My medical skills add experience

Chapter 258 Laparotomy, why didn't you say it earlier?
He begins to compress multiple areas of the patient's abdomen.

The patient makes a muffled sound when pressed to the middle area near the right side of the upper abdomen.

"Pain, pain!"

She yelled hastily with a trill.

Zhou Can did not stop the tenderness test at this point, but continued to press the surrounding area, and none of the patients responded to pain.

After pressing, he turned back to the tender area just now. While pressing, he closed his eyes and felt carefully.

If it weren't for the seriousness on his face, the family members would have thought that this doctor was dishonest and was eating their daughter's tofu.

"Well, her lesion area can basically be located in the jejunum segment of the small intestine. This is also consistent with the results of the gastrointestinal contrast examination. Duodenal lesions are generally characterized by inflammation and ulcers. In addition to inflammation and ulcers, the ileum is also prone to Hemorrhage. Only the jejunal segment has the highest rate of malignant disease in clinical practice."

When Dr. Chi, who is also a doctor, heard what Zhou Can said, he immediately understood.

Sometimes, even if the cause of the patient has been found out, it is as tactful as possible to tell the patient the diagnosis.Tell the patient directly that you have a terminal illness, which can easily break the patient's mind.

Many patients are very nervous when they come to the hospital for diagnosis and treatment.

In this case, more consideration should be given to their psychological endurance.

"Doctor, what's wrong with my daughter?"

When the family members heard that Zhou Can's words were wrong, their faces turned pale.

Pity the parents of the world.

The love for children is like the flesh on the tip of one's own heart.

Hearing that their daughter might be seriously ill, the family members were extremely panicked.

"It's still just a preliminary diagnosis, and it's too much to count. Don't be too nervous. I think she is in good condition now, and only one part has a strong tenderness reaction. This is a good thing. It shows that the disease is in a timely manner and it is still in its early stage. stage."

Zhou Can explained to his family.

Now he finally understands why the monks in the temple always love to play Zen.

Some things are told directly to the parties, and the other party cannot accept it.Let the other party understand it by themselves, but it will be more kind.

"Doctor Chi, I suggest to do a laparotomy for the patient. Of course, if possible, we can discuss it with the family members before performing the exploratory surgery. If surgery is needed, we can do it together at that time. It can minimize the surgical injury of the patient .”

Zhou Can's next proposal, not to mention family members, even Dr. Chi was taken aback.

Exploratory laparotomy is an invasive exploration, and laparotomy is only performed in the face of some critical and malignant diseases.

"Isn't it okay to have a colonoscopy?"

Doctor Chi asked seriously.

"I'm afraid not. If the colonoscopy can find out, her cause will not be difficult to diagnose. I personally recommend a laparotomy." Zhou Can's resolute attitude made Dr. Chi become more serious.

He knows Zhou Can's ability very well.

If he was not sure, Zhou Can would never be so firm in asking for a laparotomy.

"Doctor Zhou, is it convenient for you to tell me the basis for this examination?" Doctor Chi will definitely not agree rashly.

He decided to listen to Zhou Can's inspection basis first.

"Doctor, my daughter is still young and unmarried. If she undergoes a laparotomy, it will leave ugly scars. It will affect her future marriage and life. Please make a careful decision and avoid it as much as possible."

The family members begged weakly beside them.

For the family members, they have no right to change the examination and treatment decisions made by the doctor.

It is often the doctor who has the final say.

Family members and patients are in a vulnerable position because they do not understand the medical profession.

When you arrive at the hospital, you can basically choose to trust the doctors and nurses and give the right to life to the medical staff.

Generally speaking, the vast majority of doctors and nurses are just, kind, and very compassionate.I believe that with the continuous improvement of the law, the supervision and crackdown on the small group of "rat shit" will become more and more severe.

Some well-established hospitals have a large number of old comrades who spontaneously maintain the red line of medical ethics from being trampled on.

