Doctor of Healing

Every sentence is a summary of years of clinical experience, full of dry goods.

Director Kong spoke for at least 5 minutes before he smiled slightly, "This time you are thinking too much. But, you should think more."

"Mr. Kong, there is still a problem with the patient's physical examination. When you did the B-ultrasound, you pressed the gallbladder deeply, and the patient had a painful expression." Ji Xiang insisted.

Director Kong was stunned for a moment, then laughed, "You child, why are you so stubborn!"

Mr. Miao's heart sank. It's over. Director Kong will definitely lose his temper next time.

Having explained it to Ji Xiang in such detail, he still insisted that the patient had a problem with the gallbladder, which is a kind of pushing the nose on the face.The key is that Jixiang kept kicking and kicking after putting on his face, which was annoying.

"Your temper is just like when I was young!"

Director Kong patted Ji Xiang on the shoulder again, forcing him kindly.

"It just so happens that I'm fine today. I'll have surgery with you later, and I'll tell you the truth."

Mr. Miao burst into tears with a "wow".

How could Director Kong, who is usually strict, treat Ji Xiang so well!

Chapter 535 Speak with Facts

Seeing Director Kong hand over the car to the doctor in the B-ultrasound room, and then he and Ji Xiang went to talk and chat while talking and laughing, Mr. Miao felt lost and sighed deeply in silence.

Not only did he notice Ji Xiang himself, but even the director of the dignified B-ultrasound room looked at Ji Xiang differently.Not only did he look at him differently, but he also treated him like a nephew.

Forget it, I'm still busy.

Mr. Miao went to persuade the family members of the patient, then submitted the emergency operation order, and went to explain before the operation.

The set was busy, and there was no time to drink water, so the operating room came to pick him up.

When sending the patient to the stage, Mr. Miao originally wanted to ask Ji Xiang to come with him, but he saw Ji Xiang sitting in front of the computer, typing on the keyboard indiscriminately while chatting with Director Kong, and the two were talking and laughing.

Mr. Miao felt a little sour, he greeted Director Kong, and pushed the patient to the operating room.

"Mr. Miao, your shift is very busy. There is an emergency in the morning."

After entering the operating room, the anesthesiologist said with a smile.

"Don't mention it, the patient's family members disagree with the operation, and they reluctantly agree to it until it fails."

"Perforated?"

"No, Director Kong took an ultrasound and said it was fine. But there are signs of peritonitis, open it and have a look."

"Oh? The B-ultrasound performed by Director Kong himself? Who in the hospital greeted her? Or is she a relative of Director Kong's family?" the anesthesiologist asked casually.

Mr. Miao didn't bother to explain.

This is too long to say, and Mr. Miao was worried that the anesthesiologist would not believe it even if he said it, so he didn't say it at all.

"Xiao Miao, what is the emergency room?" Director Feng just stepped off the stage, and asked by the way when he saw Mr. Miao passing by the emergency room.

Mr. Miao reported the patient's medical history.

"Director Kong?" Director Feng noticed this detail.

In fact, it's hard not to notice that an ordinary patient doesn't need a consultation, and whoever has nothing to do can move Director Kong to do a B-ultrasound.

"It's Dr. Ji Xiang's opinion. He contacted Director Kong." Mr. Miao explained helplessly.

"That's right." Director Feng narrowed his eyes.

After hesitating for a second, he turned and entered the operating room, and made a gesture to ask the anesthesiologist to suspend the anesthesia and start the physical examination.

In less than a minute, Director Feng finished his physical examination, and he frowned slightly and sat on a stool in the corner.

"Director, you think it's appendicitis."

"Yes." Director Feng said seriously.

Mr. Miao noticed that his director had been staring at the patient on the operating table, full of doubts.

"Director, the patient's diagnosis is very clear, including B-ultrasound auxiliary examination." Mr. Miao said, "Maybe we are overthinking."

"Murphy's spot does feel a little tender, but it's not serious." Director Feng said something vague.

That being said, Director Feng's serious expression between his mask and hat showed the problem.

