Chapter 668 We must win!

Ji Xiang changed clothes and returned to the ward, where he saw Lu Gang angrily sitting in front of the computer and reading medical records.

"Director Lu, what's wrong?" Ji Xiang asked.

"Acute abdomen, especially gastrointestinal, liver and gallbladder, these cowards are unwilling to operate." Lu Gang said angrily, "Although I don't think it can be operated on, it doesn't look like intestinal perforation, but the patient's condition is not right."

It was obvious that Lu Gang was a little anxious and confused, so he spoke in a messy manner, as if he had no idea and relied solely on instinct to express his anxiety.

Especially after he had just scolded his liver, gallbladder, and gastrointestinal tract, and then said that he didn't think he could have surgery, he almost made Zhao Zhe laugh out loud.

Ji Xiang leaned over and took a look at the laboratory report.

Emergency abdominal color ultrasound showed thick liver echo, thickened and rough gallbladder wall, and a small amount of fluid in the abdominal cavity.

Blood gas analysis: oxygen partial pressure 53.8mmHg, oxygen saturation 84.6%.

Serum potassium 2.4mmol/L; renal function: urea nitrogen 22.08mmol/L, creatinine 352μmol/L, uric acid 428μmol/L.

Depression itself will not cause abdominal pain, but if a disease such as abdominal epilepsy persists for a long time and has no definite diagnosis, it will cause the patient to enter a state of anxiety and develop depression over time.

Ji Xiang re-examined the medical records of the Department of Gastroenterology, "Does the patient have family depression?"

But Director Lu has been hesitant.

The gastroenterologist said after briefly introducing the patient's condition.

Abdominal epilepsy is also possible.

After Lu Gang and Ji Xiang left, Lin Jiuze began to write and draw in his notebook.

This question was close to the point, and Lu Gang nodded nervously.

The antecedents and consequences are exactly opposite, but clinically they appear together, so they are also within the scope of consideration.

It's just that he didn't realize it.

Even the harmless expression of human and animal was gone. At this moment, Lin Jiu was full of fighting spirit.

Lin Jiuze caught this detail, and various diagnoses about depression causing abdominal pain popped up in his mind.

The case had already been laid. In a short period of time, Lin Jiuze wrote at least ten diagnoses, but none of the diagnoses were correct. He even had deep doubts about the knowledge he had learned.

There was a knock on the door.

"It's quite a typical acute abdomen. Does standing abdominal dialysis support gastrointestinal perforation?" Ji Xiang asked again.

Abdominal pain and acute abdomen are not organ problems, nor are they abdominal epilepsy, nor are they common diseases such as volvulus and intestinal spasm.

"The acute abdomen is already obvious. These are typical signs of laparotomy!" the gastroenterologist insisted, "If we don't even need surgery, what else can be done?"

There is a problem, and Lu Gang doesn’t know where the problem lies.

What else could it be?

Lin Jiuze racked his brains and thought.

"I remember that this patient had been consulted for the third time. The first two times..." said the deputy director of the gastrointestinal surgery department. "The most outrageous thing was the second time, when I was submitting the order to prepare for surgery, the patient suddenly said that the pain was relieved."

Soon, Lin Jiuze fell into deep confusion.

Lin Jiuze knew that many times when doctors encountered difficult and complicated diseases, they relied on years of clinical experience to make judgments. If they really wanted to tell you one, two, three, four, five, they couldn't do it.

"When will the hospital-wide consultation begin? Have you seen the patient, Director Lu?" Ji Xiang asked.

The palms of his hands were a little wet, but Lin Jiu didn't notice. He subconsciously wiped the sweat on his white clothes.

"Blood pressure 210/148mmHg, respirations 23 times/min, oxygen saturation 99%, T36.8°C, heart rate 105 beats/min. Breathing sounds in both lungs are thick, crackles are heard in the right lung, no wheezing, heart rate 105

Times/minute, regular, no pathological murmur.

There is acute renal failure, accompanied by hypokalemia. These are nothing in the face of acute abdomen and can be treated with drugs.

"I don't think we can operate." The surgeon said, "The patient's pain was relieved before the operation the first two times. If the problem cannot be seen after opening this time, or if the gallbladder can only be cut out after a long search, the pain will still be there after the operation.

What should we do."

"I took a look yesterday, and we'll go take a look together later," Lu Gang replied naturally.

This time, I absolutely cannot lose!

He opened the drawer, took out his small notebook, and held it tightly with his hand.

"Director Lu, how about the physical examination?"

When they came to the Department of Gastroenterology, Lu Gang and Ji Xiang had a physical examination, while Lin Jiu stood in the corner and observed their every move as well as the patient's face and body language.

He took this patient very seriously, much more seriously than he did at Massachusetts General Hospital.

As for the "clinical manifestations", it is just like what Lu Gang looks like now.

I have a basic understanding of the patient's condition, and it looks like he has an acute abdomen. If it were a normal hospital, the surgeon would definitely open it up and see what the problem is.

"Well, when I see patients, I don't think anyone in the family has depression. The diagnosis of this disease, hey." Lu Gang didn't continue, he just said hey.

"I have also considered this. Is it acute cholecystitis? Although cholecystitis is not serious on B-ultrasound, severe pain and acute abdomen can still occur. Every time I am hospitalized, I need to give antibiotics intravenously. Under the action of antibiotics, the gallbladder

It’s normal for the inflammation to be suppressed.”

Lu Gang's hair was hanging down, and he couldn't care less. It looked like his mind was running rapidly, trying to figure out what the patient's condition was.

fighting!!

Must win!!!

When you write, you raise your head to observe; when you lower your head to write, you raise your head again to observe.

At the same time, Ji Xiang was discussing the condition with the patient's family, and Lu Gang began to preside over the hospital-wide consultation.

Ji Xiang immediately opened the door and walked in quietly.

Many doctors have different opinions, but there is no unified answer.

Lin Jiuze suddenly became interested. Based on his understanding of Ji Xiang, he knew that Ji Xiang would follow Director Lu Ganglu to attend the consultation.

Emergency amylase 137U/L; blood routine: white blood cells 9.3×109/L, neutrophils 0.787, hemoglobin 105g/L.

Lin Jiuze went all out this time. He was no longer as lazy as before, his eyes were shining, his hand was holding the notebook tightly, and the ball pen made a rattling sound.

Some things cannot be explained clearly, it is a kind of "sixth sense" formed by seeing the patient too much.

"I don't think it's that simple. Generally speaking, cholecystitis will cause upper abdominal pain. Except for cases where the gallbladder is perforated and bile flows all over the stomach, there will be no signs of a slab-shaped abdomen."

"The situation this time is different from before. The patient's slab-shaped abdomen is particularly obvious, accompanied by tenderness and rebound pain. Acute abdomen can be clearly diagnosed. Although there is no crescent on the standing peritoneal dialysis, it may be intestinal perforation and gas leakage.

Not much."

The abdominal muscles are tense, there is tenderness and rebound tenderness throughout the abdomen, the abdomen is flat, the bowel sounds disappear, and the face and limbs are not swollen."

fighting!

Both sides insisted on their own opinions and started arguing.

The more they talked, the more intense they became, and there were even signs of slamming the table and scolding the mother.

"Keep your voices down!" Lu Gang raised his voice to suppress everyone's quarrel, "Can't you say nice things properly? What are you talking about?"

Several doctors held back their words unconvinced and angrily.
Chapter completed!