I Am Diagnosed as a Medical Titan

Chapter 310: Chapter 209: Fatal Medical Accident (Part 2)

The situation was even worse than the CT scan had shown.

A large amount of pancreatic fluid had leaked out, and digestive enzymes were indiscriminately corroding everything in the abdominal cavity.

This was especially true for the transverse colon, which lay directly in front of the pancreas.

Having been soaked in the highly concentrated, corrosive fluid for so long, the wall of the transverse colon had become edematous and congested.

It was like... a piece of toilet paper that had been soaked in water for three days and three nights.

Of course, all of this was within Jiang He’s expectations.

He said calmly, ”Meng Shiyu, retract the stomach. Xu Chen, prepare to clear the fluid from the paracolic gutter.”

At that moment, Xu Chen’s heart began to race.

He was desperate to prove himself.

’I have to prove that as the first assistant, I can perfectly keep up with Jiang He’s pace!’

’Maybe I can even predict the chief surgeon’s next move, just like him!’

Xu Chen saw a large amount of exudate pooled in the left paracolic gutter, obstructing Jiang He’s view.

To clear the field of view faster, Xu Chen didn’t wait for a specific order from Jiang He and directly grabbed the Yankauer suction tip.

In his experience, from previous appendectomies, the standard procedure for cleaning the paracolic gutter was to go right in with this kind of rigid tip on high-pressure suction. It was fast and clean.

He wanted to show off his efficiency.

”Don’t—”

Jiang He caught Xu Chen’s movement out of the corner of his eye, his voice rising in alarm.

But it was too late.

Disaster struck.

Xu Chen never could have imagined how fragile the intestinal wall was at that moment.

’Idiot, you can’t use a rigid suction tip at a time like this!’

The metal edge of the rigid suction tip had punctured the lateral wall of the transverse colon!

The intestinal wall was torn open, an irregular gash three centimeters long!

”BEEP! BEEP! BEEP! BEEP! BEEP!—”

The monitor blared an alarm.

Lin Peidong quickly reported, ”Blood pressure is plummeting! 80/40! Still dropping! Heart rate has shot up to 140!”

This was caused by the massive influx of intestinal bacteria and endotoxins into the abdominal cavity, triggering acute vasodilation.

The temperature in the entire operating room seemed to plummet.

Xu Chen froze completely.

His pupils constricted violently.

His hand hovered in mid-air, unsure of what to do.

’Iatrogenic transverse colon perforation.’

In a normal abdominal trauma surgery, if you accidentally ruptured the bowel, you could quickly suture it, rinse the area thoroughly, and maybe salvage the situation.

But this was the abdominal cavity of a patient with Severe Acute Pancreatitis (SAP)!

An SAP patient’s immune system was already on the verge of total collapse.

A rupture of the transverse colon at this stage meant that countless E. coli and other intestinal anaerobic and aerobic bacteria were now pouring into the abdominal cavity.

If left untreated, these bacteria would quickly enter the bloodstream, triggering severe Systemic Inflammatory Response Syndrome (SIRS) and septic shock.

The patient would never make it off the operating table. The mortality rate... was approaching one hundred percent!

Xu Chen’s mind was buzzing.

He knew what he had done.

’Murder.’

A conventional bowel suture was completely pointless now.

Even if he stitched the intestine up, the highly concentrated pancreatic fluid in the abdominal cavity would digest the tissue within days, inevitably leading to a second, fatal intestinal leak.

It was over.

Everything was over.

The patient was going to die.

And he was finished.

”Jiang... Jiang He... I...” Xu Chen’s voice was trembling so violently that extreme fear prevented him from forming a complete sentence.

The second assistant, Meng Shiyu, was also scared stiff, his hand holding the retractor frozen in place. He hardly dared to breathe.

Lin Peidong frantically worked the infusion pump. ”Starting a max-dose norepinephrine drip! Leader Jiang, his blood pressure won’t stabilize! Signs of shock!”

Amidst the chaos, the only one who remained absolutely calm was Jiang He.

What happened had happened. Blame was pointless.

What mattered was...

Solving the problem.

And saving the patient.

Jiang He said immediately, ”Xu Chen, let go. Step back.”

Xu Chen released his grip reflexively, his legs giving out as he stumbled back two steps.

Jiang He: ”Meng Shiyu, take the first assistant’s position.”

”Yes... Yes!”

As if waking from a dream, Meng Shiyu quickly stepped into Xu Chen’s former spot.

Jiang He knew that suturing was absolutely not an option.

The pancreatic enzymes would devour everything.

Bowel resection and anastomosis was also out of the question.

The patient, in his current state of shock, couldn’t possibly withstand a lengthy digestive tract reconstruction. Furthermore, the anastomosis site would almost certainly break down after being soaked in pancreatic fluid.

The only path to survival was damage control surgery (DCS).

”Allis forceps.”

The scrub nurse immediately handed over two toothed tissue forceps.

Using a piece of sterile gauze, Jiang He grabbed the transverse colon below the rupture.

He forcefully pulled the transverse colon out of the abdominal cavity, exposing it completely outside the abdominal wall incision.

Xiaomeng was completely stunned.

His heart was pounding, and his hands were even shakier.

Everyone had the same thought:

’What is Jiang He doing?’

Lin Peidong shouted, ”Leader Jiang, blood pressure is still dropping, it’s 60/30!”

”Mm, keep a close watch on it.”

Jiang He said:

”Tissue scissors, large right-angle clamp.”

Taking the instruments, he swiftly used the right-angle clamp to dissect the transverse colon’s mesentery on both sides of the rupture.

Then, with the tissue scissors, he completely transected the ruptured section of the transverse colon.

”Suture, 3-0 absorbable.”

What followed was a textbook-perfect double-barrel transverse colostomy!

If it couldn’t be sutured inside the abdomen, then he simply wouldn’t leave it in the abdomen!

Jiang He’s strategy was as follows:

He would create a temporary stoma on the patient’s abdominal wall. Then, he would perform a full-thickness suture to fix the mucosal layer of both ends of the bowel directly to the skin. This would allow intestinal contents to drain directly from the abdominal wall to the outside of the body.

Since the bowel had been completely transected and externalized, it physically eliminated any possibility of fecal matter continuing to leak into the abdominal cavity.

Passing the needle, tying the knot.