Practicing Medical Skills in a Small Clinic

Chapter 602: Chapter 276: Investigate When Needed, Helping Score Number Two on the Leaderboard_2

Symptoms like lack of chewing power and ptosis can exclude myasthenia gravis or polymyositis.

Symptoms such as dry mouth and tearlessness can exclude Sjögren’s syndrome.

"Achalasia can also have similar symptoms! Is there a possibility of concurrent esophageal ulcer?"

Xiao Linlin hesitated a bit.

"Achalasia can cause difficulty swallowing, but it also leads to post-meal vomiting. The patient does not have vomiting symptoms after eating, so I believe the likelihood of esophageal cancer is greater."

Li Jingsheng appeared very rational, with an exceedingly clear thought process.

Listening to his analysis, Xiao Linlin secretly admired this young orthopedic doctor more than ten years younger than herself.

It’s truly unexpected that he’s not only skilled in bone setting but also outstanding in gastroenterology diagnosis.

Without further hesitation, she directly applied for an endoscopy.

After a while, Xiao Linlin relayed the information.

"Endoscopy was performed, and at about 29cm from the tooth gate, on the right wall of the esophagus, a localized erosion of about 1.2 by 1 cm was found, with clear boundaries and granular changes at the center."

Li Jingsheng was not surprised by the examination results.

From the outset, he suspected it could be esophageal cancer, and now two consecutive examinations both point to esophageal cancer.

The granular change at the center of the lesion indicates that cancer cells are rapidly proliferating. Malignant tumors are diverse, with almost all of them sharing a common feature: an irregular surface and peculiar shape.

Examples include squamous, granular, and irregular shapes.

"Was a biopsy performed? It’s basically confirmed as cancer now."

"The biopsy has been done, but the results are not out yet. The sample was sent for testing over an hour ago, so the results should be out soon. This also shows that Qiaobang Hospital’s gastroenterology doctor’s diagnostic approach aligns with yours."

Xiao Linlin whispered as she conversed with Li Jingsheng.

She highly admired Li Jingsheng’s diagnostic ability in the field of gastroenterology.

"Most gastroenterologists would likely approach it similarly. I suggest you wait for the biopsy results. If it is indeed esophageal cancer, then submit an application for an Endoscopic Ultrasound (EUS) examination."

Li Jingsheng told her.

"Didn’t the judges say to minimize examinations? I’ve already conducted several for the patient. With an endoscopy and biopsy, it’s completely sufficient!"

Xiao Linlin asked in confusion.

Conducting more examinations would mean losing points.

It’s a competition now; she doesn’t aim for the championship, but at least hopes not to come last.

An unconventional examination deducts 2 points, which is very disadvantageous for her.

"The judges advocate against excessive examinations to avoid wasting valuable medical resources and increasing the patient’s financial burden. I recommend this examination to differentiate whether the esophagus’s mucosal, submucosal, muscular, and external layers have all undergone pathological changes, and to determine the extent of lesion infiltration. It can also observe the lymph nodes surrounding the esophagus and the posterior mediastinum, aiding in better differentiation of whether it’s a malignant lesion or if there’s mediastinal lymph node metastasis.

This will greatly benefit the formulation of the patient’s surgical plan.

It’s also being responsible for the patient’s life safety.

If there’s metastasis, the cleaning scope during surgery needs to be expanded, otherwise recurrence can easily occur.

Compared to the patient’s life safety, the cost of the Endoscopic Ultrasound examination is almost negligible. There’s no issue of occupying medical resources either.

All medical resources are meant to diagnose and treat patients.

Li Jingsheng spoke confidently, possessing his own set of thought and recognition.

On the contrary, Xiao Linlin was somewhat confined by rules and appeared too rigid.

In the words of Buddhism, it’s like saying to the female patron, you’re caught up in forms.

"Dr. Li is right, I’m indeed bound by convention. Let me tell you, before this expedition, the dean instructed me to strive for a good ranking to change the declining status of the second hospital’s gastroenterology department. The pressure is overwhelming, making me tread cautiously and act somewhat constrained."

Constrained by the number of participants, she’s fighting alone this time, being the only one from the gastroenterology department.

Also among the very young batch of chief physicians from the second hospital.

The clinical experience naturally can’t measure up to those older experts, coupled with the second hospital’s inherently weak gastroenterology department, with fewer patients.

The practical opportunities she gets surely don’t compare to those at strong hospitals like Class-A’s.

Especially with complex cases, hard ones are unsolvable, normal ones don’t significantly improve diagnostic levels.

It’s understandable why she’s so tense.

"I totally understand. If Director Xiao is willing, I can act as a temporary assistant for you."

Li Jingsheng decided to assist this young female chief physician.

Everyone’s a doctor at the second hospital, with little interaction usually.

Improving relations with her this time is quite good too.

If there’s anything needing help in the future, she would be enthusiastically willing to offer Li Jingsheng assistance.

"Really? That’s great, can you sit next to me? It’ll be more convenient to discuss cases."

Upon hearing this, Xiao Linlin couldn’t help but feel thrilled.

Due to unfamiliarity with Li Jingsheng and being thin-skinned, she felt embarrassed to ask Li Jingsheng to be her assistant.

Knowing that Li Jingsheng has already won two gold awards for the second hospital, his position will undergo a dramatic change upon returning.

No one will dare to treat him as an ordinary attending orthopedic surgeon anymore.

His status will at least be equivalent to an ordinary chief physician.

"No problem!"

Li Jingsheng stood up, crouched, and walked to the front row, sitting beside her.

The back row is quite vacant; the venue itself is large, and more empty seats are arranged when seating.