Healing Doctor

Chapter 537 Let the Facts Speak

Watching Director Kong hand the cart to the doctor in the ultrasound room, and then walk off to chat with Ji Xiang, President Miao felt a pang of loss and sighed deeply in silence.

Not only did he notice Ji Xiang, but even the head of the ultrasound department treated him differently. Not only did he treat him differently, but he also treated him like a son or nephew.

Never mind, I have to take care of myself.

Mr. Miao went to persuade the patient's family, then prepared the emergency surgery order, and then went to give pre-operative instructions.

After a whole day of work, I didn't even have time to drink water before the operating room came to pick me up.

As they escorted the patient onto the stage, General Manager Miao originally intended to call Ji Xiang along, but he saw Ji Xiang sitting in front of the computer, idly typing on the keyboard while chatting with Director Kong, the two of them laughing and talking.

Mr. Miao felt a pang of sadness. He greeted Director Kong and then pushed the patient to the operating room.

"Mr. Miao, your shift is quite busy. There were emergency cases this morning."

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

"Don't even mention it. The patient's family didn't agree to the surgery until they couldn't take it anymore and reluctantly agreed."

"Did it get a perforation?"

"No, Dr. Kong did an ultrasound, and he said everything was fine. But there are signs of peritonitis, so let's open it up and take a look."

"Oh? Director Kong performed the ultrasound herself? Who in the hospital arranged it? Or is she a relative of Director Kong?" the anesthesiologist asked casually.

Mr. Miao was too lazy to explain.

This is a long story, and Mr. Miao was worried that even if he told the anesthesiologist, the doctor wouldn't believe him, so he simply decided not to say it.

"Xiao Miao, what's the emergency?" Director Feng had just stepped off the stage and passed by the emergency room when he saw President Miao and asked casually.

Mr. Miao gave a brief report on the patient's medical history.

"Director Kong?" Director Feng noticed this detail.

It's hard not to notice that an ordinary patient, who doesn't need a consultation, would bother Dr. Kong to do an ultrasound.

"It was Dr. Ji Xiang's suggestion; he contacted Director Kong," General Manager Miao explained helplessly.

"That's how it is." Director Feng narrowed his eyes slightly.

He hesitated for a second before turning around and entering the operating room. He made a gesture to the anesthesiologist to pause the anesthesia and begin the physical examination.

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

"Doctor, you think it's appendicitis."

"Yes," Director Feng said solemnly.

Mr. Miao noticed that his director's gaze was fixed on the patient on the operating table, full of doubt.

"Director, the patient's diagnosis is very clear, including the ultrasound examination," said General Manager Miao. "Perhaps we're overthinking it."

"There is indeed some tenderness at Murphy's point, but it's not serious," Director Feng said vaguely.

That's what they say, but Director Feng's serious expression behind his mask and hat says it all.

Mr. Miao stood quietly to the side, waiting for the anesthesiologist to finish the continuous epidural anesthesia before scrubbing his hands and disinfecting in preparation for the surgery.

Director Kong's voice came from outside the operating room. He walked into the operating room while talking to Ji Xiang.

"Director Feng, what brings you here?" Director Kong asked as he entered.

"These are our patients, I just wanted to take a look. Besides, you're here too." Director Feng stood up and joked, "Old Kong, when did you become interested in surgery?"

"The patient is acting strangely, so I came up to take a look," said Director Kong. "Xiao Ji reminded me that the patient has signs of localized peritonitis, and it seems problematic to explain it as inflammatory exudate around the appendix."

"Localized peritonitis in the mid-abdomen, but it's not serious, just a little bit," Director Feng added. "Is there any problem with the gallbladder?"

"no."

After exchanging a few words, the two stopped talking.

Seeing Miao laying out the prescription, Ji Xiang suddenly spoke up, "Professor Feng, is it possible to avoid using a single-port endoscope?"

"Huh?" Director Feng was taken aback.

This is an operating room. What right do you, a junior doctor, have to speak?

Do you need to tell me how many holes we need to drill?

If it weren't for Ji Xiang's ability to get things done and unexpectedly gifting him a top-tier SCI paper, Director Feng would have kicked Ji Xiang out of the operating room long ago.

"Using it first is fine, but I think it would be best to prepare the space for other holes a little higher up, to leave room for the liver and gallbladder."

"!!!" Director Feng looked at Ji Xiang with suspicion, trying to discern what Ji Xiang was thinking from his gaze.

Ji Xiang's eyes were clear, like a pool of water, so clear you could see right to the bottom.

Because of the existence of the case of the abdominal loose body, coupled with the bribery from top SCI journals, Director Feng didn't say much. He nodded and told General Manager Miao to reserve the surgical area when he was laying out the prescription.

Mr. Miao felt a little strange, but he didn't dare to utter a word and obediently began laying out the forms as instructed by the director.

An incision was made at the navel, and as soon as the laparoscopic lens could see clearly, several surprised "Eh" sounds rang out in the operating room.

On the television screen in the endoscope, the background should have been light red, but when the mirror went in, all I could see was a gray-green and white-green mix.

There's a coating of pus, and... pus? No, that looks like bile!

It's not just a possibility, it's a certainty.

It's bile!

Ji Xiang's judgment was correct!

Mr. Miao was momentarily at a loss, and he turned to look at Director Feng.

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

He took out his phone, stood in the corner, staring intently at Ji Xiang, and dialed Director Yang's number.

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

"Xiao Ji, how did you determine that?"

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

"I estimate, I estimate, Professor Kong. Elderly patients who are fasting experience bile retention and concentration, and as the gallbladder enlarges, the gallbladder wall thins. In addition, the bile salts irritate the gallbladder wall, leading to aseptic inflammation."

"Due to pressure on the gallbladder fundus and loose tissue and edema, the gallbladder fundus eventually perforated."

"This type of perforation is different from the gallbladder perforations we usually encounter. It's not caused by inflammation, ischemia, or necrosis of the gallbladder. Therefore, the discontinuous band shown on the ultrasound is relatively short, and it's even difficult to detect. It's also quite difficult to make a differential diagnosis. I'm just guessing."

Ji Xiang gave a brief description and then stopped, saying no more.

Several doctors in the operating room fell into deep thought.

What Ji Xiang said is indeed a possibility, but such a possibility... is too rare.

"Xiao Ji, tell me your thought process."

Ji Xiang smiled without saying a word. Seeing that Ji Xiang remained silent, Director Kong and Director Feng didn't ask any further questions. Perhaps it was just a fleeting inspiration from Ji Xiang, without any detailed plan.

Similar situations are very common in clinical practice, so Director Feng understood and did not press Ji Xiang for answers.

Soon, Director Yang brought Zhai Yuhan up.

After understanding the situation, Director Yang asked General Manager Miao to rotate the camera. He barely managed to locate the gallbladder, then used pliers to pry it open. After seeing the perforation, he took a deep look at Ji Xiang with great interest.

(End of this chapter)