Practicing Medical Skills in a Small Clinic-Chapter 135 - 112: Short Bowel Syndrome, the Most Terrifying Disease Is Poverty

Chapter 135: Chapter 112: Short Bowel Syndrome, the Most Terrifying Disease Is Poverty

Li Jingsheng’s gaze slightly sharpened, and his expression became serious.

Bloody stool often indicates gastrointestinal bleeding.

If it is upper gastrointestinal bleeding, the discharged stool is often black. Because the fresh blood produced gets absorbed in the lower gastrointestinal tract, by the time it is expelled, it has turned black and mixed with the stool.

At this point, a routine stool examination often shows positive occult blood.

In fact, you can tell just by looking.

The uncle is just an ordinary person, not a doctor. When he discovers blood in his stool, it’s nine out of ten times not black stool, but directly mixed with fresh blood.

Based on this information, Li Jingsheng’s Master Level Gastroenterology diagnosis initially determined that the patient likely had a lower gastrointestinal bleed.

As for which part is bleeding, imaging tests are a good option.

In the small clinic, conditions are limited. An X-ray can show some intestinal bleeding, but its accuracy is far inferior to an abdominal CT. If conditions allow, barium enema or colonoscopy might even be needed.

Li Jingsheng immediately dismissed the idea of doing an abdominal ultrasound or X-ray for the patient.

That "grandpa-level" X-ray machine can handle bone injuries and other obvious ailments.

Asking it to detect lower gastrointestinal bleeding is really challenging it.

By looking at this uncle, he seems so penny-pinching, even a hundred yuan for an imaging test might be hard for him to accept.

The main reason is that the check might not have much significance.

Even the best hospital X-ray machine can only show intestinal paralysis or moderate distention at most. To accurately diagnose the bleeding site and obtain more detailed information, a CT scan and barium enema are required.

"How long have you been experiencing bloody stools?"

Although Li Jingsheng had already given up the idea of treating this patient, he still took this opportunity to accumulate some practical experience.

The attribute panel can increase his proficiency in diagnostic skills, but the accumulation of knowledge still requires his own effort in learning.

The magic finger can’t create a medical skill or give him knowledge out of thin air.

It can at most help him better apply what he has already learned and use it proficiently in clinical practice.

"I’m afraid it’s been more than ten days! It’s gotten worse in the past two days, with severe abdominal pain. A while ago, there was occasional blood in the stool, but not much, and the abdominal pain would occasionally subside after a while."

The uncle has been passing blood for so many days without going to the hospital for a check-up.

The main reason is the fear of spending money.

People in poverty see their lives as cheap, it’s the same in any era.

If not for the unbearable pain, he probably wouldn’t even come to the clinic.

"How about this, why don’t you lie down on the treatment bed inside, and I’ll check your abdomen."

Li Jingsheng decided to conduct an abdominal palpation test on the uncle, to at least pinpoint the approximate region of the lesion.

For example, appendicitis usually presents with pain in the lower right abdomen.

Upper abdominal pain could be due to the jejunum, ileum, or even the liver, etc. The location, along with the depth of pain, can directly indicate which organs or tissues might be affected.

"Does this test require payment?"

The uncle hesitated and asked.

"No charge."

Among the patients Li Jingsheng treated, there were many concerned about money, but few like this uncle who were so concerned.

After getting sick, almost all patients just want relief from their pain as soon as possible.

As long as the treatment fees aren’t unbearably high, they generally don’t mind much.

He speculated that either this uncle was in a financial crisis or he was naturally stingy, always calculating life down to the penny.

Such men are rare, but they do exist.

They are pickier than women when buying clothes, trying all means to bargain, to take advantage wherever possible.

After guiding the uncle to the treatment room inside, Li Jingsheng had him lie down, lifted his shirt, and began examining his abdomen. 𝗳𝚛𝚎𝚎𝘄𝕖𝕓𝕟𝕠𝚟𝚎𝕝.𝗰𝕠𝐦

He saw a long scar on the uncle’s abdomen.

The suture marks were still relatively clear, indicating the surgery was probably done within the last six months.

"Have you had surgery recently?"

"Ah, don’t mention it, about six or seven months ago, I was working one day and suddenly my stomach hurt so badly. After collapsing on the ground, I fainted from the pain. Coworkers took me to the hospital, where they said it was some kind of intestinal... strangulation, and then they operated and removed a portion of my intestine. I haven’t been able to work since then."

The uncle continually shook his head and sighed, his face full of sorrow as he recounted this event.

Needing emergency surgery to remove part of the intestine suggests an intestinal strangulation.

This condition is rare but more likely to occur in middle-aged and elderly individuals.

Especially those middle-aged men doing heavy physical labor, sometimes not resting after meals, trying to get more work done, starting hard physical labor right after eating.

In other cases, suddenly exerting too much force while working can lead to intestinal hernia or torsion.

If not treated in time, intestinal necrosis can occur, which is life-threatening.

Now it finally makes sense why this uncle repeatedly asked if there was a fee for the test and how much it would cost.

Being unable to work for over six months, and just a casual laborer without savings to begin with.

The disease probably consumed a large sum of money, and during these seven months, follow-up visits and medications are also long-term expenses.

Depleting his savings.

The uncle is likely already at the end of his resources.

"Let me examine your abdomen, try to relax."

Li Jingsheng started pressing on the painful areas of the uncle’s abdomen, finding a certain degree of abdominal rigidity.

The abdominal wall was noticeably tense, rigid, as hard as a board during palpation, which isn’t good.