General surgery, also known as general surgery, is the largest specialty in the surgical system, involving the widest range of diseases, including head and neck, breast, skin and soft tissues, abdominal wall and limbs, gastrointestinal tract and blood vessels, and endocrine system.

General surgery is very closely related to the basic knowledge of surgery, such as the use of surgical instruments, sterility principles, infection, shock, blood transfusion, etc., in a sense, general surgery is the foundation of other surgical specialties, basically all surgical specialties must rotate in general surgery for more than half a year, in order to be familiar with and master the basic techniques of surgery.

There are some things that are never meaningless just by mastering theoretical knowledge.

Just like Tian Lu now, the knowledge of the clinical manifestations of a disease, biochemical indicators, surgical plans, as well as prognosis and treatment, is almost completely preserved in his brain. However, how to use this knowledge to diagnose patients and treat diseases requires re-learning and accumulating sufficient experience.

Medicine is a practical discipline, and the knowledge in the book can never replace practice. Especially when the treatment of diseases in the future is very different from the reality, this kind of learning and accumulation is even more important.

Now, facing a newly admitted patient, Tian Lu focused all his attention。。。。。。

"So, now who can tell, women, have a lump in the right lower abdomen, what are the possible lesion sites?"

Dr. Howard's eyes were like vultures looking at a pile of carrion, and he looked at his residents and medical students viciously, and the words in his mouth whizzed out like machine-gun bullets.

Dr. Howard was followed by three of the general surgery department's own residents, as well as Tian Lu, a resident of the neurosurgery department who rotated here. The brains of three men and one woman, four young people, immediately spun at high speed when they heard this question.

Tian Lu naturally knew the answer in an instant, but before he could speak, the only blonde girl had already raised her right hand high: "Appendix, colon, ovaries and fallopian tubes。。。。。。 ”

A long list of names came out of the blonde girl's mouth, and her slightly ordinary face radiated a confident glow at this time!

Dr. Howard's expression did not change in the slightest, but he casually looked at the patient's information, and it was not until the girl finished the last word that she nodded with satisfaction, and handed everyone a copy of the case information: "This is the patient's information and the results of some examinations, you all take a look." Give you ten minutes, and after ten minutes, I'm going to hear from each and every one of you!"

Obviously, this was another test of the residents by Dr. Howard, and the four of them immediately became nervous and hurriedly looked through the materials in their hands.

On the first day of general surgery, Tian Lu and Hans were separated, and Tian Lu was accompanied by three general surgery residents and the only black physician in general surgery: Howard. Hughes.

Same name as that famous rich man.

The life of a resident is really hard.

Before 7 o'clock in the morning, Tian Lu must arrive at the hospital, then change into his hand clothes and start the busy day. Because of the existence of the referral system, all the patients who come to the Department of General Surgery for treatment are basically the right patients, so for these residents, there is never a shortage of practice objects, and every patient is a severe test for them!

Tian Lu took the case information in his hand, and first looked at the symptoms and examination results carefully.

This was a female patient, a sixty-eight-year-old woman, who came to the hospital with a lump in her lower right abdomen. Palpation can reveal a lump about the size of a ping-pong ball, with unclear borders and slight tenderness, and the lump is no longer palpable after tension in the abdominal wall.

"The lump is in the abdominal cavity. ”

Seeing this, Tian Lu had the first concept in his heart.

There were no symptoms of nausea and vomiting, abdominal distension, diarrhea, and constipation, and ultrasonography showed the presence of gas in the mass, but the possibility of gynecological disease was ruled out, and after colonoscopy, the possibility of colonic lesions was also ruled out.

After carefully reading the case information, Tian Lu frowned secretly.

It is indeed difficult to determine the cause of the disease based on the existing symptoms and examination results, and I am afraid that further tests will be needed.

After a slight hesitation, Tian Lu's eyes flashed, and he issued an order in his mind.

"Activate the clinical diagnostic support system!"

Silently, Tian Lu suddenly shook his spirit, and there seemed to be something more in his mind in an instant.

"Please enter the case information. ”

"General condition of the patient: female, age 68 years old, height 1.73 meters, weight 45 kilograms. Past medical history: Bilateral radical mastecto。。。。。。my for bilateral breast cancer 7 years ago palpable right lower quadrant。。。。。。 No nausea or vomiting。。。。。。 ”

Ignoring the results of ultrasound and colonoscopy, Tian Lu "thought" the patient's information, and immediately issued a second order: "Start diagnosis!"

Just like entering the case information without entering the system hall, after Tian Lu gave the order, naturally, the diagnosis appeared in his mind.

"Systematic diagnosis: 32.1% probability of ovarian lesions, 28.3% probability of colon lesions, and 17.9% probability of appendiceal lesions。。。。。。 The probability of antral lesions was 12.8%。。。。。 ”

"Antral lesions?"

Tian Lu's heart moved, and he hurriedly opened the case information in his hand again.

The female patient, 68 years old, is 1.73 meters tall and weighs 45 kilograms.

"Too skinny!"

Frowning slightly, keep looking!

Past medical history: breast cancer, gastric prolapse。。。。。

"Stomach prolapse?"

After seeing this term, Tian Lu's eyes suddenly lit up。。。。。。

"Alright, it's time!"

Dr. Howard looked at his watch, coldly interrupted everyone's thoughts, and asked, "Now, who can tell me what we should do next?"

"Open belly probe!"

Obviously, the blonde girl has already considered it very maturely, and replied for the first time: "The existing examination results cannot be prepared for judgment, so we can only rely on open abdomen exploration." ”

Her confident appearance was contagious, and the other two residents couldn't help but nod their heads.

Doctor Howard's face remained impassive and turned in the direction of Tian Lu: "Tian, what is your opinion?"

"I don't approve of rash open belly exploration!"

Tian Lu said categorically: "According to the patient's medical history, gastric prolapse has been diagnosed, so my recommendation is to do a gastroenterography first!"

"Gastroenterography?"

A look of surprise flashed in Dr. Howard's eyes, and the expression on his face finally loosened a little.

However, the other three residents didn't seem to agree with Tian Lu's judgment, especially the blonde girl, who said with some dissatisfaction: "You mean her stomach has been drooping all the way to the right lower abdomen?

"No, I didn't say that!"

Tian Lu smiled and said, "I just think that since she has a history of stomach prolapse, it doesn't seem like an unacceptable thing to do a gastroenterography before the open exploratory examination, right?"

The eyes of the four residents turned in the direction of Dr. Howard.

After just a moment of contemplation, Dr. Howard nodded and said, "Very well, let's go for a gastroenterography first!"

Except for Tian Lu, the faces of the other three residents changed suddenly, especially the blonde girl, who bit her lip tightly and looked at Tian Lu with a very unconvinced look.

Ignoring the performance of the other three, Howard glanced at Tian Lu with great satisfaction, and suddenly continued: "Tian, go and prepare, there will be an operation later, you will be my assistant!"

"The reward is coming!"

Tian Lu was suddenly overjoyed in his heart: being Howard's assistant on stage means that he has the opportunity to do it!

As a surgeon, several residents are desperately striving for the opportunity to become assistants, especially Tian Lu, who can not only accumulate surgical experience but also further enrich the cases of the clinical operation support system every time he undergoes surgery.

In the envious and jealous eyes of the other three, the corners of Tian Lu's mouth finally couldn't help but bend a small arc。。。。。。

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I'm sorry, my wife is on duty today, and I have to accompany my daughter during the day, so I can only write it at night, and it's been delayed until now, hehe, fortunately, it's released, tomorrow, no, it should be today, and there is still a chapter.