Doctor of Healing

"From my point of view, it should be fine."

The patient clenched his fists with excitement.

Director Bai felt helpless.

He has practiced medicine for decades, and he has never seen a doctor who turned his medical history inquiry into a chat.

Jixiang is the other kind.

Chapter 654 The Unscrupulous Physical Examination

"I read in the medical records that you have an inguinal hernia?" Ji Xiang "finally" remembered that he was a doctor, and asked a medical-related topic.

But Chief Bai expressed his helplessness.

Although inguinal hernia is a medical category, it has nothing to do with postoperative bleeding in patients with internal hemorrhoids.

"Hi, don't mention it. I have a sports hernia. Many people who play basketball have this problem. They say that there is a problem with the core muscles. When I was young, I was thinking about surgery, but I was afraid of pain and I was busy with work, so Just forget about it."

Jixiang and the patient started chatting along the inguinal hernia, and Jixiang even had a physical examination for the hernia.

If it was someone else, Director Bai would go up and kick his ass, telling him to get out.

The purpose of consultation is to solve the postoperative bleeding of internal hemorrhoids, not the inguinal hernia after exercise!

As the name suggests, inguinal hernia after exercise refers to a disease that occurs only after strenuous exercise, and it can basically be repaid, even if it is strangled with a hernia belt, it is a disease that does not matter.

Ji Xiang...

What a digression.

"Hello, Director Bai." Lin Jiuze greeted Director Bai with a harmless expression on his face while holding a notebook in his hand.

When he spoke, the patient's family was shocked.

For five or six minutes, none of them noticed that there was still someone standing here.

"Professor Lin, what do you think?" Director Bai looked forward, not looking at Lin Jiuze at all.

As long as you don't look at him, the feeling of dizziness will be much lighter. Director Bai quickly found a way to deal with Lin Jiuze.

"It's weird, I don't have any opinion for the time being." Lin Jiuze said helplessly, "Doctor Ji Xiang probably doesn't have any opinion either."

Looking at Ji Xiang who was doing a physical examination and explaining the inguinal hernia to the patient, Director Bai thought so too.

"There are not many similar patients at Massachusetts General Hospital."

"I don't know, my profession has nothing to do with this kind of disease."

Director Bai didn't say anything, since he specialized in surgery, it's normal for Lin Jiu not to understand.

Director Bai understood half of what Lin Jiuze wrote in the notebook just now, which was about the same as the guesses of the directors in the office, but Lin Jiuze also wrote about treatment, which was more detailed.

Plus some very rare diseases.

Director Bai's judgment on Lin Jiuze is that his professional level is better than that of the directors of the Second Affiliated Hospital, even though hemorrhoids is not his own specialty.

Especially for the differential diagnosis of those rare diseases, Lin Jiuze's technical level is unquestionable.

It seems that I can only go to Xiehe for consultation, Director Bai has a headache.

He usually doesn't want to use the relationship on the Xiehe side. After all, it's very troublesome to maintain the relationship.

Ji Xiang was doing useless work, Director Bai didn't bother him, but stood patiently at the door and watched.

"Doctor Ji Xiang's consultation is very strange, don't you think Director Bai?" Lin Jiuze spoke suddenly.

"good."

"Your court really values ​​talents." Lin Jiu said something nonsensical.

Director Bai heard a little provocation.

But he still didn't say anything, and didn't look at Lin Jiuze, just pretending that he didn't exist.

A few minutes later, Jixiang and the patient said goodbye with a smile. Although the time was short, the two seemed to have a good relationship, and they were short of beheading chicken heads and burning yellow paper on the spot.

"I'm going to talk about my opinion, don't worry, I will recover soon." Ji Xiang shook hands with the patient and said goodbye with regret.

After leaving the ward, Director Bai looked at Ji Xiang, and said nothing as soon as possible.

"Director Bai, the patient's inguinal hernia is very strange." Ji Xiang said the first sentence after going out.

Director Bai felt a little strange.

He guessed that Jixiang had already had a definite diagnosis, but he didn't explain it clearly. Could it be that Lin Jiuze jumped out by himself and took a blow?

