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Yi Zewen continued to ask questions while writing outpatient medical records: "Have you had any vomiting or diarrhea?"

Cui Tongzhi refused: "No!"

"In addition to abdominal pain, are there any other pains? For example, is there pain in the lower back?"

Yi Zewen stared at the patient's face closely, trying to find some problems in his face, but he saw nothing except a slightly painful expression on the patient's face, and there was no pale complexion or yellowish skin.

The answer is all negative.

"Do you have high blood pressure, diabetes, coronary heart disease, etc.?"

Cui Tongzhi hesitated for a moment, but still answered firmly: "No, not at all."

Yi Zewen felt relieved after hearing this and said nonchalantly:

"It's probably ordinary acute gastroenteritis. I'll prescribe some medicine for you. You'll be fine after you go back and rest for two days."

But Cui Tongzhi refused: "Hey, Xiaoyi, are you going to give me a check list? What if there is something wrong with my stomach?"

Yi Zewen smiled: "Well, you old Cui, if you are so afraid of death, then you should go for an ultrasound. You will know if there is any problem after a scan."

In 1989, although ordinary people had enough to eat and had some spare money in their pockets, ordinary people who were used to living a hard and poor life were still reluctant to spend money.

A B-ultrasound costs 10 yuan, which is as much as five pounds of pork. Most patients don’t want to do it if they can.

But Cui Tongzhi works at the Post and Telecommunications Bureau, so he receives public medical care and is reimbursed by his employer.

Are there any tests? Get them done! Are there any good medicines? Go ahead! Health is the most important thing.

Of course, when you are so poor that you can only boil water and make cold meals every day, who cares about whether you are healthy or not?

Cui Tongzhi hurried to pay the bill while holding his stomach. Yi Zewen looked at his watch. Although it was already time to get off work, he was still prepared to wait a little longer.

Half an hour later, Cui Tongzhi came back with the report sheet, "Xiao Yi, come and see, how am I doing? Is there any problem?"

Yi Zewen took a look: there were no gallbladder stones, no kidney stones, no obvious leakage from the pancreas, and no swelling of the tail.

This initially dispelled Yi Zewen's doubts, because the entire illness context was already clear.

Cui Tongzhi had abdominal pain caused by eating breakfast. In addition to considering gastroenteritis, he should also be wary of cholecystitis, pancreatitis, coccitis and other abdominal organ inflammatory diseases.

For example, typical acute cholecystitis will have a positive Murphy's sign and percussion pain in the gallbladder area, while pancreatitis is often triggered by eating and drinking, and coccitis is usually pain in the right lower abdomen.

But these are typical situations. There are many atypical situations in clinical practice. If you don’t pay attention to observation and do not perform necessary auxiliary examinations, it is very likely to be missed.

This is what doctors fear most.

Now the abdominal B-ultrasound is normal, and Yi Zewen is much calmer.

At least the above-mentioned diseases have been ruled out initially. Other fatal diseases, such as liver rupture and spleen rupture, are not supported because there is no history of trauma.

Yi Zewen suddenly thought of a question, "By the way, Lao Cui, have you ever had gastritis or gastric ulcer before?"

Cui Tongzhi: "I had stomach pain when I was young. I was poor and didn't have enough to eat. But I have almost never had it in the past 10 years, and my health is much better."

Yi Zewen hummed and thought to himself, if this is true, then the abdominal pain this time does not support the possibility of gastric ulcer, gastrointestinal perforation, etc.

Although a plain abdominal X-ray was not performed to rule out the gastrointestinal perforation, digestive juices would leak into the abdominal cavity, causing obvious peritoneal inflammation, severe abdominal pain, and abdominal muscle tension and other symptoms of acute peritonitis, which the patient did not have.

Therefore, even without examination, this possibility can be preliminarily ruled out.

Now that the most serious digestive system diseases have been ruled out, what else is there to say?

Yi Zewen prescribed some antispasmodic, analgesic and digestive medicine: "Okay, Old Cui, it's okay. I'll give you some medicine and you can take it."

Although Cui Tongzhi still felt pain in his abdomen, he nodded out of trust in the doctor:

"Okay, then I'll go back first. Oops, it's probably because the wonton meat today is not fresh. I have to have a good talk with Old Man Li tomorrow!"

Seeing the patient leaving, Yi Zewen took off his white coat and returned to his director's office.

Since he was promoted to the director of the emergency department by Chen Qi, he has also become the youngest department director and middle-level cadre in the People's Hospital besides Lan Lijuan.

But he always kept in mind Chen Qi's words, the department director is just the beginning, don't relax, don't be satisfied, and don't be complacent.

This is almost a clear statement, which means that as Chen Qi's confidant, he must gain a reputation and promote him again if there is an opportunity in the future.

So Yi Zewen really devoted himself to the emergency department, day and night. If his income were not 3 or 4 times that of other departments, his wife would have a fight with him.

Yi Zewen returned to the office and had just fallen asleep for an hour when there was a knock on the door.

A nurse outside called out: "Director Yi, there is a patient with abdominal pain outside. You treated him before, but now he is back and says his stomach pain is even worse."

