Healing Doctor

Chapter 640 Bleeding for No Name

"I brought it," Xie Kai replied simply, then looked at Zhao Zhe and said, "Zhao Zhe, what's the actual level of Deputy Director Zou? Don't send us a weak professor who's just coasting along."

"Let me tell you, this is my child's teacher, you know that," Xie Kai said, still not entirely at ease, adding another word of caution.

Zhao Zhe certainly knew the importance of his teacher.

"Don't worry, Deputy Director Zou is an expert from the First Affiliated Hospital. We've met him; his skill level is extremely high." Zhao Zhe remained unmoved by Xie Kai's sarcasm, as if he hadn't heard it, and replied with a smile, "Lower gastrointestinal bleeding, resection after contrast imaging, you know that, right?"

"I know." Xie Kai's expression immediately turned serious upon hearing Zhao Zhe's words.

This procedure isn't well-known because many hospitals are hesitant to perform it, given that it's a destructive surgery with numerous complications. A single mistake could lead to serious consequences.

"At the First Affiliated Hospital, Deputy Director Zou performs these types of surgeries."

Xie Kai nodded and went to say a few words to Teacher Sun.

"Dr. Ji Xiang!"

Just as everyone was about to leave, Lin Jiu appeared and waved to greet Ji Xiang.

"Dr. Lin, hello." Ji Xiang smiled. "Still not back in the US?"

Lin Jiu seemed hesitant for a moment, but only for a second before walking to Ji Xiang's side. "I want to wait and see. There are still some days left in the holiday. I'm not in a hurry to go back."

"What is this...?"

"There was a patient with rectal bleeding, so I took her to see Deputy Director Zou."

Lin Jiu then looked the patient over and started talking to Ji Xiang about the last episode of the show last night.

He was very outgoing and didn't act aloof like he did with others. Ji Xiang didn't mind, and he just chatted with whatever Lin Jiu said.

Upon arriving at the gastrointestinal surgery department, Deputy Director Zou took the patient to the pharmacy for a physical examination.

First, we inquired about the patient's medical history. The patient was a 31-year-old woman who denied a history of hypertension. She had been seeking medical attention at the emergency department of LY City Hospital for more than a month of intermittent abdominal pain, poor appetite, vomiting, and diarrhea for more than 10 days.

The gastrointestinal endoscopy report was handed to Deputy Director Zou, who carefully reviewed it.

The patient's condition seemed simple, but Ji Xiang always felt something was off. He stared intently at the patient, pondering the specifics.

"Dr. Ji Xiang, what do you think the patient's condition is?" Lin Jiu asked with a smile.

"I don't know. Normally, we would consider intestinal tumors or vascular diseases, but the patient's condition is a bit strange. Let me think about it some more."

Lin Jiu smiled slightly, took out a notebook from his pocket, and started writing and drawing on it. After finishing, he looked up at the patient, then looked down and continued writing.

Indeed, just as Ji Xiang said, the patient's condition seemed very simple and straightforward.

However, upon closer examination and differential diagnosis, it was found that none of the diagnoses had anything to do with her rectal bleeding.

In clinical practice, we encounter similar situations. For example, there is a type of fever called unexplained fever, which is actually a diagnostic term.

It is indeed a tricky situation.

Just as Lin Jiu was writing intermittently, Ji Xiang focused his mind and entered the system operating room.

At the same time, Lin Jiuze's brows furrowed more and more tightly.

His diagnosis and treatment were incorrect; the patient's condition was quite unusual.

This was something Lin Jiu hadn't expected.

Originally wanting to show off his skills to Ji Xiang, Lin Jiu had mixed feelings, but he ran into a brick wall.

Deputy Director Zou slurped a mouthful of saliva, also deep in thought.

"Deputy Director Zou, what's going on?" Xie Kai asked politely.

When Xie Kai encountered a doctor from a higher-level hospital, he immediately became much more obedient, losing the arrogant attitude he had when speaking to Zhao Zhe.

"Let me think about it some more."

Deputy Director Zou was in a difficult position.

The patient underwent comprehensive examinations at the local hospital, and all the evidence pointed to intestinal polyps.

But if there's polyp and rectal bleeding, something seems off.

Generally speaking, polyps bleed, but the patient had undergone a gastroscopy and colonoscopy, and the polyp was described as having a smooth surface and no ulcers.

The pathological changes of polyps begin with ulceration, erosion of blood vessels, and bleeding, but the appearance under the microscope is different from the patient's symptoms.

It's easy to diagnose colon polyps lightly, but what happens after that?

The patient had a doctor with him/her, but he/she came to a higher-level hospital because he/she didn't believe the diagnosis.

Deputy Director Zou encountered a problem.

Lin Jiu also encountered a problem.

One of them was drooling, while the other frowned and wrote something down, glancing up at the patient.

The atmosphere in the pharmacy became somewhat strange.

We can't just sit here without talking to each other, so Deputy Director Zou smacked his lips deeply and prepared to have the patient undergo more relevant tests, using a process of elimination to rule out possibilities step by step.

He believes that this is the only way at present.

"Have you been urinating normally lately?" Ji Xiang's voice suddenly broke the silence.

Deputy Director Zou and Lin Jiu were both taken aback.

The patient had intestinal bleeding. Ji Xiang asked the patient about urination...

Although it is normal to describe similar situations when writing medical records, medical records also include descriptions of the genitals. You can't just ask every patient to take off their clothes and pants.

If you do that, it'll probably be trending on social media before the very next day.

Xiao Ji's first department during his residency training was reportedly urology. Does he have a physiological reflex that when he bumps into a patient, the first thing he checks is whether it's a urological condition?

Although Deputy Director Zou felt that Ji Xiang's question was nonsensical, he remained silent and did not stop him.

"Dr. Ji Xiang, it shouldn't be a urinary tract disease." Lin Jiu didn't have many concerns. He had already written four pages, and his hair was almost standing on end.

"Not all problems with urine output are caused by urological or nephrological diseases," Ji Xiang said casually.

"..." Lin Jiu was taken aback.

What does Ji Xiang mean?

"I had reduced urination for a while, but it's recovered recently..." The patient hesitated for a moment, "but it seems like the recovery is a bit too much. I've been drinking more water and urinating more lately."

As she spoke, the patient blushed and said, "Excuse me, I need to go to the restroom."

After the patient left, the doctors' gazes became much more profound, as if there was something wrong. However, frequent and urgent urination is generally caused by urinary tract infection.

However, the patient's chief complaint was rectal bleeding.

Could it be diabetes?

Could it be hyperkalemia?

Could it be hypercalcemia?

Countless possibilities flashed through his mind. Deputy Director Zou's face turned grave. "Dr. Xiao Ji, what are your thoughts?"

"The patient should have their blood pressure checked after they return," Ji Xiang suggested, without directly answering Deputy Director Zou's question.

"Take her blood pressure? The patient said she has no history of hypertension," Lin Jiu said.

"It's a routine check-up, just taking your blood pressure."

"Dr. Ji Xiang, are you considering that the patient's rectal bleeding is caused by high blood pressure?"

Lin Jiuze realized how absurd it was as soon as he asked the question.

High blood pressure does not cause rectal bleeding.

What does Ji Xiang mean?

Lin Jiu looked at Ji Xiang with suspicion.

(End of this chapter)