised when I saw the walnut just now, and I lost my mind for a while, and wanted to pick it up to have a look, but Zhou Congwen reprimanded it.

Director Zhang Shanchang was in a daze as he touched the spot on his forehead that had been hit by the hemostatic forceps.

"Professor Zhou is very powerful, and he speaks clearly and logically." The itinerant nurse said, "Director Ji, did you have a diagnosis before the operation?"

"How is it possible?" Director Ji said frankly, "This kind of intestinal obstruction is rare, anyway, I didn't have any diagnosis when I saw the patient's intestinal CT."

"How do you think Professor Zhou Congwen Zhou knows so much at such a young age?"

"He is Huang Lao's closed disciple. Didn't you hear what Professor Zhou said? He accompanied Huang Lao to meet all the big bosses all over the country. It's enough for the big bosses to chat. What do you think, Director Shanchang?"

Director Zhang Shanchang sighed helplessly.

When I was studying, I only heard Mr. Li say Roujiamo, and I thought it was the ultimate skill of slaying dragons, but I didn’t expect that there would be so many things to do if I continued to deepen it.

What Zhou Congwen said just now echoed in his ears, and the more director Zhang Shanchang thought about it, the more reasonable it became.

A CT image cannot determine the diagnosis, and more clinical diagnostic criteria must be referred to. Even this time, Professor Zhou Congwen Zhou found out the real answer through the consultation.

The walnuts were placed in the contaminated area of ​​the instrument table, seeming to be silently laughing at Director Zhang Shanchang.

He repeatedly recalled what Zhou Congwen said, especially when he occasionally remembered how confident he was before, and felt ashamed at this moment.

Chapter 1605 Outer Sect Disciple

"Professor Zhou, you have worked hard this time. It is also fortunate that you are here!" Director Tan politely thanked Zhou Congwen in the locker room.

"You're welcome, Dean Tan." Zhou Congwen said with a smile, "That's outrageous, isn't it? Let's be honest, Director Ji's operation can be done without me. It doesn't really matter whether I come or not."

"That's different." Director Tan said with a smile, "One is to cut open rashly, and only after seeing it will you know what caused the intestinal obstruction; you have made a judgment before the operation, and you know it in your heart, so as to avoid accidents."

Director Tan is a good flatterer, to the point.

"Hehe." Zhou Congwen smiled.

"Professor Zhou, I told you twice before, but you were busy and didn't reply." Seeing that Zhou Congwen was in a good mood, Director Tan brought up the old matter again, "If you can fly back, we often invite you to throw knives, Close cooperation, this is the blessing of the people in the provincial capital."

"Not now." Zhou Congwen flatly refused.

Director Tan was taken aback.

"I'm going to the United States soon, and it will take a few years to come back." Zhou Congwen said.

"what?"

Zhou Congwen briefly talked about the foreign academicians of the two academies, "Dean Tan, I also know the situation here. If it is really necessary, I will talk to the boss and arrange for a 912 professor to lead the team."

Not Zhou Congwen, the others, Director Tan, are not interested.

The reason why Zhou Congwen was hired to fly the knife at the First Hospital of Medical University was that Director Tan had discussed with Dean Lin very early on.

The purpose is not as high-sounding as it sounds, but simply to find a big tree.

This big tree is getting stronger and stronger, going to the United States to get foreign academicians of the Chinese Academy of Sciences and the Royal Academy of Sciences... Director Tan's heart is getting hotter when he thinks of this.

But Zhou Congwen walked farther and farther, and flew higher and higher, and he couldn't reach it with the platform of the First Hospital of Medical University.Even if they have a relationship with Zhou Congwen, they can still talk now, but it may not be possible in the future.

Director Tan was a little sad.

"President Tan, I just said that if the doctors in the first hospital need gold plating, they can come to the United States to find me." Zhou Congwen knew well about Director Tan's needs, and he said with a smile, "For example, your people. "

"Ah!" Director Tan was taken aback.

Zhou Congwen's words were very straightforward, without concealment.Director Tan gave a smack in his heart, and a strong light was projected from the unknown place.

"Others who went to gilt can't learn anything outside, and they have nothing but a title of studying in the United States or a visiting scholar when they come back." Zhou Congwen said frankly, "It's different in my place. You can directly mark it when you come back. There's so much to learn and so much to learn."

Director Tan understands what Zhou Congwen said.

A scholar who visits the United States is just looking up. It is okay to fool ordinary people who don't know how to do it, but it is not enough to fool people in the circle.

What is really meaningful is what Zhou Congwen said he has learned, and he can be regarded as an "outer disciple".

"Professor Zhou, is this your student?" Director Tan asked with a feeling of excitement.

"Developing together, you can't be called a student." Zhou Congwen said "modestly".

Director Tan was a little depressed. He looked into Zhou Congwen's eyes and said seriously, "Professor Zhou, if you accept students, I think many professors leading the group will be happy."

Zhou Congwen waved his hand, but didn't promise anything.

Even in medical universities in provincial capitals, the level of professors leading the group varies.

Zhou Congwen knew very well that if he agreed, this group of people would not necessarily do anything under his banner in the future.

Modern society does not allow cleaning the door, what can I do if I really encounter disgusting things.It's like Keats Hospital's treatment plan for murdering for money, and it's not worth it to worry about it yourself.

"It's not a student." Zhou Congwen said, "But it can be said that I brought it with me when I came back."

"That's fine." Director Tan didn't force Zhou Congwen, and knew that it was useless for him to force himself. To have such a promise was already signed.

"Professor Zhou, when are you going?"

"Keep in touch, I can't say the exact time."

"Okay." Director Tan smiled and chatted with Zhou Congwen. He had a deeper understanding of Zhou Congwen, who had always been the opposite big BOSS.