After the operation was completed, Ma En felt very happy. This laparoscopic operation was thrilling and exciting. In fact, it broadened his horizons and gave him a deeper understanding of laparoscopic appendectomy.

Looking at the Tanglou in front of him, Ma En felt complicated. After a long while, he sighed: "Tanglou, I am completely convinced that Dr. Qing chose you to be an assistant."

After finishing speaking, Ma En ran out of the operating room in a panic.

Tanglou naturally didn't care. After going to the dressing room to wash up, he returned to the office.

The second day.

Tian Linsheng, Tang Lou, and Ma En were each in the office, busy with their own affairs.

Wang Daquan walked in very puzzledly. Looking at the nonchalant Tanglou, he had an ominous premonition and quickly walked towards Ma En.

Yesterday, after he calculated the time, he didn't answer Ma En's calls or respond to messages. Could it be that the matter of making things difficult for Tanglou was exposed?

But Ma En looked very calm.

"Doctor Ma..."

As soon as Wang Daquan spoke, Ma En directly picked up a cup, took a sip of tea, and looked away.

Wang Daquan realized that the situation was not good, so he walked to the other side and called out kindly: "Doctor Ma..."

Ma En stood up directly and looked at Tanglou: "Tanglou, Dr. Qing just called me. In half an hour, there will be a small consultation in the office. There is a patient with appendicitis who needs to discuss before surgery. Dr. Qing is roughly

I recognized typical appendicitis, but I still have some strange feelings, but I can’t find it. So I’m going to take a look at it together.”

"You, me, Dr. Qing, and Dr. Song Yang will also come together. This is the patient's medical record. You can read it first."

"OK."

Tanglou came over and took the medical records.

Tian Linsheng on the side was a little envious. Department consultations used to be exchanges between the attending doctors. Since appendicitis surgery was relatively minor, Ma En, as a resident doctor, also had the opportunity to participate in the discussion.

This time, another Tanglou was added. Obviously, in Dr. Qing's mind, Tanglou has been elevated to the level of a resident doctor and has the right to speak on appendicitis cases.

"Awesome."

After sighing, Tian Linsheng continued to work hard to type in the medical records.

"Ahem..."

Wang Daquan couldn't hold it in any longer and coughed violently.

Ma En then looked at him, but his eyes were very cold: "Wang Daquan, after discussing with Dr. Qing, Dr. Qing, Tanglou will be the first assistant for all my surgeries. Of course, Tanglou will also have its own

The first assistant in charge of the operation is Tian Linsheng. As for you, from now on you will be responsible for the research on the use of laughing gas in dressing changes for burn patients before Tanglou. In the next six months, you will go to change the pharmacy."

Wang Daquan suddenly heard a bolt from the blue: "Doctor Ma, what happened yesterday? It shouldn't be him..."

Wang Daquan glanced at the Tang Tower and had something to say.

Ma En did not answer the question, and did not want to talk about yesterday's events anymore. He scolded seriously: "Wang Daquan, do you want to hear me say it again, or ask Dr. Qing to come over and tell you again?"

"I..."

Although Ma En is usually very kind, after all, he is a resident doctor and is one level higher than Wang Daquan. Under such severe conditions, Wang Daquan did not dare to talk anymore.

After all, there is plastic friendship in the workplace. Wang Daquan can't bear to accept it and has no choice but to say: "I understand."

Watching Wang Daquan walk out of the office, Ma En shook his head. In the hospital, either you have superior technical skills or you have a strong backend.

It's a pity that Wang Daquan didn't occupy any of them, and the Tanglou...

Ma En thought about it all night last night, and he has long understood that having the friendship of Tanglou in the general surgery department is the wisest choice.

Moreover, Tanglou's technology really benefited him a lot.

"Dr. Ma, I want to go to the ward first to prepare for the next consultation."

Tanglou read the information carefully and found that the symptoms and color ultrasound did look very similar to typical appendicitis symptoms. However, since Qingping's intuition smelled something unusual, it was worth seeing the patient in person.

"Then I'll go take a look with you, and I'll get to know the patient's condition in advance."

Ma En picked up the medical records and stood up.

