Chapter 632: [632] Re-establish the preliminary diagnosis Chapter 632: [632] Re-establish the preliminary diagnosis The likely reason for the misdiagnosis at the grassroots level was that Xie Wanying looked at the pregnant woman’s lower abdomen. Most doctors, who are not gynecologists, also fear that palpating a pregnant woman’s abdomen might harm the fetus. The grassroots clinic might only have an X-ray machine and no ultrasound, and doctors are afraid to use X-rays on pregnant patients for fear of harming the fetus, thus failing to perform related examinations and unable to make an accurate diagnosis.
Doctors know a lot, so they have many concerns. The common people don’t understand much and will only keep asking why it wasn’t diagnosed.
“Yingying, how is it?” Wu Lixuan, noticing something was amiss with her expression, quietly tugged at her childhood friend’s sleeve and asked, “Does she need to be hospitalized?”
Hospitalization was necessary, and it had to be immediate!
Xie Wanying took out her phone and first called Teacher Sun to discuss the situation.
“Aren’t you off work?” Sun Yubo was surprised to receive her call, thinking all the students were gone.
“Teacher Sun, I have a patient who is four months pregnant. I preliminarily suspect she has acute appendicitis. She’s been delayed at the grassroots clinic for about a week. The situation is quite serious. I wanted to discuss with the teacher–since bed 7 will become available tomorrow, can we admit her tonight?” Faced with an urgent situation, Xie Wanying directly explained the circumstances to her teacher.
Sun Yubo told her to wait: “I can’t decide about bed availability. That’s up to Teacher Tan. Teacher Tan went to a meeting this afternoon and just happened not to have left yet. I’ll ask him.”
On the other end, having received the message, Tan Kelin asked with emphasis, “Pregnant woman, acute appendicitis?”
“Yes!” Sun Yubo realized his student was admitting a formidable case. Pregnancy complicated by acute appendicitis was rare. He definitely needed to question his student: “How are you certain it’s appendicitis?”
“I performed the Bryan and Alder tests on her in both the right and left lateral positions. The abdominal pain worsened significantly when she was on the right side, and pressing on the appendix point also intensified the pain when she was on the left side. Plus, she initially described the symptoms as stomach pain, but then it shifted to her abdomen, a typical migration to lower right abdominal pain.”
The student’s clear description transmitted through the phone, causing the listening teachers to raise their eyebrows.
This was not something they had taught the students. Being rare cases, Xie Wanying had just started her three-month clinical internship, and the chance to encounter such rare cases was like winning the lottery. The clinical mentor did not consider teaching about cases they had not encountered.
It could only be said that the student had learnt and remembered very solidly and thoroughly, and she could quickly associate knowledge. Even if such cases were mentioned in textbooks, they were definitely tucked away in the corners.
If it really was a patient with pregnancy complicated by acute appendicitis, a grassroots hospital would be helpless with such patients; they must be referred to a third-grade A hospital. Sun Yubo asked, “Where is the patient now? At home?”
“She came to our hospital’s emergency room and couldn’t get registered.” Xie Wanying said, “Probably our ER is overwhelmed and simply couldn’t take her in. She took fever-reducing medication and injections at the grassroots clinic, but they didn’t diagnose her with appendicitis. The anti-inflammatory injection they gave her was probably not potent enough. Now, her condition has clearly worsened.”
Hearing the situation, Tan Kelin didn’t hesitate and said, “Admit her!”
Sun Yubo ran out to tell the nurses to hurry and prepare an extra bed.
Thankfully, Teacher Tan was there and willing to admit the patient. Xie Wanying breathed a sigh of relief, noticing that the patient couldn’t walk and needed a gurney. Instead of going up and down floors to fetch a gurney from the general surgery ward, it would be faster to borrow one from the department on the ninth floor to transport the patient.