This doctor has a system

Chapter 508 571. Consultation from the Department of Gastroenterology

"He's the only one following you?" Mr. Ai was shocked. "Then what are you doing every day? Eating for free?"

Mr. Ai finally discovered the problem, but it seemed a little late now, and he couldn't bring himself to save a small employee.

Without Wang the Butcher, would we still have to eat hairy pigs?
No one is irreplaceable, Mr. Ai thought.

His idea is correct, but he overlooked an important point, which is that the cost of replacement may be relatively high.

After Wang Zhuo resigned, he felt relieved. He rushed to Beijing without stopping. A company had been urging him to come for an interview.

"Brother, what position are you interviewing for?" asked a young man about his age.

"Scientific research position." Wang Zhuo started chatting with the other party. The man who was talking to him was called Cheng Feipeng, and he came from the Magic City.

"The treatment in our company is not good, so I thought of coming here to take a look." Cheng Feipeng said.

“Is the company’s performance bad?”

"It's pretty good. The boss has bought several villas." Cheng Feipeng complained, "but he is reluctant to give us a raise."

"Then we are about the same." Wang Zhuo laughed, "I eat pancakes every day and I am almost dying of stuffiness."

"Brother, do you know the situation of this company?" Cheng Feipeng asked, "Before, they told me to go to Z state for the interview, but now it's suddenly changed to Beijing."

He was a little unsure and felt it was unreliable, but considering the salary conditions offered by the other party, he decided to take a look.

Another thing is to create some pressure on the old employer and let them know that without them, there will definitely be some small bugs in the operation of the company.

"It should be true. My classmate is in there." Wang Zhuo said, "He asked me to come."

Wang Zhuo's classmate asked him to call a small leader when he arrived. Wang Zhuo was a little confused about what the other party meant by this small leader, so he wanted to wait and see.

As they were talking, someone came over and asked them to come in.

"You are 27 and still not married?"

"Yes." Wang Zhuo replied.

"Do you have a girlfriend?"

"No."

"Why not?" Wang Liang asked, "Don't you want to talk?"

"I dated one, but it didn't work out." Wang Zhuo was a little embarrassed. "Girls nowadays are not easy to deceive."

"Yes, that's true." Wang Liang said, "You have a lot of advantages. You should be able to be hired."

"I have a classmate in our company, his name is Hu Qingfeng."

"You are Xiao Hu's classmate, why didn't you call me?" The little leader Wang Liang suddenly became very enthusiastic, "Xiao Hu is in my group now!"

"Pack up your things and come over in the next two days. You can follow me then."

Hu Qingfeng said that his classmate was very capable and that he couldn't let others have the advantage.

Wang Liang now has more and more say in the laboratory and leads two teams, but he is still as cheerful as before. Yue Penghui has reminded him many times to be more calm.

But he couldn't.

Gao Feng plans to take a few days off. He is now quite lazy and not as enthusiastic about his work as before.

"Youliang, isn't this a bad idea?"

"How could that be? They work hard because they want money, and you, my boss, don't lack that." Li Youliang said, "Take a break. You are already very good. If you work harder than the average person, it would be too unfair to ordinary people."

"What you said makes sense!"

But after returning home and resting for two days, I felt a little bored.

He originally wanted to take care of the child for a few days, but found that the child could not be taken care of by him at all.

Li Xinyao wants to be hugged, his mother-in-law wants to be hugged, his parents want to be hugged, and his father-in-law wants to be hugged as soon as he comes home.

Okay, you guys take care of me, I'm going to the hospital. Gao Feng decided to take a walk.

The hospital is a magical place. As long as you are in the department, you will never be idle. As soon as Gao Feng arrived at the department, he was called to the consultation.

The patient was suffering from acute pancreatitis. He was very young, only 12 years old, but very heavy, weighing more than 180 kilograms.

The patient's parents both look thin, and it seems that their child eats like this entirely on his own.

"The family runs a braised meat shop." The doctor in charge explained, "This child can eat."

The patient just started junior high school and usually lives in the school dormitory. He is not used to the school meals yet. He came back last weekend and ate 5 braised pork trotters in one go.

By the evening, I started to feel a little uncomfortable, first nausea, and then severe upper abdominal pain.

His parents were still making marinade in the store. They rushed home after receiving the call and later called 120 for emergency treatment.

The gatekeeper of the community is an old man with poor hearing. After knocking for a long time, he finally opened the door reluctantly.

