Doctor's Life Simulator

Chapter 189 Human beings have 13 diseases that need no treatment, and 13 diseases that cannot be cured.
After Qin Lang finished the simulation, Director Han Hu from General Surgery and Director Wei from the Emergency Department rushed to the meeting room.

Han Hu walked into the conference room with a big head, mixed with black and white hair.

Wang Heng still respects his future chief director very much. Just as he was about to say hello, he saw Han Hu's eyes lit up and looked at the little doctor in the corner of the meeting room. There was a little kindness and kindness in his eyes. appreciate.

"Doctor Qin, you are here too."

There was some surprise in Han Hu's tone. He still had a fresh memory of Qin Lang's last demonstration of basic surgical skills.

"Hi, Director Han."

Qin Lang nodded. He also respected Director Han very much.

After saying hello to Qin Lang, Han Hu looked at Wang Heng and said in a loud voice, "Wang Heng, welcome back. From now on, general surgery will depend on you, the new generation."

Han Hu attached great importance to Wang Heng and Lu Min. After a few simple greetings, he called Director Wei to start the consultation together.

"Wang Heng, what do you think?"

Han Hu and Director Wei looked at the various medical examination materials and asked Wang Heng, who was mainly in charge of the patients before.

Wang Heng originally wanted to take this opportunity to show his strength, but the patient's situation made him confused, a little unwilling, and a little helpless:
"The patient's condition is not very typical. According to the signs and various physical examinations, I can't confirm the specific cause. Now I can only suspect diffuse peritonitis or gastric ulcer perforation."

Hearing Wang Heng's judgment, Han Hu also nodded slightly, and soon he and Director Wei also learned about the patient's various conditions.

"Electrolytes, liver function, blood and urine amylase tests were normal, no abnormalities were found in the liver and gallbladder, and no fluid was extracted from the McBurney's point of abdominal puncture. It is really difficult to draw conclusions."

Director Han Hu is also a senior expert in the field of acute abdomen. After comparing with various common diseases one by one, there are some differences, not typical diseases.

After all, patients will not get sick according to the textbook, the human body is really too complex and sophisticated system.

Wang Heng didn't have a clear idea when he saw the two chief directors, but he was a little relieved. At least, he couldn't make a diagnosis, so he wasn't ashamed.

But, what is the cause of this patient?
Director Han and Director Wei are also a little depressed, but this kind of situation where no specific cause can be found is the norm in the medical field.

曾经一名医学泰斗就说过：人类有1/3的病不用治，1/3的病治不好，而我很惭愧，我只能看剩下那1/3疾病中的1/5。

"Both directors, if you really can't find a specific direction, I suggest that we go directly to the surgical exploration!"

Wang Heng suggested that, after all, a skilled person is bold, and he is still very confident in his own hands.

As for Wang Heng's proposal, it is indeed not a solution. Basically, some common possibilities have been ruled out by the two directors.

Before confirming the investigation during the operation, Han Hu looked at the other participants: "Doctor Lu, do you have any ideas?"

Lu Min shook his head. His position for himself was very clear, that is, the directors set the direction and design the operation plan, and then, when necessary, he would cooperate with the operation and be an executor in peace.

Regarding Lu Min's reaction, Han Hu is used to it. The only thing he looks forward to about this guy is his hands.

Han Hu looked at the owner of another pair of more powerful hands, and he came here, and asked casually:
"Doctor Qin, do you have any ideas, ideas?"

Regarding Director Han's question about Qin Lang, Director Wei, Wang Heng and others naturally had no expectations, and they were just politely asking the participants for their opinions.

Wang Heng couldn't wait to get up and went to the operating room for the first demonstration, when he heard a steady voice:

"According to the location of the patient's abdominal pain and abdominal CT: inflammatory edema in the gallbladder fossa and periduodenal tissue, a small amount of fluid can be seen, is it possible that the cause of the gallbladder and related tissues?"

Hearing Qin Lang's words, Wang Heng was taken aback for a moment, then shook his head:

"However, the patient's liver and gallbladder were normal, he had no gallstones, and he had no biliary system disease in the past. It is impossible for spontaneous bile duct perforation to occur, right?"

Wang Heng analyzed it according to common sense, but he was stunned when he said this: spontaneous bile duct perforation, he encountered it in the general surgery of Xiehe, although it is very rare, but there is such a situation, However, the last patient had undergone cholecystectomy 3 years ago and had multiple common bile duct stones.

Not so coincidental, is it?Wang Heng directly chose to ignore this flashing thought.

Regarding Wang Heng's doubts, Qin Lang continued to guide:
"The patient is older. Although he has no previous biliary system disease, he has senile arteriosclerosis, which may change the blood vessels involved in the bile duct, reduce the local blood supply, and cause ulcers and even perforation in the bile duct wall."

Hearing Qin Lang's analysis, Wang Heng thought for a while and continued to ask:
"However, according to the observation of fluid in the paracentesis, there is obviously no sign of biliary peritonitis, and the patient has no manifestation of jaundice."

For Wang Heng's well-founded analysis, Han Hu and Director Wei nodded again and again, but Qin Lang's previous thinking was also very reasonable, so how would he answer Wang Heng's question?
Unknowingly, Han Hu and Director Wei were also attracted by their discussion and began to analyze it.

On the contrary, Lu Min was very relaxed, waiting boredly for the final result, he just wanted to know which piece to cut and where to sew!
Can do it, don't make noise!
Qin Lang is the continued guidance of quotations:
"Dr. Wang's analysis is correct. I just proposed a new possibility. I encountered this situation in the emergency department of our hospital before. The patient's biliary peritonitis was also mild and non-jaundiced. After surgery, we After reflection, it was discovered that due to the poor response of the patient due to his age, the perforated microrementum quickly responded to wrap and seal the perforation."

"How about we try to do an abdominal ultrasound to look at the common bile duct area, and perform a bile amylase test on the peritoneal fluid. How?"

Qin Lang said very sincerely.

Listening to Qin Lang's analysis, Wang Heng understood that what Qin Lang said was possible.Moreover, the profession of doctors is very experienced. If you have encountered some impressive diseases once, the next time you encounter similar diseases, you will have more vision than others.

But, would it be such a coincidence?

However, Wang Yan still very much hoped that Qin Lang's deduction was correct. After all, the purpose of their discussion here was to find out the cause of the disease, not to show off each other's skills and compete with each other.

Wang Heng just nodded, Director Wei and Director Han also agreed, it is better to have a direction than to have no clue.

Moreover, surgical exploration is the last resort. Being able to find the disease before the operation is more prepared and less unexpected.

As soon as Lu Min heard that there was a job, Lu Min regained his energy in an instant, and Gu Lulu stood up: "I'll arrange it now!"

After a while, the results of B-ultrasound and abdominal puncture for bile amylase came out.

Lu Min was very experienced, and hurried back, the expression on his face couldn't hide the surprise and admiration:
"Director Han, Director Wei, Doctor Qin, the results are out!"

(End of this chapter)