Chapter 876 - 418: Unusual Throat Pain, Dangerous Aneurysm

Chapter 876: Chapter 418: Unusual Throat Pain, Dangerous Aneurysm

The man’s voice was clearly a bit hoarse.

"Come, let me take your temperature first."

Li Jingsheng measured the patient’s ear temperature.

36.6 degrees.

This is a completely normal temperature.

Clinically, the data obtained from ear temperature measurement is generally consistent with the results from oral temperature measurement. Because the temperatures are similar and the results are accurate, most hospitals now use ear thermometers instead of the older mercury ones.

The results from forehead thermometers are not as accurate as those from ear thermometers.

The oldest methods of measuring temperature were quite troublesome, like placing under the armpit, inserting into the rectum, or directly into the mouth.

However, considering infection and other factors, although oral temperature measurement is the most convenient, patients generally resist.

Even if a thermometer has been disinfected, the idea of putting a thermometer in one’s mouth that someone else has used is quite off-putting.

Doctors have no choice but to measure rectal temperature in children.

For adults, this method is also difficult to use.

Both men and women resist it, and are afraid of contracting dreadful viruses like HIV, syphilis, etc.

Improper and non-stringent disinfection very easily leads to this kind of situation.

As times progress, it has become increasingly convenient for medical staff to treat patients.

Previously, measuring temperature took at least several minutes, and had to be read by professional medical personnel. Ordinary people couldn’t understand the mercury thermometers at all.

Now, using an ear thermometer, it can be done in two or three seconds.

And the values are precise.

This male patient’s temperature is normal, so conditions like tonsillitis can be largely ruled out.

The patient himself also mentioned that he purchased medication from both the pharmacy and other clinics but found it ineffective after taking it.

Generally, throat inflammations show clear improvement after two or three days of medication.

"Have you had a cold these past few days?"

"No!"

The patient shook his head.

Li Jingsheng noticed that when the patient shook his head, he showed a painful expression.

This indicated that even just shaking his head was pulling on the throat area, causing pain.

"Open your mouth, let me have a look at your throat!"

His clinic has seen increased business in consultations, often having patients with various throat diseases. Using a small flashlight for examination isn’t very clear.

Especially for some deeper lesions, which are basically very hard to see.

Additionally, it’s difficult for the patient to cooperate.

Raising the tongue easily blocks the doctor’s view.

Some patients have very heavy oral odors, and even with a mask on, Li Jingsheng can’t avoid it. It doesn’t help at all.

If there was a laryngoscope, it could solve many problems.

By next month, he should be able to pay off the remaining balance for purchasing the clinic, and then he can consider upgrading the clinic with some new, advanced equipment.

When the patient opened his mouth, there was no difficulty.

Li Jingsheng used a small flashlight to inspect deep in the throat and didn’t see any abnormal swelling or lesions.

That’s strange, since the patient doesn’t have a cold or swollen inflamed throat, then what is causing the pain?

"Siying, take his blood pressure and heart rate!"

Li Jingsheng furrowed his brow; the cause of this patient’s illness is truly strange.

A careful check of the patient’s neck, particularly the throat, revealed no external injuries.

"Has your throat area been hit by a hard object or has anyone struck you recently?"

"No, absolutely not."

The patient denied it.

His voice was hoarse and crackling.

"Was there any trigger before the onset? Like eating spicy food, or excessive drinking, or smoking?"

"I don’t usually smoke or drink, and haven’t gone out for late-night snacks recently. About seven or eight days ago, I woke up feeling a bit uncomfortable in my throat, and when I coughed, I noticed something was off with my voice. Then when speaking, my voice was slightly hoarse. Eating also felt a bit painful.

I didn’t pay attention, thinking it was a cold or some heat in the body.

After two days, my voice became even more hoarse, and speaking became strenuous.

Eating grew more painful. Even drinking water and swallowing saliva hurt.

I hurried to the pharmacy for anti-inflammatory medication, which was ineffective.

Then I went to Quick Recovery Clinic, where Dr. Zhao prescribed me medication, and I had IV drips for two days, still with no effect."

Boss Zhao is practically a god of IV drips.

It’s estimated that out of ten patients entering his clinic, at least six would be given an IV drip.

For some illnesses, taking tablets or capsules has similar effects. IV drips increase profit a bit more.

Adding on nurse care fees, needle fees, etc., the profit is more than ten times richer than just tablets. Boss Zhao’s yearly income of one or two million, how does it come about?

Just relying on prescribing one or two yuan worth of tablets, let alone owning a luxury car, maintaining the normal expenses of the clinic would be considered good already.

"Master, the patient’s blood pressure and heart rate are normal."

Han Siying showed Li Jingsheng the measurement results on the screen.

Systolic pressure 121 mmHg, diastolic pressure 85 mmHg, heart rate 71 beats per minute.