But Lin Jiuze is also a human being, and he doesn't speak at all, as if he really disappeared.

Director Bai couldn't see through Ji Xiang, and didn't know whether his guess was true or not. Ji Xiang said immediately, "I suggest a B-ultrasound."

"I did a B-ultrasound, but didn't you see it?" Director Bai immediately realized that he seemed to have made a mistake after reminding him, "Xiaoji, what position do you want to see?"

"I consider the patient is chronic Budd-Chiari syndrome, and I want to see the location and length of hepatic vein and inferior vena cava obstruction at the top of the diaphragm and the second porta hepatis to determine whether it is a diaphragm type."

"!!!"

"!!!"

Director Bai and Lin Jiuze were both taken aback for a moment.

This diagnosis.

Unconstrained.

Both of them are very smart, and they are also top medical figures. After Ji Xiang said his diagnosis, both Director Bai and Lin Jiuze had an epiphany almost at the same time.

Budd-Chiari syndrome is a posthepatic portal hypertension characterized by inferior vena cava hypertension caused by obstructive lesions of the hepatic vein and its opening above the superior vena cava caused by various reasons.

The disease is divided into acute, subacute and chronic.

Most patients with chronic Budd-Chiari syndrome will show a dyscratic state, or a spider-man state.

However, there are very few patients who have no special physical features to suggest that, in addition to a small amount of peritoneal effusion, there will be hernia and hemorrhoids.

In one sentence, Ji Xiang connected all the things together to form a perfect closed loop.

"Xiaoji, how did you know that?" Director Bai asked with a frown.

"Everyone ignores a small amount of peritoneal effusion, because the amount is small, and it is normal to ignore it, but I don't think so." Ji Xiang said, "In addition, the patient has clinical symptoms of inguinal hernia and continuous bleeding after internal hemorrhoid surgery, so my The initial diagnosis was Budd-Chiari syndrome."

"After the physical examination, it was found that the veins in the patient's lower abdomen were slightly distended, including the patient's jugular veins. Of course, these are my guesses, so let's do an examination first."

Director Bai nodded, he turned around and went to the office with Ji Xiang.

The moment he turned around, Director Bai was a little dizzy, and he immediately overcame his physical discomfort and looked back.

Lin Jiu didn't go with him, but stood in the ward and wrote something in his notebook. As he wrote, he looked up at the patient.

Director Bai confirmed the guess in his heart, turned around and chatted with Ji Xiang while correcting his eye contact.

"Xiao Ji, how high do you estimate the correct diagnosis rate is?" Director Bai asked.

"Eighty percent." Ji Xiang gave a reasonable answer.

"Yes, the operation should be very simple."

"It's very simple. You can do it in the vascular department or the interventional department. It depends on who has done it. Similar cases are rare. Chronic Budd-Chiari syndrome + normal liver function are difficult to diagnose." Ji Xiang said.

Director Bai smiled slightly, and looked sideways at Ji Xiang.

In contrast, Ji Xiang has a kind face, while Lin Jiu looks like a devil.

"I didn't mean that." Ji Xiang saw what he wanted to say from Director Bai's eyes, and quickly explained.

"Hahaha, it's okay, I know you want to say something good for the directors." Director Bai said, "Seek a B-ultrasound consultation. By the way, Xiaoji, if you have any difficulties in the work of the Provincial Department of Self-Care, please call me directly. "

Chapter 655 Can only be attributed to luck

Lin Jiu came out of the ward, followed behind Ji Xiang and Director Bai, and silently heard Director Bai talking about the provincial self-administration department.

When he got off the plane, he heard Director Bai and Ji Xiang talking about Jieqing. Some of these terms Lin Jiu had come into contact with, and some hadn't, but it didn't matter.

Even if you change the time, place, or person, as long as people with a normal mind encounter Jixiang, they will invest certain resources after testing and understanding.

The exact amount of resources depends on the situation at the time.

For example, Lin Jiuze himself.

He is very distressed now and doesn't think much about it.

