The young devil began to state the condition, which Dr. Melz could understand.

"I saw bean-shaped oval placeholder on the abdominal wall. There were not many, and I couldn't see clearly."

Dr. Melz couldn't believe this was what a doctor said when reporting his medical history.

But Ji Xiang just explained it very seriously.

"Because I didn't do the ultrasound, I can only make judgments based on the ultrasound image."

The doctor opposite said something, and Ji Xiang listened.

"I don't think the emergency diagnosis should be acute appendicitis, but abdomen CT and abdominal strengthening CT should be done first to rule out the possibility of omental infarction. If the CT is confirmed, I suggest to do enhanced CT to determine whether to perform surgery."

Dr. Melz was stunned when he heard Ji Xiang say this.

Not only do I need to do CT, but I also need to do enhanced CT, but I have only acute appendicitis!

If you were at Massachusetts General Hospital, the insurance company would never reimburse the money!

It's simply too much. The young demon not only has to challenge himself, but also tries to challenge experts and insurance companies far away in Massachusetts General Hospital.

"Okay, I'll hand the phone to Dr. Melz, you tell him. My judgment was not listened to, and he insisted on surgery. You know, no matter whether it is Mai's point incision or laparoscopy of the right lower abdomen, it cannot meet the needs of surgery.

What's more, if there is no problem with enhanced CT, surgery for self-limiting diseases will definitely not be accepted."

As he said that, Ji Xiang handed the phone to Dr. Melz.

"John..." While Dr. Melz spoke, the person opposite the phone interrupted him.

"Melz, who was the person who just explained the condition to me?" asked the doctor across the phone.

"..." Dr. Melz glanced at Ji Xiang.

The perspective of curled up in the clinic bed was different from the normal perspective. Dr. Melz saw that the young demon was so tall and invincible.

Is it really appendicitis? Dr. Melz felt a little suspicious.

"It's the surgeon who performed the surgery on Vinban Yama."

Dr. Melz whispered to reveal Ji Xiang's identity.

"Damn it!" Dr. John cursed, "Why does a sports medicine doctor see a B-ultrasound?"

“How can I.”

"No! Melz, it's hard to judge the ultrasound of omental infarction. The best way is to do CT. Do you still remember the trouble I encountered a few years ago?"

Dr. Melz was stunned.

He vaguely remembered, but John had never said the specific situation. This was privacy, and Dr. Melz didn't ask carefully.

"A patient's examination was considered cholecystitis. The doctor who had liver and gallbladder had an operation, and found that the patient's gallbladder was very good and there was no problem at all. The problem was the patient's omentum."

“!!!”

"This damn disease looks so similar to appendicitis and cholecystitis. If you don't have abdominal CT, you can't check it. But the insurance company firmly disagrees with reimbursement of the costs related to the patients."

Dr. Melz didn't expect that his friend would stand completely on the side of the Great Devil.

"You don't understand the details here, I suggest you listen to the opinions of local experts."

Dr. John gave his own opinion after a long time of speaking.

"Why do you think he is an expert?" Dr. Melz asked.

His voice was extremely low, for fear that Ji Xiang would hear it.

But Ji Xiang has good ear skills and can hear clearly. However, Ji Xiang did not have any bad thoughts about Dr. Melz for this. The patient has many doubts, as long as he is willing to undergo a CT scan.

Ji Xiang thought more about not having to undergo enhanced CT, otherwise the operation would be difficult, and he was afraid that no one in the Second Affiliated Hospital would have experience.

Everyone is safe, it's great.

"Melz, you stupid thing, I really want to stuff the sandwich I had left in the morning into your mouth!"

“…”

"No reason, just listen to the experts' opinions. I have to have a damn surgery. Moreover, I have not completed the outpatient volume this month. If I have to go fishing on weekends, after the operation, I have to go to the outpatient clinic to see those boring patients to make up for the number of outpatient patients this month.

Melz, do you know how busy I am!"

Dr. Melz had no choice but to hear a blind voice coming from the opposite side, and then hung up the phone.

"Doctor Melz, do you have a CT scan or sign and refuse?" Ji Xiang waved the communication and explanation in his hand.

