"No, I mean the child's name. How old is he?" Kraft quickly filled in Gris's name in the family column, indicating the patient's father.
They were sitting in an empty classroom. Lucius was sent to find two blankets. It would be uncomfortable for the patient to lie on the hard bench. The students who followed were blocked behind them and allowed enough space.
.
The paper in his hand was pulled from the copy paper, with the second volume of "Human Structure" underneath. The student next to him handed him an ink bottle with a wink. The tip of the pen quickly sketched on the paper and wrote:
The words are connected into a string.
Although Kraft's handwriting is indeed good, the consultation records he wrote were always crooked. I wonder if it was affected by some mysterious force.
"Liz, her name is Liz." Gris was a little frightened and answered Kraft's question in a low voice and quickly, as if Kraft would let her go if she was slower, "She is three years old this year."
The large group of men in black robes put a lot of pressure on him. They had already moved back a little as requested, but it still made the bright classroom feel more eerie and scary.
"What's wrong?" Kraft asked while turning his head to look at the child lying on the chair. It's really hard to tell the gender of a child of this age. If you think about it carefully, you do sometimes see this in the pub.
He was a child, but a pair of nondescript clothes made him always think he was a boy.
When this topic came up, Gris looked like he was about to cry, his eyes were red, but he still controlled his emotions and described the situation he knew in the clearest way possible.
"She seemed to have eaten something two days ago and had diarrhea. She thought she would get better in a few days, but she didn't expect her stomach to hurt even more this morning. She was so painful that she couldn't say a few words.
I took her to the church to ask for some holy water before, and also went to a clinic and drank herbal soup, but it was of no use."
"What herbal medicine?" Kraft asked. He knew that the holy water was just purified water that had gone through some strange rituals. It was not that he had never drank it when he was a child. As a placebo, it was harmless to say the least.
It's hard to say about herbal medicine. Few doctors who open clinics outside are college graduates. All kinds of folk remedies are rampant and they dare to add anything to the medicinal soup.
This is not the kind of syndrome differentiation and treatment method of traditional Chinese medicine. The treatment method of Wendenggang amateur doctors is not so much for human use, but more similar to some green-skinned things that grow out of the ground. The main guiding ideology is "
I'm thinking about it."
"Sorry, I don't know..." Gris was at a loss. "The priest said it was because I didn't believe in the Lord wholeheartedly. Shouldn't I let her drink those herbs?"
This nearly middle-aged man scratched his head in pain and almost pulled out his hair. In his eyes, this was a sign of death, and he might lose his only child.
"I didn't mean that." Kraft held his shoulder and tried to calm him down. "It doesn't matter if you don't remember. I have other questions to ask you."
…
…
It has to be said that Gris is the kind of parent that doctors like most. In the panic and fear about his daughter's condition, he was quite calm, allowing Kraft to quickly ask for relatively complete information.
The patient is Gris' three-year-old daughter Liz. She suddenly developed fever and diarrhea two days ago, and her stool was as loose as water.
This is not a strange thing. It is completely normal for children of this age to have a stomachache for no apparent reason. Most of the time, parents don't care too much.
As a father who pays close attention to his children, Gris even took time to go to church to pray and brought her back some holy water.
However, one day after drinking the holy water, Little Liz's condition did not improve, so the worried Gris took her to a nearby clinic and asked the doctor to prescribe a dose of herbal decoction.
Looking at the unusual color of the decoction, Gris decided to let Liz try it, but she died after trying it. Early this morning, Liz's abdominal pain, which was not serious at first, rapidly worsened, and she did not pass much feces, but she still had
Bloody.
Anxious Gris took Liz to the church and clinic, but the priest just said that in this situation, he could only pray devoutly and wait for God's will. The doctor at the clinic was even more helpless and just wanted to remove it.
As someone who has owned a tavern next to the college for a long time, the last thing Gris could think of was to ask for help from people he knew in the college. Otherwise, he could only wait to see if Liz would miraculously recover on her own.
"I need to do a check-up, can I?" Kraft finished writing down the current medical history and basic information on the paper. There were only a few words about the past history and family history. He only knew that Liz's mother also died of a sudden illness.
Lisi couldn't tell what the illness was, but Lisi had never had any serious illness since she was born.
"Okay, thank you." Gris nodded quickly. He didn't understand why he had to ask for instructions, but judging from Kraft's attitude, he should take over.
"I mean a comprehensive examination that involves touching the entire belly, including the top of the thighs." Kraft glanced at the group of students behind him and felt that he had to explain it first, "I don't think this is suitable for too many people to watch. Mr.
