Since 1981 Health School

Chapter 767 Hemangioreticulocytoma

The timid female doctors or junior doctors could not stand this **** skinning act at this time, and they were all extremely frightened.

 In fact, the amount of bleeding from this operation was very large from the beginning, Baotuquan.

 The surgeon is mentally prepared, but the audience is not.

The older experts adjusted their glasses one by one and widened their eyes, trying to see clearly what the protruding bone was under the face.

 There is a consensus that this is abnormal bone hyperplasia, but no one knows why it occurs.

 Others don’t know it, but Professor Chen Qi and Ge Minghua know that they have already done a “biopsy.”

 So during the live broadcast of the surgery, Professor Ge’s voice came again:

“Comrades, do you think that what you are seeing now is typical skull thickening, and then the outer plate of the skull and the parietal bone expand unilaterally like a bubble, and the inner plate of the bone bulges into the plate barrier and the cranial cavity.

On CT films, localized and diffuse radiolucent areas and dense areas can be seen coexisting in the thickened skull, which look very similar to the manifestations of Paget's osteitis deformans.

 So it seems that this is the skull, and it is enlarged and sclerotic, which can expand from the frontal bone to the occipital bone, causing facial involvement, narrowing of the orbits and nasal cavities, and disappearance of the sinus cavities. "

There was a lot of discussion in the multimedia classroom, and the doctors from the Department of Orthopedics and the Department of Otology were a little scornful. They felt that Professor Ge’s explanation was too simple. Everyone was not blind and had already seen it.

Meng Yushu was still chatting with a few old friends next to him, hinting that Ge Minghua also wanted to run for academic department member at this level?

 But then a picture of a pathological slide appeared in front of the camera, and Professor Ge's voice came again.

“Comrades, this is the “biopsy” report I did on the patient’s bone overnight last night. You can take a closer look. This protrusion is not normal bone tissue.”

Many people frowned and thought, if this is not bone tissue, what is it?

Professor Meng Yushu, Professor Fang Bing and Professor Cao Lichun, these three competitors are eager to put their faces on the TV screen.

"Yes, this is not normal bone tissue, but after the bone tissue has been absorbed, it is replaced by homogeneous spindle cell fibrous tissue and poorly developed reticular bone trabeculae. I guess it may be immature reticular bone bone. Resulting from arrested maturation or poor differentiation of the mesenchyme that makes up bone.”

Once this conclusion comes out, the diagnosis of "osteofibroma" originally supported by most people will be overturned.

Meng Yushu was obviously not convinced: "If it's not fibroma, then what is it? Is there any diagnosis in the book that is more consistent with the current status of the disease than fibroma?"

An expert next to him reminded: "Maybe this is a new and unrecognized disease?"

“Ha, Ge Minghua can discover a new disease? Are you kidding me?”

 Professor Fang Bing was obviously not convinced.

A professor from Peking University next to him said angrily:

"Lao Ge even took out the pathological slides. This is the evidence. If you understand it so well, you must be sure it is osteofibroma? Everyone has remembered it. Look at the clear diagnosis given by these two people."

 Another professor from Peking University Hospital also sarcastically said:

"Lao Meng, Lao Fang, you two are awesome. After all, they have biopsies, auxiliary examinations, and operations on site. Do you doctors from other hospitals understand this? Come on, let me tell you about your diagnosis and identification. What’s the diagnosis?”

This is the home stadium of Peking University Hospital. Most experts and professors from Peking University Hospital come here. Of course, our own people help their own people.

Maybe it’s jealousy that changes people beyond recognition. Now Professor Fang Bing is dissatisfied both mentally and verbally:

"Okay, let's see how Lao Ge performs the surgery. Whether it is bone or not, this thing is in front of him. How does he cut it? If he cuts off this part of the deformed and protruding bone, Without bones, who will protect the intracranial tissue?”

“Yes, yes, what Lao Fang said makes sense.”

"The operation cannot be performed without removing this bone. If the bone is removed, the brain stem will not be protected. A slight bump or bump in the future may cause the patient's brain stem to be damaged and die."

To put it this way, the skull is the hardest of all bones.

After many corpses have decomposed for many years, or during archeology, the bones of the tomb owner have long since rotted away, but the skull or part of the long bones are often left behind.

 It is because the skull is the strongest and cannot be damaged easily. There is an old saying, "head iron" to describe a stubborn species.

 There is a reason for nature to create all things. The reason why the skull is made so strong has four aspects.

 The first and most important role is to protect brain tissue.

 Human brain tissue is soft and tender and is easily damaged by external force impact, while the skull is a hard protective shell that can prevent external force from damaging intracranial brain tissue;

  The second role is to maintain intracranial pressure.

 After skull molding, the internal space is relatively closed and fixed, which can ensure that the internal pressure is relatively stable and will not change due to changes in atmospheric pressure.

For example, when taking an elevator, flying, climbing, or diving, if there is no stable intracranial pressure, the scalp will be affected by the atmospheric pressure and the shape of the skull will change.

