Chapter 372: Addisonian Sudden Death

"What is the situation?" Lu Gang was stunned for a long time before asking in confusion.

Meng Qingfei sighed deeply.

Ji Xiang's performance was even more seasoned than an experienced Emergency Department Doctor, especially the final step where he leaped up, knelt on the Patient's abdomen, and performed chest compressions; it ignited the blood of even a slick old hand like Meng Qingfei.

But the problem immediately returned to Meng Qingfei: what exactly was the Patient's condition!

"Lu Zhuren, you didn't diagnose it either?" Meng Qingfei asked cautiously.

Lu Gang shook his head, signaling that he did not know.

He wanted to follow and take a look, but as soon as he lifted his leg, he stopped again, staring blankly at the empty end of the corridor in the distance, at a loss.

"Doctor Meng, do you know the Patient's condition?" Lu Gang asked.

Once things quieted down, Meng Qingfei recounted the Patient's medical history to Lu Gang.

A middle-aged male who ingested a large amount of floral water, experiencing symptoms like nausea, vomiting, and abdominal pain half an hour after ingestion.

Everything pointed to the floral water being the cause; a gastric lavage should have sufficed, and the physical examination showed no abnormalities.

Similar patients are very common.

No!

A meteor flashed through Meng Qingfei's mind, tearing through the dark curtain.

"The Patient has a high body temperature! The body is red and hot!" Meng Qingfei said in a deep voice.

He recalled a remark made in passing by an Emergency Internal Medicine Doctor; so that was it!

"Body temperature... restlessness..." Lu Gang muttered to himself in confusion.

"Lu Zhuren, do you remember..." Meng Qingfei only said the beginning, and Lu Gang continued, "Three years ago, an emergency case in Gastrointestinal Surgery."

"Yes!"

That was an incident from three years ago.

A patient came to the Emergency Department with abdominal pain, a body temperature over 40 degrees Celsius, nausea, vomiting, and tenderness, but no rebound tenderness.

Considering it an acute abdomen, Gastrointestinal Surgery also couldn't determine the diagnosis, and because the abdominal pain was worsening, they could only perform a laparotomy after informing the Family Member.

The result!

They opened the abdomen and found no problems at all; they traced the intestines and confirmed there was no strangulated Intestinal Obstruction, and the other internal organs were also fine.

They requested a consultation on the table; since it was already opened, they took the opportunity to have every department take a look to avoid any ambiguity later.

In the end, the problem was solved by Lu Gang—the Patient was diagnosed with Addisonian crisis. After symptomatic treatment, the Patient's condition improved, and they were eventually discharged in stable condition.

That "medical malpractice" was due to insufficient technical skill, and Gastrointestinal Surgery communicated well with the Family Member, so the family did not pursue responsibility, and the matter was settled.

Meng Qingfei and Lu Gang thought of this at the same time.

The Patient had a fever, an increased heart rate, and showed signs of restlessness.

The digestive system also had symptoms like anorexia, nausea, and vomiting, which are often early symptoms.

Yes! And the blood pressure!!

Meng Qingfei and Lu Gang simultaneously realized that the Patient had a drop in blood pressure accompanying the rise in heart rate, and by the time they were wheeled away, the Patient's systolic pressure had already reached about 85 mmHg.

Drinking floral water would not cause Hemorrhagic Shock; the shock presentation of rising heart rate and falling blood pressure, combined with the other symptoms, aligned more and more with a diagnosis of Addisonian crisis.

"I know!" Lu Gang clenched his right fist and slammed it into his left palm with a 'slap'.

"It's Addison's disease!" Meng Qingfei said at the same time.

"Yes, it is Addison's disease; the sudden death just now was Addisonian sudden death!"

The two looked at each other and smiled, as if they had solved a very difficult math problem.

But in an instant, both felt a bit awkward.

This was not an exam, but a clinical Emergency Rescue. A diagnosis made in hindsight had no damn meaning for the Patient; Ji Xiang's immediate defibrillation, chest compressions, and advance contact for an ICU bed were the keys to solving the problem.

If not for Ji Xiang, never mind getting the correct answer, even with the correct diagnosis of Addisonian sudden death, the Patient would likely have been beyond saving.

Meng Qingfei smiled sheepishly, "Xiao Ji is truly impressive."

Lu Gang was still somewhat unconvinced, but the successive blows over the past few months made him feel a bit dejected.

The only strand of hair on his head drooped down, listless.

His bald head had also lost its oily shine, looking gray and dull.

Lu Gang pondered for a few seconds and said bitterly, "I arrived late this time; the Patient had already developed complications the moment I reached the Emergency Rescue Room. Next time, definitely!"

Meng Qingfei looked at Lu Gang with slight surprise; he understood that Lu Gang's competitive spirit had been ignited and he wanted to vie with Ji Xiang.

Is there any point?

Lu Gang's approach was completely meaningless.

"Lu Zhuren, let it go," Meng Qingfei laughed, "Rest, rest; I feel like my whole body is aching a bit now."

This was the secondary reaction after stress, and Lu Gang understood this too.

"Wait a moment, I'll book an Ultrasound," Lu Gang said, "Since it's an Addisonian crisis, then the adrenal glands must have a problem. Xiao Ji, he might not necessarily know that."

As he spoke, Lu Gang took out his phone and made a call.

"ICU?"

A burst of noise came from the other side of the phone; clearly, they were in the middle of an Emergency Rescue.

Lu Gang understood that this was not the time to be long-winded; he had to be brief.

"The Patient just sent over, I suspect it's an Addisonian crisis; call for a bedside Ultrasound immediately."

"Lu Zhuren, the Ultrasound is being done; the Patient... oh, oh, oh, the Patient has calcification in the right adrenal gland, suggesting Adrenal tuberculosis," the ICU Doctor replied.

It was clear that they were watching the rescue while answering the phone.

"Then hurry and get back to work," Lu Gang hung up the phone, feeling a sense of loss.

Lu Gang knew the strength of the intensive care unit at the Second Affiliated Hospital; it was indeed second to none in the province, but for a patient who suffered an inexplicable cardiac arrest to be sent over, and for them to discover the Addisonian crisis immediately...

*Cough, cough*, the figure of a person appeared in Lu Gang's mind.

That can't be, if we're talking about timely rescue, it could still be explained by Ji Xiang being young and having quick reflexes.

But Addisonian crisis is extremely rare in Clinical practice, and every time it appears, it is basically misdiagnosed. Every misdiagnosis, in the end, has a high probability of leading to the Patient's death.

In the country, very few family members agree to an autopsy, so Patients who die inexplicably have no diagnosis, which in turn leads to a lack of experience among Clinical Doctors.

It was also because of that incident 3 years ago that Lu Gang established a general understanding of Addisonian crisis, which is why he and Meng Qingfei were able to provide a diagnosis in the first... no, the second instance.

What about Ji Xiang?

Where did his diagnosis come from!

Where did his Clinical experience come from!

Lu Gang rubbed his bald head, that strand of hair hanging down looking increasingly listless.

"Was it really Xiao Ji who diagnosed it? This is just too fast." Meng Qingfei was somewhat surprised.

Although Lu Gang didn't speak, his expression already said everything.

Ji Xiang had arrived at the correct diagnosis in a flash of lightning, and the Emergency Rescue was successful.

Truly f*cking hell, Meng Qingfei also cursed in his heart.

For a Patient who suffered cardiac arrest after drinking floral water, Ji Xiang actually determined it was an Addisonian crisis while performing the rescue; how deep must his Clinical experience be to achieve that.

(End of this chapter)