If I hadn't had the surgery with the director and saw the appendix being cut off with my own eyes, I would have really suspected that it was an ectopic appendix.

I don’t know if Boss Zheng from the ectopic appendix capital has ever had it. This kind of life-threatening operation. Once it cannot be found, the helplessness on the operating table is enough to make people collapse.

The pain points were found, only tenderness, no rebound pain or muscle tension.

Percussion is also very standard. But there is nothing new, so I do the same.

auscultation……

After the physical examination, Zheng Ren restored the clothes to the patient and turned around and left the ward.

"Boss Zheng, you..." Li Yong was a little nervous.

He saw Zheng Ren's expression without any grief or joy, as if he was sure to win, and seemed to be confused.

"Put 5ml of Meilan from the urethra from the urethra and effusion in the abdominal cavity will be drawn after 30 minutes." Zheng Ren gave a doctor's advice while walking.

"Ah?" The little doctor was stunned.

"If you can see blue liquid when you get ascites, it will prove that it is a bladder rupture. Considering that it may be caused by a rupture of the scar in the surgery many years ago," Zheng Ren said while walking.

“…”

"Boss Zheng, this..." The little doctor felt a little incredible.

"Young man, please be careful when asking about medical history and physical examination.

The medical record reflects that the patient's medical history collection, especially the past history, was not detailed when he was admitted to the hospital. For example, the patient had omitted partial cystectomy due to bladder mass more than 20 years ago, which resulted in misdiagnosis and mistreatment of important diseases." Zheng Ren said gently.

Although this little doctor is quite concerned, he has not paid attention to too many details after working in a town-level hospital for a long time. Zheng Ren just kindly reminded him without any tone of scolding.

"When you performed an appendectomy for the first time, you found that the lesion did not match the diagnosis during the operation, the appendicle inflammation was atypical, and the amount of fluid extracted was a bit large. Did you consider whether it was caused by other reasons?

No further investigation was done, and it is unknown whether there was a large amount of ascites at the time of the operation. It is estimated that there was a small amount of urine during the operation. However, it did not attract the attention of the operator, or you treated the urine as oozing out at that time."

"..." The little doctor was sweating heavily.

"Third, after applying diuretic drugs, the patient's abdominal distension significantly worsened. I remember that you wrote this sentence in the medical record. As long as you think about it a little more, you will think of the truth." Zheng Ren smiled.

"The patient has no problem with kidney function. If you use diuretics, especially after 40mg furosemide, ml of urine will be excreted. However, the urinary catheter does not increase the amount of yellow urine, which is the biggest problem."

"To sum up, I'm considering that it's a ruptured bladder. I'll hurry up and do the Meilan test. If the blue liquid is drawn out of the abdomen, I'll go to the urology department for surgery. The operation is not very difficult, and it's all done if the sewing is done."

"Boss Zheng, is it true?" Li Yong still felt incredible. When he saw Zheng Ren's still a little confused.

"Hmm? What's true?" Zheng Ren didn't understand. He said so carefully and thoroughly, why didn't he understand?

"I'll go right away." Seeing that Zheng Ren was about to leave, the young doctor mustered up the courage to ask: "Boss Zheng, can I... leave you a WeChat message?"

"Um?"

"I will do abdominal puncture in half an hour. If blue liquid appears, I will report it to you." The little doctor had a sudden inspiration and found a reason.

Zheng Ren smiled.

He took out his cell phone and opened the QR code of WeChat to the doctor, and the two added WeChat.

"You guys are busy, I'll go back and see Lao Liu." As he said that, Zheng Ren left by himself.

The diagnosis and treatment and surgical level of Xilin Town are indeed the level of a grassroots hospital. It is simple and rough. The pain in the lower right abdomen is appendicitis, so I don’t think about it anywhere else.

The differential diagnosis was not done, and the abnormal situation was not handled during the operation. After the operation... Alas, I used furosemide, and the urine volume was not much, and my kidney function was fine. I didn't notice such obvious points.

Forget it, it has nothing to do with me. Zheng Ren walked out of the general surgery ward and no longer thought about it.

Zheng Ren no longer uses the system panel of this kind of small medical record. He can read the medical history first, look at the test form and the course record, and he can basically get conclusions according to clues.

The bladder was ruptured and the abdominal fluid was urine. Zheng Ren finally used the system panel of the big pig's hoof to refer to it and gave the answer with certainty.

As for the surgery, Zheng Ren was not interested in simply suturing the bladder.

In addition to having to open the abdomen, this kind of surgery is not as difficult as appendicitis. Moreover, it is a bit too much to go to Xilin Town People's Hospital to rush the urology department.

Back at the ward, I went to the gossip with Liu Xuzhi about Li Yong's lover's condition. Liu Xuzhi's lover came in with a lunch box.

She specially made hand-rolled noodles with hot soup for Zheng Ren, and the noodles were very strong.

"Boss Zheng, if you go to the imperial capital, Lao Liu can't support his family, so I will find a small noodle restaurant to work." Liu Xuzhi's lover said.

"No, don't worry." Zheng Ren smiled and said, "There are no more than 500 people who have better interventional surgery than Lao Liu."

500, this is a big number.

Actually, Zheng Ren wanted to say that 100 is about, but that is just tips surgery. Taking into account, 500 is relatively standard.

As a doctor, he can rank among the top 500 in the country and is a perfect professor in the provincial hospital.

Old Liu's wife was so worried that Liu Xuzhi almost disappeared for 30,000 yuan.

It sounds ridiculous.

A handful of bitter tears.

Seeing that Liu Xuzhi and his wife had already prepared for a fight, Zheng Ren did not persuade him much. Even if he went to the imperial capital, he would still work hard even if he had a high level.

You can live by lying down...it seems like you can do it now.

A tenured professor at Massachusetts General Hospital can enjoy life freely with a salary of more than 100,000 US dollars a month.

Tsk, I didn't even notice that I would have reached this point so soon.

Seeing that Liu Xuzhi's health was fine, Zheng Ren ate noodles in big mouthfuls and asked Feng Xuhui to book tickets after dinner. He seized the time to return to the imperial capital.

The matter is over when Xilin Town saves Liu Xuzhi back.

After Lao Liu recuperated for a few days, he would take his family to the imperial capital, and then he could carry out large-scale embolization surgery for left gastric artery.

I knocked on him for a few surgeries and saw how much Lao Liu could master it.

Zheng Ren already knows his talent. It is of medium level. The height that Liu Xuzhi can reach in this life is probably not higher than that of Su Yunyanyi.

But as a human being, you can't compare with Su Yun, Zheng Ren smiled.

Lao Liu probably won’t be too bad. After all, he can reach the threshold even if he thinks about tips surgery himself, which is much better than most people.

Before I finished the noodles, a short, fat, strong man knocked in.
Chapter completed!