Chapter 432: Chapter 313: Zhang Qingquan Refuses to Accept Defeat, Diagnostic Error! (Part 2)

"Has it been a day or two? It started hurting on Saturday, but it wasn’t so bad."

The girl’s voice was weak and slightly trembling.

"Has your period ended?"

Zhang Qingquan continued to ask.

"Yes, about a week ago~"

"When did you vomit this morning?"

"Before the class started~"

The girl held her stomach, her facial muscles twitching in pain.

The girl’s menstrual cycle was normal, so it didn’t seem to be period cramps or issues like an ectopic pregnancy.

"Besides the pain, is there anything else?"

Zhang Qingquan asked.

"Doctor, for the past two days, her stomach really has been bloated, and she can’t eat anything. She feels like vomiting just by drinking water or eating."

The mother standing beside her quickly added.

"Did she eat anything unusual?"

"No, no, she has been at home these past two days, just eating the usual food!"

"Is the gas passing normally?"

...

"The doctor is asking you, answer him."

The mother looked at the girl and urged.

"No... no~"

The girl shook her head softly, a bit embarrassed.

"How about bowel movements? Are they normal?"

"No... no, my stomach has been hurting these past two days, so I haven’t really eaten anything. Therefore, there have been no big... issues."

"Lie down on the bed, let me examine you."

Zhang Qingquan pointed to the patient bed beside him.

Supported by her mother, the girl painfully lay down.

"Does it hurt here?"

"Yes~"

"How about here?"

"It hurts too~"

"And here?"

"Hiss~"

When Zhang Qingquan pressed the area near the lower central abdomen, the girl couldn’t help but shiver, and cold sweat instantly rolled down her forehead.

There was no board-like rigidity, indicating it was not an appendicitis issue, and peritonitis could also be ruled out. The liver, gallbladder, and stomach didn’t show major pain — it seemed to be connected pain.

But the obvious abdominal bloating suggested gas.

Listening for bowel sounds, there were none.

"You have a listen."

Zhang Qingquan instructed the resident doctor beside him.

The young doctor put on a stethoscope and listened, his expression changing slightly.

"What did you find?"

"No bowel sounds."

Zhang Qingquan nodded upon hearing this.

Standing next to him, Qin Feng’s eyes showed a glint upon hearing this.

The judgment was consistent with the feedback from Zhang Qingquan’s earlier pressing.

The absence of bowel sounds is very critical because a normal person’s stomach would typically make 3-5 sounds per minute.

This activity reflects normal intestinal function, indicating the intestines are working on digestion and movement.

But if bowel sounds disappear, coupled with abdominal distension, then the problem is very evident.

Abdominal pain can mainly be determined as an intestinal issue.

This phenomenon is usually seen in a specific condition.

Intestinal obstruction!

Intestinal obstruction: an obstruction that prevents the passage of intestinal contents for various reasons.

The main clinical symptoms are fourfold: pain, vomiting, distension, and constipation, common in clinical emergencies, and the condition is complex and variable.

The etiology of intestinal obstruction mainly includes three aspects: mechanical obstruction, paralytic ileus, and ischemic bowel obstruction.

Mechanical intestinal obstruction refers to obstructions not caused by the intestine itself, such as adhesion bands, volvulus, external tumors compressing the intestine, internal or external hernias, or intra-abdominal abscesses.

There are also cases like intussusception, Crohn’s disease, colorectal cancer, etc., which can cause mechanical obstruction.

Paralytic ileus is when the intestinal movement is impaired, preventing normal passage of contents, without any inherent organic changes in the intestinal wall.

It often occurs after abdominal surgery due to stimuli to the intestinal wall muscles from nerves and bodily fluids, causing a loss of peristaltic ability resulting in obstruction.

This is why post-abdominal surgery, doctors pay attention to whether the patient passes gas normally.

Called paralytic ileus.

The last is ischemic bowel obstruction, caused directly by mesenteric vascular disease.

Qin Feng believed that this girl most likely had paralytic ileus.

A segment of bowel content couldn’t pass through, accumulating and constantly generating gas, causing the bowel segment to expand more and more.

The patient would show clear symptoms of intestinal obstruction!

Especially since the girl mentioned having not passed gas or stool in the past two days, increasing the likelihood significantly.

"Let’s do a CT scan first."

Zhang Qingquan wrote an examination slip for the girl.

Once the CT result is out, it will be clear.

"Thank you, doctor."

The girl’s mother took the examination slip, repeatedly thanked her, and left with the father supporting the girl.

"Director Qin, any advice?"

Zhang Qingquan looked up at Qin Feng.

"Nothing, just came to have a look, you go ahead."

Qin Feng smiled, then turned and left.

In the second consultation room, Han Xiaoxiao was examining a patient, also not finding any issues.

For these experienced emergency doctors, fundamental diagnostics are reliable.

Then, after making rounds in the emergency hall, observing routine emergencies and resuscitations, and chatting with the head nurse for a while.

It had to be said that Peking Union Medical College Hospital, being such a high-level Grade 3A hospital, was highly professional in both process standards and medical staff levels.

Plus, with Qin Feng’s medical skills, everything could be handled in no time.

He even felt a slight relief~

’Big hospital emergencies sure are excellent!’

Qin Feng couldn’t help but think to himself.

Ring ring ring~

"Hello."

"Dr. Qin—no, Director Qin now."

A familiar voice sounded over the phone.

Qin Feng’s lips curved into a smile; Miss Yun actually remembered him.

"Miss Yun is well-informed. Why did you call me so suddenly?"

"I’ve arrived in Beijing. Shall we have dinner together?"

Yun Ruochu said.

"Sure, let’s meet after my shift."