Such is the case with Tuya Hospital.

Those who are not good at medical ethics have little room for development in Tuya Hospital.

"Let's go outside to discuss, don't affect the patient's rest."

Zhou Can glanced at the girl on the hospital bed, and walked out first.

"When I performed the tenderness test and palpation just now, it was clear that there might be hard nodules or tumors in her abdomen. In addition, some of her symptoms were similar to malignant tumors. In addition, I have come into contact with some similar patients in the Department of Critical Care Medicine. Many patients with the disease were discovered too late and missed the opportunity for surgery. This patient is exactly the same age as Hua, and I think life safety is far more important than leaving a scar on the abdomen.”

What Zhou Can said was not only for Dr. Chi, but also for telling the family members that the girl's illness was probably a malignant tumor.

He called Dr. Chi and his family to talk outside the ward in order not to burden the patient psychologically.

"Doctor, what disease does my daughter have? What does malignant tumor mean?"

The girl's mother asked nervously.

No matter how stupid the family members are, they can still feel that the atmosphere is not right.

At this time, they must have realized that the problem may be very serious.

It's just that Zhou Can is very young, and his family members have doubts about his medical skills and experience in diagnosis and treatment.The family members still have a lot of luck in their hearts, thinking that their daughter is so young that it is impossible for her to suffer from serious diseases.

"Malignant tumors are what people often call cancer. We divide tumors into benign and malignant tumors in medicine. The risk of benign tumors is relatively low. As long as malignant tumors spread, it will almost enter the countdown to life."

After Dr. Chi's explanation, the girl's mother was already pale, without a trace of blood, her body was shaking, and she almost sat down on the ground.

Fortunately, she was supported by her husband next to her.

"It's just a preliminary diagnosis right now. You don't have to be too pessimistic until the final test results come out. Besides, Dr. Zhou also said just now that your daughter went to the doctor in time. Even if the test results are really bad, it's not the worst. that step."

Dr. Chi quickly comforted the family members.

"According to what you mean, my daughter must have this laparotomy? Is it dangerous to cut her belly open?"

At critical moments, men can resist.

Although the girl's father was shocked by the news like a bolt from the blue, he still tried his best to keep calm and assumed the responsibility of the head of the family.

"Any invasive operation has risks, but our hospital's technology for laparotomy is very mature, and the probability of accidents should be one in a million. And before the exploratory operation, there will be a professional anesthesiologist to check the patient's physical condition. Carry out a risk assessment, and only if it is considered relatively safe, will you agree to do exploratory surgery."

Dr. Chi tried his best to dispel the concerns of the family members, but at the same time, he did not say anything to death.

In case something happens, I'm sorry, your daughter's life is not good, and she happens to be this 'one in a million'.

If the doctor doesn't know how to fool around, he really won't be able to play.

"Isn't the colonoscopy you said before also not good?"

The girl's father is still making a last-ditch effort.

"If the tumor is in the intestinal tract, it can definitely be detected by a colonoscopy. If the tumor is outside the intestinal tract, the colonoscopy will not be able to detect it. Especially some malignant tumors are very secretive in the early stage. Because of your daughter's condition It is more complicated, and I was worried about misdiagnosis or missed diagnosis, so I invited Dr. Zhou to come over for a consultation."

Doctor Chi said.

"I have something to say, please don't mind you two doctors! Dr. Zhou looks very young, can you see it accurately? Can you ask an older doctor to come over and take a look. After all, if you want to cut my daughter's stomach, it is always right to be cautious."

The girl's father finally questioned Zhou Can.

Zhou Can is indeed very young.

A young man in his 20s does not seem to be an age with excellent medical skills.

"Well... that's fine, I'll invite an older chief physician to come over later."

Doctor Chi agreed.

"Doctor Zhou, thank you for coming to help today. I will ask Director Shang or Director Zheng to look at it later, and I will give you an answer. I will definitely convey your diagnosis point of view to them."