This is perfectly normal blood pressure.

It’s quite excellent.

All vital signs are normal, so what’s causing the patient’s sore throat and hoarseness?

Could it be lung issues? But those don’t cause these symptoms!

Li Jingsheng has no leads temporarily, unable to identify the problem, he decides to listen to the patient’s heart and lung sounds.

The human body has several major organs, and the heart and lungs are among the most likely to have issues.

Moreover, they are connected with various other organs, and even if they’re fine, listening to them can sometimes reveal hints.

He carefully listens to the patient’s lung sounds; there’s some moist rales but still somewhat normal.

Initially, the heart sounds appear normal, but upon closer listening, there’s something peculiar.

Yet, he can’t quite articulate it.

He’s never encountered a situation like this before.

How to describe it? It’s like listening to his heart sounds and feeling a lingering echo, or as if there’s a weakened reverberation.

It’s difficult to express in words.

In essence, after the normal heart sounds, there’s a lingering echo sensation.

"Let me examine your chest, abdomen, and neck! Lie down on the bed inside, remove your jacket."

Li Jingsheng has the patient lie down and starts examining the patient’s abdomen.

No noticeable masses or tenderness points found.

Using a visual inspection of the chest cavity, its appearance is normal with no barrel chest or abnormal depression signs present.

It’s really strange, where exactly is this patient’s problem?

Li Jingsheng tries examining the patient’s armpit, but no lymph node enlargement is detected.

Further examining the neck, lightly pressing the throat, the patient feels acute pain.

However, he discovers the patient’s pain point is not on the throat, but slightly below it.

"Is it painful here?"

"Oh... yes, yes!"

The patient’s voice is hoarse, practically incoherent.

Li Jingsheng looks at the patient’s point of tenderness and begins to ponder.

Sadly, his clinic’s facilities are limited, making further examination impossible.

But by next month, his clinic is certain to acquire more equipment.

"Your condition could potentially be a nerve or vascular issue, with the lesion likely in this area. I don’t have the equipment here; you’ll need to get a CT at the Second Hospital. Considering this area involves the aortic vessels, I recommend directly checking with an aortic CT scan. If you trust me, I’ll write you a referral, and you can go directly to find the cardiothoracic surgery Director Zhang at the Second Hospital."

Li Jingsheng tells the patient.

The cause is yet to be determined, but it’s basically certain to be a vascular or nerve problem.

Pain can arise in many ways.

Some are due to tissue necrosis, which is the most common cause of pain.

Whenever a substantial number of cells die, their demise releases signals which not only summon immune cells to search for pathogens but also stimulate the release of prostaglandin from the prostate, causing intense pain, warning the body’s owner of a local issue.

Sometimes, even though the head hurts, the foot needs treating, also related to prostaglandin.

It’s rather rigid, unable to accurately identify some latent lesions.

Or certain stimuli may cause it to send incorrect pain signals.

"I trust you! Many say your medical skills and ethics are excellent. I didn’t know at first, and after two days of ineffective treatment at Quick Recovery Clinic, a colleague heard and told me to come here for diagnosis. So many people praised you, it mustn’t be wrong."

The patient has great trust in him.

Li Jingsheng writes a referral for the patient to find Director Zhang at the Second Hospital.

Of course, Director Zhang is the department head, an expert, and may not personally see the patient.

But when the cardiothoracic surgeon sees the referral, they’ll certainly help handle it.

And report to Director Zhang.

Doctors, whether high-ranking or not, must treat patients to realize their value.

Otherwise, it’s just empty honor.

The patient took the referral and left.

Less than an hour later, Director Zhang of the cardiothoracic surgery department called him.

"Jingsheng, the patient you referred for CT has a large vascular aneurysm detected below the aortic arch. From my experience, it’s likely a pseudoaneurysm. Surgery is necessary; if the aortic wall ruptures, it’ll be dangerous."

Director Zhang is known for his clean and efficient work style.

After identifying the cause, he immediately offers a treatment plan.

"So, it’s an aortic aneurysm, and it’s located below the aortic arch. No wonder! The patient’s throat showed no redness, and there’s no cold. Now it seems the aneurysm rapidly enlarged, pressing on the recurrent laryngeal nerve."

Upon hearing the diagnosis, Li Jingsheng suddenly realizes the truth.

Aneurysms are relatively common in clinical settings; they not only pose risks in themselves but can cause unforeseen complications as they enlarge.

However, this is paradoxically a positive development.

For this patient, young as he is, who would’ve thought an aneurysm would develop on the aortic arch?

Without symptoms, aneurysms are difficult to detect.

If ruptured, the consequences would be catastrophic.

Instantly taking a life.

Pseudoaneurysms, sometimes, are even more dangerous than true aneurysms.