Chapter 1279 - 504: The Thorny Aortic Dissection and Revelations
Chapter 1279: Chapter 504: The Thorny Aortic Dissection and Revelations
It was not until 12:43 that Zhou Can finished dealing with the emergency surgeries and patients admitted for surgery yesterday.
Some trauma and emergency patients in the emergency department need immediate attention.
These cases cannot be delayed.
Whenever such patients are admitted, examinations are usually rushed. Once the cause is identified, the attending doctor makes a preliminary judgment on whether it can be handled in the emergency department. If not, they either call the relevant specialized department to take the patient away.
In more cases, even if it cannot be handled, some initial rescue work must be done for the patient.
For instance, helping patients stop bleeding, defibrillate, open airways, etc.
For patients who can be directly operated on in the emergency department, needless to say, they will be lined up one after another to enter the emergency operating room for surgery.
Zhou Can has recently consciously begun to reduce the number of Level 1 and Level 2 routine surgeries, letting other doctors in the operating room handle them.
He mainly handles some difficult surgical cases.
Level 3 surgeries have increased from about two before to three, even four.
In Level 1 and Level 2 surgeries, difficult cases that other doctors are confident with are handled by them. Those they are not confident with are all thrown to Zhou Can and Dr. Xu.
This arrangement benefits Zhou Can and the other doctors in the emergency department operating room.
Zhou Can has almost become a new ace in the emergency department operating room. Doing simple minor surgeries indiscriminately is not conducive to growth. Naturally, the department’s leaders hope he becomes stronger.
If the leader is too weak, how can they lead the emergency department to battle?
Simple minor surgeries are given to other doctors to provide them with better training.
Doctors whose surgical skills are developed can challenge more difficult surgeries.
Eventually, this forms a virtuous cycle.
Walking out of the operating room, he looked up to see a middle-aged man in his forties sitting on a bench across the corridor. Short-haired, well-dressed, with a calm expression, his overall mental state seemed poor.
"Are you Dr. Zhou?"
Seeing Zhou Can come out of the operating room, the man stood up and asked.
"Yes, it’s me!"
Zhou Can walked directly towards him.
"Are you the patient who specifically sought me out?"
"Yes, yes, that’s me!"
The man nodded repeatedly, but after a couple of sentences, he clutched his chest and coughed. During the cough, a faint crackling sound was heard, and a painful expression appeared on his face.
"Where are you feeling uncomfortable? Come, sit down and talk slowly, there’s no rush."
Zhou Can, who was more than ten years younger, showed concern for the man like an elder.
"It’s nothing! I had heart surgery once, and I’ve been coughing frequently ever since. Lately, I’ve been feeling palpitations, shortness of breath, and occasionally sharp pains in the upper abdomen. I’ve checked at several major hospitals, and they all say it’s an aortic dissection, and very serious."
As he spoke, the man picked up a document bag from the chair.
He handed the scans he had done at other hospitals to Zhou Can.
After taking them, Zhou Can’s expression immediately changed slightly.
"Oh, this situation is indeed quite serious. This entire section is a dissection. To be honest, I’ve never seen such a huge dissection before. Moreover, this is an aorta; if it ruptures, there might not even be time for rescue. I suggest you get it treated as soon as possible; it can’t be delayed."
Zhou Can had followed Director Hu Kan in many major operations.
He had dealt with some extremely dangerous aortic dissections.
But he had never seen such a severe case as this man’s. The main issue was the length of the torn blood vessel wall with the dissection.
The blood from the dissection formed a long, water-bag-shaped shadow in the thoracoabdominal cavity.
Such a large and long dissection poses a very high risk of rupture.
Even hospitals as large as Tu Ya, upon confirming an aortic dissection in a patient, issue a critical condition notice immediately, even if there’s no angina.
Only doctors understand how dangerous an aortic dissection is.
"I inquired at many major hospitals, and they all told me that I need to undergo a cardiovascular artificial aortic graft replacement, replacing the entire diseased vessel. The incision would run from the thoracic cavity to the thigh. There are also many surgical risks, including paralysis and intraoperative death."
The man spoke clearly and knew the details and risks of the entire surgery.
This showed that he had already learned about the entire surgical process from other doctors.
For such a long aortic dissection, placing a stent is almost impossible.
Because this aorta has multiple branches supplying blood to multiple thoracoabdominal organs.
While placing a stent could seal the dissection opening, it would also block the other branches of the vessel. This would deprive multiple organs of their blood supply. At that point, it wouldn’t be saving a life, but taking one.
Replacing the entire aorta is challenging, but it can be attempted as long as the surgical skill is strong enough.
As long as Zhou Can elevates the Ligation Skill to Level 6, he will be fully equipped to challenge such surgeries.
"The surgery is traumatic and risky, and both intraoperative and postoperative risks cannot be predicted. There indeed are many issues. But your aortic dissection is already so severe; if not treated, it’s more dangerous than having a time bomb strapped to you."
The patient’s condition can no longer be delayed.
Any emotional outburst or blood pressure spike could cause the dissection to rupture.
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