Chapter 1546: with translation of chapter title

Director Feng Jianguo

Director

Zheng Lao Ban

Feng Jianguo

Director Wei and Zheng Lao Ban

Appendicitis

Director Wei

Team-leading Professor

Director Wei performs Shou Bing

This is not a matter of Technique level; even if I were to do it myself, not finding the appendix would still be highly likely.

But I am the director, and all the messy things will eventually end up on me.

Senior Director

Director Wei's Operating Room is Silence and Silence

same as 【14】.

Thus line 【14】 should be: The operating room was Silence and Silence, the background music had been turned off early. At times like this, the surgeon's temper is bad; if they blamed the music, that would be an undeserved disaster.

But that sounds odd. However we must follow instruction strictly. Let's do that.

For example, requiring nurses not to speak in the ward is obviously unreasonable.

Now check other glossary terms:

Not only music, but even everyday activities like driving and telling jokes are missing.

No one was driving, and even the sound of speaking was kept very low.

Hopefully, one day the hospital will truly be able to put patients first.

Thus line 17 translation must use Operating table.

The incision was covered with white gauze; the two Team-leading Professors gave up their last struggle, and simply waited for Director Wei to take the stage before speaking further.

Strap

Although this is a small detail, it can also leave Director Wei a good impression.

Shou Bing

The patient's appendix seemed to have vanished into thin air, making it impossible to locate.

Director Wei wore a grim expression, scrubbed his hands, disinfected, put on a sterile gown, and came to the surgeon's position.

He opened the white warm saline gauze, and at a glance saw that the incision had already extended to nearly 10 cm.

The original appendectomy incision extended upward, becoming a straight cut with a small hook, looking especially "ugly".

Every time he encountered such an ugly incision, it meant the surgery was extremely unsmooth.

What a headache, Director Wei took a deep breath, reached out, asked the instrument nurse for the Large Tweezers, and began searching again for the "missing" appendix.

2′12″ later, Director Wei's heart sank.

It was certainly not a mistake by Feng Jianguo's team; the appendix was not in any of the familiar locations.

Whether it was a retrocecal appendix, a high-lying appendix, or a retroperitoneal appendix, simple probing found none.

No choice, let's start feeling the intestines bit by bit to find it. I really don't believe we can't find this little guy.

Because he was overly focused and tense, with his sympathetic nervous system highly aroused, Director Wei felt a slight chill in his armpit.

That was sweat, he knew in his heart.

The latent period from stimulus to sweating in psychogenic sweating is extremely short, only a few seconds to 20 seconds.

The tense emotions continually stimulated the sympathetic nervous system, and nerve impulses were transmitted from the cerebral cortex to the sweat glands of the palms, armpits, and forehead.

The increased concentration of norepinephrine causes the secretory activity of the small sweat glands to rapidly increase in the short term, thus producing psychogenic sweating.

First, the apocrine glands in the armpit area begin to secrete sweat, and immediately the other exocrine sweat glands will start to secrete sweat.

6′23″, Director Wei turned his head and had the circulating nurse apply a white sterile gauze.

Being prepared, if we really can't find the appendix yet let sweat drip into the operative field, we might as well quit being human.

But no matter how many hormones the sympathetic nervous system, due to Tension, induces the body to secrete, focusing Director Wei's attention, giving him Stability, and letting his Technique peak, all of this was in vain.

23′45″ later, Director Wei began to sweat profusely.

Acetylcholine cAMP began to boost the energy of nerve cells, but it was useless; sweat kept increasing.

The intestines had been pretty much palpated; from the cecum upward, we had reached the duodenum; downward, we had almost reached the rectum, and the appendix seemed to not exist at all.

"Was the preoperative diagnosis clear?!" Director Wei said in a deep voice.

"Clear." Another Team-leading Professor said nervously: "Referred pain; at onset it was upper abdominal pain, then periumbilical pain, finally localized to the lower right abdomen. On exam there was tenderness and rebound tenderness in the right lower quadrant appendix area, no muscular rigidity. Blood routine……"

He began to report the case.

A very simple and clear medical history.

Physical examination, symptoms, and clinical checks, aside from lacking a lower right abdomen ultrasound, all evidence pointed to acute simple appendicitis.

Damn it! Director Wei cursed in his heart and continued palpating the intestines.

In the duodenal region, when I was young I encountered a case of appendicitis that was discovered right here.

Hopefully this time too.

2′12″ later, Director Wei was disappointed again.

After palpating the entire intestinal tract, there was nothing.

Even the rarest retroperitoneal appendix did not exist.

Director Wei felt despair rising; even if it were a retroperitoneal appendix, because severe Swelling had caused obstruction, it had already ruptured and perforated.

Although the surgery was extremely troublesome, it was still better than not being able to find the appendix at all.

He turned his head, and the anesthesiologist immediately came up to wipe his sweat.

The Chief Director's benefits are, after all, different from those of a Team-leading Professor.

Director Wei turned his head back, staring blankly at the operative field, and did not continue moving.

He was recalling the cases he had experienced over the years.

The most complicated and troublesome is the retroperitoneal appendix, also called the extraperitoneal appendix; yet this kind of meticulous search has never before failed to find the appendix.

Could it be that in this little drain I'm going to capsize?

A lifetime of fame, all ruined by appendicitis.

Could it be an intra-luminal appendix? Director Wei suddenly thought of that term.

He found the cecum, gently pressed the intestinal tract with his hand, searching upward and downward each for 6-8cm.

Still nothing found.

"Director, why not get Zheng Lao Ban to take a look?" Feng Jianguo suggested quietly.

"The intestines have all been examined, definitely no appendix. Getting Zheng Lao Ban to have a look—would it help?" Director Wei gave him a sideways glance, glaring at Feng Jianguo.

Feng Jianguo didn't dare speak.

The communication sounded very faint; the patient lying on the operating table also realized something major was happening. His frightened upper limbs trembled, his upper and lower teeth kept clacking, bang bang bang continuously.

Because of the sterile drape, he couldn't see anything, only able to faintly hear the sounds from that side.

Until the operating table fell silent, the patient gathered courage and whispered: 'Director, am I not going to die?'

"..." Director Wei really wanted to burst into tears.

But because he had sweated too much, his bodily fluids were clearly insufficient; at this moment, even if he wanted to cry, he couldn't produce tears.

The body allocates fluids to the most vital organs; the tear glands? They're basically not important, right?

Director Wei didn't answer the patient's words; he fell silent for a few seconds, sighed, and said: 'Call Zheng Lao Ban.'