What left the ambulance driver, doctors and nurses speechless was that the corridor downstairs was full of cars and they couldn't drive in at all, so they had to park at the main entrance.

The patient lives on the 6th floor and there is no elevator.
The difficulty increased suddenly.

Fortunately, the neighbors were very enthusiastic and everyone worked together to lift the fat man down.

Because of the patient's history of overeating, the emergency department doctor immediately considered acute pancreatitis. After taking an X-ray, the diagnosis was confirmed, so the patient was sent to the gastroenterology department.

"The current situation is that there is a large amount of pleural effusion on both sides," said the doctor in charge.

"Then you should put a drainage tube in him." Gao Feng said. Is it necessary to ask for a consultation?

"After the operation, a pleural reaction occurred." The attending physician of the gastroenterology department was a little embarrassed. The patient burped and fainted.

But he woke up soon, and the nurse didn't even give him the epinephrine.

Pleural reaction is a serious complication during pleural puncture. It refers to a series of reactions such as dizziness, chest tightness, pale complexion, sweating, and even fainting in the patient during pleural puncture for the diagnosis or treatment of pleural diseases.

From a physiological perspective, thoracentesis can lead to reflex vagal hyperfunction; young patients are sensitive to stimulation and the incidence of pleural reactions is significantly increased.

Another reason is that the doctor is not skilled in the operation, the preoperative positioning is inaccurate, and repeated punctures can often lead to pleural reaction.

This patient was fat and had thick skin, which caused great inconvenience to the operation.

Although the pleurisy pneumonia was cured this time, the gastroenterologist was still reluctant to try it again.

"You have done a lot more chest punctures in the respiratory department than we have. Let's see if you can give him one." He said in embarrassment, "If it doesn't work, I'll treat him as a critically ill patient."

Gao Feng could understand his dilemma. The current doctor-patient environment was not very good. Besides, the patient was still a child. It would be terrible if something really went wrong.

"Forget it, I'll do it for you." Gao Feng said after thinking for a while. Who made me free? Besides, I'm here anyway.

"This is too much trouble for Director Gao." The attending doctor was very happy. It was his first time dealing with Gao Feng. He originally thought that such a great man would be difficult to communicate with, but he didn't expect that he had no airs at all. He was even willing to help him solve the problem himself.

As soon as Gao Feng put on his gloves, Director Ding from the Department of Gastroenterology came over.

"You are just kidding." He lectured the attending physician, "You asked Professor Gao to come over to do a thoracotomy?"

"Good for you."

"Professor Gao, look at what has happened." Director Ding looked embarrassed. The people below were too ignorant.

Gao Feng waved his hand. He didn't think it was a big deal. As a doctor, relieving the patient's pain should be the first priority.

Of course other people could do it, but now that he is here, he can't let the patient wait because of his status.

Gao Feng touched the location of the color ultrasound positioning point. It felt good, with a thick layer of fat. If he took it out to extract oil, the profit should be good.

"Uncle, does it hurt?" The patient looked worried.

Fear of pain will also increase the probability of pleural reaction. Gao Feng smiled at him and said, "It doesn't hurt. It's just like being bitten by an ant."

If you want to relieve the patient's pain, you must do anesthesia properly. For some experienced doctors, this step is actually not difficult.

In the past, one bottle of lidocaine would definitely be enough, but this time Gao Feng deliberately took one more. This is why it is expensive to treat fat people.

Several trainees stood by and watched, their clear eyes revealing a look of stupidity.

"Have you been transferred to the respiratory department?" Gao Feng asked.

"No, it will be next month." A girl answered.

It turned out to be a group of little trash. Gao Feng explained to them the things they needed to pay attention to during the operation while he was doing it.

This operation was so simple for him that it could only be described as effortless. Soon, the light yellow fluid flowed out of the drainage tube.

It's so easy! The students watching thought, "I can do it, too."

Just as I was about to leave, Director Hu from the General Surgery Department came over and asked, "Director Gao, you're back?"

Gao Feng exchanged a few words with him and learned that he was also here for a consultation.

"Let's go. It's said to be a difficult and complicated case. And you're the best at this." Director Hu invited him to go with him.

The patient is also a young man, 24 years old.

I went out to eat hotpot with my girlfriend 3 days ago, and after I came back I started to have abdominal pain and diarrhea.

At first I thought it was just ordinary acute gastroenteritis, so I bought some medicine, but it didn't work.

Later, the abdominal pain worsened and was accompanied by nausea, which seriously affected my work, so I had to go to the community hospital for treatment.

