Chapter 94 - Retroperitoneal Hematoma (1/2)

Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation

Zheng Ren entered the ICU and felt hateful gazes directed at him.

‘What did I do?’ Zheng Ren thought.

He had never had any misunderstandings with ICU staff. The nurses…

“Chief Physician Pan, you’re here.” An ICU doctor walked toward them and started to explain the patient’s condition.

“The patient was involved in a traffic accident and sent to the fifth orthopedic department at 9:18 am. He was diagnosed with a pelvic fracture. Blood pressure was at 100/60 mmHg but an hour later, it was at 85/45 mmHg. We suspected severe hemorrhage from the fracture and did a CT scan. The scan revealed a retroperitoneal hematoma.”

The patient’s records detailed the condition with a simple, clear-cut diagnosis. The hematoma was to be expected due to pelvic fracture.

Minor pelvic fractures rarely required surgery and were manageable with just rest.

The design of the pelvis naturally made it so. Fractures typically led to bleeding that would cause a small to medium internal acc.u.mulation. Usually, treatment with hemostatics and antibiotics was sufficient.

However, if the pelvic fracture ruptured any blood vessels, it would be the internal and external iliac veins, along with the common iliac vein.

These blood vessels were located at the retroperitoneal s.p.a.ce and the bleed would be enveloped by the peritoneum. In most cases, the ruptured vessel was either a small artery or vein and the bleeding would stop due to higher retroperitoneal pressure.

However…

This patient seemed to be a special case. The odds of a case like this was less than one in a hundred.

It was likely that there had been severe laceration to one of the bigger arteries in the retroperitoneal s.p.a.ce and the pressure could not staunch the bleed. The patient’s blood pressure was at a level that indicated hemorrhagic shock.

The higher retroperitoneal pressure was tricky as it did not allow for standard general surgery methods to stop the bleed.

If they cut open the retroperitoneum, the trapped blood would burst out due to pressure.

Zheng Ren looked to the side and saw Su Yun move a chair to the patient’s bedside. He sat by the patient and scrawled something on a piece of paper as if making calculations.

Su Yun could be hungover but did not look drunk, just mildly dispirited.

The gloomy expression on a handsome face like his gave off a completely different vibe.

“Let’s have a look at the patient first,” Old Chief Physician Pan said steadily. He approached the patient and read his vital signs, then proceeded to view the CT scan.

“Pelvic fracture with ruptured arteries. Hematoma in the retroperitoneum.” Su Yun heard Old Chief Physician Pan’s voice and looked up. He did not rise from his seat or look at Chief Physician Pan, but only stared at Zheng Ren.

Zheng Ren knew what he meant.

The patient’s condition was not suitable for open surgery, leaving only interventional surgery the only option for stopping the bleed. That was their priority now.

Su Yun’s diagnosis and rescue plan were accurate. He was sharp.

“Little Zheng, are you confident?” Old Chief Physician Pan was not familiar with this manner of interventional surgery, but after the placenta abruption case, he had bought a book to study it further.

He was not capable of performing the surgery but wanted to make sure Zheng Ren was confident before rus.h.i.+ng into it.

Sometimes, hot-headed youngsters need the steady hand of an older fellow to guide them.

A pelvic fracture with retroperitoneal hematoma and developing hemorrhagic shock was the perfect case for an interventional radiology-a.s.sisted surgery.

Nevertheless, Old Chief Physician Pan had never performed such surgeries before and wanted Zheng Ren’s opinion.

“No problem,” Zheng Ren replied confidently. “Get the paperwork. Prepare the blood and transfer the patient to the interventional radiology operating room.”

Su Yun’s black hair swayed as he bobbed excitedly. The tiredness in his eyes slowly disappeared.

The change in Su Yun made Zheng Ren cautious. ‘What is this nancy boy up to?’