The road to the rise of great doctors

Chapter 119 What Hot Pot Can't Solve
The half-day meeting was full of useful information.But precisely because of this, the overall atmosphere of the meeting was relatively serious and dignified.Focused listening and thinking also consume energy quickly.

Even though he ate snacks and fruits and drank a cup of coffee during the tea break, towards the end, Liu Dong's stomach growled uncontrollably.

Liu Dong touched his stomach, looking helpless.When I looked at Zhao Gang, I found that he had the same expression.

"Hey, so do you!"

The two said in unison, and then laughed.

Zhao Gang was the first to break the silence and said, "Teacher Zhang Wei was asked to leave at noon, leaving us two alone. Do you have any arrangements?"

Liu Dong shook his head, "No, I had a friend come here to study when I was an undergraduate, but this year I changed the place. For a while, I really can't think of anyone who is here."

"That's just right. Let's have a big dinner together at noon. What do you want to eat?"

"It's up to you, Teacher Zhao, to arrange it. You come here a lot. This is my first time here. I've always heard that there are a lot of delicious food here, including hot pot and skewers!"

Liu Dong paused and continued: "Even the delicacies from other places may have some changes in taste here, so you can try them. Or, let's go to the food court here to try some snacks?"

"Okay. When I booked the tickets, I thought of eating well, so I bought it a little later, and we had plenty of time. However, I think we should choose the same food. I will inevitably come more in the future, and then gradually Eat them all, what do you think?"

Liu Dong agreed with both hands.

This is the best thing about the Saturday morning meeting. Those who come early can have some fun the night before, and those who leave late can make their own arrangements on Saturday afternoon.Whether you are playing by yourself or gathering with old friends, it is a beautiful thing.

In the end, they chose a hot pot restaurant near the venue, which was recommended by a local medical sales specialist.After they tasted it, they felt it was well-deserved.

While eating, I listened to the locals next to me talking with local accents, which gave me a unique flavor.

When the two of them were eating enthusiastically, a petite beauty next to them suddenly held her stomach and shouted "Ouch, ouch".The sensitivity from medicine made both of them involuntarily pay attention.

I heard this beauty's companion asking anxiously, "What's wrong with you? What's wrong with you?"

The beauty kept shouting "Ouch, ouch", and sweat beads as big as soybeans began to roll down from her head and face. She pressed her belly with one hand, curled up, and lay on the ground.After a while, she said, "My belly is so bloated."

"Are you hungry?" the companion asked.

When the girl fell to the ground, the waiters had gathered around, and their faces changed when they heard this sentence.

At this time, another of her companions said, "But we all eat from the same pot. If we get a bad stomach, we are fine."

"That's true. But what else could be the reason?"

The girl talked about her symptoms intermittently. After listening to it, Liu Dong and others came up with a guess.

It turns out that this girl had abdominal distension and pain not just for one or two days, but for three or four days. She would sometimes experience nausea and vomiting, and occasionally fart, but she had not had a bowel movement for three or four days. It used to happen once a day, and today she also farts. Gone.She thought it might be gastrointestinal discomfort, and she might recover after adjusting her diet.

This time, her companion invited her to have hot pot, but she didn't want to come. After all, she had abdominal pain, bloating, and gastrointestinal discomfort. She didn't want to come out.But when my companion learned about it, he said, "There is nothing that hot pot can't solve. If it can't be solved with one meal, just two."

She was repeatedly persuaded, and she, who was already soft-hearted, followed.Before coming, she secretly made up her mind to stay with him as much as possible, but eat less or not at all.As a result, when I saw other people eating excitedly, I had no appetite and hadn't eaten much in the past few days. After I felt that the bloating in my stomach didn't seem that bad, I couldn't bear it anymore and ate a lot of meat and tripe. Then I suddenly felt... The pain in my stomach became severe.

"vomit" she suddenly started vomiting as she spoke.

The companion next to him was anxious.

When Liu Dong heard "abdominal pain, bloating, vomiting, and stopping defecation", he felt a bit like "intestinal obstruction."However, she is a woman of childbearing age, and the sudden abdominal pain still needs to be ruled out as pregnancy-related diseases.

When he saw the girl in pain, her companion was just anxious and did not act, and the waiter was also a little timid, he couldn't hold it in anymore and said loudly, "This is not far from the hospital, call the emergency number quickly!" "

"Yes, yes, yes," her companion suddenly realized and started dialing.

