Chapter 818 - 383: Step-by-Step Diagnosis, The Apology Visit

Chapter 818: Chapter 383: Step-by-Step Diagnosis, The Apology Visit

"Siying, check the patient’s groin."

Li Jingsheng naturally wouldn’t rashly examine a female patient.

Although it’s possible, it could easily lead to conflicts.

If the female patient insists the doctor took advantage of her, it might even lead to getting beaten by her husband.

Running a clinic requires extra caution; one cannot take risks with details.

Han Siying felt the groin area.

"Master, there seems to be a small lump here in her groin!"

"Let me see!"

Li Jingsheng perked up at the mention of a lump.

With a serious look, he reached out to feel the patient’s groin. The patient herself felt somewhat nervous and slightly embarrassed upon hearing about the lump.

After the examination, Li Jingsheng’s expression grew even more solemn.

He examined the patient personally because Han Siying’s skills were still limited, making it difficult to assess the patient’s true condition.

The nature, size, and number of lumps—these factors need thorough assessment before making an accurate diagnosis.

Through examination, he found more than a dozen lumps of various sizes in the patient’s groin area.

The largest was over 2 centimeters in diameter, while the smallest was slightly larger than a mung bean.

The lumps were hard in texture.

Upon pressing, the patient showed no obvious signs of pain.

Moreover, the lumps were not adhered.

They were slightly movable.

"You should be able to feel them while bathing, right?"

Li Jingsheng looked at the patient.

"I can feel some. I thought it was normal since they don’t hurt or itch, so I didn’t pay attention to them. Dr. Li, are these lumps cancerous?" she asked softly.

It was evident that her heart was filled with fear.

Suffering for so long, this visit to the hospital didn’t bring improvement, and now finding lumps added to her ominous feelings.

"These are just lymph nodes, not cancer."

Li Jingsheng reassured the patient.

In reality, he leaned towards suspecting tumors.

Not these lymph nodes in the groin, but suspecting a tumor inside the patient.

To become this thin, benign tumors generally lack this capability.

Only malignant tumors replicate intensely, consuming the body’s nutrition, leading to such severe consequences.

However, the patient’s symptoms and examination results didn’t align with malignant tumors.

Li Jingsheng pondered over the location of the patient’s lesions.

No abnormalities in the neck or armpit lymph nodes; only multiple lymph nodes in the groin indicated the lesions might be in the lower abdominal or pelvic region.

There aren’t many organs in the lower abdomen.

Uterus, ovaries, bladder, etc.

The first thought goes to uterine abnormalities. Uterine cancer is still the leading killer among women, alongside breast cancer, earning them the nickname "The Black and White Twins."

This is why the cervical cancer vaccine gained massive popularity once available.

Even post-menopausal women in their fifties and sixties are eager to get vaccinated.

"Let’s talk outside!"

Li Jingsheng motioned for the patient to tidy up her clothes before he walked out.

If the patient had malignant tumors and it’s been so long, pain should have appeared by now. No matter what type, malignant tumors are accompanied by pain.

The later, the more painful.

Cancer pain levels might even exceed labor pain.

Besides no apparent pain and only groin lymph node enlargement is a positive sign.

Cancer or malignant issues often involve widespread lymph enlargement.

Also, living with the condition so long without treatment, still able to eat, sleep, and work doesn’t fit the behavior of malignant tumors.

Based on these points, Li Jingsheng boldly inferred the patient likely doesn’t have a malignant tumor.

Which leaves only benign tumors as a possibility.

But benign tumors typically don’t cause prolonged fever or nutrient depletion.

These do not match the patient’s symptoms.

It’s neither malignant nor benign tumors, then what could it be?

Besides tumors, if there is unexplained nutritional depletion, only parasites remain.

A routine stool test would be beneficial.

At least it could rule out many issues initially.

With Li Jingsheng’s current diagnostic ability in gastroenterology, he could almost rule out parasites as the cause of her symptoms.

If parasites are excluded, then the only cause of her emaciation seems to be nutritional loss.

The digestive system might have issues leading to crucial nutrient loss.

Like protein.

And fats.

Protein loss can be detected through a routine urine test.

Fat loss makes even a stool test necessary.

At this moment, the patient and Han Siying also walked out from inside.

"Do you often have diarrhea?"

"Occasionally, but not frequently. Sometimes, if my stomach catches a cold, or I eat something unclean, it makes me have loose stools. It’s usually better the next day."

The patient replied.

This indicates she doesn’t have a regular diarrhea issue.

If there’s no obvious diarrhea, and tumors are ruled out, the only issue could be with urination.

Hematuria, proteinuria in urine could lead to emaciation and anemia.

Relying solely on a complete blood count, examination, and symptoms for diagnosis is truly challenging.

Fortunately, Li Jingsheng now has multiple diagnostic skills, coupled with growing clinical experience. Through constant effort, using a methodical approach, he eliminates possible problem organs and disease categories one by one.