The Enhanced Doctor-Chapter 573 Experience is a double-edged sword

"Director, this is the patient’s condition, so I plan to first perform a laparoscopic cholecystectomy and then conduct a biopsy on the patient to see the actual situation."

Liu Banxia quickly reported the situation after Zhou Shuwen finished the operation.

"If it is indeed pancreatic head cancer, Director, could you please do it? The patient wants to have children in the future, and your prognosis would be better than mine."

"It’s the first time I’ve seen you lack confidence in a surgery. But this patient’s condition is indeed interesting," Zhou Shuwen nodded.

"I don’t have anything on my schedule tomorrow; let me know after the pathological results are out. Situations like this are rare, but diseases always have some peculiarities."

"Director, have you ever encountered such a disease?" Liu Banxia asked curiously.

Zhou Shuwen shook his head. "It’s my first encounter too, so you’re doing it right. When instrument examinations show contradictory information, pathological testing is the only definitive standard."

"Thankfully, you all followed procedure. What if the patient genuinely had pancreatitis? We would have proceeded directly with an open resection. If the pathology later showed pancreatitis, that would have caused a huge problem."

"Director, to be honest, it was almost a miss," said Liu Banxia.

"According to our usual practice, with the patient’s pancreatic head so swollen, it should at least be stage two, so subsequent tumor markers should correspond."

"We really need to be careful in the future. All examination indicators must be meticulously cross-referenced before making a diagnosis. Otherwise, if we miss even one item, it could lead to serious trouble."

"It’s good that you’re thinking this way. Go and get busy. Also, remind everyone that we must be careful about this in the future. We can’t just rely on experience. Sometimes, the more experience we have, the bigger the mistake we might make," Zhou Shuwen nodded.

Emerging from Zhou Shuwen’s office, Liu Banxia had a lot on his mind. It really seemed to be the case. The more experience one had, either there would be no misdiagnosis, or if one occurred, it would be a major medical dispute.

He gathered everyone and, using this patient’s actual situation as an example, explained the issue again. Before making a diagnosis, they must carefully confirm everything, striving to avoid missed diagnoses or misdiagnoses.

Actually, this was a frequently discussed issue; this kind of situation occurs in a certain percentage of cases in every hospital. It’s just that the signs of some diseases aren’t very clear, so sometimes they have to be treated as if they were other diseases.

"I’ve been pondering for a long time and couldn’t figure out what’s going on. Have you figured it out?" Shi Lei moved closer to Liu Banxia.

Liu Banxia shook his head straightforwardly. "I haven’t figured it out either. If things are quiet tonight, I’ll stay in the patient’s ward for a while and see if I can make any further deductions."

"Personally, I still lean towards pancreatic head cancer, but we’ll have to wait for the test results. Right now, I really can’t figure out what’s going on. It’s a real headache."

"Who will do the exploratory surgery tomorrow? Who will be the surgeon?" Shi Lei asked.

"I’m thinking about that too. The interns can draw lots for it. Let them get a good look at whether it’s an ordinary cholecystectomy or if we’ll need to add a pancreatic head cancer resection," Liu Banxia said with a smile.

For this patient, the interns also showed strong interest. They had never seen such a case before and were intrigued by the novelty.

"Teacher Liu, two car accident patients will be sent over later," the dispatch nurse called out.

"Okay, Brother Wei and Old Shi, you handle the admissions. The rest of you can choose who to follow," Liu Banxia said.

After a while, two patients were brought over, accompanied by traffic police.

"Vital signs are all stable, but one is dizzy and the other has neck pain," Shi Lei said after walking out from completing the examination.

Liu Banxia laughed. "They’re definitely at a standoff. Now they’re probably trying to compete over who’s more seriously injured."

"Possibly. But during our physical examination, their vital signs were indeed stable. If the CT scan doesn’t clear things up, we’ll have to proceed with an MRI," Shi Lei said.

"Teacher Liu, please come over. A patient came in on his own, complaining of acute abdominal pain," Li Hao called out at this moment.

Liu Banxia came over. The young man was lying on the examination bed, rolling around in pain.

"What’s the preliminary diagnosis?" Liu Banxia asked.

"Body temperature is 38.6 degrees Celsius, blood pressure is a bit low at 70/90, and heart rate is 110. He’s experiencing abdominal pain, his abdomen is rigid, and he can’t describe exactly where it hurts," Li Hao said.

"We just did an ultrasound; the view wasn’t very clear. We suspected an intestinal perforation or appendicitis, which has already caused a perforation. Especially since the patient mentioned pain in the right abdomen over the past few days, we suspect it might be an appendiceal perforation."

Liu Banxia carefully examined the patient’s abdomen and sighed inwardly. "This could very well be acute peritonitis already. Let’s take him directly to the operating room. Have you drawn blood?"

Li Hao nodded. "We’ve also done the preoperative blood test, but the results haven’t come out yet."

After saying this, he eagerly looked at Liu Banxia.

"Alright, let’s go to the operating room. We don’t have time to explain much to the patient now; have him sign the consent form first. Saving his life is what matters most. Liu Yiqing, you’re the first assistant," Liu Banxia said.

