After 100 Days Of Sign-In, The First Operation Shocked The World

Next, there is a simple post-operation.

The nurse came up, rinsed with saline, replaced the gauze pads, counted the instrument dressings, removed the shoulder pillows, placed the drainage tube...

Next, use 1% vigorous iodine cotton ball to disinfect the skin around the incision.

A set of routine procedures are done...

Lin Feng left the operating table, and the rest was sutured by the second assistant Song Ziming.

Count the number of items first, and then start sewing.

Suture the platysma muscle, use toothless forceps, small needles, and silk thread to suture intermittently...

At this time, Lin Feng couldn't help but remind Second Help Song Ziming:

"Lao Song, please pay attention, the patient is a fat man with a lot of body fat. When suturing, the subcutaneous tissue should be sutured completely without leaving a dead space. When tying the knot, the movement should be gentle to avoid cutting the fat tissue and causing the formation of dead space. If subcutaneous If the fat tissue is too thick, it is estimated that there is a possibility of fat liquefaction. A rubber sheet should be placed under the skin to drain the necrosis and exudate, and it should be removed after 24 to 48 hours."

Zhang Yuan, who had already gone to brush his hands, trembled his shoulders and heads.

Hemp egg!

Are you the devil?

This detail control is too detailed, right?

You are awesome!

Song Ziming smiled openly: "Okay, Mr. Lin-Teacher!"

Gain Lin Feng’s guidance, experience +1+1+1...

The operation is over.

Pushing the fat man's flat car, he returned to the ward.

...

...

night,

Lin Feng is on the go, chatting with nurse Xiaoli.

No way, as an emergency practice dog, an average of 20 hours out of 24 hours is spent in the emergency department. Chatting is the daily entertainment of emergency doctors.

The night shift doctors and nurses chat-tell each other jokes.

Lin Feng's turn: "Speaking of which, a patient suffered from abdominal pain at night. The intern asked the superior doctor. The superior said, call 6542. After a while, the intern came again and said: No one will answer if I call!"

"Huh? Hahaha~"

Xiaoli smiled.

At this moment, the two patients happened to be supported and reached the door of the emergency doctor's office, but they looked at each other with a confused expression.

This kind of joke is professional, and only doctors and nurses can understand it.

6542, also called anisodamine, is an anticholinergic drug that has the effect of relieving smooth muscle spasm. Therefore, it is commonly used clinically to treat gastrointestinal colic, abdominal pain caused by intestinal spasm, biliary colic, renal colic and so on.

In addition, organophosphorus pesticide poisoning and microcirculation disorders can use this drug.

"Right! It's time to change the apple!"

Xiaoli cupped her belly and laughed, suddenly remembering something.

"Apple? What apple?"

Lin Feng was dumbfounded.

"Dr. Lin, don't you know? The apples are provided by our emergency department. In that corner. There is an incense burner and 7 apples stacked together. Please bless our emergency department night shift. There are so many patients. Otherwise, if you hit the evil door, you will be busy to death!"

Lin Feng couldn't laugh or cry.

Forget, the god of night shifts!

"You have a culture, but you can't help but believe it!"

Xiaoli complained: "Isn't it the night before? Suddenly there were 5 or 6 waves of stomach troubles, most of the night, and the corridors where I lay were all over the floor, the evil door!"

Lin Feng curled his lips: "It's too late!"

"what?"

Xiaoli dumbfounded: "Why is it late?"

"At the door, the patient has arrived!"

Lin Feng pointed to the door of the office, two patients supporting each other.

Xiaoli had a black thread, and said brokenly: "It really is not sincere! Don't blame the night shift god! I will give you the old man to exchange the tribute~~"

"First help the patient come in and check it out."

Lin Feng glanced at the two patients.

It's amazing, it's actually~~

Two crooked nuts?They are still very young, a man and a woman, estimated to be around 20.

Among them, the girl was pale, clutching her belly and sat opposite Lin Feng, frowning.

The man knows a little Chinese, and he even said with gestures, mixed with blunt Chinese: "Doctor! Please, help, her!"

"What's up with her?"

Lin Feng asked.

"She, can't eat anything, what's that called, dry rice! Yes, I can't dry rice for three months."

The male foreigner gestured.

cooked rice?

Lin Feng can't laugh or cry~~

What kind of internet stalk is this?

Blame the funny sounds!

The crooked nuts that were originally said to be unsatisfactory are completely crooked!

The mouth is full of funny stalks!

What the hell is it with the accent of the northeast big ballast?

"I said you can speak Mandarin?"

"We will! What we said is not the most standard Mandarin?"

Mike looked dumbfounded.

Lin Feng: "····Where did you learn this Mandarin?"

"Before I came to Xia Country, did I talk to an old Tie Xuedi in the Northeast of the United States? He said that he is from the international city of Gangling!"

Mike looked proud.

Lin Feng covers his face~~

Poor baby!

Lin Feng was really awkward seeing him speak Chinese, so he simply asked in fluent English: "Let's speak in English!"

"What? Your English is so good?"

