"Director Lu, we don't recommend surgery." Consultation experts in hepatobiliary surgery and gastrointestinal surgery said in unison.

The two of them glanced at each other, and then looked at Lu Gang at the same time.

The opinion is very clear, and the surgeon feels that this is a black pot, so they don't want to carry it.

Similar examples have been seen clinically, though not very frequently.

Acute abdomen, open it to see that there is nothing wrong with the stomach, and whoever opens the abdomen will be embarrassed.

What should I do if I can't find the problem? Is it closed?

How to explain to the patient's family if the patient is in pain after going down?

Therefore, in this case, you can only organize a consultation on the table.

Faced with patients with open stomachs, doctors are helpless in the operating room. You can't really put a zipper on the patient's stomach as the joke says, and pull it open when you want to see it.

However, if you don't open it and take a look, the existing tests do not support internal medicine.

This is where the disagreement comes in.

Lu Gang frowned, and he sighed, "I'll call Director Bai and ask for the leader's opinion." ”

The meaning of this has been made clear, if you want to take a look at it on stage, it must be borne by the medical department, so that the clinical surgeons can rest assured.

"Director Lu, teachers, there is a detail about the patient that I don't know if you have noticed." Ji Xiang suddenly broke the awkward silence.

"What details." Lu Gang had already taken out his mobile phone and was about to call Director Bai. He asked as he looked for Director Bai's phone number.

Although Ji Xiang began to babble, he did not stop Lu Gang's movements.

"In the first two hospitalizations, the patient recovered on his own, and once he almost missed the operation, and the patient refused surgery because of the relief of abdominal pain before the operation, and was automatically discharged after a complete recovery."

"Yes, I just said that." Lu Gang pressed the button on his mobile phone and dialed Director Bai's number.

"Every time they were hospitalized, the patient's blood pressure was high, and they were pumped with micropumps to take antihypertensive drugs. The patient had a history of hypertension for 2 years, and he did not take oral antihypertensive drugs for 2 years, and the only antihypertensive measures were pumped during hospitalization. ”

Lu Gang pressed the last button, and his fingers stopped in mid-air.

"High blood pressure has nothing to do with abdominal pain, if it is an abdominal aortic dissection, the patient estimates that the grass on the grave is already old and tall." Said the gastroenterologist.

"I think it's related, it's almost time to pump in the antihypertensive medication this time, and I just asked, and the patient reported a slight relief in his abdominal pain."

"Maybe it's numb?" Said the gastroenterologist.

He looked down on Ji Xiang very much.

Director Lu was obviously ready to consult Director Bai of the Medical Department, which proved that Director Lu was biased towards surgery and laparotomy.

Ji Xiang suddenly jumped out to block it, leaving the tricky patient to himself, this is not looking for trouble or something.

He looked at Ji Xiang coldly, no matter what Ji Xiang said, he didn't think it was right.

Although his tone was not good, Ji Xiang didn't care, but smiled slightly, "According to the dosage of the medicine, there is still half an hour for the blood pressure to drop to about 150, and the pain should be relieved by then." ”

"Xiaoji, don't talk nonsense." Lu Gang lowered his voice and said, "Acute abdomen caused by blood pressure, do you think your diagnosis is logical." ”

"Director Lu, yes." Ji Xiang also lowered his voice, as if whispering to Lu Gang.

It's just that it's quite quiet in the office, and you can still hear what they're saying if you listen carefully.

High blood pressure, abdominal pain, is there a connection?

If Ji Xiang is just an ordinary training doctor, I am afraid that he has been kicked to the science and education department by the department to which he belongs, and the training certificate will not be issued.

"What logic! Joke. Lu Gang was a little unhappy, but he didn't taunt him as directly as he did when he talked to other doctors.

"Hypersympathetic nervous system and increased release of vasoactive substances, such as renin and angiotensin II, a sharp rise in blood pressure, spasm of small blood vessels throughout the body, decreased circulating blood volume, reflexively induced activation of vasoactive substances leading to further vasoconstriction and inflammatory factor production."

"At the same time, the elevated blood pressure leads to damage to the vascular endothelium, and the combined effect of the above mentioned mentioned things is that the tissue exudation increases significantly, and the perirenal effusion appears. With effective control of blood pressure, polyserous effusions disappear, abdominal signs disappear, and diagnostic treatment excludes surgical disease of the abdominal organs. ”

"Anyway, if the blood pressure is too high for surgery, there is no way to anesthetize, and the anesthesiology department has to wait for the blood pressure to drop down a little, wait."

Ji Xiang said very easily and freely.

The door was pushed open at some point, and Lin Jiu walked in and stood in the corner, looking at Ji Xiang in a daze.

What Ji Xiang said was reasonable, but Lin Jiu had been working in clinical practice for about ten years, and he had never encountered a similar situation.

The logic seems clear, but it is only theoretical.

It can't be said to be unreasonable, it can only be said to be too idealistic.

However, Ji Xiang's last sentence was right - the patient's blood pressure was too high, and the anesthesiology department would wait until the blood pressure was under control before going on stage.

Suddenly!

Lin Jiuze had a thought in his mind - the patient was hospitalized for the second time and retreated, and he was ready to go to the operating room for surgery, and the pain was suddenly relieved.

At that time, it must have been because the patient's blood pressure had dropped, and his stomach would not hurt.

Although Ji Xiang's judgment has no reason and seems to be "untenable", there is a sense of being in touch with the actual situation of the patient.

"Huh? Wait and see? Lu Gang asked.

"I estimate that acute renal failure is also related to hypertension, but fortunately, the patient did not have complications such as aortic dissection due to malignant hypertension." Ji Xiang smiled, "Wait and see, the anesthesiology department hasn't arrived yet, and it won't pick up patients when it arrives." ”

That's right.

Under Ji Xiang's "harmony and mud", the department of medicine and surgery has reached the most basic consensus - to lower blood pressure first.

Regardless of surgery or not, blood pressure is a must.

Lin Jiu's face was full of doubts, he looked at Ji Xiang silently, and repeatedly smacked what Ji Xiang said in his heart.

What is the ...... It's like a joke, it's like mud, but it's not like a cure at all.

But Lin Jiu had a feeling that maybe the patient's stomach really didn't hurt after the blood pressure dropped.

Time flies.

Forty minutes later, everyone came to the ward together.

The patient's blood pressure is 155/80 mmHg, and the plate-shaped abdomen is showing signs of relief, and it no longer feels hard like a wooden plank.

Moreover, the patient reported relief of symptoms, and as in the previous hospitalization, he expressed significant dissatisfaction with the operation.

From the patient's point of view, if you can solve the problem with a little medicine, why do you need to have a disemboweling surgery?

Seeing the patient's condition, he carefully examined the body, and after calling all the tests that could be done at the bedside, Lu Gang brushed up the strand of hair that had fallen off.

"No surgery, let's go back to the office."

(End of chapter)