"..." Doctor Melz looked helplessly at the great devil who was showing off his power in front of him, speechless.

Let him pretend again!

Damn it!

Doctor Melz vaguely knew that the disease should involve blood vessels.

But it’s okay, it’s okay. Once something happens, assuming that there is no blood supply to the large-scale omentum, the next step is acute abdominal disease!

If diagnosis and treatment are delayed, the next step is a difficult disease such as bacteremia, and it is likely to have infection, toxic shock, and even life-threatening.

It's definitely not as simple as acute appendicitis.

Thinking of this, Dr. Melz was a little anxious.

"I want to do CT! Enhanced CT!!"

After saying that, Dr. Melz added, "It doesn't matter if the insurance company doesn't pay the reimbursement, I'll spend the money myself!"

The fear of large-scale necrosis of the omentum has exceeded the idea of ​​Dr. Melz's desire to defeat the young demon in front of him. He endured the severe pain in his abdomen and almost wailed.

"What did he say?" Director Bai asked.

"Doctor Melz agreed to have CT, but he still needs to do enhanced CT." Ji Xiang was a little helpless.

"Do you need me to contact?"

Enhanced CT without a doctor on duty at night because this test is not an emergency program.

If you have to do it, Director Bai needs to call the relevant doctor from home and start the computer to prepare.

Ji Xiang thought for a while, "I'd better call me. Although I don't think it's possible, what if? The experts from Massachusetts General Hospital died of illness in our hospital. It's not nice to say it."

“!!!”

The last sentence shocked Director Bai.

It is not an exaggeration to say that the consequences are unimaginable.

Director Bai even thought of the series of chain reactions caused by the Massachusetts expert's "death" in the Second Affiliated Hospital, and his scalp was numb.

Contact the CT room, Director Bai took someone to send Dr. Melz, a "big trouble" to have a test.

CT images show large area of ​​fat density shadows with blurred edges, with unclear boundaries.

Is this yarn?

The doctor on duty in the CT room looked at the image in confusion, and he had no idea how to diagnose it.

"It's an omental infarction." Ji Xiang said with certainty, "but there is no need for surgery for the time being, so it will be fine if you observe for a few days."

Director Bai asked nervously, "Really? Director Niu is coming anyway, so you can do an enhanced CT?"

Ji Xiang did not insist, but agreed to Director Bai's opinion.

Anyway, I only need to rest. Now I see Dr. Melz's omental infarction is a self-limiting disease.

Whether to do enhancement CT or not does not matter to Dr. Melz's disease, but to Director Li can buy peace of mind.

After countless empathy, Ji Xiang subconsciously thought about the problem from the perspective of others.

When Director Niu arrived, he came to the same conclusion as Ji Xiang when he saw the image. Director Bai was relieved.

However, he still insisted on doing an enhanced CT.

Dr. Melz was doing the examination. Listen to the buzzing sound, Director Bai asked, "Director Niu, it's okay to not have surgery, what's going on?"

"Director Bai, what you understand is an omental infarction like a large omental thrombosis."

"Yes." Director Bai nodded.

"In fact, primary omental infarction often occurs in children and adults. The pain area is often located in the upper or lower abdomen on the right side, and is easily misdiagnosed as appendicitis or cholecystitis. The only positive factor is obesity in children."

"I read a report that about 0.3% of patients with acute appendicitis have a wrong diagnosis, and in fact, omental infarction should be diagnosed."

Director Bai really doesn't understand this.

Yet, it is impossible for a medical director who is a neurosurgeon to be omniscient and omnipotent.

He listened to Director Niu's explanation of omental infarction very carefully.

"Primary infarction is prone to occur in the right upper abdomen, which may be related to the longer omentum and greater mobility at this place."

"The lower abdomen is not very rare. Most of them are self-limiting diseases. Just take care of yourself for a few days."

"So, looking at the clinical practice of appendicitis, conservative treatment of cholecystitis, I feel that it is better to have a CT scan."

"However, now we have said that we have abused CT. After taking blood for B-ultrasound, we have to take another CT scan. It is estimated that 99.7% of patients with appendicitis will not accept it."
To be continued...