CHAPTER 464: 464: A BLACK DAY - PART TWO

(Thanks to Book Friends 20201112175901593, Lazy Puzzle Bug, Pirate Flag Xino, Chen Jie Ting for the monthly ticket encouragement)

"President Liu, the blood test results have arrived. Laparotomy or laparoscopy?" the anesthesiologist, Li Liwei, asked.

"Laparoscopy," Liu Banxia said. "I suspect the fluid in the abdominal cavity is mainly ascites, but there’s also internal bleeding now, which is life-threatening if left untreated."

Li Liwei nodded. "Given the severity of the jaundice, it must be quite serious. He could already be on the transplant list."

"Exactly," Liu Banxia said with a bitter smile. "I’m just hoping the liver isn’t damaged. Otherwise, the situation will indeed be critical."

The jaundice was so severe, indicating that liver function had already declined significantly. If this already poorly functioning liver sustained further damage, it would be like adding frost to snow.

"Laparoscopic exploration reveals damage to the right lobe of the liver and cirrhosis. The bleeding isn’t severe, and there’s a small amount of ascites in the abdominal cavity. Suturing is feasible. Prepare for second and third port incisions," Liu Banxia said after careful observation.

"Hmm... contact the people downstairs immediately and find the patient’s family. Have them get in touch with his attending physician; his ranking on the waiting list can be improved now."

"President Liu, not to be a wet blanket, but I suspect it might be too late," Li Liwei said. "How many more days can he hold on like this? Given his condition, he’s definitely near the top of the transplant list."

"We do our best and leave the rest to fate. There’s always a glimmer of hope," Liu Banxia said. "We can also try our luck within our hospital; you never know."

"Today has been an ordeal. Fortunately, his liver damage isn’t too extensive, and no major blood vessels were injured. However, the cirrhosis is so severe that even if we can’t find a suitable liver donor, this might at least give him time to say goodbye to his family."

The atmosphere in the operating room grew heavy at his words. Even though many present were nurses, not doctors, they had seen enough to understand.

What Liu Banxia is doing now is just buying time, they thought. The patient’s liver is already failing, isn’t it? The only cure is a liver transplant; nothing else will work.

DING! Emergency mission completed.

You have gained 200 experience points, 200 Diagnostic Skill proficiency points, 100 Dressing Change Skill proficiency points, 100 Suturing Skill proficiency points, 100 Liver Surgery Skill proficiency points, and 4 Glory Points.

"Send him to the ICU for a day of observation," Liu Banxia said.

"Teacher Liu, the patient’s family has arrived at the hospital," Xu Yino reminded him.

Liu Banxia paused for a moment, then nodded.

He went outside, found the patient’s wife and parents, and led them aside.

"The surgery was successful for now; the liver has been sutured," Liu Banxia explained. "However, his underlying condition is still very dangerous. You should contact his previous attending physician, explain the current situation, and see if his position on the transplant list can be moved up."

"We’re already second on the list," the patient’s wife said, wiping away tears. "But we’ve been waiting for over two months, and the person ahead of us hasn’t received one either."

Liu Banxia sighed inwardly. It’s truly hopeless, he thought. Donor organs are just too difficult to find.

"Doctor, how long does he have left?" the patient’s father asked.

"I haven’t conducted a detailed evaluation yet," Liu Banxia replied. "But based on the current state of his liver and the injuries he sustained, the best-case scenario is likely less than a week."

"If you have any close relatives, you should try asking them. This is the last chance. What I just described is the best-case assessment; a lot will depend on his recovery tonight."

"We’ve contacted all the relatives we can; none were a match," the patient’s wife said despairingly.

Liu Banxia couldn’t find any words of comfort. For this family, all they could do was hope for a miracle.

There are strict legal requirements for organ donation. Even spouses must have lived together for more than three years or have children. Otherwise, donors must be immediate blood relatives or collateral relatives within three generations.

Other possibilities include adoptive parents and adopted children, or stepparents and stepchildren. The final option is donation from deceased individuals.

Sources beyond these are not accepted. If the regulations were truly relaxed, it would likely foster more organ trafficking.

Actually, this is also similar to the situation with freelance surgeons. If regulations are too strict, it will undoubtedly affect some patients. But if you loosen the controls too much, chaos will ensue.

「」

"Is the situation not good?" Wang Chao asked when Liu Banxia returned to the first floor.

"His cirrhosis is very severe," Liu Banxia said. "He might have had two or three months on the waiting list before, but now it’s been shortened to less than seven days. How’s your patient? Is his condition under control?"

"He’s a bit better now. The Tylenol has had some effect, and his temperature has come down a little," Wang Chao replied. "But shouldn’t he be in the rash stage by now, typically?"

Liu Banxia nodded. "I don’t know how many days it’s been. Continue to observe. In any case, even when this is over, he’ll need to be isolated. We’ll also have to contact their local health authorities and trace his movements. It’s all such a hassle."