Hey guys, can you avoid it for a while? You can take this time to review why I have to ask so many questions."
"Well... no problem." Gris hesitated but agreed, preparing to go out with the students. Perhaps it was Kraft's serious attitude that gained his trust, so he did not raise any questions.
"Grice, come back. I'm talking about them. The family members will stay with you and help comfort the child." The students quickly left the scene, and Kraft pulled Gris to the side of the child and began to examine it.
Kraft lifted up her hair and touched Liz's forehead. The temperature was not high. The child's face was full of tears. If she wasn't crying, she probably had been crying for a long time and couldn't cry now.
In fact, he already had some idea in his mind. This kind of thing is one of the things that he likes to talk about in diagnostics-acute abdomen, which is commonly known as "Doctor, I have a stomachache." Even if Kraft is not given extraordinary memory, he can
Be able to use the content skillfully.
A 3-year-old child has had diarrhea and fever for two days. It may be a digestive tract infection caused by some pathogen. It is very common in Wendeng Port where seafood is everywhere.
But today's situation is probably not due to aggravation of infection. The sudden decrease in bowel movements and the presence of blood are probably caused by an obstruction.
Kraft touched the abdominal wall, which looked normal, and felt no obvious tightness or stiffness when he pressed down.
This made him feel a little relieved. It seemed that it was not serious enough to cause leakage of fluid to irritate the peritoneum. Maybe it was not serious.
Following a fixed direction, he quickly found evidence to support his point of view. It was a mass on the right lower abdomen, which felt somewhat similar to a sausage.
The situation was okay, and Kelat was completely relieved. It must be intussusception. At this location, we can make a bold guess that it is ileocecal intussusception.
At the junction of the small intestine and the large intestine, a section of the ileum in the ileocecal part was inserted into the large intestine. One layer of the wall changed into several layers, causing obstruction on the spot. This is not uncommon for children who are prone to intestinal disorders.
One of the most common acute abdominal diseases treated by surgery.
This unlucky child may have had viral diarrhea, which itself is a risk factor for intussusception, and then he drank some weird herbal decoction, which naturally led to intussusception.
This diagnosis process was quite smooth, allowing Kraft to find a bit of the feeling of responding to the teacher's questions in a case discussion class, and confidently giving answers after finding all the evidence.
Logically speaking, the next step is to confirm the diagnosis through imaging examinations, but unfortunately there is no B-ultrasound here, and we cannot do standing abdominal X-rays. Don't even think about a 100% diagnosis.
He covered the child with clothes again, picked up a pen and paper and wrote out "preliminary diagnosis" at the end of the page. He combined the words "intestine" and "introduction" in Norse, and reserved a line at the bottom.
space.
When he has free time, he has to add a line of explanation below. Ever since he became a lecturer, he has to leave space for noun explanations everywhere. It has almost become an occupational disease.
He raised his head and explained to Gris: "You can understand that one section of her intestines was inserted into another section, and then it was blocked. Do you remember when she started to feel pain?"
"Probably before the bell tower rang twice, I took her to the church. I can't remember the exact time."
That was probably between an hour and a half to two hours, which is a great blessing among misfortunes. If it is discovered in time, even if you go to the church for a walk first, this time period is not yet to the extent of intestinal necrosis. With non-surgical solutions
It can be solved.
So what is the non-surgical option?
"No..." Kraft murmured, and his worries that had just been put down were immediately raised again, just like when he was stuck at the last step of a high-level math problem and found that everything was fine, but the calculation amount was not enough.
Not coming out.
"What's wrong?" Gris also became nervous. It was clear that Kraft had just explained the cause of the disease to him, but now things seemed to be complicated again. The most feared thing at this time was that the doctor pretended to be "smile gradually disappearing"
expression.
Kraft did not answer him. A serious question was in front of him, blocking the final way.
For the current situation, the standard answer he knew was air enema, which could easily resolve most early-stage acute intussusceptions like Liz's.
But this requires corresponding equipment. He is not a machine maker, and he has no idea how this thing can control the air pressure and inflate the intestines back to their original position without perforation.
Even if he knew how to make it, could he make a machine out of thin air? To put it bluntly, even if the God of the church appeared on the spot and created a machine for him, how could he do it without B-ultrasound, X-ray and other imaging
Check the case to confirm that the reset was successful?
The air enema plan didn't work, so the only traditional method left was that Kraft had to use surgery to get Little Liz back under the knife, using a traumatic but more direct and effective method to get the intestines back.
But if air enema is not possible, is it possible to perform surgery under these conditions? To perform surgery without anesthesia and without sterility, it would be better to pray to God to send an angel to send him an air enema machine.
