Yi Zewen continued to do physical examination, and when he pressed his hand on his abdomen, he found that there was obvious tenderness in the right lower quadrant.

This is McFarland's point, which is the tender point of the appendix. What is hidden underneath is usually the appendix. Obvious tenderness here usually means that the appendix underneath is inflamed or even invades the local abdominal wall.

Out of a sense of responsibility, Yi Zewen also took out his stethoscope and listened to the bowel sounds.

The bowel sounds are slightly more active, but there are no obvious hyperactive bowel sounds. If the bowel sounds sound very active or even hyperactive, it means that there may be intestinal obstruction.

Therefore, intestinal obstruction can also be ruled out.

Yi Zewen breathed a sigh of relief when he thought of this. After all, if he encountered a patient with intestinal obstruction in the middle of the night, he would have to undergo major surgery, so he couldn't sleep well that night.

Originally, Yi Zewen wanted to call the B-ultrasound doctor for a check-up, but when he thought that the B-ultrasound doctor was a female doctor, she was tired after a busy day, so he wanted to take care of her and decided to do a few clinical tests by himself.<

/p>

There is a test that can assist in the diagnosis of appendicitis, called the colon aeration test.

Just put the patient in a supine position, use your right hand to compress the patient's left lower abdomen, and then use your left hand to squeeze the proximal colon. The gas in the colon can pass to the cecum and appendix.

If the appendix is ​​inflamed, the pain in the right lower abdomen will worsen.

Yi Zewen's movements were as fierce as a tiger's, and his movements were neat and smooth, taking less than 10 seconds.

When the doctor squeezed Adem's colon with his left hand, Adem couldn't help shouting, "It hurts, it hurts~~~~"

When Yi Zewen saw that the colon aeration test was positive, he was almost certain that the appendix was inflamed.

Adem still has some medical knowledge, and endured the pain and asked: "Doctor, do I have appendicitis?"

Yi Zewen took off his gloves and replied:

"The high probability is yes, but examinations are still required for evaluation. For example, to rule out the possibility of intestinal obstruction, kidney stones, gallbladder stones, etc. Diseases are ever-changing. Without examinations, there is no evidence, and without evidence, there is no treatment."
p>

"Doctor, I forgot to tell you. I have had a hernia before and have never had surgery. Do you think this could be the problem?"

Adem suddenly remembered something and added.

"Holy crap, this is a huge signal."

Yi Zewen couldn't help but exclaim, thinking that maybe the patient's abdominal pain was not appendicitis, but a hernia.

After all, he was new to the country, and the organization's boss told him every day that he had to be careful when treating international friends, otherwise he would easily be liable for diplomacy and cause disputes between the two countries, so Yi Zewen was very timid.

He was afraid that he would be doomed if he got a misdiagnosis, so he planned to ask carefully.

"Sir, did you have an indirect hernia or a direct hernia?"

"I don't know, it seems to be an indirect hernia. I remember hearing the doctor say that I had a swelling here two years ago." Adem pointed to his right groin.

"When it was severe, the vaginal area was severely swollen, but later it became smaller on its own. The doctor originally ordered surgery, but later the condition improved and no surgery was performed. In the past two years, the swelling has not increased again."

You may not understand what a hernia is, please explain.

When an organ or tissue in our body leaves its normal anatomical position and enters another part through some congenital or acquired weak points, defects or gaps, it is called a hernia.

Common people are used to calling it "hernia" or "intestinal gas".

There is a potential gap in our groin, because semen passes through here and enters the vagina. If the intestines and tissues in the abdominal cavity also squeeze into this gap, come to the surface of the body, and even fall into the vagina,

This is an indirect inguinal hernia.

The clinical manifestations of indirect inguinal hernia are mainly a protruding mass in the groin (which may be intestines or other tissues), and a little swelling and pain. In addition, there may be no other discomfort.

If the mass can automatically retract into the abdominal cavity without causing incarceration, it generally will not cause major problems.

But if the mass is stuck, unable to move, or becomes larger and larger, it may cause compression and ischemia. Over time, the pain will worsen and even ischemic necrosis, which will be troublesome.

Change the source app and view the latest chapters of this book on multiple sites at the same time.】

Ordinary people in Haidong Province like to call this disease "big follicle", which shows that the incidence rate is quite high.

Clinically, there is nothing to say when encountering an indirect inguinal hernia. If you catch one, do an operation, repair the weak area directly, block the outlet, and naturally the disease will not occur again.

Yi Zewen was sweating profusely and carefully examined the patient's right groin area again, and found that except for the McBurney's point tenderness in the right lower abdomen, there were no swollen masses around it, and the vaginal area was also in good condition with no signs of swelling.

.

"It's not like abdominal pain caused by an inguinal hernia attack," Yi Zewen said to himself.

