Rubbing his hands vigorously, John first asked Mr. Miller to sit down at the table.

Thomas was busy on the side, getting his thermometer, stethoscope, and blood pressure monitor ready, while John sat next to Mr. Miller, ready to begin his physical examination......

Although John's temporary goal was appendicitis, and according to Mr. Miller's medical history and Fang Cai's account, a typical pain site metastasis did fit the characteristics, but John knew that he must not be careless and judge in the examination!

At the end of the day, acute appendicitis is just one type of acute abdomen.

To put it simply, acute abdomen is a disease with acute onset, rapid development, severe illness and many changes, mainly abdominal symptoms, and it is characterized by stomach pain.

How common is an acute abdomen?

According to some physicians, it can account for 25 to 40 percent of emergency and outpatient procedures, and more than 20 percent of general surgeries. I don't know if the number jù is accurate, but it's very common for sure. However, there are many reasons for acute abdomen, such as gastric perforation, appendix perforation, etc., and acute abdomen of solid organs such as liver cancer rupture, spleen rupture, abdominal aortic aneurysm rupture and hemorrhage.

So, to put it bluntly, acute appendicitis is just one of them, although it is the most common one.

Therefore, although John's goal is acute appendicitis, and he also thinks that Mr. Miller is likely to have acute appendicitis, he must still be careful when examining, strictly analyzing, screening, and making his own judgment.

Without the assistance of instruments and equipment, John can be described as stressful.

If it were any other surgeon, even a surgeon of Bergman's level, he wouldn't have thought too much about doing these things. If you succeed, everyone will be happy, and if you fail, it's nothing, anyway, there are more people dying in the operating room and ward, what is one more? But for John, a time-traveler, such a result is unacceptable!

So when Thomas was ready, John's face became very serious. The history has been collected. The next thing was to look at John's own, and motioned for Thomas to begin the initial physical examination of Mr. Miller, while John himself closed his eyes and carefully relived the relevant memories in his mind......

"John, it's up to you next."

I don't know how long it took for John's voice to hear Thomas's low voice.

"It's over?"

Opening his eyes in some surprise, John first saw the examination record handed by Thomas, and then saw the surprised face of Professor Bergman!

"John, this blood pressure monitor is your new invention?"

Seeing that John opened his eyes, Bergman immediately stepped forward and asked.

"Ugh. Yes. ”

John nodded and said with a smile, "If you're interested, I can send you a slow study later." ”

John didn't have the heart to explain the principle and use of the blood pressure monitor to Professor Bergman, and after nodding politely, he immediately focused on the test results that Thomas had just written. And Bergman also knows very well that now is not the time to talk about this, but look at the magical blood pressure monitor next to him, and then look at John, who is indifferent at this time, his heart is tumbling. I can't calm down anymore......

……

“…… Pulse rate 90 beats, breath 18 times. Systolic blood pressure 140, diastolic blood pressure 80, body temperature 39.1, ...... Nothing else is normal, but the increase in temperature is one of the evidence. ”

After a brief glance at Thomas's measurements, John nodded secretly.

An increase in body temperature indicates the presence of inflammation. In this way, it seems that Professor Wolfgang's YAPIAN to Miller is indeed very effective, in addition to relieving pain, it also masks many obvious mental symptoms, at least from the current mental state, Mr. Miller does not look like an ordinary person who is in a body temperature of 39 degrees!

So in that sense. John was very disgusted with the use of yapian.

When diagnosing a patient, the general condition is a very important reference aspect, such as the patient's face, mental state, etc., but opium makes a qiē no longer accurate. It's like people taking cold medicine and going to the doctor, what else can the doctors see besides a blood test that can detect an increase in white blood cells?

After looking at the results of the examination, John walked up to the patient and said with a smile, "Mr. Miller, could you please lie flat on the bed and pull up your clothes?" I need to get your belly checked! ”

"When...... Of course. ”

A little stammered back, and Miller hurriedly lay down on the examination table that Thomas had prepared, and then consciously lifted his shirt. Fortunately, it's summer, so it's easy to pull out his clothes and not feel cold, which doesn't make him feel embarrassed.

John took a hand to help, leaving Miller's abdomen completely exposed.

The physical examination of acute abdomen is very complicated, in fact, it is relatively easy to master it, because he does have rules to follow, which is nothing more than four steps: looking, touching, percussion, and listening, and finally there is a digital anal examination, genital tract examination, etc., and puncture when necessary......

Of course, John won't be so particular all at once, and four steps are enough for now.

Wang, which means to carefully observe the condition of the patient's abdomen. Subtle changes in the shape of the abdomen can indicate the possibility of various diseases. For example, in peptic ulcer disease, the abdomen is generally sunken and scaphoid abdomen; If the abdominal wall is locally bulging and accompanied by a bowel pattern, it may be volvulus......

In John's eyes, Mr. Miller's abdomen was flat, his abdominal breathing was normal, there were no gastrointestinal peristalsis waves, and there were no abdominal wall varicose veins......

Overall, it's relatively normal.

After reading it, John smiled slightly and said, "Mr. Maitreya, please bend your legs...... Ok thanks. ”

After whispering a few words to Mr. Miller, John stretched out his right hand and placed it on his stomach.

"John, why did he bend his legs?"

At this moment, Professor Bergman still couldn't suppress the curiosity in his heart, and leaned over and asked.

"Because I need to get his belly to relax."

John explained without even looking back, and then he smiled at the patient, "Mr. Miller, I'm going to start with the non-painful area and gradually press on your abdomen. Please note that you don't have to worry about it if it's just pressure, but if you feel pain when I press it, you have to sue me right away, okay? ”

"Okay."

Without hesitation, Mr. Miller nodded.

Thomas and Bergman were both close together, one at the head of the bed and the other at the end of the bed, squeezing Mrs. Miller, who cared more about her husband, into a nowhere to stand. Both of them had read John's report and naturally knew that this was the most critical time, so their attention was also highly focused.

In John's material, two distinct features of appendix inflammation are clearly stated: tenderness and rebound tenderness!

The meaning of tenderness is very clear, that is, when the finger is pressed down, you will feel pain, and you can judge the location of inflammation; Rebound tenderness means that it hurts when you press down and suddenly lift your hand, because the inflammation has affected the peritoneum. Therefore, if you want to determine whether there is zài inflammation in the appendix, tenderness and rebound tenderness of the appendix at the projection position on the body surface will be the most important signs! It can even be said that if this is confirmed, the diagnosis is almost half done!

So when John finished checking the other parts and finally moved his fingers to the McClave point, the breathing of all three of them suddenly became heavy!

The appendix is located in the right iliac fossa of the abdominal cavity, and the projection on the body surface is in the middle third of the line between the umbilicus and the right anterior superior iliac spine, which is the McNell point. McT's point, which is the marker for locating the appendix and the point for selecting the surgical incision for the appendix, is named after the American surgeon McBurney who discovered him, and of course its discoverer has now become the venerable John? Mr. Huntelaar......

According to John's point of view, the tenderness and rebound tenderness of the McCollett point will be one of the important bases for judging appendiceal inflammation!

"Ahh

When John pressed lightly on the position of the McShit, Mr. Miller suddenly let out a miserable cry, causing the three surgeons in the office to shake their bodies at the same time, as if they were also feeling Mr. Miller's pain......

……

Chapter 2 needs to be revised, maybe an hour in the evening. (To be continued......)