When the Doctor Uses A Hack-Chapter 888 - 889 The Overburdened Stomach
Chapter 888: Chapter 889: The Overburdened Stomach!
Chapter 888 -889: The Overburdened Stomach!
The car sped along!
Chen Cang also felt a sense of urgency in his heart.
“Dr. Chen, the patient’s temperature is now 39 degrees Celsius!”
Fever!
Chen Cang immediately furrowed his brow.
Inflammation?
Or infection?
That was the question.
No, perhaps both were issues!
At this point, the patient began to vomit again.
Large amounts of undigested contents poured out, mixed with blood.
Xiao Ke reacted quickly, catching it all with a bag promptly.
The sour, rotten smell permeated the small space; yet Xiao Ke, who was closest, showed no change in expression.
It seemed that this was just part of her job.
Chen Cang picked up his stethoscope and listened to the abdomen, finding that the bowel sounds had disappeared; tapping lightly, he discovered a problem!
The liver dullness boundary had disappeared?
Chen Cang furrowed his brow again!
A serious issue came to mind!
With that thought, he quickly performed percussion on Luns’s stomach.
The drum-like sounds of the gastric air bubble were gone.
This was…
Chen Cang, proficient in physical examination, knew the human body intimately.
Inside his mental four-dimensional model, he played out various clues, which were by now quite clear.
Although he hadn’t conducted any laboratory or imaging tests, the results were roughly guessable to Chen Cang, as the critical clues were now clear.
Diagnosis didn’t require doing every test; a successful emergency doctor must utilize the limited diagnostic techniques to achieve an effective diagnosis.
Chen Cang thought of a very likely disease, “Gastric perforation!”
If that was the case, then everything made sense.
Abdominal pain was the most direct and main manifestation and the most important symptom.
The pain was usually at the site of the perforation, often described as cutting or burning, generally persistent, though there were cases like Luns’s where the pain was intermittent and worsened in spurts.
Moreover, the patient’s vomiting was due to bacterial peritonitis and paralytic ileus.
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The current presentation was “toxic” symptoms!
After all, with a large volume of contents entering the abdominal cavity, bacterial peritonitis was a possible complication, and while Luns wasn’t in shock yet, Chen Cang estimated she wouldn’t last much longer.
The onset of paralytic ileus already indicated a severe infection within the abdominal cavity.
Chen Cang now placed his hand on Luns’s abdomen and immediately felt it was as hard as a board!
“Tense abdomen, board-like rigidity!”
This was Chen Cang’s first impression.
It was almost certain!
With this in mind, Chen Cang looked directly at a plump blond woman in her forties and said, “The patient is very likely suffering from acute peritonitis and paralytic ileus due to a gastric perforation. The situation is critical, and after arriving at the emergency room, we’ll need to complete the diagnosis quickly and proceed with surgery.”
“Can you sign for her?”
Trish nodded eagerly, explaining, “No problem, I can do it. I’m Luns’s aunt and manager—I have the authority to sign.”
“Doctor, you must save Luns, God, she’s only 24!”
“She should never participate in such a terrible competition again!”
Trish was very anxious, praying to God with her hands continuously.
Chen Cang actually wasn’t very familiar with competitive eating contests and couldn’t help but ask, “Does she often participate in such competitions?”
Tracy shook her head, “No, actually, while competitive eating contests are often held, for competitors like Luns, they generally participate in less than ten contests a year.”
“This time it was just commercial in nature, which could be related to her participating twice in the past month.”
“Who would have thought it would turn out like this! God, bless Luns!”
Chen Cang nodded his head.
In fact, competitive eating isn’t something innate, it requires continual practice afterward, practicing the stomach’s ability to distend.
Such an ability, in Chen Cang’s view, is utterly useless other than damaging the stomach lining!
Because adults’ stomachs are actually quite similar!
It’s not that your stomach is big and someone else’s is small.
The stomach itself is “astonishingly structured,” with tremendous elasticity, just like a “top-notch balloon.”
You inflate the balloon, and its capacity increases; likewise, the stomach’s capacity also changes with food intake.
However, the stomach’s elasticity is excellent, after all, it’s top-notch, and it is a biological structure, so there shouldn’t be much of a difference in size, as long as your food is emptied, the stomach will obediently return to its original size.
It’s like a one-size-fits-all stretchy pair of pants, looking like different sizes when worn by people of various builds.
But once you take them off, the stretchy pants return to their original dimension.
A normal adult’s stomach capacity is only about 50ml when empty and can reach 1.5L after eating, mainly due to the expansion of the greater curvature of the stomach.
The stomach’s volume gradually increases with age.
Of course, children’s stomachs are, in fact, quite small.
After a full meal, a newborn’s is about 7ml, reaching 300ml at one year old, 600ml at three years old, and an adult’s can be as much as 3000ml.
And competitive eaters don’t actually possess any special innate function; it can be trained afterwards.
But, generally speaking, no one trains to increase stomach capacity, after all, having such a large capacity is unnecessary.
Typically, only sumo wrestlers need this, who after special training can consume 10 to 20 times more food than the average person.
But… if you blow a balloon up too much, it’s definitely going to burst!
The stomach is not infinitely expandable; there is a limit, and if food intake consistently exceeds the limit of stomach capacity, the stomach wall muscles will be stretched thinner and thinner, leading to acute gastric dilation.
And if there is already a peptic ulcer, coupled with acute gastric dilation, then naturally, gastric perforation can occur!
Because ulcers are like wounds in the stomach!
There was silence on the way as Chen Cang’s eyes were fixed on the monitor; the decrease in blood pressure must have been caused by electrolyte imbalances and internal bleeding.
Thinking of this, Chen Cang picked up the phone, hurriedly contacted the hospital to quickly open the green channel and prepare the operating room.
Before long, the car stopped firmly at the emergency entrance, where people were already waiting at the door!
Chen Cang and Xiaoke pushed the cart down!
The staff accompanying the vehicle helped with the procedures.
Chen Cang was busy issuing various medical orders:
“Complete blood count, liver and kidney functions, blood type, coagulation functions…”
“Infectious disease screening!”
“Abdominal CT!”
“Chest radiograph!”
…
The emergency center really is a hospital that never stops, 24 hours a day, with every department ready to spring into action instantly.
Pre-surgical checks and preparation had already been completed, and the blood bank department had even delivered and started warming the required blood.
Everyone was busily working in a state of emergency!
After pushing Luns into the resuscitation room, Chen Cang said to Xiaoke, “Prepare for abdominal paracentesis!”
Now, they still needed to make a clear diagnosis through abdominal paracentesis.
Indeed, right after Chen Cang successfully performed the abdominal paracentesis, he withdrew a yellow, murky digestive fluid or food residue!
By this time, diagnosis was essentially confirmed!
Soon, the x-ray and abdominal CT results came in, allowing for direct diagnosis, with everything waiting on the physiological and biochemical results.
