top student at medical school

Chapter 20 Asymptomatic Aortic Aneurysm (Please add to your favorites and read on!)
"It's possible."

"Sister, do you experience any pain when I press on it?" Fang Ziye did not feel any particularly obvious pulsating lumps, indicating that the aneurysm might not be very large in diameter.

But we still need to ask to clarify.

The older woman shook her head: "No, my stomach has never hurt, I don't feel anything."

"Okay, then, please go downstairs and get an emergency abdominal vascular ultrasound. I just listened to your chest and there was a pulsating murmur in the blood vessels in your abdomen."

“But we don’t know what it is! Is that okay? Although we’re going to have surgery, we need to understand the diagnosis and the situation to minimize the risks,” Fang Ziye suggested.

The man said, "We're already at the hospital, so of course we'll listen to what you say, doctor. But is this ultrasound expensive?"

"It's alright, it'll cost about 150 yuan. You were going to get a color Doppler ultrasound of the blood vessels in both lower limbs anyway, so you can do it together," Fang Ziye replied.

Patients with lower limb deformities definitely need to undergo thrombosis testing, because prolonged passive immobilization can easily lead to thrombosis.

"Okay then." The two were relieved to hear that it wasn't particularly expensive.

After the two left, Lan Tianluo asked, "Senior brother? Is there really a problem?"

“It’s like a blowing noise. You can listen to it after the ultrasound. It’s very typical,” Fang Ziye replied.

Although the patient is currently asymptomatic, the morphology of the abdominal aortic aneurysm is still very important. The absence of symptoms does not mean that no treatment is needed. If the morphology is not good, even without symptoms, surgery will definitely be required to remove it.

This requires evaluation by a vascular surgeon.

"Tianluo, go to the nurses' station and tell the nurse on duty that we'll put this patient in our group for now. I'll report to my mentor." Fang Ziye assigned the tasks in this way.

Ultimately, a junior master's degree holder is just an attending physician, someone who works at the very bottom. Fang Ziye has no decision-making power, so he can only get his teacher involved or report to the head ward.

But the patients weren't in their own group, so even if they were reported, they'd probably be told to wait until a consultation was arranged. Fang Ziye then considered whether he could bring the patients to his own group first.

After sending a message, I briefly and clearly explained the situation and offered suggestions to the teacher.

Yuan Weihong then called: "Have you listened carefully?"

"Yes, Master, it's a blowing noise, that's pretty much it, very typical. I've already had the patient and family get an abdominal aortic ultrasound."

"Should we request an emergency consultation or a scheduled consultation?" Fang Ziye replied when he answered the phone.

Patients who come to the department from the outpatient clinic for elective surgery are all patients with severe symptoms who absolutely need surgical treatment. Even if a patient goes to the vascular surgery department, they will still need to come to the orthopedics department for treatment later.

Otherwise, the lameness caused by the unequal length of the two lower limbs will continue.

"I need an urgent consultation. I'll call the vascular surgery department. Send me the patient's medical record number, and I'll have them take a look."

“If you call the chief resident, they might not even answer,” Yuan Weihong said before hanging up.

Asymptomatic abdominal aortic aneurysms, if they have not ruptured, are not considered emergencies, but the orthopedic department will need to wait for an assessment to determine if a referral is necessary.

In such situations, one needs to make use of their personal network. Yuan Weihong is often asked to come for urgent consultations and to review medical images, and they help each other out.

……

Then, after the patient and his wife finished their ultrasound and hadn't even returned to their ward, the phone rang from their teacher, Yuan Weihong.

"Call the chief resident of vascular surgery and ask him to come over as soon as possible to advise the patient to transfer to another department."

"Although this hemangioma is not large, its shape is not good, so it must be treated urgently. Otherwise, if it ruptures, it will not be just another disease, it will be a matter of life and death."

"Just tell them that Deng Haibo from the vascular surgery department asked you to make the call," Yuan Weihong quickly instructed.

“Okay, Master.” Fang Ziye was overjoyed upon hearing this. Because, after Yuan Weihong ended the call, Fang Ziye's knowledge points panel jumped dramatically—

Knowledge Points +21.2!

Holy crap.

This shows just how critical the patient's condition was; if not diagnosed in time, he might have lost his life or even half of his life.

With the title of Professor Deng Haibo, who was a higher-level doctor in vascular surgery, he called the chief resident of vascular surgery again. The chief resident didn't say a word of objection. After hurriedly asking Fang Ziye to send over the medical record number, he personally came from vascular surgery to trauma surgery.

Together with Fang Ziye, they persuaded the patient and his family, who both agreed to the transfer to another department for treatment, their faces dark with anger.

The chief resident of vascular surgery said, "Brother and sister, don't think Dr. Fang is annoying. This disease didn't appear because of his discovery; it has always existed. If Dr. Fang hadn't discovered it..."

"That could rupture during surgery and endanger life."

"Treatment for hemangiomas is simple now, and it's covered by insurance. Even after insurance, the cost isn't high. You know that?"

"It is unacceptable to bury one's head in the sand or to avoid seeking medical help when one is afflicted with a disease."

"If we don't discover it, and the person is gone by then, wouldn't that be a case of losing more than we gain by trying to find something small?"

Upon hearing what the resident said, the two patients sighed and nodded, "Thank you, Dr. Fang."

Fang Ziye stopped all the inpatient orders he had written, informed the nurse on duty, and the nurse on duty also stopped all the long-term orders within the department. Then, she wrote an order to transfer the patient to the vascular surgery department, and the two patients rushed to the vascular surgery department...

Upon witnessing this turn of events, Lan Tianluo's face turned ashen, and he asked solemnly, "Senior Brother Fang, what if you hadn't performed a routine physical examination on this patient, and something went wrong?"

"Then Chief Resident Jin Hongzhou is in big trouble!"

"My job is simply to detect and report it promptly. None of the patient's physical signs pointed to an abdominal aortic aneurysm."

"If we don't perform an auscultation of the abdomen, we might not even notice it on the operating table," Fang Ziye said with a smile.

While still feeling lingering fear, I also felt sorry for the couple who were suffering.

It's clear that their family isn't well-off. They came here for osteotomy and reshaping surgery, which was a hard-won opportunity. Now, with another hemangioma, things have become even more complicated. This will definitely put their wallets in an even tighter spot.

But what can Fang Ziye do about it?
As the chief resident of vascular surgery said, this disease did not appear because of Fang Ziye's discovery, but existed on its own.

If Fang Ziye hadn't been discovered in time, and had gone to the operating table, hoping to recover and walk normally, the result would have been a case of someone going in and out of the operating room—

Knowledge Points Balance: 26.9

Just then, Jin Hongzhou, who knew what had happened in the department, rushed over. After confirming the ultrasound results again, he was both shaken and relieved.

"Xiao Fang, you're truly my lucky star." The chief resident is in charge of all patients in the ward, and whether you're careless or fail to notice things in time, he bears some responsibility.

"Brother Zhou..."

"No doubt about it, you'll each get a cup of coffee as a reward."

As Jin Hongzhou spoke, he added, "Brother Zhou, I just got married and have a little one now, so I don't dare to spend too much money. Ziye, please don't say that your brother Zhou is stingy."

Fang Ziye and Lan Tianlu both shook their heads.

Before Jin Hongzhou could even order his coffee, the phone rang for an urgent consultation. Jin Hongzhou quickly put his phone away: "You guys order, I'll reimburse you later, I have to go to another consultation..."

Jin Hongzhou's pace was hurried, as if he were trapped in an endless cycle. At that moment, a new patient arrived from the direction of the nurses' station...

(End of this chapter)