Yi Zewen opened his eyes and quickly opened the door: "Let's go and take a look!"

On the hospital bed, Cui Tongzhi, who had just been able to walk out of the hospital, was already lying on the emergency bed groaning, surrounded by several colleagues.

"Old Cui, what's wrong?"

"Xiao Yi, Director Yi, hurry up, brother, my stomach is getting more and more painful. Do I have appendicitis?"

In this era, Vietnamese and Chinese people are accustomed to collectively refer to abdominal diseases such as coccitis, colitis, intestinal obstruction, etc. as "appenditis".

Before Yi Zewen could speak, Cui Tongzhi hummed again and said:

"Director Yi, there is something I was embarrassed to say before. In fact, I have diabetes and have been taking medicine."

Yi Zewen was speechless when he heard this: "Then why didn't you say anything just now? Isn't this just delaying things?"

"There were so many people around me just now, I was embarrassed to say it."

The Vietnamese and Chinese people still tend to avoid medical treatment. When talking about diabetes, they feel like it is a terminal illness or an infectious disease.

In rural areas, if a diabetic patient urinates in someone else's latrine, the owner will scoop out the "bubbles" because people think that the urine of diabetic patients is poisonous.

This was all caused by the young man's lack of medical knowledge, so Cui Tongzhi felt inferior and didn't want others to know that he had diabetes.

To be honest, Yi Zewen was shocked when he heard Cui Tongzhi say that he had diabetes.

Diabetes has an acute complication called ketoacidosis, which is caused by the accumulation of acidic metabolites produced by the patient's body when it cannot fully utilize glucose and begins to utilize fat, causing organ dysfunction.

A rare symptom of ketoacidosis is abdominal pain.

If it is severe ketoacidosis, it will be fatal if the rescue is not timely.

Yi Zewen immediately directed the nurse next to him: "Quickly, take an emergency blood sugar test."

Blood glucose testing at this time was not like that of later generations, where you would prick a needle with your finger, squeeze a drop of blood, and get the results in a few seconds.

Nowadays, to measure blood sugar, you have to draw blood, then take it to the laboratory, and finally issue a report. It can take dozens of minutes at most.

"Director Yi, the patient's blood sugar is 5.9mmol/l."

5.9, this index is no problem. Postprandial blood sugar is generally considered normal within 11 o'clock.

The patient's blood sugar is normal, and the possibility of ketoacidosis is basically ruled out. Because blood sugar is often very high during ketoacidosis, often exceeding 30mmol/l.

For the sake of safety, Yi Zewen didn't care. Anyway, while checking his condition, he checked his income, liver and kidney function, electrolytes, trace elements, ketones, and blood routine.

I also went for an abdominal CT scan, and almost everything I could get was done.

Anyway, it was reimbursement from public funds, so Cui Tongzhi didn't care. Several colleagues ran up and down busy paying for inspections.

As a result, after the blood was drawn, Cui Tongzhi's abdominal pain still did not improve, and even worsened, and he began to roll over in the hospital bed.

"Ouch, hey, mother, it hurts so much. It hurts so much. Please take some medicine quickly~~~~"

When patients become irritable and their mental state deteriorates due to pain, this often indicates that the disease is getting worse, and there must be something wrong in some link.

Yi Zewen was also anxious, but he couldn't figure out what the problem was even if he tried hard. He had checked everything that should be checked inside and outside, and everything was normal.

Although he also graduated from a university, Yi Zewen was born in surgery after all, and the limitations of specialist doctors limited their clinical thinking.

At this time, Zhang Xing happened to come to take over the shift, and he hurriedly saw Yi Zewen making a fuss.

After he looked through all the medical records, he could only say helplessly: "Lao Yi, why don't you ask Dean Chen to come and take a look."

Yi Zewen was right when he heard it. "If you have any questions about your illness, go to the director." This was a popular slogan within the People's Hospital.

"Okay, help me keep an eye on it, and I'll go find the dean."

In the emergency room, Chen Qi has already taken over the patient.

At this time, Cui Tongzhi was holding his stomach in pain, rolling around on the hospital bed, and his face was very pale.

"Hey, Lao Cui, where does it hurt? Is it this? Is it this?"

"Dean Chen, please help me quickly, it hurts me to death."

Chen Qi hurriedly touched the patient's belly and began to read the examination report, thinking about possible situations.

At this time, doctors from Xijing Hospital, led by Professor Tong, also came to the emergency department of People's Hospital.

Upon arriving at the emergency department, Professor Tong and the others keenly discovered that the emergency building looked ordinary, but when they walked inside, they found that both the internal layout and the diagnosis and treatment equipment seemed to be different and very advanced, somewhat like foreign emergency departments.

That’s what I mean.

For example, three lines of different colors are drawn from the door, red, yellow and blue, extending to the emergency room, outpatient room and auxiliary department respectively, so that patients can know where to go after entering the door.

In addition, the emergency department of the Vietnam-China People's Hospital uses imported medical equipment, and even the electrocardiogram is made in the United States.

Xijing Hospital cannot meet this condition alone. They use basically all domestic products, but whoever uses them knows the quality of domestic products.
To be continued...