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When the Doctor Uses A Hack-Chapter 835 - 836 Nocturnal Bustle (Part 2)
Chapter 835 -836: Nocturnal Bustle (Part 2)
Chapter 835 -836: Nocturnal Bustle (Part 2)
The problem was becoming more and more complicated.
Chen Cang shook his head!
Emergency physicians must have a clear diagnostic pathway and clinical thinking that follows regulations.
“Haven’t eaten anything messy recently, right? Or anything particularly stimulating, how are your bowel movements? Are you passing gas often? Have you had sexual activity?”
Chen Cang asked several questions in quick succession.
The girl shook her head repeatedly.
The man hurriedly said, “No, none of that. Ever since Tingzi became pregnant, I’ve been taking extra care of her, especially with her diet, eating things that are good for sustaining the pregnancy and for the stomach. Her bowel movements are normal, I guess, and as for passing gas… it’s been normal as well, but since she got pregnant… we haven’t had sexual activity.”
Chen Cang closed his eyes and constantly pondered over various reasons, hoping to find a breakthrough clue!
It wasn’t long before the car arrived at the hospital. After they brought her to the emergency room, Chen Cang quickly called for Dr. Xiao Ke.
“Do a routine blood test, and…”
Due to the pregnancy, many tests were actually limited, and an abdominal CT was out of the question.
Otherwise, Chen Cang wouldn’t be having such a hard time.
After conducting some blood tests, Chen Cang felt that he should administer some relatively safe acid-suppressing and stomach-protecting drugs.
These drugs were safe for the child, and their primary purpose was to address the problem of gastroenteritis.
Chen Cang could only start with the most basic and most common causes of abdominal pain.
Normal bowel movements, normal passing of gas, obstruction ruled out!
No signs of peritoneal irritation, peritonitis ruled out!
Appendicitis… could not be ruled out!
Biliary system diseases… also could not be ruled out!
Pancreatic issues… likewise could not be ruled out!
Gynecological issues… awaited further observation!
At the moment, these were all Chen Cang could think of.
“Do an abdominal ultrasound, and a gynecological sonography.”
Having said this, Chen Cang hurriedly looked for an ultrasound technician.
By this time, vital signs were also being monitored.
“Blood pressure: 95/65 mmHg!”
“Oxygen saturation: 96.”
These were all normal.
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Chen Cang breathed a sigh of relief; it seemed there was no danger to her life?
At this point, the ultrasound technician rushed in, pushing the ultrasound machine, “Dr. Chen, what’s the situation?”
Chen Cang frowned, “20 weeks pregnant, cause of abdominal pain pending investigation!”
With a single sentence, he stunned the other party.
Patients in pregnancy, better not provoke!
Hastily performed the abdominal ultrasound.
Chen Cang stared at the ultrasound results; liver, gallbladder, pancreas, spleen, kidneys all normal!
Oh!
There was a small kidney cyst, but such things basically wouldn’t affect the diagnosis.
“Check the gynecology!”
The ultrasound technician nodded in agreement.
Soon, the results were out.
“Normal!”
One word, and Chen Cang was stunned.
Normal!
Everything normal!
That was too abnormal!
All tests normal, yet the patient’s abdominal pain not only hadn’t subsided, but had intensified.
How illogical was that?
Chen Cang took a deep breath.
He pondered deeply.
Seeing the girl in discomfort, Chen Cang could only wait for results.
The man became anxious, “Doctor, isn’t there any pain relief? Please use something!”
Upon hearing this, the girl immediately shook her head, “No using it!”
Chen Cang thought and thought, and seeing the girl sweating continuously, he said, “I’ll administer some medication, it might provide some relief.”
Chen Cang administered some saline and glucose to replenish her fluids.
But…
The patient’s abdominal pain had indeed subsided a bit!
Chen Cang was speechless, could placebos be this powerful?
Clinicians often use placebos to help patients relieve symptoms with unexplained causes.
However, Chen Cang always felt that the situation was not so simple.
He simply went back to his office to start looking through books.
There was a bookshelf in the emergency office, filled with reference books and guidelines.
After about an hour or so, while Chen Cang was pondering strategies and consulting the books, Xiao Ke rushed into the office, “Dr. Chen, the patient’s vital signs have suddenly become abnormal!”
Chen Cang’s face changed instantly, and he hurried into the room.
The heart monitor started beeping ominously.
“Dr. Chen, heart rate 110 beats per minute, blood pressure dropped to 85/55 mmHg, breathing is rapid!”
With that comment, Chen Cang’s complexion changed dramatically.
“Call Dr. Wang, quickly do another ultrasound to see what’s going on!”
By this time, it was nearly three o’clock, and the ultrasound doctor had already gone to the duty room to sleep.
After all, they didn’t need to be on duty all night; they just needed to be called if something came up.
Dr. Wang was quick, and before long, the results were out!
“There is a significant amount of fluid in the abdominal pelvic cavity, likely blood!” Those words stunned Chen Cang!
It was now approaching three or four in the morning, and Chen Cang swiftly called out to Xiao Ke, “Contact gynecology for an emergency consultation!”
At this moment, Team Leader Ma was on the operating table, and such an uncertain patient was yet another severe test for the on-duty Chen Cang!
The gynecology resident arrived soon after, and after getting the details, said, “Let’s do a puncture check!”
Abdominal paracentesis!
Chen Cang was familiar with it, Xiao Ke brought the puncture kit.
Chen Cang was very careful with his technique, and it wasn’t long before he drew out the fluid.
Seeing the liquid extracted, Chen Cang immediately frowned!
The blood did not clot!
Was this… organ rupture?
Instantly, both Chen Cang and the gynecology resident were baffled.
Now, there was only one possibility left, “Perform an exploratory laparotomy to seek the cause!”
At this moment, an exploratory laparotomy had become a necessary examination.
And it had to be done quickly!
But…
There was a problem before the two of them.
An exploratory laparotomy might sound simple, just opening the stomach to check, but… this one procedure could mean the loss of the child.
Therefore, family consent was mandatory.
Chen Cang looked at the blood pressure on the heart monitor, getting lower and lower.
He couldn’t help feeling relieved, thankful for the fluid resuscitation done earlier, otherwise… it could have been a major problem.
But now, a laparotomy was an essential procedure to face.
The girl was already unconscious, and Chen Cang turned to the man, “The situation is very dangerous right now, there is an organ rupture inside the patient’s abdominal cavity, the cause is still undetermined, and immediate surgery is necessary to investigate and then perform prompt surgery.”
After hearing Chen Cang’s words, the man was startled!
“What’s going on? Why would this happen?”
The man was instantly bewildered!
Chen Cang shook his head, “The cause is unknown at the moment, so we need to open the abdominal cavity to find out, but… there’s something you need to understand, once we go ahead, the child may not be saved!”
“But if we don’t proceed, both mother and child might not be saved! You are her husband, aren’t you? Sign the forms quickly!”
This decision didn’t seem too hard to make, did it?
But, the man was instantly stunned.
“I… we’re not married yet…”
Those words rendered Chen Cang speechless, “Contact the patient’s family immediately!”
The man gritted his teeth, picked up his phone, and quickly contacted the girl’s mother.
Chen Cang hadn’t anticipated encountering such a problem at a critical time!
His head tingled with anxiety!
…
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PS: Thanks to “Lei Shu” brother for the 10,000 reward, thank you!