Chapter 1018: Chapter 844: Switch Departnts Quickly! Chapter 1018: Chapter 844: Switch Departnts Quickly! Dr. Chen led Yang Ping and Director Fang to the ward, where a 25-year-old young woman lay. She had a rather pleasant appearance but was extrely thin, especially around the collarbone area which had a downright skeletal feel— the epito of “bony.”
Her physique would make for a perfect live advertisent for selling weight loss products. This manufacturer truly had a knack for scouting talent, even managing to have this patient participate in live-streaming sales.
The girl lay in bed with a large bag of nutrient solution hanging on the IV pole; she currently relied on parenteral nutrition to sustain life.
Parenteral nutrition refers to the intake of nutrition not through the gastrointestinal tract but by direct infusion of nutrient solutions into the bloodstream for the body to use.
By definition, enteral nutrition ans that no matter the thod, whether one eats on their own or receives nutrients through a nasal feeding tube into the stomach, the nutrients must pass through the intestinal tract and be absorbed there.
Now the girl’s intestinal tract had almost completely lost its motility function. No matter what was introduced, it would cause accumulation in the intestines; nutrients could not be absorbed, and waste could not be expelled from the body.
Not to ntion eating, even drinking a sip of water would cause abdominal distention and pain, so it was impossible to deliver anything further into her intestines. The only option was to supply nutrients to her body through parenteral nutrition, but it wasn’t feasible for her to be connected to a nutrient bag 24 hours a day for the rest of her life.
After a brief introduction by the physician in charge, Yang Ping perford so simple abdominal examinations on her. There was a clear accumulation of gas within the abdominal intestines, causing the abdon to balloon out like a balloon. It felt very much like pressing on a balloon, and the bowel sounds were also absent upon auscultation.
Back in the ward, the physician in charge said that the girl was quite pitiful. She had been sick for seven or eight years but had been unable to afford treatnt due to her parents’ death in a car accident. Also, the symptoms were not as severe back then; intermittent visits to the hospital for enemas managed the condition. However, her illness had worsened significantly in recent months, to the extent that she couldn’t even drink water for the past two weeks.
“Is there a video of the colonoscopy?”
Musing, Yang Ping’s mind flickered through various case scenarios. Combining her dical history and physical examination, he began to grasp a thread of a clue. A mind map of diagnostic reasoning started to unfold in his mind.
“The endoscopy room will definitely have a video archive. I’ll have soone copy it,” said Dr. Chen, sensing a breakthrough in Yang Ping’s expression, and promptly sent a standardized training student to retrieve the video from the endoscopic room.
Although Yang Ping was a surgeon, he had made astonishing contributions during several hospital-wide case discussions, diagnosing a few challenging cases. Therefore, even Dr. Chen, who usually scorned surgeons, had altered his opinion about them.
Moreover, who was Yang Ping? Among the young doctors at Sanbo Hospital, he was secretly nicknad “Yang God” behind closed doors.
Previously, in Dr. Chen’s eyes, surgeons were rely craftsn who perford surgery.
“Has a tissue section of the small intestine mucosa been taken for pathological examination?”
Yang Ping inquired, and Dr. Chen nodded, affirming that not only had mucosal sections been taken but specins had been collected from several different areas as well.
Yang Ping then reviewed the report of the pathological diagnosis. The pathology slice had not been examined by Wen Ruzheng, which slightly disappointed Yang Ping, as the pathologist from the Pathology Departnt at Sanbo was indeed very skilled. Especially after “running bare” once, Wen’s skills had significantly improved.
“Without Wen Ruzheng, Sanbo’s Pathology Departnt would regress three years.” That statent from Wen Ruzheng, who indeed had the expertise, was not an empty boast. His departnt director must be understanding; otherwise, such an arrogant fellow would have long been dismissed— “regress three years,” as if the director was just idling around, right?
Unknowingly, a crowd of doctors had gathered around Yang Ping. Unlike surgery, where surgeons spend most of their ti in the operating room, rendering them rarely seen in the ward, the surgery ward would be devoid of people except for the duty doctors sauntering with their interns. Internists didn’t perform surgery and, aside from the high-ranking doctors who ran outpatient clinics periodically, most of them were piled up in the ward. Therefore, the doctor’s office was usually cramped, especially with young doctors busy writing dical records, amid a clatter of keyboard typing.
This challenging case piqued everyone’s interest, and hearing that “Yang God” had beco involved, they quickly gathered around.
“Don’t you all have work to do? Have you finished your cases, gathering around to watch the buzz?” Dr. Chen chided.
The crowd scattered like birds and beasts, but when Dr. Chen lowered his head to converse with Yang Ping, they slowly started gathering again in twos and threes, like dead pigs not afraid of scalding water— Yang God’s allure was still very strong.
The standardized training student returned from the endoscopic room with the copied video. Yang Ping wanted to examine the appearance of the intestinal mucosa through the video. Despite the reports indicating no problems, viewing the original footage was preferable.
The sa went for viewing pathology slices; for unusual pathologies, Yang Ping preferred to examine the slices himself.
Pathology slices may be standardized, but in the end, the interpretation relies on human judgnt. There’s a natural disparity in expertise levels. In very rare instances, what is diagnosed as a malignant tumor in one hospital may not be considered such in another, causing unnecessary alarm for the patient.
After watching the colonoscopy video, Yang Ping decided that he would personally review the pathology slice.
The graduate student had already played the video. Yang Ping scrutinized it ticulously, not sparing any detail and occasionally pausing to zoom in and examine closely.
After reviewing the video, Yang Ping noticed a slight atrophy of the villi in the small intestine. If not observed carefully, this minor atrophy would be undetectable—or perhaps a typical doctor might not consider such slight atrophy as significant.
In fact, for complex diseases, obtaining a diagnosis involves reverse logical reasoning for doctors, much like a police detective’s thought process in solving a case. Doctors start from a patient’s clinical symptoms and deduce the diagnosis, so reasoning also requires clues.
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