Mr. Miao stood aside silently, and waited for the anesthesiologist to finish the continuous epidural anesthesia and began to brush and disinfect his hands to prepare for the operation.

Director Kong's voice came from outside the door of the operating room, and he walked into the operating room while talking to Ji Xiang.

"Director Feng, why are you here?" Director Kong asked after entering.

"This is a patient from our department. Let me take a second look. Besides, you're here too." Director Feng stood up and joked, "Old Kong, when did you become interested in surgery?"

"The patient is rather strange, so I'll follow up to take a look." Director Kong said, "Xiaoji reminded me that the patient has signs of localized peritonitis, and it seems problematic to explain it with the inflammatory exudation around the appendix."

"Limited peritonitis in the middle abdomen, but it's not serious, just a little bit." Director Feng added, "Is there any problem with the gallbladder?"

"No."

The two exchanged a few words and said nothing more.

Seeing Mr. Miao's list, Ji Xiang suddenly asked, "Mr. Feng, can we use the single-hole endoscope?"

"Huh?" Director Feng was taken aback.

This is the operating room, what qualifications do you, a junior doctor, have to speak!

You have to tell me how many holes to drill!

If it wasn't for Ji Xiang's coming and giving him a top SCI paper for nothing, Director Feng would have kicked Ji Xiang out of the operating room long ago.

"It's okay to use it first, I think it's best to prepare the reserved position for other holes a little higher, to leave room for the liver and gallbladder."

"!!!" Director Feng looked at Ji Xiang suspiciously, trying to figure out what Ji Xiang was thinking in his gaze.

Ji Xiang's eyes are clear, like a pool of stream, which can see the bottom at a glance.

Because of the case of intraperitoneal loose bodies and the bribe of the top SCI, Director Feng didn't say much. He nodded and reserved the surgery area when he asked Mr. Miao to place the order.

Mr. Miao's mood was a little weird, but he didn't dare to let go of a fart, and honestly followed the director's instructions and started laying out the list.

A hole was drilled at the navel, and as soon as the endoscopic lens could see clearly, several surprised "huh" voices sounded in the operating room.

On the TV of the cavity mirror, there should be a light red background, but when the mirror goes in, the whole field of view is gray-green plus white-green.

There is pus moss, and... pus?No, that looks like bile!

Not as if, but for sure.

It is bile!

Ji Xiang's judgment is right!

Mr. Miao felt numb all of a sudden, he turned to look at Director Feng.

"I'll go to Lao Yang for a consultation on the stage." Director Feng said.

He took out his mobile phone, stood in the corner, looked deeply at Ji Xiang, and made a call to Director Yang.

Director Feng hung up the phone after briefly telling the patient's situation.

"Xiaoji, how do you judge?"

Director Kong, who wanted to educate Ji Xiang with facts, was also stunned, and he asked suspiciously.

"I guess, guess Mr. Kong. Elderly fasting patients, because of bile retention and concentration, as the gallbladder enlarges, the gallbladder wall becomes thinner. Coupled with the stimulation of bile salts, the gallbladder wall becomes aseptically inflamed."

"Due to the compression of the gallbladder fundus, loose tissue, and edema, it eventually leads to perforation of the gallbladder fundus."

"This kind of perforation is different from the gallbladder perforation we usually encounter. It is not a perforation caused by inflammation, ischemia and necrosis of the gallbladder. Therefore, the discontinuous band shown on the b-ultrasound is relatively short, and it is even difficult to find. It is also relatively difficult to make a differential diagnosis. Difficult, I'm just guessing."

After a brief description, Ji Xiang stopped and said no more.

Several doctors in the operating room were lost in thought.

What Ji Xiang said is indeed a possibility, but this kind of possibility...is too rare.

"Xiaoji, tell me your thinking."

Ji Xiang smiled and said nothing, Director Kong and Director Feng saw that Ji Xiang was silent, and didn't ask too much.Maybe it was just Jixiang's flash of inspiration, and he didn't have a detailed idea.

Similar situations are very common in clinical practice, especially common, so Director Feng understood and did not "press" Ji Xiang.

Soon, Director Yang brought Zhai Yuhan up.