The patient who kept bleeding after internal hemorrhoid surgery was the patient who Lin Jiuze actually met Ji Xiang for diagnosis in his clinical work.

There is no film crew here, and there is no such thing as leaking a confirmed diagnosis or a major diagnosis in advance.

He repeatedly "diagnosed" and got wrong answers, but Jixiang got the diagnosis of Budd-Chiari syndrome after chatting with the patient when he went to ask about the medical history.

Lin Jiu felt that Ji Xiang was interesting.

Diagnosis is wild and unrecognizable.

As long as it is a doctor, he will be obsessed with the inexplicable postoperative bleeding of the patient. Who will make a fuss about the inguinal hernia after exercise after asking the medical history.

But Jixiang did it, and it was full of flowers.

In the end, Lin Jiuze himself confirmed that the patient was indeed Budd-Chiari syndrome.

If it was other diseases, Lin Jiu would not have a strong sense of frustration. Budd-Chiari syndrome is an exclusive disease of intervention and blood vessels, and he didn't even see it!

In this regard, Lin Jiu fell into deep confusion, regret, guilt, and unwillingness.

The diagnosis was confirmed by B-ultrasound, and emergency surgery was arranged. The final diagnosis was made by angiography, and the operation was performed by the Department of Vascular Surgery.

The operation of Budd-Chiari syndrome is not difficult, but the difficulty of this patient lies in the diagnosis.

After all, it is a chronic and non-stereotyped disease. Generally, it depends on luck or rich clinical experience to get a diagnosis.

Ji Xiang is very young, and his rich clinical experience seems to have nothing to do with him. Lin Jiu blames all this on luck.

It can only be attributed to luck, otherwise Lin Jiu would not be able to pass this hurdle at all.

A few days passed, and everything was uneventful.

Ji Xiang and Zhao Zhe are doing hybrid surgery for kidney cancer, and Lin Jiuze is also involved.

Because of the variety show, more people came to seek medical treatment than before, which solved Jixiang's initial distress.

And Lin Jiu is the third member of the medical team. He always stands aside and observes Jixiang quietly.

As if looking at his first love, Lin Jiu can't get enough of Ji Xiang.

This is a very strange doctor, at least Lin Jiuze has never encountered it before.

On this day, after get off work, Lin Jiuze and Ji Xiang changed clothes and prepared to go home. They performed 7 interventional embolization operations before nephrectomy in one day. The operation volume was a bit heavy, and Lin Jiuze felt very hard.

At Massachusetts General Hospital, he could only perform less than 100 surgeries a year, but he did not expect to be able to perform the usual annual volume of surgeries in one month when he came to the Second Affiliated Hospital.

However, Lin Jiu didn't feel wronged and complained. He could learn something from every operation, and his cooperation with Ji Xiang became more and more proficient.

"Doctor Lin, you should go back first, and call it a day after work." Ji Xiang said after changing his clothes.

"What about you?"

"I'm going to the emergency department. Teacher Meng is on duty today."

"Emergency department?!" Lin Jiuze's head buzzed.

When he was in Massachusetts, Lin Jiuze was particularly reluctant to go to the clinic. The patients were all kinds of strange things. Although he only saw 10 patients a day, Lin Jiuze felt overwhelmed.

Emergency, Jixiang, these two words are all over my mind.

"Can I follow along?" Lin Jiu asked.

"It's okay, it doesn't matter." Ji Xiang walked to the emergency department, took out his phone while walking, and told Meng Qingfei that he wanted to order two dumplings, stuffed with leeks and shrimps.

"Why dumplings?" Lin Jiu asked without understanding.

Ji Xiang has always been brooding about this matter, and he can't say that the more he eats, the more he gets. Fortunately, he can't drink alcohol when he is on duty in the emergency department, which is still different from the old saying.

Or is it delicious but dumplings?But the next sentence is too serious.

When Lin Jiuze saw Meng Qingfei, he felt a little bad.Especially the two dark marks on the back of Meng Qingfei's white clothes, it is hard to believe that this kind of doctor will gain the trust of patients.

He also couldn't believe that Ji Xiang would show extreme respect when talking to Meng Qingfei.