Liu Dong and Zhao Gang looked at each other and then walked over, "We are general surgeons and are familiar with gastrointestinal problems. Let's see if we can help."

The waiter and the onlookers spontaneously made room for an opening so that they could walk to the girl's side.

"We'll ask you a few questions. You answer them first. This will provide them with some clues when the emergency personnel arrive and help you get effective treatment as soon as possible." Zhao Gang said to the girl and several companions.

"Everyone else should disperse first. Don't gather here. This is not conducive to the patient's recovery." Liu Dong said to the waiter, asking the waiter to evacuate the diners first.

After seeing the other people leaving, Zhao Gang asked in a low voice, "Stomach distension and pain are mostly symptoms of gastrointestinal diseases, but considering that she is a woman of childbearing age, some pregnancy-related diseases may occur or be dangerous. Sometimes, you will also experience abdominal pain and bloating. So don’t take it offence, the doctor will ask about it.”

"First question, have you had sexual intercourse recently? How is your menstruation? Does it come on time, or is it missing or is there a possibility of pregnancy?"

After the girl heard this, although she still felt some abdominal pain, bloating and other discomforts, her face suddenly turned red from pale, and she said loudly, "It's absolutely impossible. I don't even have a boyfriend, so this kind of thing can't happen."

"OK, let's rule out this situation first. After the emergency personnel arrive, you can also tell them about this situation."

"Second, have you had any surgery before? Have you had intestinal obstruction before?"

"I haven't had any surgery, and I haven't had an intestinal obstruction."

"Are your symptoms abdominal pain, bloating, vomiting, and stopping of flatulence and defecation?"

"What is exhaust?" "Exhaust is fart."

"Oh, at first it was mainly vomiting, abdominal pain, bloating, and flatulence. I haven't had a bowel movement for three or four days, and I didn't have any more flatulence today. Oops."

"Sister, this sounds very much like intestinal obstruction. When the symptoms were not severe before, it may be incomplete intestinal obstruction. Now after suddenly eating a lot of meat, it may be irritated, and it may look like complete intestinal obstruction." Zhao Gang said.

Liu Dong nodded again and again after hearing this, and added, "First do an ultrasound to rule out peritoneal irritation caused by gynecological diseases and common acute abdominal diseases, such as appendicitis, cholecystitis, etc. Then, after confirming that there is no pregnancy, etc., you can do a CT Wait for the examination. The diagnosis is relatively quick."

"However, if the disease is confirmed to be complete intestinal obstruction, emergency surgery will be required."

"Where's the person who made the emergency call? What should I say?"

The girl's companion replied, "We'll be there in five minutes."

"That's good. Remember to inform your family. If the surgery requires family care, they also need to know the informed consent form for the surgery."

Maybe it's because Liu Dong is younger, looks like someone of the same age, and is easier to talk to?

One of the girl's companions added Liu Dong's contact information when the ambulance arrived. The reason was, "If the doctor at the hospital has a problem, he might want to help."

Liu Dong looked at the other party. Although he was a little short, he spoke nicely and was quite cute.In this way, it is difficult for him to refuse to help others.

Wave goodbye to each other.

After waiting for them to leave, Zhao Gang and Liu Dong continued to eat hot pot, adding some soup, and there was still a lot left to continue cooking.If they encounter a case while eating hot pot, it will not affect their eating at all.Just like the medical students who finished the anatomy class back then, they still went to eat "Gourd Head" or "Braised Boiled and Fired". It is also fun to identify the structure while eating.

Perhaps, when I eat hot pot again in the future, I will remember from time to time a girl who suffered from symptoms of acute complete intestinal obstruction while eating hot pot, and "Intestinal obstruction cannot be solved by eating one, two, or three meals of hot pot." thing."

Zhao Gang took a piece of chopsticks and put it into his mouth after dipping it in the material bowl.Then he asked Liu Dong, "Before you ate, I saw you went to a small stall and bought a Q version of the panda. Are you going to give it to your girlfriend?"

"Yes, Teacher Zhao, your eyes are so sharp, I can't even hide this from you!"

"Hahaha, that's right, don't even look at who I am. I have been here for so many years since I was an undergraduate, and there is no gossip in the hospital that I don't know about."

