Watching Director Kong hand over the car to the doctor in the B-ultrasound room, and then he and Ji Xiang walked over and chatted while talking and laughing, Mr. Miao was stunned and sighed deeply silently.

Not only did he notice Ji Xiang, but even the director of the dignified B ultrasound room looked at Ji Xiang differently. not only looked at him differently, but also treated him like a nephew.

Forget it, I'm still busy.

Mr. Miao went to persuade the patient's family, then submitted the emergency surgery order, and then went to explain before the operation.

One set was busy, and the water didn't have time to drink, and the operating room came to pick up people.

Sending the patient to the stage, Mr. Miao originally wanted to call Ji Xiang together, but he saw Ji Xiang sitting in front of the computer, chatting with Director Kong while tapping on the keyboard indiscriminately, and the two were talking and laughing.

Mr. Miao felt a little sour in his heart, greeted Director Kong, and pushed the patient to the operating room.

"Mr. Miao, your shift is very busy, and there is an emergency department in the morning."

After entering the operating room, the anesthesiologist said with a smile.

"Don't mention it, the patient's family did not agree to the operation, and they reluctantly agreed until it was not good."

"Perforated?"

"No, Director Kong played a B ultrasound and said it was fine. But there are signs of peritonitis, open it and see. ”

"Oh? Director Kong's personal B-ultrasound? Who greeted in the courtyard? Or is she a relative of Director Kong's family? The anesthesiologist asked casually.

Mr. Miao didn't bother to explain.

This is too long to say, and Mr. Miao is worried that even if he says it, the anesthesiologist will not believe it, so he simply does not say it.

"Xiao Miao, what emergency?" Director Feng just stepped down, and when he passed by the emergency room, he saw Mr. Miao and asked by the way.

Mr. Miao reported the patient's medical history.

"Director Kong?" Director Feng noticed this detail.

In fact, it is difficult not to notice that an ordinary patient does not need a consultation, who has nothing to do to move Director Kong to do B ultrasound.

"It's Dr. Ji Xiang's opinion, and he contacted Director Kong." Mr. Miao explained helplessly.

"That's right." Director Feng narrowed his eyes.

He hesitated for a second, then turned around and entered the operating room, making a gesture for the anesthesiologist to pause the anesthesia and begin the examination.

In less than a minute, Director Feng finished his physical examination, and he sat on the stool in the corner with a slight frown.

"Director, do you think it's appendicitis?"

"Yes." Director Feng said cautiously.

Mr. Miao noticed that his director's eyes had been staring at the patients on the operating table, full of doubts.

"Director, the patient's diagnosis is very clear, including B-ultrasound auxiliary examination." Mr. Miao said, "Maybe we're thinking too much." ”

"Murphy's dot does have a little tenderness, but it's not serious." Director Feng said a word with a lake.

That being said, the serious expression between Director Feng's mask and hat speaks for itself.

Mr. Miao stood aside silently, waiting for the anesthesiologist to finish the continuous epidural anesthesia and began to brush his hands and disinfect to prepare for the operation.

Director Kong's voice came from outside the door of the operating room, and he walked into the operating room while talking to Ji Xiang.

"Director Feng, why are you there?" Director Kong asked after coming in.

"This is a patient in our department, and I look twice. Besides, you're not here too. Director Feng stood up and made a joke, "Old Kong, when did you become interested in surgery?" ”

"The patient is weird, I'll take a look." Director Kong said, "Xiao Ji reminded me that the patient has signs of localized peritonitis, and it seems to be a problem to explain it by the inflammatory oozing around the appendix. ”

"Localized peritonitis in the mid-abdomen, but not severe, only a little." Director Feng added, "Is there a problem with the gallbladder? ”

"Nope."

The two exchanged a few words and said nothing more.

Ji Xiang saw that Mr. Miao was laying out the list, and suddenly spoke, "Teacher Feng, can you not use a single-port endoscope?" ”

"Huh?" Director Feng was stunned.

This is the operating room, what qualifications do you have as a junior doctor to speak!

Hit a few holes and ask you to say!

If it weren't for Ji Xiang's coming, he would have given himself a top-level SCI paper, and Director Feng would have kicked Ji Xiang out of the operating room a long time ago.

"It's okay to use it first, I think it's best to prepare other holes to reserve a little bit of space to leave room for the liver and gallbladder."

“！！！” Director Feng looked at Ji Xiang suspiciously, trying to identify what Ji Xiang was thinking in his gaze.

Ji Xiang's eyes are clear, like a pool of stream, and you can see the bottom at a glance.

Because of the existence of the case of celiac loose bodies, coupled with the purchase of top SCI, Director Feng didn't say anything, he nodded, and beckoned Mr. Miao to reserve the operation area when he laid the list.

Mr. Miao's mood was a little weird, but he didn't dare to let go of a fart, and honestly began to lay out the list according to the director's instructions.

The position of the belly button eye was punched in, and as soon as the laparoscopic lens could be seen clearly, several surprised "huh" sounds sounded in the operating room.

The TV with the endoscope was supposed to have a red background, but when the mirror went in, I saw something gray and green all over the field.

There is pus, and there is ...... Pus? No, it seems to be bile!

It's not like, it's for sure.

It's bile!

Ji Xiang's judgment was right!

Mr. Miao suddenly felt a little numb, and he looked back at Director Feng.

"I'll go to Lao Yang to come to the stage for a consultation." Director Feng said.

He took out his mobile phone, stood in the corner, looked at Ji Xiang deeply, and called Director Yang.

After briefly describing the patient's situation, Director Feng hung up the phone.

"Xiao Ji, how do you judge?"

Director Kong, who wanted to educate Ji Xiang with facts, was also stunned, and he asked suspiciously.

"I guess, I guess Mr. Kong. In elderly fasting patients, the gallbladder wall thins as the gallbladder enlarges because of the retention and concentration of bile pigs. Coupled with bile salt stimulation, aseptic inflammation of the gallbladder wall occurs. ”

"Due to the compression of the gallbladder floor and tissue looseness, edema, and finally the perforation of the gallbladder floor."

"This kind of perforation is different from the gallbladder perforation we usually encounter, it is not a perforation of the gallbladder caused by inflammation, ischemia and necrosis. Therefore, the discontinuous bands shown on the B-ultrasound are relatively short and even difficult to detect. It's also more difficult to make a differential diagnosis, so I'm just guessing. ”

Ji Xiang briefly described it and then stopped, saying no more.

Several doctors in the operating room were lost in thought.

What Ji Xiang said is indeed a possibility, but this possibility...... It's too rare, isn't it?

"Xiao Ji, tell me about your thoughts."

Ji Xiang smiled and didn't say anything, Director Kong and Director Feng didn't say anything when they saw Ji Xiang, and they didn't ask too much. Maybe it's just a flash of inspiration for Ji Xiang, and there is no detailed idea.

Similar situations are very common in clinical practice, especially common, so Director Feng understood that he did not "force" Ji Xiang to ask.

】

Soon, Director Yang came up with Zhai Yuhan.

After asking about the situation, Director Yang asked Mr. Miao to turn the camera, barely found the location of the gallbladder, tossed it with pliers, and looked at Ji Xiang deeply with interest after seeing the perforated point.