After asking about the situation, Director Yang asked Mr. Miao to turn the camera, barely found the location of the gallbladder, moved it with pliers, and took a deep look at Jixiang with great interest after seeing the point of perforation.

Chapter 536

"I'm going to brush my hands." Seeing that the gallbladder was ruptured, Director Yang greeted him and turned to brush his hands.

Zhai Yuhan took a deep look at Ji Xiang, didn't this kid go to the gastrointestinal surgery to exchange experience, why did he toss himself and the boss again.

What a busy guy.

"Xiao Miao, come down." Director Feng and Mr. Miao said.

Mr. Miao was a little confused. Before he could ask Ji Xiang about the loose abdominal body, Ji Xiang taught himself a lesson.

Cholecystitis presenting as acute appendicitis?Or the very rare gallbladder rupture?

I haven't seen it, and I + B ultrasound director Kong didn't see it.

Mr. Miao was a little embarrassed after stepping down.

Although it did not lead to an accident, it was still a misdiagnosis.In the face of misdiagnosis, it is inevitable for doctors to have a mentality of self-blame.

"I'll make the sheets." Zhai Yuhan said with his hands in front of his chest, and wiped his hands as he walked into the operating room.

"Surgical sheet, I have reserved a seat for you." Mr. Miao said.

"Huh?" Zhai Yuhan was stunned for a moment, "You have already made a judgment? Why didn't you ask me for a consultation?"

After two consecutive questions and a knowing blow, a huge number popped out of Mr. Miao's head, and his blood turned red.Difficulty breathing and rapid heart rate.

Director Kong smiled and said, "Xiao Miaozi called the bedside ultrasound. I did it, but I didn't see it. It was Xiaoji who insisted on it, so I reserved your place. It's just a simple disinfection, just punch a hole upwards, The belly button one works too."

Zhai Yuhan didn't straighten out the relationship for a while, but she didn't stop, she got dressed and prepared for the operation.

"Director Feng, if you didn't notice it, I'll ask you if you're embarrassed." Director Kong didn't care that he didn't see the gallbladder perforation, but asked Director Feng.

Director Feng glared at him, and said, "What's so embarrassing about this rare situation? The most embarrassing time I encountered was when the anesthesia was completed, the sheet was laid out, and the patient complained of pain as soon as the knife was performed on the stage."

"Is the anesthesia not in place?"

"It's in place. At that time, Lao Liu was still on stage, and he was numb." Director Feng said, "I don't know what's going on, so I can only stop and press the incision with my hand, and Lao Liu continued to administer medicine."

"If Lao Liu is anesthetized, there is nothing to say." Director Kong said, "But this matter is indeed... the patient should be shocked."

"Well, it was really painful when I was a patient, I almost overturned the operating table."

"I encountered an embarrassing thing during my internship." Ji Xiang said suddenly.

Director Kong didn't find it strange at all. He looked back at Ji Xiang with a smile on his face. Seeing Ji Xiang standing obediently in the corner, he was even more satisfied with this young man.

Complacent but not forgetful, I didn't have this kind of heart when I was young.

"What happened to you, Xiaoji?"

"During my internship in the affiliated hospital, I once went to the interventional catheterization room. The asepsis in that side is very general, not so strict, and it is incomparable with our large foreign operating room."

When several directors heard Ji Xiang talk about our operating room, they were all in a daze.

Jixiang's interventional surgery is so wonderful, and there is a high probability that he will continue to improve in the interventional discipline in the future, and then reach the pinnacle.

But he casually said things like our surgery room.

This kid is really weird.

"One day the dean came for an inspection, and the head nurse and I went to greet him. The head nurse was very attentive and handed over the shoe covers. The dean came from an administrative background and rarely entered the operating room. He just put the shoe covers on his head. superior."

"!!!"

"Just as I was about to speak, the head nurse stopped me, winked, and pretended nothing happened."

"Hahaha, that's true. It's not true if you don't say it, and it's not true if you don't say it. It's best to pretend that you didn't see it." Director Kong laughed.

"At that time, I couldn't hold back the laughter, and all the merits of the day were gone." Ji Xiang chuckled.