(Thanks to my friend Extreme Flying Snow 18K for your encouragement, and thanks to book friends 160712150011189, tmoo, Wind Rain Xiao, Wind Crazy, Brains, and Benbo monthly pass for encouragement)

"Doctors, doctors, doctors upstairs said our kids need to have surgery. ”

Before Liu Banxia could change shifts and eat, the mother of the child who had just taken the child upstairs to do color ultrasound ran back in a hurry.

"Don't worry, I'll take a look at the color ultrasound pictures first. Liu Banxia said.

The child's mother hurriedly handed the inspection report of color ultrasound to Liu Banxia.

The description given by the doctor is that the mass is located in the middle of the upper abdomen, and the arteriovenous vessels are distributed around, which can rule out intussusception and prove that Liu Banxia's first judgment is accurate.

Intussusception masses usually occur in the right middle and lower quadrant, and the blood flow signal of the intestinal wall will increase. This is also the unique ability of color ultrasound, and B ultrasound does not have this ability.

Ding! Completion of the consultation

Gain 100 XP and 100 Diagnostics Skill Mastery

"Doctor, is this disease very dangerous? Have you finished eating? Can you do it?" the child's mother asked nervously.

"Don't worry, judging from the child's symptoms and blood vascularity, there are no symptoms of necrosis at present. Liu Banxia said.

"Let me first explain to you what this disease is, this disease is a congenital disease. To put it bluntly, it is the problem that it brings in the womb, and the internal performance is like the one shown above, and a part of the intestine takes the place of others. ”

"But your child's condition is not very serious, after all, it is a problem that has been born since birth. Many children need surgical intervention in the neonatal stage, or it can be dangerous. ”

"What we need to do is to restore this part of the somewhat unruly intestinal tube to its original position, and we can do laparoscopic surgery, which is minimally invasive, or we can do open surgery. ”

"Laparoscopy is to make a small hole in the abdominal cavity, and then smooth and reset the malrotated intestine. Laparotomy is to make an incision in the abdomen and then operate again. ”

"But there is also a point that it still depends on the actual situation in the child's abdominal cavity. There will definitely be some adhesions in such a long period of poor rotation, and if the adhesions are severe, laparoscopy is very laborious to do, and it is not as safe as laparotomy. ”

"If you choose laparoscopic surgery and you see that the adhesions are severe when you look at the hole, we will switch to a normal laparotomy. This is not only for the convenience of our doctors, but also for the sake of the child. ”

"After all, it's surgery, so we also have to do a detailed preoperative examination. When the results of the examination come out, the operating room can be vacated, and then we can go in and do it directly. ”

"Wang Chao, you lead the preoperative examination. Then I will explain the operation process in detail, so as to save the eldest sister from worrying. Our surgery is not an emergency operation like appendicitis perforation, but a sub-emergency operation. ”

"Don't worry, if it's really dangerous, how can the child be so painful now, he has to jump in pain. After a detailed preoperative examination, we can also be safer during the operation. ”

Hearing his explanation, the child's mother was finally not as excited as she was just now.

These are also two completely different reactions from the patient's family.

One is very suspicious of the doctor, what tests you ask, the first thing he thinks of is whether you prescribe this diagnosis just to make money. They will repeatedly ask you, ask for verification, and even resist inspection.

The other is like the eldest sister just now, her mood suddenly became very urgent, and she couldn't wait to push the operating room to do the operation well.

If you meet a doctor who has no medical ethics, you can give a certain degree of "guidance" in terms of medication and surgical methods.

Are the children's mothers panicked, basically what you say is what, and you can make whatever you want.

At this time, the test is medical ethics, and laparoscopy must make more money than ordinary laparotomy. However, it is necessary to let the patient's family choose, and you can't make random recommendations in order to make more money.

In fact, the difficulty factor of this operation is really not high, and in the most serious case, the volvulus cannot be corrected, and a section of the intestine may need to be cut out.

However, there is no need for him to tell the child's mother about this matter, and Wang Chao needs to be responsible for more detailed steps and operations. Wang Chao is not an assistant, he will be the chief surgeon of this operation.

Wang Chao also led the child's mother to the office, and the relevant preoperative examinations were issued and the nurses were responsible.

As for who he wants to bring to the stage, Liu Banxia doesn't have to worry about it. This is also Wang Chao's personal choice, but according to the current situation, it is all caught now.

The key is that he is a little wrong with the upper beam, and he rushes to bring other people's interns. Others are also used to this kind of operation, and it is more worry-free.

And the performance of these interns is very good, otherwise there would not be such a comprehensive training opportunity. After all, if the interns you bring do not perform well, it will also affect your rating in the future.

"Teacher Liu, can poor intestinal rotation really drag on for so long?" asked Liu Yiqing on the side after checking the information.