Zhou Can was somewhat embarrassed by the family's questioning, and Dr. Chi tried his best to eliminate this embarrassment.

"You're welcome. If you have any questions, Dr. Chi can come to me at any time. This patient's illness must not be delayed. I'll go back and get busy first. Goodbye."

Zhou Can waved his hand, turned and left.

Not long after he left, Dr. Chi felt that the situation was serious, and hurried to the chief physician to help with the consultation.

Director Shang was not there, so he found Director Zheng Hongtao.

Although the chief physicians of the department are very busy, they are very enthusiastic about the patient's affairs.

Zheng Hongtao personally went to the ward with Dr. Chi to examine the female patient.

After reading the information of the female patient, Zheng Hongtao pondered for a moment.

"I look a bit like intestinal tuberculosis. You can try the effect of anti-tuberculosis before making a further diagnosis."

"Uh...Director Zheng, that's it. I just invited Dr. Zhou Can to help with the consultation." Dr. Chi didn't expect Zheng Hongtao's diagnosis to be consistent with his own.

He guessed that Director Zheng might have missed this time.

So hurry up and say that Zhou Can also came to see it.

"Oh! Doctor Zhou also came? What did he say?"

Zheng Hongtao's long eyebrows twitched twice, and it could be heard that he attached great importance to Zhou Can's diagnostic point of view.

"Dr. Zhou suggested an exploratory laparotomy to clarify the cause. He said that when he pressed the patient's abdomen, he could feel obvious nodules or tumors. Before leaving, he specifically explained that the disease cannot be delayed."

Dr. Chi hurriedly picked the key points.

"Ah...why didn't you say it sooner? Dr. Zhou's diagnostic ability is not inferior to mine, and he would not let patients undergo exploratory laparotomy easily. Let me take another look. I just took a rough look, not that detailed."

Zheng Hongtao's face changed slightly when he heard Zhou Can's proposal to have the patient undergo an exploratory laparotomy.

Immediately changed his tune.

A dignified chief physician cannot be slapped in the face by a Gui Peisheng in public.

And based on his observations of Zhou Can during this period, as long as Zhou Can thinks the patient's condition is very serious, it is almost 100% fulfilled.

When the family members beside the hospital bed heard this, their expressions became complicated.

Judging from the tone of this elderly Director Zheng, the young doctor who came to treat his daughter before seemed very unusual!

Director Zheng just said that Dr. Zhou's diagnostic ability is not inferior to his.

It's hard to imagine that such a young doctor is as good as this old chief physician.

In the future, I really can't judge people by their cover.

After a while, Director Zheng's review of the patient ended.

"Although I didn't find any serious problems, Dr. Zhou's request for an exploratory laparotomy must have his reasons. Moreover, the patient's symptoms are indeed inclined to malignant tumors. I suggest you do this examination. Of course, the decision is up to you. "

Director Zheng is more or less graceful.

He didn't shamelessly say the same diagnosis as Zhou Can.

However, he very seriously asked the family members to agree to a laparotomy.

"Since you said so, then we agree to do this test. Please ask the hospital to arrange it for us earlier, okay?" The girl's father became sad.

Originally, I still had a lot of luck in my heart.

But after really inviting Director Zheng to come for a consultation, he felt that the young Dr. Zhou was more like that.

Before Zhou Can left, he told the girl's father not to delay the illness, which made the girl's father start to worry.

I just look forward to an early checkup and early treatment.

It is not easy to raise a daughter so big.

How can they live if there are three ups and downs!

"This examination requires fasting. From now on, the patient should not eat, preferably not even drink water. I will apply for an exploratory laparotomy for her immediately, and the anesthetist will come to talk to you later, to the patient Do a surgical risk assessment and sign a consent form."

Dr. Chi was very happy to see the family members' attitude so positive.

