Practicing Medical Skills in a Small Clinic

Chapter 601: Chapter 276: Investigate as Needed, Go Straight to Rank 2

The Second Hospital did not send anyone to participate in the next two competition events.

The skills are not enough, sending someone up there would only be embarrassing.

Such things are rarely done by anyone.

Almost all larger hospitals value their reputation greatly. They are determined not to do anything that could cause negative impacts or expose major shortcomings of the hospital.

Li Jingsheng sat in the audience watching, and gained some insights.

Observing how experts from other hospitals diagnose and treat can be very inspiring.

"Today’s sixth competition event is the diagnosis and treatment of digestive diseases that many doctors have been looking forward to. However, there is one difference from other events; considering that internal medicine primarily relies on medication, we have intentionally placed the digestive surgery competition event after gastroenterology. If gastroenterology diagnoses the cause and digestive surgery needs to remove the lesion, then digestive surgery can come on stage."

The distinction between internal medicine and surgery lies in internal medicine primarily using medication and therapy to treat, almost capable of handling most diseases.

Surgery relies on operations as the main treatment method, supplemented by medication.

It’s not as commonly misunderstood by the public that surgeons only know how to use the scalpel and cannot diagnose or prescribe.

From a development perspective, surgical treatments are becoming increasingly important.

For example, exploratory surgery, early removal of cancerous tissue, necrotic tissue removal, and the connectivity of nerves and intestines, etc.

These are the specialties of surgery.

Many diseases cannot be treated by internal medicine, sometimes even delaying the condition.

Internal medicine doctors have also recognized this issue, so in recent years, interventional surgery has quietly developed into a surgical treatment method within internal medicine. It causes less trauma, has good effects, and short recovery time.

This makes interventional surgery more popular among patients than traditional surgery.

Surgery, seeing internal medicine come up with a ’secret technique’ threatening to take their bread away, are anxious!

Surgeons, hoping not to be eliminated, choose to keep pace with the times and drew inspiration from interventional surgery to develop minimally invasive surgery.

So, competition is indeed a good thing.

It can become the drive for rapid progress in medical skills.

"Next, all gastroenterology doctors present, please diagnose this newly admitted patient."

As the host finished speaking, the large screen displayed the patient’s detailed information.

This patient is ill, which is unfortunate.

But having so many doctors and experts for a live consultation, this treatment can’t be found nationwide.

With the wisdom of so many experts gathered, even the most difficult illnesses can likely be diagnosed on site.

Patient: Male, 51 years old, worker.

Recently, while eating, consuming fruits or other solid foods, there is a strong sensation of choking.

Drinking water or porridge, or drinking soup also causes slight choking sensation, but not strong.

The feeling of choking during eating is accompanied by severe pain behind the sternum, somewhat similar to a burning pain.

No symptoms of acid reflux, burping, choking, nausea, or vomiting.

No weakness in chewing or hiccups.

No fever, weight loss, or fatigue symptoms.

Body temperature 36.6 degrees, pulse 80 beats per minute, breathing 21 times per minute, blood pressure 125/85 mmHg.

These baseline vital signs are all normal.

Li Jingsheng felt it was either a minor problem or a significant illness.

Considering the patient’s occupation and older age, the likelihood of a major illness is higher.

During the physical examination, no murmurs were heard in the valve auscultation areas, clear breath sounds in both lungs, and no dry, wet rales heard. The abdomen is flat, palpable without masses, and no tenderness or rebound tenderness.

No tonsillar swelling, no pharyngeal congestion upon examination, no sinking or protrusion of both eyes, and no palpable superficial lymph nodes.

The thorax is symmetrical, with no tenderness or pain upon percussion.

From these examinations, it can be essentially determined that the patient’s lesion is likely small in scope, and if it’s a major illness, it should be in an early stage.

The results of the patient’s routine blood, urine, stool, and two routine tests are mostly normal.

Results for serum creatinine, creatine kinase, blood urea nitrogen, and alpha-fetoprotein are all within normal range.

"This sure needs an X-ray barium meal test for further diagnosis!"

Li Jingsheng muttered to himself.

The gastroenterology chief physician Xiao Linlin sitting before Li Jingsheng heard him and immediately operated on her tablet.

Judging by the situation, she might have been undecided and aligned with Li Jingsheng’s thinking.

"The results from the requested examination came out. There is a wall-like change in the right side of the mid esophagus, approximately 1 cm by 0.7 cm."

Xiao Linlin relayed the results of the barium meal examination to Li Jingsheng.

The Second Hospital’s gastroenterology department’s strength was average, and Xiao Linlin had heard that Li Jingsheng was skilled in diagnosing complex cases.

Although this case is not a complex situation, everyone was racing to diagnose it, and time was precious.

Having Li Jingsheng assist in the brainstorming would be more efficient.

"It could be esophageal cancer! Suggest checking with an endoscope and take a biopsy sample."

Li Jingsheng’s gastroenterological diagnosis had reached a high degree of proficiency and skill.

He already had a preliminary diagnostic result in mind, and now hearing the wall change in the esophagus at one location, he was more confident in his initial diagnosis.

Upon hearing Li Jingsheng’s suggestion, she thought it over briefly and submitted the examination request.

Li Jingsheng’s clear diagnostic rationale and focused aim were due to the patient’s very singular symptoms.

Apart from the sensation of choking when eating, burning pain behind the sternum, there were virtually no other abnormalities.

The patient showed no obvious choking, articulation difficulties, effectively ruling out neurological disorders.