My Medical Skills Give Me Experience Points-Chapter 336 - 164: Forethought and Seeking the Cause of Illness for Patient 7 - Part 2
Chapter 336 -164: Forethought and Seeking the Cause of Illness for Patient 7 – Part 2
As for the written exam for the senior professional title, that is just the easiest first minor hurdle.
Dr. Shi should be around 39 to 40 years old.
Some doctors with good talent, solid foundation, and luck might get promoted to a senior professional title at 38, but there are very few of them.
Many people would be grateful to get such a promotion before the age of 45.
Why add good luck?
Because when choosing research topics, if you can hitch a ride on a big shot’s coattails, participate in a decent project, or get tasked with heading an ordinary project.
These good fortunes require luck and character to achieve.
Dr. Shi being promoted to senior professional title at 40, and at a highly competitive major hospital like Tu Ya, is definitely a very successful transition.
Zhou Can went through the trouble of looking into this matter in preparation for his own future professional evaluations.
A man knows his own situation best.
His low academic qualifications are a major handicap. The higher he climbs, the more obvious this handicap becomes.
Although with his current trajectory, there’s a high probability he could resolve the issue of qualifications in the workplace, one must always prepare for the worst.
Inquiring more now is also a way of being proactive.
“Xiao Zhou, remember to arrive about half an hour early before the 8:00 am shift handover at the ICU tomorrow.”
Doctor Hu reminded Zhou Can before parting. frёewebnoѵel.ƈo๓
Today was only his first day at work; Zhou Can mainly learned how to operate various instruments and familiarized himself with the environment.
Tomorrow, he would probably start to take on more tasks gradually.
After work, even as Zhou Can had dinner at the hospital cafeteria, his mind was still pondering over patient No. 7’s causes for lower gastrointestinal bleeding.
The patient’s various test reports played back continuously in his mind.
Intestinal bleeding, if not treated promptly, can easily lead to perforation. Yet that patient had postponed treatment for six months without suffering from intestinal perforation.
This should not be any miracle.
There must be an unknown reason.
The patient had already undergone an endoscopic hemostasis treatment. If there were evident abnormalities within the intestine, the doctors would have discovered them promptly.
The patient had undergone routine fecal tests, including tests for occult blood.
The test reports did not reveal an obvious cause of illness.
An anatomical diagram of the human digestive tract appeared in Zhou Can’s mind.
The human intestine consists of the small intestine and large intestine.
The small intestine starts at the pylorus of the stomach and continues down to the cecum of the large intestine.
The entire length of the large intestine is about 1.5 meters in adults, not too long, and because the terminal end can be probed through the anus, abnormalities within the large intestine are a bit easier to detect.
Zhou Can pondered to himself that intestinal tumors, polyps, ulcers, and various enteritis can basically be ruled out now.
Vascular malformations and varices can also be ruled out.
This disease is indeed challenging.
It’s no wonder the doctors in Gastroenterology couldn’t figure it out.
It’s because the patient’s condition is too complex.
It is complex, and yet, it is simple.
Because the bleeding has been basically determined to be diffuse bleeding in the large intestine segment.
The large intestine mainly includes the cecum, appendix, colon, rectum, and anal canal.
The appendix can be ruled out first.
If it had issues, the patient would be in agonizing pain and couldn’t have lasted six months.
Additionally, it would decay within the abdominal cavity.
The anal canal can basically be ruled out as well.
That leaves only the cecum, colon, and rectum.
Starting from these three parts, it is feared that there will be little to harvest.
His current level in pathological diagnosis is at the median among resident doctors, and no matter how brash, he could not possibly think himself to be more capable than a chief physician.
What he relies upon for repeatedly distinguishing himself are unconventional diagnostic approaches.
Looking at problems from different perspectives, he could see some dead angles and blind areas that other doctors don’t notice.
This is one of his advantages.
“Could it be that there is a malignant tumor in the large intestine segment that then infiltrated?”
He couldn’t help but let his imagination run wild, thinking of a possibility.
The patient had undergone a blood routine test; leukemia could be ruled out.
Generally speaking, leukemia and hemorrhagic diseases are the first to be screened for when dealing with unexplained bleeding.
With a malignant tumor, it should have been discovered during the patient’s angiography.
Zhou Can tried hard to recall the angiography report and ultimately preliminarily ruled out the possibility of tumor infiltration.
Only one last hypothesis remained.
He boldly speculated, might the cause be found in the small intestine?
In adults, the small intestine is about 7 meters long, with the shortest being about 5 meters. It is the main organ for nutrient absorption in the human body.
The patient’s emaciation was indeed due to prolonged bleeding.
But bleeding might just be a smokescreen.
This is why doctors are led by the nose during diagnosis or fall into this almost ironclad misconception.
When Zhou Can first learned about the patient’s condition, hearing that the patient had rectal bleeding for more than half a year before seeking medical attention from the hospital,
he instinctively thought that the patient’s emaciation was due to the prolonged delay.
If anyone experiences rectal bleeding for more than half a year, it is impossible to maintain their weight.
“Yes, the small intestine should be examined.”
The more Zhou Can thought about it, the more it made sense to him, and his train of thought became clearer.
The unconventional diagnostic approach allowed him to break the established conventions and step out of the diagnostic misconception.
What could be the most significant possibility if there is an issue in the small intestine segment?
It must satisfy one condition.
The filthy liquid expelled from the small intestine would lead to bleeding when it enters the large intestine.
This would also well explain why the bleeding location in the large intestine is not fixed.
Zhou Can decided to ask the patient’s attending physician for more information.
The doctor on duty who took in this patient was named Xia Ping, a gastroenterologist attending physician.