Li Hao pumped his fist. This indicated that he would be the chief surgeon for this operation. This was his first time dealing with such a critical patient.

"Old Shi, keep an eye on things for me. I’m going to the operating room to supervise them," Liu Banxia said.

"Peritonitis?" Shi Lei asked.

Liu Banxia nodded. "Probably an appendiceal perforation. Let’s open him up and take a look. He probably didn’t take it seriously and let it drag on until it got this bad."

When they arrived at the operating room, the anesthesiologist on duty was Wang Lei.

"Old Wang, Li Hao is the chief surgeon today. The patient’s vital signs are in your hands," Liu Banxia said.

"I’ll do my best. The patient’s condition is quite poor; his blood pressure has dropped again, probably due to the pain. You guys better hurry. I’ve given him a vasopressor," Wang Lei replied.

Liu Banxia gave Li Hao a look; this patient could only undergo a standard open laparotomy.

As the abdominal cavity was opened, the sight within made even Liu Banxia frown. Pus, blood, and fecal matter were all mixed together.

"Suction," Li Hao ordered.

With two suction machines working simultaneously, the condition within the patient’s abdominal cavity finally improved somewhat.

"Exploration reveals a ruptured appendix and diffuse peritonitis. An appendectomy is feasible," Li Hao said after a look.

Liu Banxia nodded, signaling them to continue.

Actually, this was also a very routine surgery; there wasn’t much more that could be done. It involved removing the appendix, suturing the site properly, administering antibiotics to suppress the inflammation, and adjusting the body’s electrolytes.

Of course, for this patient, the recovery period would be longer. Even if his abdominal cavity was carefully irrigated, the risk of postoperative infection would still be very high.

But that was part of the entire treatment process and didn’t have much to do with the surgery itself. The surgery was just a crucial step in the treatment.

Because the patient’s abdominal cavity was severely contaminated, the debridement and irrigation process took quite a long time.

A normal appendectomy, if Liu Banxia were doing it, could be completed in half an hour. Moreover, he could keep the incision small, ensuring a low infection rate and fast recovery.

But that wasn’t possible for this patient. No matter who performed the operation, they would have to repeatedly irrigate the abdominal cavity. After the resection, a drainage tube would have to be left in place, and the patient would need to be sent to the ICU for overnight observation and care.

DING! Surgery completed.

Experience gained: 100 points.

After Li Hao and his team finished their work, the system issued a reward.

"How was it? You must have learned a lot from performing this surgery, right?" Liu Banxia asked with a smile.

Li Hao nodded. "This is the first time I’ve dealt with such severe abdominal contamination. Looking at him, his appendix probably ruptured before he even came for consultation. He really endured a lot of pain."

"When he wakes up, you can ask him if he has a history of chronic appendicitis. He’s likely experienced similar situations before and thought he could just tough it out this time as well," Liu Banxia said with a smile.

"A good swimmer often drowns. It is the same for us doctors. That’s why I always tell you not to rely solely on your experience, as it can be a double-edged sword that can harm others and yourself."

Li Hao nodded; it really was like that.

If this patient had experienced such pain for the first time, he would definitely have gone straight to the hospital instead of trying to endure it at home. It was because of his previous experience that he got himself into this situation.

Not every appendicitis attack is chronic; if just one of them is acute, it can very well lead to a situation like this.

Had he come two hours earlier, it would have been a simple appendectomy, and he could have been admitted to a normal ward. Now, he will have to spend more money and pray that he doesn’t get infected.

And in this instance, Li Hao’s experience played a very good role.

He didn’t wait, nor did he order a CT scan to confirm the situation, which bought the patient a lot of time. Diffuse peritonitis, like what this patient had, could very likely lead to sepsis.

"How are the two car accident patients doing?" Liu Banxia asked once they were outside.

"They’re perfectly fine, but I wouldn’t mind having more patients like that," Shi Lei said with a laugh.

"You’re getting quite cheeky. I’m going upstairs to check on the ectopic pregnancy patient," Liu Banxia said.

Shi Lei nodded. That patient could indeed be considered a key concern for the Emergency Center.

This was one of the important reasons Liu Banxia was occasionally quite busy; he needed to personally check on some key patients. Simply looking at medical records wasn’t enough. As the chief resident, he needed to grasp the entire situation for all of them.

Moreover, Liu Banxia had a lot on his plate. Even though Zhou Shuwen had returned, Liu Banxia was still in charge of many things.

Don’t think that managing the residents in training at the Emergency Center is an easy task. It’s not as simple as just asking about them when you think of it; they each have their own attending physicians guiding them.

You also need to conduct a comprehensive assessment of these individuals, which requires you to observe more and pay more attention; otherwise, this work wouldn’t be done thoroughly.

It might be possible to muddle through in other departments, but it definitely wouldn’t fly with Zhou Shuwen.

If there wasn’t a mentor-apprentice relationship, he might have been able to get by with slacking off. Now, no matter what Liu Banxia did, he had to hold himself to high standards and strict requirements.