Chapter 904 - 445: Tenderness Positive, Colonoscopy Prone to Miss Diagnosis

Chapter 904: Chapter 445: Tenderness Positive, Colonoscopy Prone to Miss Diagnosis

Although Mr. Wan’s blood pressure and heart rate are quite good, it’s also true that he is quite overweight. His belly sticks out like that of a pregnant woman in her seventh or eighth month.

His body size definitely exceeds the standard for a healthy weight.

However, when it comes to weight, there’s no need to obsess over an ideal weight. In this world, there have always been both skinny and overweight people. As long as one is healthy, being a bit overweight or underweight doesn’t matter.

Some women, in their pursuit of beauty, desperately lose weight, resulting in more health issues.

That is definitely a case of losing more than gaining.

Once the patient was comfortably lying down, Li Jingsheng began to examine the patient’s abdomen.

The patient’s abdomen was quite firm, resilient to the touch, but very hard.

Although both men and women can have big bellies, there are some differences. Men’s bellies are generally harder, like a balloon filled with air.

Women’s bellies are softer, usually feeling like they are filled with water when pressed.

"Oh..."

The patient suddenly cried out in pain.

Li Jingsheng had pressed on the lower right side of the patient’s abdomen.

This wasn’t where the appendix is located, but rather where the ascending colon is.

"Is this the spot where it hurts when pressed?"

"It seems like it. It was particularly painful when you pressed down just now, but it doesn’t seem as painful now."

The patient confirmed.

"Does this spot usually hurt?"

"No, it doesn’t."

"This should be the ascending colon section. When you undergo a colonoscopy, this area can be a focus for inspection. Normally, pressing here shouldn’t cause a pain response."

Li Jingsheng mentally noted this pressure point.

He carefully pressed the area and felt around, but didn’t detect any obvious lumps.

This was primarily because the patient’s abdomen was quite hard, and the abdominal fat layer was thick, which affected the tactile assessment.

After checking the entire abdomen, he also examined the anus.

No issues were found.

"Mr. Wan, the examination is complete, and no obvious lumps were found. However, as you know, if there is indeed a lesion inside the intestines, it can’t be felt through the thick layer of abdominal fat.

Unless the tumor is already very large.

If you want to undergo a repeat colonoscopy, my team can provide this service for you.

The standard fee is 3000 yuan for the examination alone. If polyps or other lesions are found, they can be addressed during the colonoscopy, and we would communicate on-site with your family. Given your special situation, you might consider adding 1000 yuan for a painless colonoscopy. If any issues arise, they can be resolved in a single procedure."

Li Jingsheng provided his suggestion.

"Is it safe?"

Even though Mr. Wan is already 67 years old, he is still very afraid of dying.

Colonoscopy is technically challenging and generally safe, but there are still numerous risks.

Intraoperative risks mainly include bleeding and perforation.

Especially when removing polyps or taking large biopsy specimens, persistent bleeding can occur easily.

There’s no need to mention perforation; there are quite a few medical incidents of intestinal perforation.

In theory, a traditional colonoscopy is a bit safer.

Because if the intestine is actually perforated, or about to be, the patient would feel unbearable pain and immediately stop.

If it’s a painless colonoscopy, sometimes the doctor might not even realize they’ve perforated the intestine.

This is extremely dangerous.

After an intestinal perforation, the contents of the intestine can enter the abdominal cavity, leading to an abdominal infection.

If acute peritonitis is not promptly and properly managed, the risk of death is high.

Besides this, various postoperative complications are also common.

These include abdominal distention, vomiting, anal swelling, and others.

Although a colonoscopy poses some hazards, with proper operation, it is generally very safe.

"My team will be responsible for safety, so you can rest assured about this."

Li Jingsheng made a promise to the patient.

The high fees must have their reasons.

Why else would someone pay an extra few thousand yuan?

Safety is one of Li Jingsheng’s main selling points.

"Generally, a painless colonoscopy costs around a thousand yuan, why does it cost an extra thousand here? Shouldn’t it be about five hundred?"

Mr. Wan’s wife asked.

The wealthier people are, the stingier they become.

Poor people sometimes care a lot about face, feeling embarrassed. Wealthy people, on the other hand, don’t care; they only care about wealth, not so-called face.

"The additional thousand yuan for painless here is due to the fact that my anesthesiologist is a top-notch professional returned from abroad. I’ll be honest, this person earns a yearly salary of over 180,000 US Dollars abroad, which translates to over 1.2 million RMB domestically. If the fee is too low, they wouldn’t agree to work.

In surgery, the main surgeon cures while the anesthetist saves lives.

The importance of an anesthesiologist cannot be overstated, and I believe that with your financial standing, you wouldn’t mind an extra five hundred yuan. On the contrary, being able to hire a top international anesthesiologist’s service for just an additional five hundred yuan should be well worth it."

Li Jingsheng provided a reasonable explanation.

The two listened and nodded repeatedly, their expressions looking much more agreeable.

"Money is not a problem, four thousand it is, as long as it’s safe and skillful, it’s very much worth it. If I need a colonoscopy again, I’ll come to you guys, and I’ll also recommend you to others who might need it."

Mr. Wan didn’t fret over the five hundred yuan.

Since both parties reached an agreement, Li Jingsheng didn’t waste time and signed the service agreement with Mr. Wan on the spot.