There is no ink stain, and the examination is arranged for the patient on the spot.

……

The next day, as soon as Zhou Can finished his ward rounds, Dr. Chi found him.

"Doctor Zhou, the family of the female patient has agreed to undergo an exploratory laparotomy. I also communicated with the family members before the operation according to your suggestion. If a tumor is found, it can be removed during the exploratory operation."

The recovery time of laparotomy is quite long, requiring more than one month.

It is best to be able to perform the operation at one time.

Patients can also avoid suffering twice.

"Very good! The family members are much more enlightened than expected!"

Zhou Can said with a smile.

"Uh... Do you have time? In our department, you have the strongest surgical skills. Can you help me with this probing technique?" Dr. Chi looked like a child who was afraid of being rejected.

"Yes, this is completely fine. It's just that after the inspection, I found a tumor and needed to be removed. Although I can do it, but my professional title is not enough. And we don't have the conditions for this operation in the Department of Gastroenterology. It is safest to drag the patient to the General Surgery Department for this operation. .”

Zhou Can's current surgical ability is already very strong.

He even has the ability to perform many surgeries that can only be performed by deputy chief physicians.

For some ultra-difficult separation and resection tasks, he can even go beyond a big realm and reach the operating level of a chief physician by relying on the blessing of the sharp knife technique.

The only problem is that the job title is a bit low.

He is still a resident doctor in the regular training stage, and his qualifications are very low.

Under normal circumstances, other doctors at this stage are still happy to grab the task of skin suturing for a surgery.However, Zhou Can has been able to open his abdomen, chest and even his head independently.

He is not at the same level as those ordinary trainees.

"The general surgery department has been contacted. This operation will be performed in the newly built gastrointestinal surgery department. It has also been agreed there that a deputy chief physician will come to the operating room to guide the operation. But we need to send it ourselves. A competent doctor to complete the surgical task."

Dr. Chi's coquettish operation made Zhou Can shake his head and smile wryly.

It seems that Dr. Chi has already targeted him.

However, this kind of joint operation with other departments is not easy to coordinate.

Even in the surgical department, not every surgeon performs well.

The level of many surgeons is also half-baked.

In order to implement this matter as soon as possible, Dr. Chi found a deputy chief physician with average surgical ability to circumvent the surgical admission system, and then asked Zhou Can to be the chief surgeon.Although these coquettish operations are criticized, they are very practical.

"Doctor Chi has already made up my mind! Can I still refuse?"

Zhou Can smiled wryly.

"Hey, who made you famous in the general surgery department? When I discussed it with the deputy chief physician of the digestive surgery department, the other party originally disagreed. But when I heard that you are the chief surgeon on our side, I immediately agreed. He also praised that you performed the operation quickly and well, and that you were particularly stable, and your strength was not inferior to that of an ordinary chief physician."

Doctor Chi smiled slyly, very proud.

After Zhou Can finished listening, he rubbed his nose and smiled wryly.

People are afraid of famous pigs.

If the pig grows strong, it is easy to be targeted by the butcher.If a person is famous, more people will stare at him.

"They really flattered me, and actually promoted me to the rank of chief physician. Should I go to the surgery now? I need to go to the outpatient clinic with Director Shang to assist in the consultation later."

Zhou Can is now one of the busiest doctors in the department.

Even busier than the chief physician.

He is too busy to sit in the clinic, go to surgery, manage patients in the ward, and participate in the consultation of difficult and difficult cases.

"It's over now. The patient's side is ready for surgery, just push it over."

Dr. Chi is quite prudent.

Every time I come to ask Zhou Can for help, I always do enough preparations.

Zhou Can followed him to push the patient to gastrointestinal surgery.

The last battle for the right to build sub-departments of general surgery also made Zhou Can famous.The reputation in general surgery has not lost to any chief physician.

Pushing the patient all the way, doctors and nurses greeted him from time to time.

(End of this chapter)