The wind was chilling.

Except for Professor Shen and Mao Mao, no one expected that the hospital's ward rounds would be so serious, and no one expected that Director Yang, who originally looked amiable, would change his face in an instant, making people dare not look at him.

"In the last episode of the law firm's program, I thought they were too serious, but I didn't expect that compared with the doctors in the hospital, they were simply too gentle."

"Yes, Director Yang is going to curse?"

"I couldn't stand it even when I wasn't there, and my legs were shaking a little. Did Director Yang do it on purpose? ”

The guests whispered.

Their voices were subconsciously lowered, as if they were worried that Director Yang on the screen would hear it.

……

"The gallbladder is normally located in the gallbladder fossa at the anterior border of the left and right hepatic interfaces, which is relatively fixed and not easily torsional. So far, the exact cause of gallbladder torsion is unknown. ”

"However, the medical community believes that there are several possibilities, first, congenital anatomical variations: mesangial gallbladder, free, drooping, and increased mobility."

"Second, in the elderly, lipoatrophy, ligament laxity, and increased gallbladder mobility."

"Third, hunchback causes internal organs to droop and change their position."

"The fourth predisposing factor is the change of body position during exercise or strong peristalsis of the gastrointestinal tract, and even cholestasis and stone incarceration can induce gallbladder torsion."

"The patient complained of walking almost before the pain in his abdomen, and I became suspicious." Ji Xiang was not deterred by Director Yang's momentum, and his answers to questions were reasonable and clear.

"Intermittent pain, tender point in the mid-abdomen, differential diagnosis ......"

After Ji Xiang finished talking about the predisposing factors of gallbladder torsion, he began to talk about differential diagnosis, Director Yang's expression did not change, but Ji Xiang's words set off huge waves in his heart.

It seems that Ji Xiang is "dropping the book bag", but the senior doctors know that Ji Xiang is telling his own mental journey at that time.

That is to say, at that moment, Ji Xiang thought about countless things from the performance of the physical examination.

"In summary."

3′12", Ji Xiang finished speaking, he still smiled, "Because gallbladder torsion is a relatively rare disease, plus many differential diagnoses, so only a preliminary diagnosis, suspected gallbladder torsion and recommended that the patient check the upper abdomen and mid-abdomen CT." ”

】

"Why is there no gallstone disease in the diagnosis?" Director Yang suddenly asked an extremely strange question.

"There is no significant correlation between gallstones and gallbladder torsion, and about 70% of patients with gallbladder torsion have no gallstones at the time of diagnosis.

Congenital factors are the main cause of gallbladder torsion in children, while age-related physiological changes are more likely to be the cause of gallbladder torsion in adults.

There was also no significant correlation between the direction of gallbladder torsion and the degree of torsion 180°, incomplete torsion, > 180°, and complete torsion. ”

"Later, the patient did auxiliary examinations, which confirmed the above judgment, and the diagnosis was clear, which was gallbladder torsion with acute noncalculous cholecystitis."

After listening to Ji Xiang's speech, Director Yang looked seriously at the young man in his prime in front of him.

He wanted to give Ji Xiang a problem, but the so-called "problem" couldn't bother him at all, and Ji Xiang answered it fluently.

From the initial caution, to the incidental discovery that the patient's condition is wrong, to the directional signs, to the various judgments, the organization is clear and impeccable.

Director Yang was a little dazed, even if he answered this question by himself, it was impossible to be as simple and clear as Ji Xiang's answer.

"Doctor Jixiang, this is a rare disease, how do you know so much."

Director Yang's tone finally softened, and he asked with a calm expression.

"We have been exposed to similar cases at our local hospital." Ji Xiang said with a smile, "Teachers Park Heyun, Liu Yulin, and Yan Guanghua wrote a similar report - laparoscopic resection of gallbladder torsion with necrosis in 1 case. ”

Director Yang nodded.

"As for the medical records......"

"Wait until you pick up the patient, you will write." Director Yang looked at Ji Xiang and said.

"Okay."

……

……

In the review room, there was silence.

The atmosphere at the scene was too depressing, the host's bald head lit up, the corners of one side of his mouth were crooked, and he began to save the scene.

"I didn't expect our reality show interns to be so powerful." The host snorted a haha.

The layman guests didn't know what to say, and they didn't know how to put their beaks even if they wanted to say anything.

The semi-expert guest Mao Mao looked at Ji Xiang on the screen in a daze, not knowing what he was thinking.

Professor Shen was the only expert, and he was even more silent, and ignored several reminders from the film crew, just frowning thoughtfully.

"Professor Shen, is it common for interns like Ji Xiang to be seen in hospitals?" Seeing that no one answered his words, the host had to throw out a question and forcibly enliven the atmosphere.

"Intern?" Professor Shen smiled wryly.

"yes, he's still a doctor."

"Let's put it this way." When Professor Shen saw that the screen switched to another ward, he immediately became interested, remembered his identity as a guest, and began to talk, "Dr. Ji Xiang gave me an illusion that he was not an intern with no clinical experience, but the kind of ...... who had been in clinical practice for more than ten years."

As he spoke, Professor Shen felt that his description was a little wrong, and laughed, "Oily is a word we occasionally describe, and this paragraph is cut out." ”

The host also laughed, this matter is over. As for whether to cut it out in the end, it depends on what Director Fan means.

"Well, he's like the kind of doctor who has had a medical malpractice, who was almost sentenced, and he felt a deep sense of guilt...... I could sense a very strong sense of OCD in him. ”

"Obsessive-compulsive disorder? How do you say that? ”

"Everyone knows that there is a small probability of everything. Small and medium-probability events in medical care are the most headaches, but seeing dozens or hundreds of patients every day, no matter how small the probability is, it will become a high-probability event over time. ”

"If you can't make a mistake, it's because you don't see the patient enough."

"But the medical industry has its own peculiarities, what if something goes wrong? That's all human life. Therefore, many doctors have obsessive-compulsive disorder, like Dr. Ji Xiang, the patient has gone to the emergency department, and he is worried that the emergency department is busy, and the emergency doctor has no time to tell the patient to pay attention to the position when vomiting. ”

"As for the physical examination, if you find a problem, you must continue to investigate, there is nothing special about that. I just sighed that he was such a young doctor, and he knew that he was responsible before he took care of the bed. ”

"Responsible?" The moderator was a little confused.

"Yes, interns are not responsible, so the pressure is not so great, and there are often problems at work. And only when you take care of your patients and take responsibility can you be a real doctor. ”

"Let's not talk about treating diseases and saving people, just go all out, I think Dr. Ji Xiang is already a qualified clinician."

Professor Shen gave a high enough evaluation.