Chapter 538: Speaking with Facts

Watching Kong Zhuren hand the cart over to the B-ultrasound room doctor, then seeing him walk off to chat and laugh with Ji Xiang, Miao Zong felt a sense of loss in his heart and let out a deep, silent sigh.

It wasn't just that he himself had noticed Ji Xiang; even the great head of the B-ultrasound room held Ji Xiang in high regard. And it wasn't just high regard—he treated him like a nephew.

Forget it, he still had work to do.

Miao Zong went to persuade the Family Member, then submitted the emergency surgery order, and ran off to handle the preoperative briefing.

After finishing all the tasks, he hadn't even had time to drink water when the operating room called to receive the patient.

Sending the patient to the table, Miao Zong had originally intended to call Ji Xiang along, but he saw Ji Xiang sitting in front of the computer, typing away haphazardly while chatting and laughing with Kong Zhuren.

Miao Zong felt a bit sour; he greeted Kong Zhuren and pushed the patient into the operating room.

"Miao Zong, your shift is quite busy; you've got an emergency in the morning."

After entering the operating room, the Anesthesia doctor said with a smile.

"Don't mention it. The Family Member didn't agree to the surgery; they only reluctantly consented when the patient couldn't hold on any longer."

"Perforation?"

"No, Kong Zhuren performed the B-ultrasound and said it was fine. But there are signs of Peritonitis, so we're opening them up to take a look."

"Oh? Kong Zhuren performed the B-ultrasound personally? Did someone in the hospital pull strings? Or is the patient a relative of Kong Zhuren's?" the Anesthesia doctor asked casually.

Miao Zong couldn't be bothered to explain.

The story was too long, and Miao Zong worried that even if he told it, the Anesthesia doctor wouldn't believe him, so he simply didn't say anything.

"Xiao Miao, what's the emergency?" Feng Zhuren happened to be coming off a shift and asked as he passed the emergency room and saw Miao Zong.

Miao Zong reported the patient's medical history.

"Kong Zhuren?" Feng Zhuren noticed this detail.

Actually, it was hard not to notice; for an ordinary patient, there was no need for a consultation, so who would bother to move Kong Zhuren to perform a B-ultrasound?

"It was Doctor Ji Xiang's suggestion; he contacted Kong Zhuren," Miao Zong explained helplessly.

"I see." Feng Zhuren narrowed his eyes slightly.

After hesitating for a second, he turned and entered the Operating Room, making a gesture for the Anesthesia doctor to pause the anesthesia before beginning the physical examination.

In less than a minute, Feng Zhuren finished the examination; he frowned slightly and sat on a stool in the corner.

"Zhuren, you think it's Appendicitis, right?"

"Yes," Feng Zhuren said cautiously.

Miao Zong noticed his own superior's gaze fixed on the patient on the operating table, full of doubt.

"Zhuren, the patient's diagnosis is very clear, including the B-ultrasound Auxiliary examination," Miao Zong said. "Maybe we're overthinking it."

"There is indeed some tenderness at the Murphy point, but it's not severe," Feng Zhuren said vaguely.

Even so, the serious expression between Feng Zhuren's mask and cap spoke volumes.

Miao Zong stood silently to the side, waiting for the Anesthesia doctor to finish the Continuous Epidural Anesthesia before beginning to scrub in and disinfect in preparation for the Surgical Operation.

Kong Zhuren's voice came from outside the operating room door; he walked into the Operating Room while saying something to Ji Xiang.

"Feng Zhuren, why are you here?" Kong Zhuren asked after entering.

"This is a patient from our department; I'm taking a look. Besides, aren't you here too?" Feng Zhuren stood up and joked, "Old Kong, when did you get interested in Surgical Operation?"

"The patient is a bit strange, so I followed to take a look," Kong Zhuren said. "Xiao Ji reminded me; the patient has signs of localized Peritonitis, and using inflammatory exudate around the appendix to explain it seems problematic."