Then he provided a bowel-cleansing agent.

Compound polyethylene glycol electrolyte powder.

This drug isn’t expensive, costing only about 100 yuan.

The appointment was made with Mr. Wan for a colonoscopy tomorrow, at the People’s Hospital.

After seeing off the couple, Li Jingsheng felt quite excited, having successfully secured another deal.

I believe that as long as we serve each customer well, his advanced medical business will quickly gain traction.

These people are either rich or noble, and their circle of friends is generally of the same tier.

When chatting over tea, just talking about this matter is equivalent to advertising for Li Jingsheng.

The first thing he thought of was to find Yani to help.

"Yani, there’s a new job, we need to do a painless colonoscopy tomorrow. Can you find time to help?"

He sent her a message.

Last time was four hundred bucks, this time doing the painless colonoscopy she can get six hundred.

Earning a thousand in two days is not too little.

If there could be thirty colonoscopies per month, she could earn an extra fifteen thousand yuan a month just by taking on a side job every day.

This also isn’t taxable.

"OK! Still after six in the afternoon?"

She agreed readily.

Money can make the devil turn grindstone.

The four hundred yuan red envelope that Li Jingsheng gave her yesterday worked well.

"I’ll let you know the exact time then, alright? I’ve already prescribed laxatives for the patient. If it works well, we should be able to do it by tomorrow morning. Then, we need to coordinate with the People’s Hospital to see when their endoscopy room can be available for us."

Not having an endoscopy room of our own is indeed inconvenient.

Endoscopy rooms in many big hospitals are usually fully booked.

It’s not easy to jump in line during the day.

It’s relatively free in the evenings.

...

The next day, when Li Jingsheng got up in the morning, he received a message from Director Xiao Linlin.

The patient with reduced bowel sounds, suspected intestinal obstruction, really developed abdominal pain and vomiting symptoms at night, and was later diagnosed with acute intestinal obstruction. He was transferred to General Surgery for surgery.

Li Jingsheng wasn’t surprised at this outcome at all.

Because he basically already diagnosed it on the spot yesterday.

Xiao Linlin was just too timid and overly cautious, not daring to jump to conclusions without obvious symptoms and solid examination evidence.

Sometimes, that’s just the process doctors go through.

The doctor might already have a judgement in mind, but if the symptoms are not typical or obvious, simple treatment might suffice.

In such cases, the patient’s opinion might not even be solicited; a prescription can be directly issued.

But if it’s something big, like an intervention or even surgery, then one has to wait for a basic confirmation before proceeding.

Otherwise, if a patient creates a fuss later on, claiming surgery was done without surgical indications, the doctor would be in trouble.

Li Jingsheng replied to Xiao Linlin and quickly got ready, had breakfast, and went to the reception hall for consultations.

Around noon, Mr. Wan called him, saying that diarrhea symptoms had already appeared and asked when the colonoscopy could be arranged.

Li Jingsheng asked Mr. Wan to go find Director Lian Tao at the People’s Hospital.

Now that the team was so difficult to assemble, he must pull Lian Tao in.

Once you board Li Jingsheng’s pirate ship, there’s no getting off.

The endoscopy room at People’s Hospital was extremely busy, and even Lian Tao couldn’t do much. He told Li Jingsheng to come after 6:30 PM for Mr. Wan’s colonoscopy.

...

Around 6:50 in the evening, Li Jingsheng arrived at the People’s Hospital endoscopy room with Meng Luo and Yani.

Lian Tao had already arranged for Mr. Wan to lie on one of the beds in the endoscopy room.

"Mr. Wan, how is your body feeling now?"

"Hungry!"

Mr. Wan’s stomach was growling.

"I’m sorry, it’s my fault for not scheduling well. I didn’t expect the endoscopy room to be so hard to book. Luckily, Director Lian helped secure a spot."

Li Jingsheng apologized to him.

"Yani, let’s start working!"

"Mr. Wan, this is our professional anesthesiologist from the Sunshine Medical team, you can call her Dr. Ya."

"Alright, ma’am, my life is in your hands! I’m counting on you!"

"Don’t worry, you’ll just take a nap and when you wake up, the examination will be done."

Yani gently reassured him.

She expertly began to establish an intravenous line for Mr. Wan.

Her technique was visibly professional, and she was very meticulous in her work.

"No coagulation disorders, right?"

She asked Mr. Wan.

"No!"

"Any drug allergies?"

"None either."

Reassured by Mr. Wan’s confirmation, she felt relaxed.

Not long after, Mr. Wan was asleep. Li Jingsheng controlled the colonoscopy handle and started the endoscopy bit by bit.

No issues were found in the anal canal or rectal segment.

When he got to the colonic segment, Li Jingsheng inspected particularly carefully. Advancing the scope is not just about the straightforward manipulation of the handle. Experienced colonoscopy doctors usually rely on the peristalsis of the colon to advance the scope.

Upon encountering obstructions, they will also think of ways to overcome them.

Since there are many folds inside the intestines, it’s practically impossible to check every corner with a colonoscopy.

This sometimes results in missed diagnoses or overlooked checks.

And sometimes, even forgotten.

"There’s something!"

Li Jingsheng focused on examining the ascending colon based on his intuition.