Crooked Guoren was overjoyed, and Xiaoli was stunned.

Lin Feng curled his lips.

Doctors' English is good at first, after all, you have to read a lot of original English papers, even the textbooks are in English.

Coupled with the sign-in system, Lin Feng has countless experiences, so it is not a problem!

Lin Feng spoke fluent English and talked with two crooked nuts, and basically figured out the situation.

The patient, female, Golia, is a 19-year-old American from Italy. She came to Xia Guo to study Chinese with her boyfriend Mike for half a year. Due to indigestion and loss of appetite for three months, she came to see a doctor tonight with a serious attack.

Goliya said: "Doctor, when my abdominal pain occurs, my stomach is like a knife cut."

"Location?"

"Release to the upper right abdomen."

"duration?"

"Every day lasts about 3 to 5 hours. Occasionally, I wake up with abdominal pain at night. No diarrhea, no nausea and vomiting, no weight loss, no change in bowel habits."

"You hurt so long every day, you only came to see the doctor in 3 months?"

Lin Feng was surprised.

"I, I practiced gymnastics before, and felt that after I came to Xia Country, I didn't accept it and didn't take it seriously. The pain is not very severe."

Goliath said embarrassedly.

Lin Feng was speechless.

There is a reason why there are few crooked nuts!

Sure enough, the skin is thick and thick series!

These people advocate natural remedies and would not come to the hospital if they hadn't made a lot of trouble. May not be familiar with or trust Xia Guo's medical and health system, and worry that his level is limited.

Lin Feng can clearly feel that Mike and Golia sometimes have a conversation with Dr. Xia Guo and he is not at ease about the level of himself and Dr. Xia Guo. If they didn't know that Lin Feng understands English, they might have gone back.

Lin Feng curled his lips.

This foreigner is still looking at Xia Guo from the past!

You thought Xia Guo lived 20 years ago?

Xia Guo's current medical and health conditions, as well as the level of Doctor Xia Guo, are no longer what they used to be, is it better? Maybe better than the hospital in your hometown, okay?

Lin Feng sees through but doesn't tell the truth, let's use facts to speak.

Lin Feng continued to question, and Golia admitted that she had a fever two days before coming to see her, and her body temperature reached 39.9.

Lin Feng was surprised.

F*ck~

Does this foreigner have a fever?

Could it be... some kind of infectious disease?

Fortunately, Lin Feng has a strong sense of protection. He wears masks, hats, gloves, and goggles.

Emergency doctors are high-risk departments and need to be fully armed, otherwise they are easily infected.

Goliya continued to state her condition. She had some erythema and itching on her upper limbs, hips, and buttocks. No cough, no abnormal urination.

Lin Feng pondered for a moment, considering the cause of the female foreigner's condition.

When a doctor sees a doctor, what he says is nothing more than finding the cause of the disease and prescribing the right medicine, that's all.

From what she described, the main problem is indigestion and fever.

Dyspepsia may be related to gastroesophageal reflux, peptic ulcer or tumor. Fever may be related to infectious or malignant diseases. Such as celiac diarrhea can be manifested as gastrointestinal symptoms, accompanied by rash and itching. When indigestion is accompanied by weight loss, anemia, or dysphagia, it is recommended to perform digestive endoscopy to rule out the possibility of tumors.

Lin Feng continued to chat with Golia, asking about the condition and travel history, and further judge the possible cause.

Mike interrupted again in bad Chinese: "Doctor, my wife, I've always been old and strong! You know?"

"Old... dead strong?"

Lin Feng stunned.

"Yes, English, strong! Huh?"

Mike stretched his right arm, biceps position.

Lin Feng: "····"

Please don't speak nonsense if you don't speak Chinese well!

It's English and Northeastern Chinese, which makes me very confused.

Goliya glared at Mike and continued to make statements.

She was previously healthy, had no history of surgery, and no history of medication. The physical examination at school 6 months before this visit showed that blood routine, liver function, and kidney function were all normal.

The patient lives with her boyfriend Mike and has a pet dog at home.

Three months before coming to see her, she once returned to Italy to visit relatives in Daoli. I have eaten cold cress in Italy, and I have noticeable upper abdomen discomfort half an hour after eating.

Goliya said: "After this, I always had upper abdominal discomfort repeatedly."

"Italian? Cold cress?"

Lin Feng's eyes flashed: "You said, after half an hour after eating, your upper abdomen started to feel uncomfortable?"

"right."

Lin Feng thought slightly.

Acute gastroenteritis is common among travelers, and there are many pathogens.

But unlike this case, most cases of acute gastroenteritis are self-healing, and unlike this case, patients often have diarrhea, which is rejected.

Norovirus can cause chronic gastroenteritis in immunosuppressed patients, but this patient has no history of immunocompromised function, so rejected.

At the time of visit, the patient had normal vital signs, no scleral jaundice, and no hepatosplenomegaly on abdominal examination, which was rejected again.

Lin Feng thought for a while and swiped a decisive pen~~

Open an inspection list!

