Chapter 1383: Surgery "Upgraded

Chapter 1383: Chapter 1383: Surgery "Upgraded

"Ugh... ugh..."

After finishing the CT scan, the patient started retching.

For him, enduring it was truly difficult, even biting his lips until they bled.

"Rinse your mouth first, do you feel a bit better now?" Liu Banxia asked.

"I feel a bit better. Was it successful just now?" the patient asked.

"I haven’t had a chance to check yet. Please wait outside for a moment, and I’ll take a look," Liu Banxia said.

The patient nodded and walked out with some difficulty.

Wu Bo looked at Liu Banxia and shook his head, "There’s still some impact. We can only see signs of obstruction in the lower segment of the small intestine, but the rest is unclear."

"It’s pretty much like this now. Shall we add more scans, or do you want to study this first? Moving forward might be tough, right?"

"Let’s go back and study it first, to avoid delaying later patient examinations," Liu Banxia said.

Even if the view isn’t very detailed, the scan results now are not great. One can barely make things out, not expecting too much.

Back in the internal medicine office, Xu Hui had a headache looking at the CT images on the computer.

"For now, it’s confirmed as a small bowel obstruction, but the cause is somewhat uncertain," Xu Hui said.

"The blood test results are out too. The complete blood count is a bit low, with a high white cell index. It’s a headache, isn’t it? From just the CT results, we can’t figure out what caused the bowel obstruction."

"Whether it’s a mass, adhesion, or just simple bowel dysfunction, we can’t see it, too frustrating. What’s your opinion?"

"I’m a bit frustrated too; the indicators aren’t very clear right now. Although it shows a bowel obstruction, he has a long medical history. Rushing into surgery might treat the symptoms and not the root," Liu Banxia voiced.

"Should we give some medication and do an MRI scan? Judging by the current situation, I’m not very confident. We can at least draw blood for pre-surgical examination."

"That sounds good, let’s administer some midazolam to try to support the MRI," Xu Hui said.

"Alright, let’s go with that," Liu Banxia agreed.

There’s really no other choice. If the CT images were clear, this trouble could be avoided.

It’s not the patient’s fault, after all, vomiting is a physical reaction that not everyone can overcome with willpower.

Midazolam does have some effects on medication, but with the patient’s current condition, medication has to be continued. Otherwise, during the next scan, the body might still move.

However, this time Liu Banxia didn’t need to follow up; putting the medical advice down is enough, and the nurses will organize everything.

"What do you think is happening? Could there be a mass inside the bowel?" Xu Hui asked.

"I think it’s unlikely, even though it isn’t very clear," Liu Banxia replied.

"I’m leaning more towards bowel function issues, given his long medical history. If it were due to a mass or adhesion, what would it have developed into by now?"

"But if that’s the case, is it an issue caused by the bowel itself or by other conditions?" Xu Hui murmured.

"Actually, I wanted to do a gastroscopy, but his vomiting response was so strong I gave up. If the MRI doesn’t reveal other issues and just shows bowel obstruction, what then?"

"We can only operate to resolve the bowel obstruction," Liu Banxia said.

"The patient’s pain intensifying and temperature rising is not a good sign. If we don’t address it, I worry there’s a possibility of bowel necrosis, which would be troublesome."

Xu Hui nodded, acknowledging Liu Banxia’s reasoning.

"Teacher Liu, this is the wife of the patient you just saw," Liu Yiqing led a woman over.

"He’s undergoing an MRI now. Based on the current situation, we don’t rule out the possibility of surgery; his bowel obstruction is quite severe," Liu Banxia explained.

"Sigh... he’s been saying he has stomach pain and nausea for the past two years, and we haven’t figured out the exact illness," the patient’s wife sighed.

"It’s affected daily life quite a bit, hasn’t it? Have you noticed any other symptoms?" Liu Banxia asked.

"Nothing else, just frequent stomach pain and not daring to eat much. He hasn’t been able to work outside, staying at home for over a year now," the patient’s wife explained.

"Head to the MRI room to find him. During the CT scan, there was a vomiting reaction, so those images are blurry, needing a redo," Liu Banxia said.

The patient’s wife nodded and headed directly to the MRI room to find him.

"Prepare the operating room; the small bowel obstruction will soon need surgery," Liu Banxia addressed Liu Yiqing.

"Alright," Liu Yiqing responded.

"What do you think, do you lean towards any particular judgment?" Xu Hui asked.

Liu Banxia shook his head helplessly, "This patient, really, I’m confused. Could it be a blood supply issue causing this? But even then, it couldn’t have developed so slowly."

