Gou is practicing medicine in the clinic

Chapter 445: Tenderness is positive, colonoscopy can easily miss the diagnosis
Although Mr. Wan's blood pressure and heart rate are not bad, it is true that he is relatively obese.Her belly was swollen, like a pregnant woman who was seven or eight months pregnant.

This body type is definitely above the healthy weight standards.

However, there is no need to pursue a golden weight when it comes to weight. There are always thin people and fat people in this world.As long as you are healthy, it doesn't matter if you are a little fat or thin.

Some women love to look beautiful and work hard to lose weight, but in the end they end up with a variety of health problems.

This is definitely not worth the loss.

After the patient lay down, Li Jingsheng began to examine the patient's abdomen.

The patient's abdomen is quite firm and elastic when pressed, but very hard.

Both have big bellies, and there are some differences between men and women.Men's penises are generally hard, like an inflated balloon.

A woman's belly is soft, and it usually feels soft when pressed, as if it contains water.

"Ah yo..."

The patient suddenly exhaled in pain.

Li Jingsheng pressed the patient's right lower abdomen.

This is not where the appendix is, but where the ascending colon is.

"Does it hurt when you press this point?"

"It seems so. It hurt a lot the moment you pressed it down, but now it doesn't seem that painful anymore."

The patient confirms.

"Does this position usually hurt?"

"No pain."

"This should be the ascending colon segment. You can focus on checking it during the colonoscopy when the time comes. Under normal circumstances, there will be no pain reaction when pressing."

Li Jingsheng secretly noted this tender point.

I pressed this area with my hand and felt it carefully, but I didn't feel any obvious lump.

The main reason is that the patient's abdomen is relatively hard and the abdominal fat layer is very thick, which will affect the judgment of the feel.

The patient's entire abdomen was examined, and then the anus was examined.

no problem.

"Mr. Wan, we have completed the examination and found no obvious masses. But you also know that if there are real lesions in the intestines, they cannot be detected at all through the thick layer of abdominal fat.

Unless the tumor is already very large.

You would like a repeat colonoscopy, my team can provide this service for you.

The charging standard is 3000 yuan for a simple inspection.If polyps or other lesions are found, they can be solved together during the colonoscopy, and the family members will be communicated with on the spot.In view of your special situation, you may consider adding 1000 yuan for a painless colonoscopy.At that time, if there is any problem, it can be solved at once. "

Li Jingsheng gave his own suggestion.

"Is it safe?"

Although Mr. Wan is 67 years old, he is still afraid of death.

Colonoscopy is more difficult and generally safe, but there are still many risks.

The main intraoperative risks are bleeding and perforation.

Especially if the polyps are removed during surgery or the biopsy sample is too large, it is easy to cause bleeding.

Not to mention perforation, medical accidents that pierce the intestines are not uncommon.

Theoretically, ordinary colonoscopy is safer.

Because the intestines are really punctured, or are about to be punctured, the patient will be in unbearable pain.It will be blocked immediately.

If it is a painless colonoscopy, sometimes the doctor does not realize that the patient's intestines have been punctured.

This is very dangerous.

After intestinal perforation, intestinal contents will enter the abdominal cavity, causing abdominal infection.

If acute peritonitis is not treated promptly or improperly, the risk of death is high.

In addition, some postoperative complications are also common.

Such as abdominal bloating, vomiting, anal swelling, etc.

Although colonoscopy has certain hazards, it is generally safe as long as it is performed properly.

“You can rest assured that the safety aspect will be taken care of by my team.”

Li Jingsheng made a promise to patients.

If the fee is expensive, there must be a reason for it.

Otherwise, why would people pay thousands of dollars more?
Safety is one of Li Jingsheng's main strengths.

"Usually, the cost of a painless colonoscopy is only about one thousand. Why is it more expensive for a painless colonoscopy here? Shouldn't it be about five hundred?"

Mr. Wan's wife asked.

The richer people are, the stingier they are.

Poor people sometimes want to save face and feel embarrassed.Rich people don't care. They only care about wealth and don't care about the so-called face.

"I have to pay an extra 1000 yuan for painless surgery here because my anesthesiologist is a top anesthesiologist who has returned from abroad. I don't hide it. Frankly speaking, someone's annual salary abroad is more than 18 US dollars. The domestic RMB is more than 120 million. The fee is too small to afford it.

During the operation, the surgeon treats the disease and anesthetizes to save life.

Needless to say, the importance of anesthesiologists. I believe that given your financial conditions, you won’t care about the extra 500 yuan.On the contrary, it should be very worthwhile to spend only 500 yuan more to buy the services of a top foreign anesthesiologist. "

Li Jingsheng gave a reasonable explanation.

After hearing this, the two of them nodded repeatedly, and the expressions on their faces became much better.

"Money is not an issue. Four thousand is four thousand. As long as it is safe and the quality is high, it is worth it. I will also look for you when I need a colonoscopy in the future and introduce you to other people in need."

Mr. Wan did not worry about the 500 yuan.

Now that the two parties had reached an agreement, Li Jingsheng did not hesitate and signed a service agreement with Mr. Wan on the spot.

Then I prepared a bowel cleansing medicine.

