Free Web NovelChapter 58: Chapter 58: Wu Ting’s Astonishing Diagnosis: Lumbar Disc Herniation
"Uncle Qian, we’re going to hold a consultation now. After that, we’ll formulate a proper treatment plan for you."
After speaking with Qian Xiong, Jiang Ming led Wu Ting, Song Qi, and the others back to the conference room.
"Let’s all share our thoughts."
"Dr. Song, you first."
Jiang Ming looked at the somewhat indignant Song Qi. Song Qi nodded and stated his assessment:
"I think that last medical history inquiry and physical exam were barely better than nothing. They didn’t really help us diagnose the patient’s condition."
Song Qi’s biased statement was a clear attempt to put Wu Ting down, a bit of a power play to warn others. Unlike Qin Donglai, Song Qi believed the team should have only one core figure—Jiang Ming—with himself as a close second. He thought everyone else should simply fall in line around Jiang Ming in an orderly hierarchy.
In his view, even though Wu Ting had some standout moments under Qin Donglai, he was here to learn laparoscopic techniques. That meant he should be starting from zero, learning the rules, and progressing gradually, not trying to steal the spotlight like he did today.
After speaking, Song Qi deliberately paused for a few seconds before continuing with his opinion:
"First of all, we can basically deduce that the patient most likely doesn’t have typical acute appendicitis. It’s probably another type of acute abdomen, maybe even a rare and easily misdiagnosed one."
"So, based on my years of clinical experience, I believe we should stick to the classic method for diagnosing an acute abdomen. We need to perform an abdominocentesis on the patient as soon as possible and make a diagnosis based on the properties, color, clarity, odor, and lab results of the abdominal fluid."
"As we all know, while there are many diagnostic aids for acute abdomen these days, abdominocentesis remains the method of choice!"
"The diagnostic accuracy for acute abdomen via abdominocentesis is as high as 96.5%!"
Song Qi looked directly at Wu Ting, as if lecturing him:
"Of course, if we still can’t get a confirmation from the abdominocentesis, then I think we should proceed directly to a traditional exploratory laparotomy and make the final diagnosis during the operation."
Song Qi finished stating his opinion.
Jiang Ming nodded slightly. This was also the plan he currently favored. frёewebnoѵel.ƈo๓
"What if the patient doesn’t have an acute abdomen?"
"What if the patient’s condition can be cured with conservative treatment, without needing open surgery?"
Faced with Song Qi’s aggressive attitude, Wu Ting was completely unfazed.
"Not an acute abdomen?"
Song Qi had clearly never considered that possibility and was struck silent. After a moment, his face flushed as he replied:
"Theoretically, there is a possibility of other diseases, but what evidence do you have? A diagnosis isn’t just guesswork."
Jiang Ming was also taken aback by Wu Ting’s idea. His mind opened up. ’Could it be something other than an acute abdomen?’
"Wu Ting, what’s your line of reasoning?"
Wu Ting analyzed calmly:
"I have a few deductions that suggest the patient doesn’t have an acute abdomen and only requires conservative treatment. However, we’ll still need to invite doctors from Orthopedics and the National Medical Department for a consultation."
"I suspect the patient has a herniated lumbar disc. As for the treatment plan, it would be traction combined with acupuncture and massage therapy. Therefore, I believe there’s no need for an abdominocentesis or open surgery before we have a firm diagnosis."
Hearing Wu Ting’s diagnosis and proposed treatment, Jiang Ming, Song Qi, and even the overlooked Yasui were all somewhat dumbfounded.
"That’s impossible. Although pressing on the right side of the patient’s spinal intervertebral space causes referred pain in the lower right abdomen, the probability of a high lumbar disc herniation is only 0.4% to 2.1%..."
Song Qi had a comprehensive and precise grasp of such statistics, and he immediately refuted it:
"Dr. Wu’s idea isn’t without merit, but the probability is too low. I still insist it’s an acute abdomen and that we should perform the abdominocentesis as soon as possible. If we follow Dr. Wu’s plan and coordinate with the National Medical Department and Orthopedics, it will definitely take some time. If it really is some form of acute abdomen, we’ll miss the optimal treatment window."
Jiang Ming thought for a moment. Song Qi had a valid point. Conventionally speaking, his diagnosis was more likely. As for Wu Ting’s idea, it was certainly refreshing, but the probability was just too low.
"Wu Ting, I think your line of reasoning and diagnostic approach are still worthy of acknowledgement and praise."
"However, Dr. Song’s diagnosis is a bit more likely, and if it really is a type of acute abdomen, time is of the essence."
"Alright, let’s prepare for both scenarios. We’ll prioritize Dr. Song’s diagnostic approach and immediately arrange the abdominocentesis for an acute abdomen. If that confirms the diagnosis, great. If it’s still inconclusive, then during the preparation period before any open surgery, we’ll invite doctors from Orthopedics and the National Medical Department for a joint consultation."
"During this pre-operative preparation time, if we can confirm it’s a herniated disc, that would be for the best. If not, then we have to prepare for the worst-case scenario and perform a traditional open abdominal surgery on the patient."
After Jiang Ming made the final decision, Song Qi immediately got up to arrange the abdominocentesis, shooting Wu Ting a look that screamed, ’You’re still wet behind the ears, kid.’
"Wu Ting, you prepare the backup plan. If Dr. Song’s side yields no results, you’ll be responsible for immediately arranging a second consultation."
Wu Ting nodded, completely unaffected by Jiang Ming and Song Qi’s plans. He trusted his own judgment.
Without waiting for the results of Song Qi’s abdominocentesis, he immediately began organizing the case files and contacting Orthopedics and the National Medical Department.
Watching Wu Ting’s relentless drive, the overlooked Yasui was moved. A junior doctor like himself would never have dared to argue so vehemently with a senior physician or propose his own alternative line of thinking.
’Wu Ting’s persistence will probably lead to nothing,’ Yasui thought. ’As soon as the abdominocentesis results are out, this multi-departmental consultation will be dead in the water.’
However, at this moment, Yasui still wanted to help Wu Ting. He somewhat admired Wu Ting’s courage:
"Dr. Wu, let me help you organize the files."
"Thanks."
Wu Ting nodded. The files were nearly ready. He immediately sent messages to Lu Xiong, Director of Orthopedics, and Huang Hong, Deputy Director of the National Medical Department.
He briefly explained the patient’s situation to them.
Soon, Deputy Director Huang Hong replied:
"Dr. Wu, I understand. Once you’ve contacted Orthopedics and have a time for the consultation, let me know in advance. I’ll be there on time. If it really is diagnosed as a herniated disc, I’ll take charge of the patient’s acupuncture and massage therapy."
Huang Hong was more than happy to accept Wu Ting’s invitation. To a certain extent, these consultations also helped raise the profile of the National Medical Department within the hospital, so he had no reason to refuse.
A short while later, Lu Xiong also replied to Wu Ting.
"Dr. Wu, I very much agree with your idea and line of thinking."
"To connect the dots between the patient’s history of climbing stairs with heavy loads for years, the weakened dorsiflexion of his right big toe, and the referred pain on the right side of his spine... and then to consider a lumbar disc herniation—your observational skills and fundamentals are truly solid. You’re a broad-minded thinker."
"How about this: as soon as I’m done with the surgery I’m in, I’ll hurry over and we’ll do the consultation together!"
