Chapter 780 - 363: Acute Abdomen, Profiting General Surgery

Chapter 780: Chapter 363: Acute Abdomen, Profiting General Surgery

"Should I call her over now to join you for the consultation? She could learn some medical knowledge from you."

Xiao Linlin said with a teasing expression.

When it comes to a big sister who is eleven or twelve years older, Li Jingsheng might not necessarily be a match for her.

"Ahem... let’s forget about it. Gossip can be fearsome, and Qinglan calls you Sister Xiao. You wouldn’t want to see her feelings get hurt, right? You go ahead and get busy."

Li Jingsheng backed down.

These days, young girls are quite bold.

He is so ’outstanding’ that many young female doctors and nurses at the Second Hospital see him as a hot commodity.

Sometimes, when someone is willing to take the initiative, Li Jingsheng gets a headache.

"Hehe, didn’t you just say you can withstand temptation? What are you afraid of?"

"I’m not afraid; I’m being cautious!"

He stubbornly responded.

When it comes to standing firm against temptation, he’s not actually afraid. But he can’t fend off gossip.

Gossip can be daunting, and if it reaches Ou Qinglan’s ears, it would pierce her heart like a thorn.

Li Jingsheng isn’t willing to do anything that might make her sad.

"It’s good to be cautious; trust is the foundation of marriage. I’m off to get busy; I’ll leave these two patients’ diagnoses to you."

She left quickly.

The child’s condition is rapidly deteriorating; the cause must be identified quickly for further treatment.

Dragging it out until a life is lost would be bad for everyone.

Doctors are also flesh and blood; they can’t just watch a patient fall into danger.

After Director Xiao left, Li Jingsheng first reviewed the examination details of the senior cadre.

To maintain such a good condition with no serious underlying diseases at over eighty years old is indeed remarkable.

Both stool routine and biochemical test results appeared fairly normal.

Pathogens like dysentery bacteria were negative, and all stool indicators seemed normal. No abnormal signs like pus or fatty stools were present.

After going over the details repeatedly, he couldn’t identify the cause.

He decided to give it some more thought after work.

He took photos of the senior cadre’s examination details for easy review during his free time or for discussion with Director Lian Tao.

Looking at the time, there were only about sixteen minutes left.

He had to quickly diagnose the other case.

Otherwise, he’d feel awkward asking Xiao Linlin to treat him next time.

This patient is relatively young, 35 years old, working as a company white-collar, engaging in planning and sales, male.

The onset of severe upper abdominal pain occurred about an hour after lunch.

The patient was brought to the hospital by the 120 emergency ambulance.

This indicates a rather serious condition.

The attending physician had already carried out some examinations. After the Gastroenterology department took over, further inquiries and tests were conducted.

However, the cause was not confirmed because the young doctors might lack experience, so they escalated the case to Director Xiao.

This is a common occurrence in small departments, where tricky problems are mostly handled by the chief physician.

Unlike major departments, which have plenty of staff and experts.

In some cases, even seasoned attending physicians can handle many problems on behalf of the chief or deputy chief physician.

Why is Li Jingsheng popular in Orthopedic Surgery?

To put it simply, while his interpersonal skills are one thing, what truly makes superiors appreciate him is his ability to help solve problems in critical moments.

Difficult and critically ill cases—Li Jingsheng can handle them all.

Who wouldn’t love such a capable aide?

"Temperature of 37.9 degrees, indicating the presence of fever. The heart rate is as high as 121 beats per minute, but blood pressure is quite low, with systolic down to 95, and diastolic at 64 mmHg. Oxygen saturation is still good, at 99%, which should be normal..."

Li Jingsheng quickly reviewed the patient’s information.

These data were obtained either through inquiries or examinations by the attending physician.

Resident doctors often perform such tasks.

The abdominal examination of the patient showed a flat abdomen without distention but with a board-like abdomen.

Additionally, there was obvious tenderness throughout the abdomen.

This implies a large lesion area.

The rebound tenderness test was particularly pronounced.

Abdominal CT results from the emergency department revealed free air under the diaphragm in the abdominal cavity.

Such scenarios typically suggest an upper gastrointestinal perforation.

No wonder this case required Director Xiao to diagnose it personally.

"If the patient ate quite a bit during that lunch, it could very well be acute abdominal syndrome. I need to inquire."

He headed to the doctor’s office with the information to find someone.

"May I ask who Dr. Zhang Ruozhen is?"

"That’s me!"

A young female doctor with a delicate appearance raised her hand and looked up at Li Jingsheng standing at the doorway.

"Is this patient, named Zhao Changsheng, the one you took from the emergency department?"

"Yes!"

"The patient experienced intense abdominal pain about an hour after lunch. Did you ask what he ate?"

"Just the regular company meal. We can probably rule out food poisoning."

"Did he eat enough for this meal?"

"Well... I didn’t ask."

The female doctor’s handsome face flushed slightly.

"Is the patient in the ward now?"

"Yes!"

"Take me to see the patient. I’m Li Jingsheng, Director Xiao asked me to help diagnose this patient, she’s busy with other things."