The doctor who received the patient asked about the situation and still considered it to be acute gastroenteritis. After giving the patient infusion treatment, the patient's abdominal pain improved slightly.

In order not to delay work, the patient quickly left the community hospital. After resting for half a day, the abdominal pain and nausea worsened that night, and he vomited several times, throwing up everything he had just eaten. Accompanied by his girlfriend, he went to the hospital emergency room.

The emergency doctor saw that the patient had obvious abdominal pain. Although he did not dare to be careless, he did not think too much about it.

Generally speaking, abdominal pain in such a young patient is mostly a minor problem. If it is a middle-aged or elderly patient, then you should be alert.

"Where does it hurt?" asked the emergency doctor.

"Here." The patient pointed to his lower right abdomen. He frowned and it was obvious that he was in pain.

The emergency doctor asked the patient to lie on the examination bed and performed some examinations on his abdomen, especially pressing the right lower abdomen.

Although the patient was in severe pain, his entire abdomen was still soft, which suggested that the condition might not be too serious.

If the entire stomach feels hard, it indicates that the situation in the abdominal cavity is serious and there may be acute peritonitis. At this time, the patient will feel very painful.

"It could be acute appendicitis, but it could also be something else." The doctor in the emergency department was more cautious, "Let's check it out."

He prescribed an abdominal X-ray and color Doppler ultrasound of the appendix area, as well as a blood test.

The patient didn't want to do it, "Why don't you just prescribe some medicine for me, or even some intravenous fluids."

"That won't work." His request was directly rejected by the emergency doctor.

Doctors in the emergency department often possess a rare and valuable quality, which is caution.

After working in this field for a long time, those who are not careful will be slapped in the face by life, and some will even learn a bloody lesson that they will never forget. You can't be careless. Careless emergency doctors are hurting others and themselves.

"You also need to collect urine for a routine urine test." The emergency doctor added another test item while speaking.

If there are red blood cells in the urine, then you should also consider the possibility that renal colic is caused by kidney stones or ureteral stones.

However, it is unlikely that the patient suffers from renal colic, because when he tapped the patient's lower back and waist on both sides just now, he did not find that the pain worsened, and there was no percussion pain in the kidney area, which does not support the abdominal pain caused by kidney stones.

But for safety reasons, routine considerations should still be made, and it is best to have a B-ultrasound examination.

The patient had considerable trust in the doctor and went for a check-up quickly.

The abdominal B-ultrasound was completed quickly. No gallbladder or bile duct stones were found, no obvious lesions in the appendix were found, and there were no kidney or ureteral stones. Everything seemed to be fine.

Cholecystitis, cholangitis, and kidney stones can basically be ruled out, but it is hard to say about appendicitis, after all, B-ultrasound is sometimes not very accurate.

After all, the patient has pain in the right lower abdomen, and the appendix is ​​located in the right lower abdominal cavity. If the appendix is ​​inflamed, almost all patients will have symptoms of pain in the right lower abdomen.

However, typical appendicitis does not cause pain in the right lower abdomen at the beginning, but pain around the navel, which gradually manifests as pain in the right lower abdomen. This is called metastatic right lower abdominal pain.

The reason is that the nerve control of the abdominal organs is relatively complex. At the beginning, appendicitis is relatively mild, and the pain is transmitted to the brain through nerve fibers, causing the brain to mistakenly think that there is a problem around the navel.

Later, the inflammation of the appendix worsened and invaded the local abdominal wall. After the pain stimulation was transmitted to the brain through the abdominal wall nerves, the brain actually discovered that the problem came from the appendix in the right lower abdomen. At this time, the pain was fixed in the right lower abdomen.

"I suggest you do another CT scan, which can further confirm whether it is appendicitis."

The patient hesitated for a moment, but eventually agreed, because his stomach was really hurting, and he wanted to find out what the problem was as soon as possible so that he could get targeted treatment.

After obtaining the patient's consent, the emergency doctor pushed the patient directly to the CT room.

The results came out quickly: no abnormalities were found.

This was disappointing for both parties.

As a last resort, the emergency doctor gave the patient the antibiotic levofloxacin injection and the antispasmodic drug pyrogallol.

But the effect was not satisfactory. The patients felt that the pain was relieved, but not significantly.

"Just let him be hospitalized and have a detailed check-up." The patient's girlfriend was a little worried, and after her persuasion, the patient finally agreed to be hospitalized.

Soon, the patient was sent to the Department of Gastroenterology.

(End of this chapter)