"President Liu, it seems there’s been some development in Liu Yiqing’s case. I just saw the police arrive," Wang Chao said cautiously.

He could sense the darkness in Liu Banxia’s current mood and didn’t dare to speak as casually as usual.

Liu Banxia nodded. Seeing Liu Yiqing nearby organizing case files, he walked straight over.

"Has it been investigated?" Liu Banxia asked.

"Yes, it was school bullying. We’ve reported it to the police," Liu Yiqing said. "But it happened last night, and she showered after getting home, so no evidence was preserved."

"Teacher Liu, I took the initiative to admit her. I felt that if she went home, she would undoubtedly face a lot of blame, and I..."

Before Liu Yiqing could finish, Liu Banxia nodded. "She needs care; she’s a minor. You were the admitting doctor, so she probably has a certain degree of trust in you. Try to spend some time talking with her when you can."

"Also, you need to advise her parents not to blame her for this. It could leave her with psychological trauma."

Liu Yiqing nodded silently.

"In the hospital, we encounter all sorts of situations and witness many tragedies you might never have imagined before," Liu Banxia added.

"Doctor, Doctor, please save my child!"

Just then, a man rushed into the lobby, cradling an unconscious child.

"What happened? How old is he?" Liu Banxia hurried over.

"He’s three! He pulled over a storage cabinet, and it fell on his chest! Doctor, please, you have to save him!" the child’s father said frantically.

"Resuscitation Room Two! Call a cardiothoracic surgeon over!" Liu Banxia shouted.

He didn’t take the child, worried that a transfer might cause secondary injury.

"Connect the monitor! STAT X-ray!" Once the father laid the child on the examination table, Liu Banxia pulled him aside.

"No rib fractures, but the abdomen doesn’t look good. Where’s the cardiothoracic surgeon? Notify the OR to prepare. STAT blood tests, type and crossmatch, establish IV access, bedside ultrasound!" Liu Banxia barked, looking at the displayed X-ray images.

"President Liu, what’s the situation?" Wu Xiaoyue, the cardiothoracic surgeon, rushed over.

"Crush injury from a storage cabinet. It looks like the diaphragm is compromised, and the chest X-ray is a mess. There’s also free fluid in the abdominal cavity. Take him directly to the OR," Liu Banxia said.

Wu Xiaoyue glanced at the X-ray, her expression turning grave.

Even though an X-ray wasn’t as clear as a CT scan, organ displacement was still roughly visible. The child’s heart silhouette was obscured; something was definitely blocking the view.

"Wang Chao, explain to the father. We’re going straight to the OR," Liu Banxia ordered, then pushed the gurney towards the elevator, looking almost frenzied.

People quickly cleared a path, not only because it was an emergency but also because of Liu Banxia’s grim expression.

「」

"Su Wenhao, perform an exploratory laparotomy. The ultrasound wasn’t very clear, but I suspect intestinal perforation," Liu Banxia said while scrubbing in.

"Doctor Wu, we can’t assess the thoracic situation yet. We’ll need your expertise for the chest after our initial exploratory laparotomy. If necessary, I’ll assist you."

Wu Xiaoyue nodded. "If it’s just a simple displacement of abdominal organs, it might not be too bad. Let’s see."

Upon entering the operating room, they found the anesthesiologist was Li Liwei, who had just finished another procedure.

"The child is already anesthetized. You can begin," Li Liwei said.

"Su Wenhao, exploratory laparotomy. I’ll be first assistant," Liu Banxia stated.

Su Wenhao began the operation immediately.

"Exploration reveals intestinal contents in the abdominal cavity, two intestinal perforations, a ruptured diaphragm, and the stomach... has herniated into the thoracic cavity. Intestinal perforation repair is indicated," Su Wenhao announced after opening the abdomen.

"You clean the abdominal cavity and repair the perforations. I’ll reposition the stomach," Liu Banxia directed.

He’d never done this specific repositioning before, but it had to be done now, and carefully.

"Damn it! There’s a one-centimeter tear in the stomach! I’ll repair it."

Liu Banxia cursed as he gently shifted the stomach.

The tear wasn’t visible while the stomach was in the thoracic cavity, but now it was clear. Some stomach contents had already leaked out.

"I’ll insert a chest tube for irrigation and post-operative drainage," Wu Xiaoyue quickly offered.

The gastric tear posed a greater threat to the thoracic cavity than the intestinal perforations did to the abdomen. Stomach contents, containing gastric acid, could damage thoracic organs and cause infection.

The most straightforward approach would be a thoracotomy, but that would be too invasive for the child. So, Wu Xiaoyue stepped in to handle this part. Even if it was more complex, it needed to be done meticulously.

Even through the observation screen, Xu Yino and the others could almost feel the simmering frustration emanating from Liu Banxia. Ordinarily, during a gastric repair like this, he would have been explaining the steps.

Now, he was too preoccupied to utter a word, a clear sign of his foul mood.