"The current problem is that his medical history is rather long, making it harder to judge. Let’s wait for a moment and discuss further once the MRI results come out."

"Let’s give it a try—predict something like a divine prophecy," Xu Hui suggested.

Liu Banxia shook his head vigorously, indicating that it was impossible to predict anything for this patient. If the CT were clearer, maybe a prediction could be attempted.

The reasons for causing intestinal obstruction are simply too many; it’s genuinely hard to guess.

After waiting a bit longer, the patient’s MRI images were ready.

Upon receiving the notification, Xu Hui hurried to check them on the computer.

"Goodness, there’s a lump at the distal end of the pancreas; it doesn’t look very large. Could this lump be the cause?" Xu Hui asked.

Liu Banxia furrowed his brow, "Given the current situation, this possibility does exist. Pancreatitis can also cause symptoms like abdominal pain and vomiting, although the patient doesn’t have back pain."

"But the lump isn’t very large, and the patient’s medical history is quite lengthy. If it were truly impactful, why is it only this big after so long?"

"Anyway, my personal inclination is quite strong towards chronic pancreatitis triggered by this lump, leading to weakened intestinal movement and consequently intestinal obstruction," said Xu Hui.

"It might be that it was too small earlier on and wasn’t detected in checks at other hospitals. Do you think this possibility is significant?"

"The possibility is quite significant, but this surgery is much riskier than an intestinal obstruction surgery," Liu Banxia said helplessly.

He’s performed a fair number of pancreatic surgeries, yet he remains cautious when it comes to operating on the pancreas.

However, given this patient’s unique condition, the intestinal obstruction is quite severe and absolutely requires surgery. If we don’t address the lump for now and it’s truly the triggering factor, a surgery will eventually be necessary.

But the pancreas is incredibly fragile, with a significant chance of complications, so careful consideration is essential.

The best course is avoiding surgery if possible; conservative treatment is optimal. Surgery would only be considered when absolutely necessary.

"Let’s speak with the patient when they return," Liu Banxia suggested.

"The patient certainly has no other thoughts; he’s already overwhelmed by the pain," Xu Hui said.

After waiting a bit more, the patient’s wife returned, pushing a rented wheelchair.

"How’s the pain now?" Liu Banxia asked.

"It’s unbearable, it’s excruciating," the patient replied.

"Come, lie down on the examination bed, let me take a look again," Liu Banxia said.

"Doctor, can we directly view the MRI results here?" asked the patient’s wife.

"Yes, we can view them directly. There’s indeed a new development. There’s a small lump at the distal end of the pancreas; this lump might likely be the cause of your symptoms over these years," Liu Banxia said while examining the patient.

"You must decide now whether to undergo this risky surgery. Pancreatic surgery carries significant risk. But your abdomen is now quite rigid and your fever is rising rapidly; the intestinal obstruction must be addressed."

"Doctor, is this lump cancerous?" the patient’s wife asked anxiously.

"We can’t determine that currently; it appears to be a tumor, likely benign. If it were a cyst, it wouldn’t fit the current symptoms over such a prolonged period," Liu Banxia explained.

"Typically a biopsy should be done to make such determinations, but given his critical state, immediate surgical intervention is necessary. Any delay could jeopardize the safety of the intestines."

"Do it, do it—what if it’s cancer? Just get it removed. Will it be very expensive? I’ll go save money now," the patient’s wife said.

"Alright, we’ll prepare immediately and have someone brief you on the surgery," Liu Banxia responded.

"Liu Yiqing, proceed with preoperative preparations for distal laparoscopic pancreatic resection, preserving the spleen. Administer antipyretic and analgesic treatment now, then send him to the operating room."

"Once preparations are complete, explain the surgery process to the patient’s family and have them sign the confirmation form. I’ll also start my preparations; we must hurry up."

Liu Yiqing nodded and quickly got to work.

Liu Banxia hadn’t expected to take on such a substantial task right upon returning. The initial intestinal obstruction case has escalated to distal pancreas resection.

Given the patient’s rigid abdomen and serious fever, there isn’t much time left to explain things thoroughly to the family.

If the CT were clearer, there might be more time, but as it stands, time is minimal.

Xu Hui felt deeply moved; this is Liu Banxia we’re talking about—able to operate on such short notice. Otherwise, to undertake such a significant surgery, who else would do it?

The patient is fortunate in a way; had they come yesterday, Liu Banxia wouldn’t have been here.

At least he’d have suffered more pain, waiting for Zhou Shuwen or an inpatient department doctor capable of the operation to arrive.