Rigid abdon only occurs with conditions such as acute gastrointestinal perforation, organ rupture, and acute peritonitis.
The uncle has experienced bloody stools, and it has been going on for several days.
Now the bloody stool is worsening, and abdominal pain is intensifying, all indicating the progression of the disease, and it’s coming aggressively.
"Does it hurt here?"
"Yes."
"Is it just a little pain or very painful?"
"Quite painful."
Just after the uncle answered, Li Jingsheng slightly increased the pressure.
"Ow... it hurts, it hurts!"
Li Jingsheng imdiately withdrew his hand, judging that the pain location for the uncle should be in the jejunum.
The small intestine is part of the digestive tract, divided into the duodenum, jejunum, and ileum.
Interestingly, the dical separation between the upper and lower gastrointestinal tract is marked at the duodenum.
The suspensory ligant of the duodenum is also known as the ligant of Treitz.
It acts like a ’boundary marker’ between the upper and lower gastrointestinal tract.
Above the ligant of Treitz is the upper gastrointestinal tract, below it is the lower gastrointestinal tract.
The jejunum makes up about two-fifths of the small intestine’s length, slightly shorter than the ileum.
The current pain location is in the ileum, further diagnosis requires more information.
"Alright, the examination is finished, you can get up! Is the color of the blood in your stool bright red or dark red?"
This is very important.
It can help Li Jingsheng roughly infer the intestinal section of the bleeding point.
Rectal bleeding is usually bright red, the further up, the darker the color of the bleeding.
Because it takes ti from bleeding to exiting the body.
The longer this ti, the darker the color of the fresh blood will be.
"Hmm... it seems to be dark red! I noticed blood on the paper when wiping, and the color is quite dark. But I’m sure it’s blood."
"Is the amount of bleeding large?"
"These past few days it feels a bit much, and the stool looks a bit like jelly, with so whiteness, and it’s very slly. Kind of like the sll of rotten at."
The uncle described the condition of his stool.
"Doctor, is my illness very serious? Is it treatable? How much will it cost to cure?"
"Don’t worry for now, let’s talk outside!"
Li Jingsheng walked while pondering what exactly is the uncle’s illness?
From the uncle’s description of his bowel movents, there should be fat diarrhea accompanied by pus and blood in the stool.
The uncle had undergone intestinal resection surgery, and his entire look reveals rough skin, yellowed hair, and a thin body, clearly indicating long-term malnutrition.
He is currently experiencing abdominal pain, with the pain point located at the ileum, has undergone surgery, and has had bloody stools for several days...
When Li Jingsheng’s gastrointestinal diagnosis had just ascended to the Master Level, he felt that any patient with gastrointestinal diseases would be easy to handle, with diagnoses easily reached.
At this mont, he feels a bit like a frog in a well, overly confident.
Diagnosing this uncle, due to the lack of examination evidence, is particularly challenging.
To compensate for the lack of examination evidence, his diagnostic skills need to be one or two levels higher than those of doctors in large hospitals to barely match them.
Large hospitals, because they can conduct various examinations, might only require the skills of a senior resident to diagnose the uncle’s illness.
Li Jingsheng, although possessing the diagnostic ability of a junior attending physician, still finds it very strenuous.
This is an unavoidable situation.
Without enough instrunts, one can only rely on skills.
That being said, once he improves all his diagnostic skills to a very high level, when he goes to a large hospital in the future, he can imdiately ’dominate kindergartens and nursing hos.’ He will undoubtedly be able to outperform the majority of doctors in big hospitals.
This is sowhat like the difference between wild and dosticated animals.
A wild wolf can easily hunt a dostic dog of equal size.
Li Jingsheng belongs to the self-taught one, with simple conditions, but the honed skills are particularly solid.
"Apart from bloody stools, do you also have diarrhea now?"
"Yes!"
"How many tis do you have diarrhea a day?"
"A few days ago, it was about two to three tis a day, today it has been four tis."
The uncle is experiencing diarrhea, with the jelly-like white liquid excreted being intestinal mucus.
"Do you know which part of the intestine was removed?"
"They said they removed part of the small intestine, but what’s it called... I’ve forgotten."
"Is it called the jejunum or the ileum?"
Li Jingsheng gave so hints to the uncle.
The small intestine has only three parts, an internal hernia strangulation usually ans cutting either the jejunum or the ileum.
"Yes, yes, it was the jejunum that was cut, I rember now."
With this further accurate information, Li Jingsheng finally has a direction for diagnosis.
Combining the patient’s dical history, symptoms, pain location, and partial small intestine resection information, the uncle is likely suffering from short bowel syndro.
This is a rather tricky condition in clinical practice.
The total length of an adult’s small intestine is about 4-6 ters, cutting a little doesn’t cause major problems.
Of course, the premise is that the surgeon’s skills are solid, avoiding anastomotic leakage or strictures in intestinal anastomosis.
If too much of the intestine is removed, it will certainly affect the absorption of nutrients.
The small intestine is the body’s main organ for nutrient absorption.
Excessive removal can easily lead to short bowel syndro.
"After my diagnosis, it’s very likely that your illness is short bowel syndro. It’s better to go to a large hospital for further examination and treatnt. Especially now that you have fat diarrhea accompanied by pus and blood stool, if left untreated, it can be life-threatening."
Li Jingsheng is cautious and dares not to treat such a serious condition.
This illness varies in severity.
The uncle’s symptoms are clearly severe. Even a tertiary hospital of the Second Hospital’s caliber would take the case very seriously upon reception.
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