Chapter 1382: Patients with Persistent Abdominal Pain and Nausea

Chapter 1382: Chapter 1382: Patients with Persistent Abdominal Pain and Nausea

(Thanks for the encouragement with the Sterling monthly ticket)

"You don’t have any surgeries scheduled today, right?"

Xu Hui asked.

"No, anything up?" Liu Banxia replied with a question.

"I just examined a patient with abdominal pain, nausea, occasional constipation, and some fever. When examining him, I found his abdominal muscles a bit tense, did a blood test, and then sent him for an X-ray." Xu Hui said.

"His symptoms have lasted quite a long time, about three to four years. He has consulted other hospitals too, but no one has found the problem."

"I was planning to have you take a look together with me later; I’m worried he might now have bowel obstruction or torsion. But his nausea situation puzzles me, he often vomits."

"This really sounds a bit troublesome; could it be intestinal parasites or some other intestinal disease?" Liu Banxia asked.

"Parasites are unlikely since he was checked at other hospitals. And his medical history is quite long; if it’s parasites, that would be a major issue." Xu Hui replied.

"He actually came to us because he heard we have a fecal transplant program here, as he’s inclined to believe it’s a bowel issue."

"I even suspect he’s a diet-induced vomiting patient, but he denies it. It’s not that he doesn’t want to eat more; he very much wants to eat heartily, but as soon as he eats a bit more, he vomits."

"The X-ray should involve a barium meal, but he couldn’t even handle that and had to undergo some anti-emetic treatment. That’s why I felt something’s off; it’s not gastric reflux."

"Let’s wait and see the X-ray first; at least there should be some basic symptomatic indication." Liu Banxia said.

Sometimes it’s like this; for acute abdominal pain patients, the diagnosis process is relatively simple. Often, the location of the lesion is quickly found and processed.

However, for patients with chronic symptoms, finding the root cause can be quite tricky.

This patient has had three years of abdominal pain and nausea history. Over such a long time, no one has figured out the root cause, which is troubling.

There are just too many possible causes for the current symptoms; we have to find them step by step.

It’s not like other hospitals are roadside stalls, and only the second hospital is top-notch. If there is an organic disease, it should be seen on the instrument examination as well.

"Alright, the patient has finished the imaging; let’s pull it up on the computer to take a look." Xu Hui said.

Liu Banxia followed him to the internal medicine consultation room and saw the patient who walked in later was indeed quite thin.

But of course, poor nutrition due to bad eating over such an extended period would lead to this.

"Doctor, I’m really miserable." The patient said with a bitter smile.

"Let me introduce you; this is Director Liu from our emergency center. I invited him to help with your consultation." Xu Hui said.

"Let me first pull up your imaging; let’s not wait for the film to be developed. Your case is somewhat complicated, and your symptoms are currently quite severe."

Xu Hui said as he began operating on the computer.

"Bowel expansion is quite obvious now; how is your abdominal pain?" Xu Hui asked after looking at the image.

"Painful, more than just a while ago. I don’t know what’s happening; today it’s so painful like never before over these years." The patient said.

"Doctor, can you do that fecal transplant? My intestines are really not okay; just go ahead, everyone says it works."

"Let’s not rush; we haven’t found the root cause yet, so we can’t proceed with the treatment plan. Lie down first, let me check manually." Liu Banxia said.

The patient didn’t speak and directly lay down on the bed, lifting his clothes.

"Hiss..."

As soon as Liu Banxia placed his fingers on the patient’s abdomen, the patient let out a hiss.

"It hurts that much?" Liu Banxia asked, puzzled.

"Pain, truly painful, I’m not pretending." The patient said.

"Then can you describe your situation over the past two years? Does nausea and vomiting occur every time you eat too much, or only with certain foods?" Liu Banxia asked.

"Overeating isn’t okay; other hospitals say it’s a bowel problem, saying my intestinal function is weakened, easily irritated, overeating overloads it." The patient said.

"What about your bowel movements? In keeping with your normal diet, how’s your bowel movement situation?" Liu Banxia asked again.

"Sometimes good, sometimes bad. Anyway, I eat little and try to stick to porridge and softened meat, occasionally experiencing constipation." The patient said.

"My diet is quite monotonous now, just some greens and chicken. Strong flavored dishes don’t work; things like crown daisy, beef and lamb, pork haven’t been eaten in nearly half a year due to the triggered nausea."

His last sentence left Liu Banxia a bit puzzled again, looking at Xu Hui.

Xu Hui nodded, indicating he should continue speaking.

"Alright, let’s proceed with a CT scan to check the abdominal situation further and wait for the blood and urine test results." Liu Banxia said.