Li Jingsheng briefly introduced the situation.

"Hmm, I know you. Director Xiao is my teacher, she often praises you lately, saying that if our Gastroenterology Department had a young doctor like you, she could relax a lot more. She told me to learn from you."

"Director Xiao is flattering me! Let’s go see the patient quickly, I’ve got to return to the Orthopedics Clinic for consultations after this."

In front of this young female doctor, Li Jingsheng could be considered a senior.

Even though he was only a few years older than her.

But in terms of capability, he was stronger than Director Xiao in many aspects.

"Please follow me!"

She tidied her beautiful hair with her hand, tucking it behind her ear, revealing a delicate face.

Her skin looked quite fair.

Hiring such a pretty female doctor in the Gastroenterology Department is a blessing for the male patients.

The two of them arrived at the ward and saw the male patient.

His face was pale, sweat continuously beading on his forehead, and his expression was painful. He was in pain.

"Mr. Zhao, did you eat a lot for lunch today?"

"Well, I ate a bit too much."

The patient answered painfully, his voice somewhat weak.

"Today’s company meal had two dishes I really like, so I had a bit more and went for seconds. Could it be that I had too much spicy food that’s causing my stomach pain?"

"That possibility cannot be excluded. In the future, you can eat spicy foods in moderation. If the spice level is too high, like with ghost peppers, it can be deadly. Let me listen to your bowel sounds."

Li Jingsheng took over the conversation.

At the same time, he borrowed a stethoscope from Dr. Zhao to listen to the patient’s bowel sounds.

"Do not eat anything, including water. Once we’ve made a further diagnosis, there will be a new treatment plan for you. Don’t be too nervous; next time, control the amount you eat, don’t eat too much. It harms the stomach and intestines and hurts the body."

After speaking, Li Jingsheng motioned for Dr. Zhao to talk outside.

She was quite perceptive, and followed him out with just a glance.

"This patient’s bowel sounds are hyperactive, the abdominal pain location is fixed, and he has obvious peritoneal irritation signs. Also, the abdominal CT shows intestinal obstruction, free gas, and other phenomena. Therefore, my preliminary diagnosis is an acute abdomen.

As for the cause of this condition, it could be kidney stones, gallstones, acute appendicitis, acute cholangitis, acute necrotizing pancreatitis, or acute gastrointestinal perforation, etc.

It’s advisable to focus on the duodenum, as it’s quite possible he originally had a duodenal ulcer, and then overeating caused an acute perforation.

This can’t be handled by the Gastroenterology Department and needs to be transferred to surgery for an operation."

Li Jingsheng quickly stated his diagnosis.

Because he had to rush back to the Orthopedics Clinic for consultations.

"Okay, I’ll arrange the examination immediately and contact General Surgery for the transfer."

She didn’t raise any objections, whether it was because she was naturally naive, a good girl from childhood, or because she admired Li Jingsheng’s abilities, leading to almost blind trust.

"The cause of the old cadre’s diarrhea hasn’t been found yet, let Director Xiao know. I’ll check it out after work."

Li Jingsheng finished speaking and hurried away.

Once busy, the afternoon passed by diligently.

Around six o’clock, with three patients still awaiting treatment, Xiao Linlin had already called.

"I really don’t know what to say today. Our Gastroenterology Department was busy for almost the whole day, and both patients were sent to General Surgery. The child named Chen Huan has been diagnosed with acute appendicitis, and it has turned purulent and perforated, causing acute peritonitis. Surgery has already been arranged.

That patient Zhao Changsheng had the same diagnosis as yours, acute abdomen, duodenal ulcer perforation, also transferred for surgery.

Sigh, all gone to General Surgery."

As the department head, she surely hoped that the admitted patients could generate benefits for the department.

Transferring them all to General Surgery, it’s not a complete waste of effort, but at least the major gains went to General Surgery.

"As long as the patients can be cured! General Surgery might return the favor in the future by transferring some patients to your department."

Li Jingsheng consoled her.

"That’s one way to think about it. That old cadre is still pushing for the cause of his illness, and I really can’t find it out. Please help me think it over. That’s all for now; I still have work to do today, so I won’t chat anymore."

She probably made this call just to update Li Jingsheng on the outcomes of the two patients.

It’s also a form of respect.

Li Jingsheng then continued to treat the patients as quickly as possible.

Nearing the end with the second-to-last patient, Ye Hui reminded him.

"Teacher’s wife is here!"

Li Jingsheng looked up to see Ou Qinglan waving at him, holding a packed meal box.

She had already bought food for Li Jingsheng.

She listened to Li Jingsheng quite well; when he said to save money and not dine at hotels, she really went for simpler meals.

"I really envy the love between the teacher and teacher’s wife."

Yang Luqing couldn’t help but say.

"What’s there to envy? You all will find your significant others in the future. As long as you’re sincere and support each other, you’ll surely be very happy."

Li Jingsheng said.

"Dr. Ye, do you have a boyfriend?"

Jin Yanyu suddenly asked.