Compound polyethylene glycol electrolyte powder.

This medicine is not expensive, and the price is only about one hundred yuan.

I made an agreement with Mr. Wan to have a colonoscopy tomorrow at the People’s Hospital.

After seeing off the couple, Li Jingsheng was quite excited and successfully took over another business.

He believes that as long as he serves every customer well, his advanced medical business will soon flourish.

These people are either rich or noble, and their circle of friends are basically people of this level.As long as we talk about this matter while drinking tea and chatting, it is equivalent to advertising for Li Jingsheng.

The first thing he thought of was to find Yani as a helper.

"Yani, I have received another job. I need to do a painless colonoscopy tomorrow. Can you take the time to come and help?"

Sent her a message.

She was given 400 yuan last time, but this time she can get 600 yuan for a painless colonoscopy.

I made 1000 yuan in two days, which is not a small amount.

If she can receive 5000 colonoscopy services a month, she will be working part-time every day, earning an additional [-] yuan per month.

There is no need to pay tax on this.

"OK! Is it still after six o'clock in the afternoon?"

She readily agreed.

Money can turn the devil around.

The four hundred yuan red envelope Li Jingsheng gave her yesterday played a very good role.

"Can I let you know the specific time then? I have already prescribed bowel cleansing medicine for the patient. If the effect is good, it should be done tomorrow morning. Then we need to coordinate with the People's Hospital to see when the endoscopy room over there will be available. Let us use it."

There is indeed a lot of inconvenience in not having an endoscopy room.

Endoscopy rooms in many large hospitals are basically fully booked.

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

The evenings are relatively free.

……

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

The patient with weakened bowel sounds and suspected intestinal obstruction actually developed symptoms of abdominal pain and vomiting at night, and was later diagnosed with acute intestinal obstruction.I was transferred to the general surgery department for surgery.

Li Jingsheng was not surprised at all by this result.

Because he was basically diagnosed at the scene yesterday.

It's just that Xiao Linlin was timid and acted too cautiously. She didn't dare to jump to conclusions until the patient showed no obvious symptoms and the examination basis was insufficient.

Sometimes, doctors basically treat patients with this procedure.

Maybe the doctor has already made a judgment in his mind, but the symptoms are not typical and not obvious. If only simple treatment is needed.

Perhaps there is no need to consult the patient and just prescribe the medication.

If you want to do something drastic, such as intervention or even surgery, you may have to wait until the diagnosis is basically confirmed before you can perform the operation.

Otherwise, if the patient makes a fuss and claims that the surgery was performed even though there was no indication for surgery, the doctor will cry.

Li Jingsheng replied to Xiao Linlin with a message, quickly washed up, had breakfast, and went to the reception hall for a consultation.

At noon, Mr. Wan called him and said that he had diarrhea symptoms.Ask him when can I arrange a colonoscopy?
Li Jingsheng asked Mr. Wan to go to the People's Hospital to find Director Lian Tao.

Now that we have finally formed a team, we must bring Lian Tao in.

If you get on Li Jingsheng's pirate ship, you won't have to run away.

The endoscopy room at the People's Hospital was extremely busy, and Lian Tao had no choice but to ask Li Jingsheng to go to the endoscopy room after 06:30 in the afternoon to perform a colonoscopy on Mr. Wan.

……

At about [-]:[-] in the evening, Li Jingsheng, Meng Luo and Yani rushed to the endoscopy room of the People's Hospital.

Lian Tao has arranged for Mr. Wan to lie on the bed in the endoscopy room.

"Mr. Wan, how are you feeling now?"

"hungry!"

Mr. Wan's stomach growled.

"I'm sorry, I didn't arrange the time well. I didn't expect the endoscopy room to be so difficult to schedule. It was thanks to the help of the director that I finally got it scheduled."

Li Jingsheng apologized to the other party.

"Yani, let's start working!"

"Mr. Wan, this is the professional anesthesiologist of our Sunshine Medical Team. You can call her Dr. Ya."

"Sister, my life is in your hands! Please!"

"Don't worry, just take a nap. When you wake up, the examination will be completed."

Yanni comforted him gently.

Already started to skillfully establish an intravenous channel for Mr. Wan.

It can be seen that her approach is extremely professional and she is also very meticulous in what she does.

"You don't have a coagulation disorder, right?"

she asked Mr. Wan.

"no!"

"Do you have any drug allergies?"

"nor."

After getting Mr. Wan's affirmative answer, she felt relieved.

Not long after, Mr. Wan fell asleep. Li Jingsheng controlled the control handle of the colonoscope and began to inspect the colonoscope bit by bit.

No problems were found in the anal canal and rectum.

Entering the colon segment, Li Jingsheng checked particularly carefully.In fact, entering the mirror is not just a matter of controlling the handle to rush forward as imagined.Experienced colonoscopy doctors usually use the peristalsis of the colonoscope to insert the scope.

When encountering obstacles, you will also think of some solutions.

Because there are many folds in the intestines, it is almost impossible to inspect every corner during a colonoscopy.

This also results in missed diagnosis and missed investigation sometimes.

Even forgotten.

"There is a situation!"

Based on his impression, Li Jingsheng focused on the ascending colon.

(End of this chapter)