"Try to relax as much as possible, it can also alleviate your current symptoms. Today, two doctors are here to serve you, we will strive to get a clear understanding of your situation."

"Doctor, can’t you just perform a fecal transplant on me directly?" the patient asked.

"It’s not possible for now. You have some bowel dilation, so we are considering the possibility of a bowel obstruction. Moreover, the dilated segment is in the small intestine, so we must conduct a detailed examination," Liu Banxia said.

"It’s not to scare you, but if it’s a bowel obstruction, we have to consider surgical methods. It would be best if you could contact a family relative to come over, okay?"

"This is just in case; otherwise, the symptoms of abdominal pain you’re experiencing make it difficult to walk. Doctor Xu, please write up the order, and I will accompany him to get a CT scan."

Xu Hui nodded and quickly operated on the computer.

The patient’s condition was indeed somewhat poor, possibly due to worsened abdominal pain. From the current X-ray images, the likelihood of a bowel obstruction seemed high.

Additionally, the patient had a history of constipation, which also needed to be considered.

The patient’s condition was really poor, almost needing Liu Banxia’s support to walk. Seeing this situation, they prioritized the patient for an urgent examination when they arrived at the CT room.

However, they had to wait for the patient ahead to finish their inspection; they couldn’t just pull them out halfway.

Liu Banxia touched the patient’s forehead; it felt a bit hot. The increased abdominal pain probably caused the fever.

"Doctor, it hurts," the patient said.

"Hang in there a bit longer; soon, the CT scan will be over," Liu Banxia said.

The patient nodded weakly but also dry-heaved.

Seeing his condition, the other patients waiting for a check-up unconsciously moved aside.

No one knew what was going on with him, and in such times, no one would come closer just to watch. Even if they wanted to observe, they would do so from a safe distance.

After waiting for about ten more minutes, the patient inside came out, and only then did Liu Banxia take the patient in.

"This patient is for an abdominal scan?" Wu Bo asked.

Liu Banxia nodded, "The situation is a bit severe and has developed quite rapidly, so thoroughly scan the abdomen. The X-ray shows bowel dilation, so we worry it might be an obstruction."

"Alright, let’s try to do it quickly. Considering his bad state, it’s important he doesn’t move during the scan," Wu Bo said.

"We are about to start scanning, just lie down and don’t move. Any movement will compromise the accuracy of the scan," Liu Banxia pressed the intercom button.

"Doctor, I feel like vomiting," the patient said.

"Hold on, the scan will be done quickly," Liu Banxia reassured him.

Now, he was a bit concerned because if the pain or nausea got too intense, sometimes the body could move involuntarily.

Nausea, especially, triggers a series of physiological responses.

The preventive method is quite simple, just use some medication for the patient. But since they’ve already used it recently, more caution is required.

"Director Liu, how’s your study outside been going lately?" Wu Bo asked after the scanning started.

"Just managing, it’s been quite busy for me. Every day at our center feels like a whirlwind; we handle emergencies and surgeries quickly and then head out again," Liu Banxia replied wryly.

"During today’s ward round, I realized I have no recollection of many patients in our department. Some of them even underwent surgery by me; isn’t that frustrating?"

"The time does seem a bit long, but everyone believes our emergency center is surely getting better and more comprehensive," Wu Bo said.

"Honestly, while I don’t resist pediatric surgical operations as much as before, I still lack confidence. After observations, it seems like an entirely new field," Liu Banxia said.

"You’ll grasp it eventually, given your solid foundation. Oh, the patient just moved slightly, hopefully it doesn’t affect the results," Wu Bo said.

"Is it almost done?" Liu Banxia asked.

"Almost, but the quality this time might not be great," Wu Bo frowned.

"Doctor, I want to vomit," the patient said at this point.

"Hold on a little longer, two more minutes. Just two minutes more and we will be done. Try not to move or think of anything else, focus on something happy," Liu Banxia quickly pressed the intercom button to distract the patient.

"Didn’t you just call your wife? She’ll be here soon. Today’s goal is to pinpoint the cause of your illness; you must hold on, otherwise you’ll suffer more,"

The patient didn’t respond, but both Liu Banxia and Wu Bo knew the patient must be going through great discomfort now.

He had just stated that the nausea was intense.

However, CT scanning isn’t something that can be rushed through just because they wished it were faster; it requires a specific timeframe to ensure thoroughness.

Although the patient wanted to hold on, the nausea was truly unbearable. Liu Banxia and Wu Bo could only exchange a helpless glance, relying on luck at this point.

Perhaps the movement at the final stage wouldn’t have too much impact?