If your head is round for a while, long for a while, and flat for a while, this is not a question of whether you look good or not, but a question of whether you are going to die.

 The third function is that there are many small holes at the base of the skull, and each small hole has nerves and blood vessels passing through it, which is used to communicate with the intracranial and extracranial structures.

 The fourth function is easier to understand. The shape of the skull is also part of the appearance and is the basis for maintaining a good face. If the skull is rounder, the head shape will be better-looking.

Like the big power, before plastic surgery, the chin was so wide and ugly, but after the bone reduction surgery, the chin became pointed and much more beautiful. This is the importance of bones.

The brain is the headquarters of the human body, so the skull is the garrison that protects the headquarters.

So you can imagine, if the garrison protecting the headquarters is gone and the city gate is opened, what will happen to the headquarters? The enemy will definitely go straight to Huanglong. If you were a patient, it would be one word: death!

 This is one of the reasons why everyone is not optimistic about this operation.

The "bone" now placed in front of the surgeon looks like an upside-down bowl.

But it was obvious that Chen Qi was not an ordinary doctor. The operation he was going to perform now was to remove the inverted bowl.

 Last night, Chen Qi had used the most advanced Siemens ForceCT to conduct a comprehensive scan and three-dimensional structural reconstruction, and he had a clear picture of the situation under the bones.

 So Chen Qi decisively picked up the "craniotomy chainsaw" specially designed for brain surgery and began to cut the bones.

 “Zhi~~~KakaKaKa~~~~”

The sound of a chainsaw cutting bones sounded from the operating room.

People in the multimedia classroom couldn’t understand. Everyone covered their mouths and discussed:

 “This old Ge is really crazy, did he really cut his skull?”

“Didn’t Lao Ge say that this is not a real skull, but a kind of bone?”

“It doesn’t matter what the bone is, if this bone is gone, what will happen to the little patient’s brain tissue next?”

Meng Yushu was overjoyed and deeply agreed with Ge Minghua's "adventurous" behavior, and watched how he overturned.

Even some professors from Peking University are discussing privately: "Sewing the bones is just the beginning of the operation. We don't know what the inside will look like. It's too easy to have accidents."

 In the operating room, Professor Ge was so anxious that the corners of his mouth were blistered.

 I shouted in my heart: What kind of trouble is this? Oh my god, this is going to kill people.

He wanted to ask Chen Qi, why did you really cut off the bones? The cut bones cannot be put back, so should we use water to glue them? If there is no bone, then isn’t the city gate open?

Professor Ge did not dare to ask in front of the live broadcast camera, so he could only keep gesturing to Chen Qi with his eyes, trying to get a hint.

But his eyes were blinking red, and Chen Qiniao ignored him and concentrated on the operation.

 About half an hour later, as the chainsaw head fell, the circumcision was completed, and the protruding abnormal "bone" was finally cut off.

 The next step is when the lid of the bowl is opened.

 This is the most intense stage of revealing the secret. What exactly is here?

 Everyone in the operating room, including the anesthetist and nurses, all stretched their heads.

Chen Qi himself was also very curious, so he held the cut bone with his left hand, and then slowly opened it with a swish like an upside-down bowl.

 Then everyone screamed.

 Chen Qi and Professor Ge looked at each other. Chen Qi was fine anyway, but Professor Ge's eyes were filled with despair.

At this time, everyone in the multimedia classroom also said "Ah~~~" with regret after seeing it.

 There are several brain surgeons who are already popularizing science:

“This looks like intracranial hemangioblastoma. Professor Ge will be in trouble now...”

“Intracranial hemangioblastoma is a disease that even our brain surgeons cannot handle, and plastic surgeon Ge Minghua cannot handle it at all…”

“This operation is going to be overturned, and it will definitely not go on, but all the bones have been removed. It’s a pity...”

 There were many experts from other disciplines who also asked:

“Tell me, what is intracranial hemangioblastoma? Why do you all look like you’re sighing?”

At this time, Professor He from the Department of Neurosurgery of Peking University First Hospital stood up and gave everyone popular science:

“Cerebral hemangioblastoma, also known as hemangioreticuloma, is generally benign and a vascular-derived non-encapsulated tumor. It mainly affects young adults and is relatively rare in clinical practice.

 The tumor you see is the most complex brainstem hemangioblastoma.

We all know that the brainstem itself has special functions and the risks of surgery are extremely high. Important complications such as hemiplegia and coma are very likely to occur after surgery.

In addition, there are many important nerves and blood vessels around the brainstem, including the trigeminal nerve, facial nerve, posterior cranial nerves, etc. A slight mistake in the operation can cause neurological dysfunction.

 The young patient already suffers from insomnia, loss of sense of smell, hearing loss and other neurological damage. If surgery is not performed in time, it is likely to cause further damage to neurological function until it is life-threatening.

What’s even more dangerous is that the young patient’s brainstem tumor is also complicated by complex brainstem vascular malformations, which makes the operation too difficult. "

 (End of this chapter)