"Does menstrual period affect pneumothorax? Or is it related to menstrual period?" Su Yun looked at Zheng Ren in confusion.

Zheng Ren was also in a daze.

There is this saying about menstrual pneumothorax, but most of them are related to endometriosis. But if it is endometriosis...

Zheng Ren was stunned for a moment. Could it be menstrual pneumothorax?!

This disease is so rare that Zheng Ren didn't even think about it.

"Boss, if it is endometriosis, it will be dominated by pneumothorax on the right side and it will occur during menstruation, but... Lao Shao, the patient has 7 surgeries, how many times have they had on both sides?" Su Yun asked.

"4 times on the left, 3 times on the right." Shao Jinghe replied immediately.

"That probably isn't." Su Yun frowned and said in a low voice.

He was unsure and subconsciously said that it was spontaneous pneumothorax caused by endometriosis.

Zheng Ren suddenly stood up, came to the front of the video reader again, and looked at the image.

Shao Jinghe was stunned when he heard this. He looked at Fang Lin with a frown, at a loss.

Fang Lin has never encountered this disease. Although he knows about pneumothorax during menstruation, he can't even take the exam.

If an examiner sets a question to test this, he will probably get pneumothorax.

"The endometrium migrates to the pleura and lung surface to grow, and falls off when menstruation occurs. Because the pleura is very thin, it is easy to cause damage, causing air to enter the pleural cavity from the lungs, forming pneumothorax, and symptoms occur." Zheng Ren said while thinking.

It's like talking to oneself, or it's like a conversation in the dark.

"The diaphragm is fine."

"Well, it's not like the problem of the diaphragm." Zheng Ren looked at the film, "Generally, pneumothorax is accompanied by diaphragm damage during menstruation..."

After saying that, he held his cheek and asked, "Old Shao, if I understand correctly, what you just said is that when the patient suffers from pneumothorax, it is always menstruation, and then the menstruation is still very long and the amount is relatively large. That's it."

Shao Jinghe nodded repeatedly.

Although he had no idea what this boss Xiao Zheng was thinking, he could still answer the most basic question.

"Uh..." Fang Lin did not watch the movie, but looked at Boss Zheng, feeling speechless.

"Diagnose menstrual pneumothorax." Zheng Ren said with certainty, "There are 4 criteria for diagnosis."

"..." Fang Lin looked at Boss Zheng in shock. Did he hear what he just said wrong?

"First, the spontaneous rupture of the lung vesiculus."

"Second, uneven uterine contractions during menstruation prompt gas to enter the uterine cavity and enter the abdominal cavity through the fallopian tube. At this time, the ectopic endometrium that blocks the diaphragm micropores fall off, the diaphragm channel opens, and gas enters the chest cavity and becomes sick."

"Third, the ectopic endometrial loss on the visceral pleura causes air leakage."

"Fourth, bronchioles caused by prostaglandin or alveolar rupture caused by the unidirectional flap mechanism caused by endometriosis of the bronchioles."

Zheng Ren started to tell the story one, two, three, four, and five again. Not only Shao Jinghe, but also Fang Lin was confused.

"There is endometriosis and the diagnosis is pneumothorax during menstruation, meeting 1 or 3 standards." Zheng Ren said.

"But..." Shao Jinghe wanted to say something, but in the end he didn't say it.

"There is a problem with the diaphragm," Su Yun added. "There are very small clefts, and only when the abdominal pressure increases will there be a small gap, causing the endometrium to appear again."

"again……"

"Walk farther and fall directly on the lungs. Finally, it erodes and breaks the visceral pleura during the menstrual period, resulting in constant spontaneous pneumothorax."

"Yeah." Zheng Ren nodded, "Old Shao, have you observed the diaphragm during the operation?"

"without……"

Shao Jinghe was confused and had pneumothorax surgery. Who can observe what the diaphragm is doing if she has nothing to do?

"Well, during the operation, single-chamber ventilation, carefully find the location of the diaphragm, and there is probably a small crack. Forget it, it's better to apply the pressure laparoscopy. If the pressure is too high, you can see gas entering the chest cavity."

"Boss Zheng, Brother Yun, let's go up and have a look?" Fang Lin was unsure.

"It seems like you don't have the second-tier professors in the team." Su Yun spitted casually.

That's it, but it is absolutely impossible to prevent him from going to the stage. Such a rare menstrual pneumothorax, if you don't go up and take a look, Su Yun has to fight Fang Lin desperately.

The patient had no problem with fasting water, and the operation was performed on the bill of lading. There was still half an hour before the operation, so Zheng Ren and Su Yun went directly to the operating room.

"Boss, the muscles of the diaphragm are very developed and rarely have problems. Is it a congenital problem?" Su Yun asked.

"It's possible, just go up and take a look." Zheng Ren said, "If you repair the diaphragm, you must take chorionic-releasing hormone therapy after the operation, and it should be cured soon."

Su Yun suddenly remembered something. He looked at Shao Jinghe and asked: "Have you done postoperative pathology in the past?"

“…”

In one sentence, Shao Jinghe was stunned.

In theory, all the cuts must be sent for pathological examinations. For example, the appendix, 1-2 of them may have malignant changes in the appendix.

Because the pathological diagnosis cycle is long and the cost is relatively expensive for some families, many people refuse to undergo pathological examinations.

Doctors, especially doctors in lower-level hospitals, rarely force patients to undergo pathological examinations. The patients who came to 912 did not tell the patient about this at all. It is natural to have a pathological examination after the operation.

This is the difference between a small local hospital and a top tertiary hospital in the imperial capital.

The patient had spontaneous pneumothorax and the diagnosis was clear. There were basically no problems with the lung bullae that were cut off during the operation.

At least Su Yun has never seen him.

It is estimated that Shao Jing and Dr. Shao also considered the same thing. Judging from his appearance, he probably did not have a pathological examination.

Sure enough, Shao Jinghe said embarrassedly: "I didn't do it."

"Old Shao, your work is too intricate." Su Yun said contemptuously, "If you did it once, even if you only once, this will not happen. You..."

"Brother Yun, it's not like that." Shao Jinghe was almost crying and said quickly: "The patient's family is not very wealthy. I didn't dare to use titanium clips during the operation. They were all hand-sewn. The pathology reward was also a kind of - suitable for the changes in lung bullae, and I don't think it's meaningful."

Zheng Ren sighed and shook his head slightly.

This is the case with the examination, and there is little possibility of problems. However, once problems arise, such as the current situation, it may lead to misdiagnosis and missed diagnosis.

This is the standard good intentions to do bad things.

But then again, even if Shao Jinghe had a pathological examination and the specimen was sent to the pathology department, the doctor on that side would probably be crazy.

The pathological examination of lung bullae is consistent with the endometrium under the microscopic condition, and no one in the local hospital dares to diagnose it.

At that time, I will take the pathological section to the superior hospital before making a diagnosis, but it will be a bit of a problem.

It is already very good for grassroots hospitals to correctly diagnose and treat common diseases.

As for rare diseases, there is no case in ten or twenty years, and even if you learn a dragon-slaying skill, it is useless.

...

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Chapter completed!