"It's very possible, don't look at it as a congenital malformation, the degree is still very different. Liu Banxia said with a smile.

"In fact, as a normal family, many times it is careless, this child will definitely have a lot of symptoms in his previous life, but where will he usually pay attention to these. ”

Liu Yiqing nodded, it was indeed the same.

Many symptoms will be noticed by the doctor, and when they go to the individual's home, it is not good to drink some hot water for treatment. Take a little more attention and take some antibiotics.

At this time, a 40-year-old male patient wearing a mask and glasses walked in, Liu Banxia took a look, and it was better to receive the treatment by himself.

Took the registration ticket and glanced at the patient's information, 46 years old, hiccups.

"How long has it been hiccups, and has there been any change in your diet?" asked Liu Banxia.

"I've been hiccups a bit lately, but it's been a bit severe these days. Belch...... , just like this. The patient said.

"What about the diet? Have you made a big adjustment to your usual diet? Do you feel bloated?" asked Liu Banxia.

The patient shook his head, "Hiccup...... Nothing else, a little bloating. At first, I thought it was a hoard, burp ....... I took stomach digesting tablets, and then it was the same. Bowel movements also burp...... Normal. ”

"Do you have that feeling of sour throat?" asked Liu Banxia.

The patient shook his head, this time not speaking at all, or he would have to burp.

"In your case, it doesn't seem like it's regurgitation. I'll check on you first, and then you will lie on the bed first. Liu Banxia said.

Gastric reflux is an abbreviation, and the full name is gastroesophageal reflux. It is that the contents of the stomach reflux back into the esophagus, and some patients also have hiccups, and some serious reflux will return to the throat, and there will be that feeling of sour throat.

This is also a common disease in daily life, even Liu Banxia occasionally refluxes.

There are also many factors that cause this situation, such as diet, alcohol, strong tea, mental aspects, etc., which are also easy to cause.

Occasionally, it's nothing, even if it's more serious, you can get it by taking some acid suppressants.

If it becomes a habit, it will have to be examined in detail. If you don't do it well, there may be a possibility of gastrointestinal cancer, especially those who have a family history of this aspect should pay special attention.

This patient was a little different, there was no abdominal symptom feeling, just dry hiccups.

However, after the patient untied the cotton suit and exposed his abdomen, Liu Banxia frowned, wearing the cotton suit was not obvious, and the current patient was a little thin.

"Do you have diarrhea now?" asked Liu Banxia.

"Diarrhea is occasional, and the gastrointestinal function is not very good. However, it is not very frequent, as long as you don't eat spicy or cold, and you don't eat hot pot, you generally don't have burps...... , what's the matter. The patient said.

"I'll press it in a moment and let me know if I'm feeling uncomfortable. Liu Banxia said and began to finger diagnose.

"Hiccup......

Just pressing into the upper abdomen, the patient burps again.

"Is there something uncomfortable here?" asked Liu Banxia.

"It's dispensable, but there's no special feeling. You just pressed this one and hiccuped a little...... Dot. The patient said.

"Hiccup...... and sometimes lumbar burping...... There will be a slight pull pain like stretching. It's not too serious though, I burp...... , usually less exercise. ”

"Do you usually have urethral pain when you pee?" asked Liu Banxia.

"Nope. The patient said.

Liu Banxia pondered in his heart, and just now suspected that the patient had kidney stones.

Even if the kidney stones do not get stuck in the ureters and cause severe pain, sometimes they accumulate too much in the kidneys, which can cause these symptoms.

"Doctor, hiccup...... , can you prescribe some medicine so that I don't have hiccups for now?" the patient asked after sitting up.

"Don't worry about this first, we have to find the right way to see what causes it so that we can do targeted treatment. Liu Banxia said.

In fact, he would like to prescribe an ultrasound directly to the patient, but the current indications are not obvious enough.

It's not that you need to rely on instrumental tests as a basis for diagnosis and you can prescribe it randomly, you must at least have a clear indication.

The patient has no symptoms of abdominal pain, only a little bit of back pain occasionally, and a little bit of gas and hiccups.

Kidney stones should not be either, if there are a lot of kidney stones, some small particles will often be brought out in the process of urinating, so there will be pain.

Ding!Quest Posted: Patients with hiccups

Open-ended task: The patient receives habitual hiccups, but no clear indication has been found in the current diagnosis process, and the patient needs to be further diagnosed to confirm the condition. Task rewards will be awarded based on the diagnosis results

Liu Banxia had a slight headache, so he could only continue to listen to the patient's heart and lung sounds.

It is hoped that before the ultrasound diagnosis is prescribed, there will be a clear indication, rather than leaving the patient busy with the examination.

You have examined carefully, and there is no way to rely on the instrument to open the instrument as soon as you come up with the patient, and you will open the instrument immediately after a simple examination, which will give the patient two different feelings, and it is also an attitude problem.