"Blood routine, liver function, tumor markers, ct, ultrasound..."

0 ········Find flowers····

Lin Feng said lightly: "There is no one on the night shift now, so the results should come out soon."

Lin Feng said this because he discovered that this pair of crooked nuts already meant to retreat.

In particular, Ge Liya seems to be very distrustful of Xia Guo's medical level. She wants to go back to the U.S. for inspections during her conversation, but she has a mouthful of old iron Mike with a northeast flavour. She has been persuading her to check on the spot, otherwise it will be too tossing and easy. Delay in treatment.

Mike also mentioned that in the United States, this non-fatal and dangerous chronic disease often requires appointments a few months in advance, and it may not be interesting. It usually takes a year and a half to cure.

One and a half years?

Lin Feng just wanted to laugh.

In Xia Guo, this kind of efficiency does not exist!

It is often Doctor Xia Guo, who has not cured for three days, and the patient has already cursed.

Smash the hospital!

Who dares to treat it for a year or a half?

Hearing Lin Feng said that Xia Guo’s night shift was very efficient, and he couldn’t stand his stomachache, and it was estimated that he could not make it to his hometown in the United States, so Golia was reluctant to go for a checkup.

The efficiency is really high.

After just an hour, Lin Feng got the results of the experimental inspection.

·Blood routine: eosinophils have greatly increased...·liver function:……

·Tumor markers: None...

· HBV, HCV, HEV current infection indicators, negative, none;

Lin Feng's heart is like a mirror, already knowing it.

The results of these examinations, there is no major problem, the only thing is the increase of eosinophils in the peripheral blood!

………

………

Ye Xuan continued to read the inspection report.

·Ct: No problem.

·Ultrasonic examination: It is found that the liver is abnormal, there are ill-defined hypoechoic areas in the liver, and there is no intrahepatic and extrahepatic duct dilation.

........ .... ...

Lin Feng started reasoning at the speed of light~~

·Normal levels of sebitol rule out the possibility of adrenal insufficiency!

· A negative ANCA antibody test excludes eosinophilic granulomatosis with polyangiitis!

·Vitamin B12 is slightly elevated, which may be related to liver cell damage!

A series of thoughts flashed past Lin Feng's eyes at the speed of light~~

·She has obvious gastrointestinal symptoms, and the peripheral blood eosinophils are significantly increased, so the possibility of parasitic infection is greatly increased!

"You will do another enhanced CT of the upper abdomen!"

Lin Feng exhorted.

"More?" Goliath was obviously unwilling.

"Let's go, the cause will be found soon~~" Mike Old Iron pushed her away.

Soon after,

The enhanced CT report comes back.

·Enhanced CT of the upper abdomen: There is a patchy low-enhanced area in the liver parenchyma, and the lymph nodes around the portal vein are enlarged!

"Do you have cats and dogs in your family?"

Lin Feng asked.

"Yes! I have a dog! She has a cat!"

Mike was straightforward.

Lin Feng said in a deep voice: "Since you have a history of pet dog contact, it is also considered to be caused by toxoplasma infection. This can explain abdominal pain and eosinophilia, and it can also explain the unclear boundaries in the liver. Lesions."

"But Toxoplasma gondii infection is generally more common in infants and young children, and the primary focus is mostly in the lungs."

"You have no problem with your chest radiograph, which excludes Toxoplasma gondii infection!"

Lin Feng's eyes flashed: "You said to yourself, half a year ago, you would have eaten cold cress during your trip?"

"Yeah!" Goliath had abdominal pain, her face was pale and impatiently said: "You have asked so much, is there any way to judge my illness? If not, I will take the first flight tomorrow morning and go back to the United States for treatment. ."

Lin Feng despised.

To the United States?

Wait half a month, I think you still have half your life left.

If I'm not a doctor, I'll take care of you to death!

"According to your description, the gastrointestinal reaction occurred after you consumed it, and the upper abdominal discomfort occurred after this incident. Therefore, the liver infection caused by ingesting edible aquatic plants has become the biggest doubt! "

"Fasiformis hepatica has become the most suspected diagnosis."

"Originally, you could obtain relevant parasite identification evidence through liver biopsy. But liver biopsy is invasive, and our emergency department does not have such equipment!"

"Then draw blood and check with a serum sample!"

Lin Feng said quickly.

Goliath was dubious: "cold cress? Just because I had a meal of cold cress made by my aunt?"

"right!"

Lin Feng said lightly: "As far as I know, due to the well-developed animal husbandry industry, Idali is a high-risk area for Fasciola hepatica. If you eat the aquatic food cress there, it is easy to be infected with Fasciola hepatica. You have repeated abdominal pain. Attacks, as well as increased blood eosinophils, should be directly related to the parasites!"

"so what should I do?"

"It's easy, go for a blood test!"

Lin Feng issued a blood list and sent it to the pathology department for examination.

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ps: This is the last chapter. It is estimated that more than 30,000 words have been updated today...Is it powerful? Ask for subscription, keep on exciting!

. Knife.

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