Tian Linsheng's fingers were hanging on the keyboard, and he typed a few times. His ears did not dare to miss a sentence of the conversation between Tanglou and the others.

"Okay, stop pretending. Just type the keyboard. You can come with Tian Linsheng. Let's go together."

"Okay!"

Tian Linsheng chuckled, and immediately came over, taking the notebook and pen from Tanglou's hand, as if he was guarding them with a knife.

Among the three of them, Tang Lou was walking faintly. Looking over, Ma En and Tian Linsheng were holding notebooks with information, while Tang Lou was looking relaxed.

Looking at it from the front, Tanglou has the feeling of a chef with two younger brothers.

Soon the three people arrived at the ward.

The patient is a 48-year-old middle-aged woman, and her daughter is by her side.

"doctor."

Seeing Tanglou and the others coming over, the patient's daughter Hu Jingjing stood up, said hello, looked at Tanglou between them, and was slightly surprised.

At first glance, of course, he is so handsome.

The second thing is that this doctor is so young, he looks similar to me, and he already has two assistants.

The third thing is that she blushed. After all, Tang Lou was so handsome, and with the bonus of the white coat, she couldn't take her eyes away.

After regaining her composure, Hu Jingjing stepped aside: "Dr. Qing came to see me just now. The initial diagnosis was appendicitis. He said that he would decide whether to operate after discussion. Are you here to check my mother's condition?"

Because Qingping had done a good job in comforting him before, the patients and their families had a relatively stable mentality, and appendicitis was just a minor surgery in the minds of most people.

Tanglou said nothing and walked directly towards the patient.

Ma En originally wanted to speak, but seeing that Tang Lou had already walked up, he did not deliberately try to steal the limelight, and he also wanted to see what Tang Lou was capable of.

Tanglou naturally used diagnostic techniques directly:

[Patient: Wang Xiufen, female, 48 years old

Symptoms: Mainly due to metastatic right lower quadrant pain, I was admitted to the hospital for 1 day.

There was no obvious trigger for epigastric pain 1 day ago, which transferred to the right lower abdomen a few hours later. The abdominal pain was persistent, paroxysmal and intensified, accompanied by fever, without nausea or vomiting. He had a history of right oophorectomy for 20 years and a history of gastric cancer for 2 years.

a.

Vital signs: T 39.0 ℃, P 96 times/min, R 19 times/min, BP 120/80 mm Hg.

The abdomen was slightly distended, and a 6 cm longitudinal surgical scar was visible in the middle of the lower abdomen; tenderness, rebound tenderness, and mild muscle tension were present in the McFarland point area of ​​the right lower abdomen; there was no shifting dullness on percussion; bowel sounds were normal. WBC 18.6×109/L.

Special reminder: The patient’s physical examination symptoms can easily be misdiagnosed as typical appendicitis.

The patient had a history of surgery and gastric disease before. The lumen formed by adhesion after surgery may be mistaken by the sonographer as the blind end of the appendix.

In addition, the exudate after appendiceal gangrene flows to the right lower abdomen through the paracolic groove, causing tenderness in the right lower quadrant, rebound tenderness and other typical appendiceal symptoms.

Diagnosis: The patient has congenital colon variation. The patient's ileocecal region is tightly adherent to the liver, and the appendix is ​​wrapped by the omentum. The appendix cannot be detected by conventional McLaren incision. Conventional laparotomy can only detect the appendix by expanding the wound upward twice during the operation.

If it reaches the appendix, there is a risk of infection after surgery, and the scar will be too long. Laparoscopic appendectomy is recommended.】

After reading Tanglou, I was a little surprised. One was the patient's condition. It was such a coincidence. Who would have thought that the shadow seen by the color ultrasound was not the blind end of the appendix, but the official cavity formed by adhesions after surgery.

In addition, the patient was born with a congenital colon mutation, and the appendix grew under the liver. By chance, the exudate flowed to the right lower abdomen. If a McLaren incision was performed as a typical appendix, the consequences would be disastrous.

Tanglou briefly examined the patient's private parts: "I already know the cause of the disease, let's go back and prepare for consultation."

Not wanting to waste time, Tanglou turned around directly.
Chapter completed!