I can see the status bar

Chapter 1054 D+7 day (2)

If there is anything that can make a doctor who is ready to make a quick diagnosis put aside that little psychological construction, and immediately devote himself to the treatment of a patient... I am afraid that there is only a little girl's helpless cry for help.

After arranging for the little girl to go directly to the CT room for an abdominal scan, Sun Lien called Section Chief Wang, and greeted her in the most polite tone with the most important words he had learned from Zhou Jun for three years. A hard working civil servant.

"Is your skull filled with boiled eggs without any wrinkles?" Sun Lien took a deep breath and asked, "What are you thinking? Yes, let a 12-year-old girl come to the hospital alone and wait in line for an hour to see the acute abdomen?"

"We invited doctors from the community to come over for triage. They checked. The child is most likely to have acute appendicitis..." Director Wang Zhenyu who was scolded was very innocent and confused, "He said that although this It hurts, but it's not serious now, she doesn't have McBurney's point rebound pain, only tenderness..."

"So you let her see the doctor alone? Are you crazy or am I crazy?" Sun Lien was furious, and now he didn't care about the tone and tone he tried to suppress at the beginning, "Mai's point rebound pain is negative, tenderness A positive doesn't necessarily mean it's mild appendicitis—it's not fucking appendicitis at all!"

Section Chief Wang was also annoyed, "I don't know anything fucking! I'm studying laws and regulations, and I'm not a fucking doctor! If you don't like it, then he will go to the fucking general practitioner who misdiagnosed , if you are not happy, you can beat him up when the matter is over!" Wang Zhenyu stared at Sun Lien panting, then took a deep breath, forced himself to calm down and asked, "Now, is there anything I need to do? ?”

"Send the parents of the children here, at least one." Sun Lien also took a deep breath, "Her problem must be more serious than appendicitis."

"What's the problem?" After hearing this topic, Section Chief Wang quickly took out his mobile phone and prepared to make a call, "How serious is it?"

Sun Li'en took a deep breath. He looked at the screen that was still showing "The test result is not available", then shook his head and said, "I don't know."

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Acute abdomen is the most troublesome patient in the world, especially when this acute abdomen is afflicting a little girl, the situation is even more complicated.

There are many organs that can cause acute abdomen. Problems with the liver, gallbladder, intestines, kidneys, and even spleen and heart may cause acute abdominal pain.For a woman, the uterus, ovaries and fallopian tubes can cause acute abdomen.

For a 12-year-old girl, prioritizing gynecological issues is obviously a silly and worrying direction, but Sun Lien dare not rule out this option at all.Gynecology wasn't his specialty, and pediatrics wasn't something he dealt with often either.When I was in the Fourth Hospital, the Department of Pediatrics had its own emergency room and an independent night shift clinic.The young patients that Sun Lien can come into contact with usually have at least ruled out these problems.

Pediatrics is a complex and comprehensive discipline.This is not only because most of the patients treated in pediatrics are not very verbal, but also because many organs in their bodies are still in the development stage.With extremely high hormone levels and intense and rapid cell secretion, their reactions to drugs must be different from normal adults.

Yes, pediatrics is a "dumb department", and it is also a department that treats "alien creatures".The situation is further complicated when the tiny "alien creature" is also a girl.

Women have a unique "internal environment".Due to the difference in physiological structure, the internal environment of women is directly connected with the outside world.Usually under the protection of mucus and mucous membranes, their reproductive system can be kept relatively isolated from the outside world.Before puberty, the thicker Hymen can largely prevent pathogens from entering the uterus or even the pelvic cavity through the reproductive system.

Sun Li'en didn't know whether this little girl with four characters including her first name and last name was prepubertal or in puberty, whether her problem came from the reproductive system or the gastrointestinal tract, or what caused her to show symptoms of fever, vomiting and abdominal pain. Is it an infection or an immune problem?He couldn't figure out almost anything.

But the only thing that is certain is that this disease is definitely unusual.The status bar is a thing with its own deep operating logic. If there is no logical difficulty in the diagnosis process, it will directly write the name of the disease on the surface.But if this disease is something that Sun Lien has not seen before, or it is a disease that is not very common.Then it will list every "reminder item" that leads to the current patient's state-but it just doesn't tell you directly where the lesion is and what the lesion is made of.

In Sun Lien's words, the status bar is just an old jerk with a bad taste.It forces you to start from scratch when you need an answer most urgently, who knows how many pieces there are.The status bar will do nothing until the puzzle is solved.And you have to race against the disease at the same time, before the disease kills the patient, complete this irregular jigsaw puzzle that may have fifty pieces, or one or two thousand pieces, and has no reference picture at all.

Well, bad old bastard is too "mild" to say it.Sun Lien's opinion now is that the status bar is a son of a bitch.

But a useful bastard.

"Director Qian, I have something to ask you." After diverting the patients at his door to other wards, Sun Lien quickly took out his phone and contacted Qian Hongjun, "I met a patient here, and the situation is a bit strange .”

"Strange? It seems really weird to be so weird that you call me." Qian Hongjun raised his eyebrows, and then asked, "What's the specific situation?"

"Female patient, 12 years old. There was 18 ml of pelvic effusion, symptoms of acute abdomen, increased peripheral blood leukocytes, increased C-reactive protein, abdominal tenderness, vomiting and fever." Sun Lien quickly repeated the content prompted in the status bar, and then asked Said, "The community transfer operation here... has a problem. The little girl didn't come with her parents. I asked her to have a CT scan, but the results haven't come out yet."

"That is to say, you don't know whether she has entered puberty, so you should consider gynecological problems." The well-informed Qian Hongjun quickly grasped the point of the problem. "How is her vital signs now? Is there anemia?"

"No." Sun Lien rejected the possibility of ruptured ectopic pregnancy and ruptured corpus luteum, "There are not many self-complaints from patients, but community doctors think it is not too serious appendicitis."

"It cannot be ruled out that the pedicle of the ovarian cyst is torsion. Has the CT result come out?"

"Not yet." Sun Lien refreshed the page again and frowned, "I remember that twist, it should be very painful, right?"

"It can make people faint from pain." Qian Hongjun also understood that this symptom is not suitable, he frowned, "Is she fat?"

Sun Lien tried his best to recall the face of that little girl, and then said, "It is indeed a little fatter than normal adolescent girls. The height is less than 1.5 meters, and the weight must exceed 60 kilograms."

"BMI is high, and we need to consider the pancreas problem." Although he talked about the pancreas problem, it was obvious from Qian Hongjun's tone that he did not intend to take the pancreas as his main consideration. "How is her bowel movement? Have you had a gas or bowel movement recently?"

"It doesn't seem like an obstruction." Sun Lien frowned, "Her pain didn't intensify in frequent paroxysms, and the vomiting appeared later."

"If there is no problem with the intestinal tract itself, then it may be a matter of the mesentery." Qian Hongjun said, "Mesenteric torsion, tumor or embolism needs to be considered. If so, the operating room needs to be arranged immediately."

As an emergency doctor, Sun Lien is very clear about the meaning of mesenteric torsion. He vetoed this guess, "It is unlikely to be mesenteric torsion. She has been in pain for more than a day."

"Mesenteric panniculitis is also possible, but now there are no test results. You think I am a god and know everything?" Qian Hongjun's voice was a little anxious, "Arrange the operating room. No matter what the disease is, it sounds like It is an acute attack symptom closely related to the mesentery. Conservative treatment is useless for this disease, and you have only one way to go now—surgical treatment.”

(End of this chapter)