"Awesome!" As an excellent "praise", Liu Dong gave a timely compliment and then gave a thumbs up.

"Don't give me a sloppy eye. I just saw that a beautiful companion of the girl with intestinal obstruction added your contact information. Don't eat what's in the bowl, look at what's in the pot, and corrupt our surgeons reputation!"

"Ouch, brother. I couldn't help it when you said this, hahaha." Liu Dong laughed and almost spit out the food in his mouth.

"First of all, I have a girlfriend, and we have a very good relationship. There is no doubt about it."

"Secondly, having a girlfriend is different from getting married. Of course, I will not 'step on both sides'. You will see how I behave in the future."

"Again, I added the contact information for a purpose. We are here to 'operate like a tiger for a while'. What is the answer? It is 'a record of [-]'? Doesn't it all depend on the final definite diagnosis! With the final With the diagnosis, treatment, and prognosis, we can see whether our famous detective is 'Conan' or 'Mouri Kogoro', aren't you curious?"

"Lastly, you said that you know all the gossip about the hospital. So, do surgeons have a reputation? Ah, what kind of reputation? I have heard a lot of stories."

Zhao Gang picked up a piece of beef with a male spoon and put it in Liu Dong's bowl, with a bright smile on his face.

"Eat meat, eat meat, this meat is so fresh."

"Hey, you eat too." Seeing Zhao Gang avoiding talking about it, Liu Dong simply stopped pursuing it.

While the two were eating, they talked about the disease just now.It's quite delicious when paired with hot pot. "Nonsence!"

Intestinal obstruction, like appendicitis and cholecystitis, is a very common clinical acute abdomen. Delay in diagnosis and treatment may lead to aggravation of the disease, and even serious conditions such as intestinal necrosis and peritonitis.Therefore, early diagnosis and timely intervention and treatment are very necessary.

In general, intestinal obstruction is divided into four categories.

Mechanical intestinal obstruction.One type is called adhesive intestinal obstruction, which is the most common type of all intestinal obstructions and can account for 40.00% to [-]%.Postoperative abdominal adhesions are the main cause of adhesive intestinal obstruction.Of course, current surgeries have undergone great changes, and there are certain measures to prevent intestinal adhesion. However, the most effective measures to avoid adhesive intestinal obstruction are to move the abdominal cavity as little as possible and as little as possible.Just like urology and kidney surgery, most doctors in China prefer the retroperitoneal approach, which does not go through the abdominal cavity, because of this consideration.

In addition, there are three categories: dynamic intestinal obstruction, vascular intestinal obstruction and pseudo-obstruction.

Some patients with advanced gastrointestinal tumors will transfer to the intestinal tract or anastomosis, which will also cause intestinal obstruction.Such patients are usually in poor condition and find it difficult to withstand the impact of surgery, and placement of stents or catheters may not be successful in all cases.Failure is sometimes the knell before death, which is a pity and a sigh.

Why should you consider that this person may have an intestinal obstruction?
The typical clinical manifestations of intestinal obstruction are sudden abdominal pain, bloating, and cessation of gas and bowel movements.

Intestinal obstruction means that due to obstruction, food, feces, etc. from the proximal end of the obstruction cannot move downward. The intestine is still peristaltic in order to move downward, so paroxysmal colic will occur.

Abdominal bloating often occurs after abdominal pain.The degree of abdominal distension varies greatly depending on the location of the obstruction.High small bowel obstruction usually presents with fullness in the middle part of the upper abdomen, while low small bowel obstruction presents with general abdominal distension.

Stopping exhaust and defecation is the main symptom in complete intestinal obstruction, but it is not obvious in partial intestinal obstruction.

Therefore, it is easy to suspect that these are the diseases.

After eating, the two returned to the hotel to pack their things.Then rush to the high-speed rail station.

After arriving in the evening, Liu Dong received feedback from the girl's companion that it was indeed the disease, and due to the key information provided by the two, after arriving at the hospital, quick and effective ultrasound and imaging examinations, as well as timely treatment by the general surgery department The consultation finally enabled the "girl with intestinal obstruction" to complete preoperative examination and preparation in a very short period of time. After timely surgical treatment, the disease was resolved.

Of course, the smell of the operating room mixed with hot pot gas and feces gas will probably leave a deep impression on those who participated.
(End of this chapter)