Chapter 54 - Intensive Training Again In The System (1/2)

Chapter 54: Intensive Training Again In The System

The patient’s diagnosis was displayed in the upper right corner of Zheng Ren’s vision—chronic cholecyst.i.tis.

Zheng Ren’s heart sank immediately as this was clearly a complication of acute food poisoning.

The risk of complications would be minimized if the patient underwent an intravenous infusion of antibiotics for one week, but antibiotic misuse by idiotic doctors had become a trend in the country these days.

There were indeed idiots among doctors. For example, there was the usage of triple-drug therapy—including quinolone, which was metabolized by the kidney—as postoperative prophylactic antibiotics in an underaged patient with an uncomplicated appendicitis case.

The vast majority of doctors had good intentions, and they placed disease treatment and saving patients’ lives as their top priorities.

However, their intentions were usually and ruthlessly destroyed in reality.

Veterinarians in charge of the medical industry had issued regulations to restrict the clinical usage of antibiotics. Their prescription was justified only when the patient exhibited signs of pyrexia, positive bacterial culture, derangement in routine blood investigations and so on.

However, only a few people knew that meat and milk actually contained a large amount of antibiotics from animal husbandry. Even producers had no choice. How could they meet the increasing demands of the market if they stopped using antibiotics and production fell?

Would they force everyone to be a vegetarian? Zheng Ren would be the first to disagree as he was very fond of eating meat skewers.

This was a troublesome issue and there was nothing Zheng Ren could do about it.

It was good enough if he could manage the emergency department in Sea City General Hospital.

“Do an emergency bedside B-scan ultrasonography. I’m guessing that he has cholecyst.i.tis.” Zheng Ren quickly made a diagnosis.

“Chief Zheng, how did he get cholecyst.i.tis when he was previously well?” asked the patient’s son in distress.

“I told you, an acute toxic liver injury will result in exudation and the exudate has a chance of acc.u.mulating around the gallbladder. Physical function declines with age, and constant stimulation for one week can lead to cholecyst.i.tis,” Zheng Ren explained.

However, this type of cholecyst.i.tis was uncommon. In fact, its risk was less than 10 percent.

Luck was the predominant factor in this issue. Obviously, it had not been on this patient’s side.

It was inappropriate to discuss bad luck with the patient and his family members. Zheng Ren was indeed insensible, but that was limited only to women. He was still emotionally mature and was a smooth talker around patients.

This elderly man had the honor of becoming the first patient of the emergency ward.

His B-scan ultrasound showed that his gallbladder was 95x47mm in size, with marked asymmetry in its wall and striated thickening at 3mm. The gallbladder wall had normal echogenicity with echogenic debris noted within the gallbladder itself.

The ultrasound report concluded that he was indeed suffering from late-onset chronic cholecyst.i.tis. Other tests—routine blood investigations, coagulation profile, Hepat.i.tis B serology test, HIV and syphilis tests, renal and liver function tests and so on—were then performed in the emergency department.

Electrocardiogram findings were normal with his sinus rhythm noted.

Zheng Ren instructed a nurse to insert a nasogastric tube for gastric decompression before inviting the patient’s son to his office for preoperative counseling.

The son was dejected as he was the one who insisted on a hospital discharge due to the noisy environment disturbing his father’s rest.

He did not expect his father to have cholecyst.i.tis just as Zheng Ren predicted.

Zheng Ren had had a good relations.h.i.+p with the family members of the patients who had been receiving treatment in the emergency department observation unit, so he chose to comfort the patient’s son first after they had sat down in his office.

After that, he began explaining the patient’s condition based on his ultrasonography.

This was not a simple case of acute cholecyst.i.tis, and its cause had been explained previously. Acute food poisoning would cause transient derangement in liver function, which would result in exudation. The exudate would acc.u.mulate in the gallbladder fossa and infiltrate the gallbladder, finally causing acute cholecyst.i.tis.

The possibility of young men getting cholecyst.i.tis was very minimal. After all, they were in better physical shape and had stronger immune systems, so their bodies would be able to deal with inflammatory responses easily.

Older men were different and could not handle inflammation well, hence the cholecyst.i.tis. If conservative treatment with antibiotics was used, it would not have much effect.

After listening to the explanation, the family member stated that he would follow Zheng Ren’s arrangements.

It was a sign of trust in the doctor after a period of acquaintance.