"Localized Peritonitis in the mid-abdomen, but it's not heavy, just a little bit," Feng Zhuren added. "Is there a problem with the Gallbladder?"

"No."

After exchanging a few words, the two stopped talking.

Seeing Miao Zong laying out the drapes, Ji Xiang suddenly spoke up, "Feng Laoshi, can we avoid using Single-port laparoscopy?"

"Hmm?" Feng Zhuren was stunned.

This is the operating room; what right does a junior doctor have to speak!

You don't need to tell me how many holes to make!

If it weren't for the fact that Ji Xiang was capable and had gifted him a top-tier SCI Thesis for nothing, Feng Zhuren would have kicked Ji Xiang out of the operating room long ago.

"Using it first is fine, but I think it's best if the positions reserved for the other holes are slightly higher, to leave room for the liver and gallbladder."

"!!!" Feng Zhuren looked at Ji Xiang, full of suspicion, trying to discern what Ji Xiang was actually thinking from his gaze.

Ji Xiang's gaze was clear, like a pool of mountain water, visible to the bottom at a glance.

Because of the existence of the free peritoneal body case, plus the bribery of a top-tier SCI Thesis, Feng Zhuren didn't say much more; he nodded and signaled Miao Zong to reserve the surgical area while laying the drapes.

Miao Zong felt a bit strange, but he didn't dare to make a peep and obediently began laying the drapes according to his superior's instructions.

After punching a hole at the navel and entering, as soon as the Endoscope lens could see clearly, several surprised "Eh?" sounds rang out in the operating room.

On the monitor, what should have been a pale red background was instead filled with gray-green and white-green matter as soon as the Endoscope entered.

There was purulent coating, and also... pus? No, that looked like bile!

It wasn't "looked like," it was certain.

It was bile!

Ji Xiang's judgment was correct!

Miao Zong was momentarily flustered; he looked back at Feng Zhuren.

"I'll go find Old Yang to come to the table for a consultation," Feng Zhuren said.

He pulled out his phone, stood in the corner, and while looking deeply at Ji Xiang, dialed Yang Zhuren.

After briefly describing the patient's condition, Feng Zhuren hung up.

"Xiao Ji, how did you judge it?"

Kong Zhuren, who had wanted to use facts to educate Ji Xiang, was also stunned and asked in confusion.

"I guessed, just a guess, Kong Laoshi. An elderly patient who has been fasting, due to bile stasis and concentration, as the gallbladder enlarges, the gallbladder wall thins. Plus the irritation of bile salts, it caused aseptic inflammation of the gallbladder wall."

"Due to the compression of the gallbladder fundus and the loose, edematous tissue, it ultimately led to a perforation of the gallbladder fundus."

"This kind of perforation is different from the gallbladder perforation we usually encounter; it is not a perforation caused by ischemia and necrosis due to inflammation. Therefore, the discontinuity shown on the B-ultrasound is relatively short, and it is even difficult to detect. It is also quite difficult when performing a Differential Diagnosis; I was just making a guess."

Ji Xiang briefly described it and then stopped, saying no more.

Several Doctors in the operating room fell into deep thought.

What Ji Xiang said was indeed a possibility, but this possibility... was just too rare.

"Xiao Ji, tell us about your line of reasoning."

Ji Xiang smiled and said nothing; seeing that Ji Xiang was not speaking, Kong Zhuren and Feng Zhuren did not ask too much. Perhaps it was just a flash of inspiration for Ji Xiang, and there was no detailed line of reasoning.

Similar situations are very common in Clinical practice, especially common, so Feng Zhuren understood and did not "press" Ji Xiang.

Soon, Yang Zhuren came up with Zhai Yuhan.

After asking about the situation, Yang Zhuren had Miao Zong rotate the camera, barely found the position of the Gallbladder, used forceps to move it, and after seeing the point of Perforation, he took a deep, interested look at Ji Xiang.

(End of this chapter)