So he said to Aunt Hei with a firm tone: "I think acute appendicitis is the most likely possibility, and we'd better perform surgery immediately."

Generally speaking, if appendicitis is diagnosed, surgery can be considered unless there are contraindications. Even if you do not have surgery for the time being, surgery will inevitably be required in the future for appendicitis.

Acute appendicitis can be cured immediately by surgery to remove the appendix and prevent future troubles.

"Okay, okay, everything depends on you, doctor!"

The attitude of the family members was very cooperative. Appendicitis was not a serious illness anyway, and Adem and his wife both breathed a sigh of relief.

Chen Qi had just finished playing cards at this time, and because he was worried about Yi Zewen facing "international friends" alone, he was ready to take a look in person.

He came to Africa because of a medical accident, so it was inevitable that he would have some shadows in his heart.

If this causes any more trouble in Africa, it will be a serious international dispute. Then Chen Qi feels that he will definitely be assigned to the Antarctic Great Wall Station.

"Xiao Yi, how is the situation?"

Yi Zewen was just writing medical orders when he saw Chen Qi coming and shook his hair and said with a relaxed expression:

"Dean Chen, no problem, it's a small case of appendicitis, just a small operation. Oh, by the way, this patient said he had a hernia before."

Appendicitis? Hernia?

Chen Qi's heart skipped a beat. Although the two diseases have typical symptoms, they are very easy to distinguish.

But the problem is that if the disease is atypical, these two diseases are very easy to cause misdiagnosis, which is not uncommon in clinical practice. It would be fun to get it wrong.

So Chen Qi decided to check it again himself.

Mrs. Adam became dissatisfied when she saw a young doctor coming and touching her belly.

"Little doctor, my husband has been diagnosed with appendicitis. Please don't repeat the examination. This will make my husband's discomfort worse."

Before Chen Qi said anything, Yi Zewen ran over immediately:

"Madam, there is a misunderstanding. This is the best surgeon in China. He is also a double director of the International Medical Association. He is also the vice president of our China-Serbia Friendship Hospital. He can diagnose and treat Mr. Adem. You will definitely

You can rest assured."

Adem and his wife were a little stunned for a while, what they were thinking was, such a young vice-dean?

However, both of them had a palace, so they quickly smiled and said: "It turns out to be Dean Chen, so I'll trouble you."

Chen Qi also smiled and said, "It's okay. I'm often misunderstood and I'm used to it."

Hahaha, the atmosphere at the scene has relaxed a lot.

Chen Qi is not like Yi Zewen looking for a needle in a haystack. His goal is very clear and he directly hits the Mai point.

Adem cried out in pain again.

Chen Qi carefully checked some of the groins and vagina. These areas appeared normal and had no abnormal bulges. It seemed that the possibility of hernia could be ruled out.

Just when Chen Qi thought it was a minor illness, he unconsciously pressed his hand gently around Max's point.

When he pressed to the inner ring opening (2cm above the midpoint of the inguinal ligament), Adem suddenly shouted loudly:

"Ah doctor, it hurts here, it hurts..."

Chen Qi's eyebrows twitched, and he suddenly felt a little excited. He repeatedly pressed his fingers on the two places of Max's point and the inner ring mouth for comparison.

"Sir, of these two places, which one do you think hurts more?"

"The lower part hurts more."

At this time, Chen Qi said to Yi Zewen: "Something's wrong. It's not necessarily appendicitis. There's something wrong with the pain point."

"What's the problem?"

At this time, the door to the rescue room was pushed open, and several black uncles in suits came in.

In this country, people who can wear suits obviously have a certain status. If you ask if there is any problem, it is the black uncle who takes the lead.

Seeing the person coming, Mrs. Adam rushed forward, grabbed the black uncle, and said anxiously:

"Piette, my brother, you are finally here. Your brother-in-law has a severe stomachache. This Chinese doctor said it was appendicitis, but this doctor Chen thinks there are other problems. Please help your brother-in-law have a look quickly."<

/p>

This middle-aged man named Piet comforted Aunt Hei, and then walked up to Chen Qi.

"Hello Dr. Chen, let me introduce myself. I am Pieter, a surgeon at the National Hospital in Freetown. I once worked at Newster Hospital in England. The patient is also my brother-in-law. Nice to meet you."

Chen Qi thought to himself, what kind of hospital is this? I have never heard of it. But he smiled and shook hands firmly: "Good evening, Doctor Piette."

"Can I diagnose my brother-in-law?"

Chen Qi shrugged and made a gesture of invitation.

I saw Piette conducting a comprehensive examination of the abdomen again. From a professional perspective, Chen Qi felt that he did it meticulously and seriously and should be praised.

When he pressed on Max's point, he found that there was obvious tenderness and rebound pain. This symptom was so typical that it was exactly the same as in the textbook.
To be continued...