The Enhanced Doctor

Chapter 1070: Chapter 1070: Liu Yiqing’s Misdiagnosis (Part 1)

(Thank you to book friends 20190331160529695, o the little troublemaker o, and little trouble monthly ticket encouragement)

"What exactly is the situation?"

After arriving at the operating room, Liu Banxia asked.

"Teacher Liu, when I examined it, I diagnosed it as appendicitis, and I performed a small incision appendectomy on the patient. But after I brought out the appendix, its condition did not seem as severe." Liu Yiqing said.

Although she was trying to maintain her composure, there was a hint of panic in her voice.

Liu Banxia nodded, "Let me take a look."

Upon hearing his words, Liu Yiqing hurriedly stepped aside.

Walking over to the operating table, Liu Banxia carefully examined the appendix that Liu Yiqing had extracted.

Although it indeed looked slightly swollen, from its current condition, it wouldn’t cause the patient such severe pain.

To be precise, this kind of appendix wouldn’t cause any issues even if left untreated. It was precisely because of this discovery that Liu Yiqing was hesitant.

"Panicking?"

Liu Banxia asked.

Liu Yiqing pitifully nodded.

The atmosphere in the operating room became even more tense. The outcome of this situation was really hard to say, and if taken seriously, this could be a misdiagnosis.

"How panicked are you?" Liu Banxia asked again.

"Teacher Liu, please think of a way, what’s going on?" Liu Yiqing was so anxious she was about to cry.

"First, put the appendix back in, then use your fingers to explore and carefully feel to see if there’s any different sensation." Liu Banxia said.

Liu Yiqing was stunned. Looking at Liu Banxia’s calm eyes, she mustered some courage despite not wanting to continue on stage.

However, this tiny bit of courage was truly not much, as she stood by the operating table, looking at the appendix but not daring to put it back into the abdominal cavity.

"What are you afraid of? At worst, it’s just a misdiagnosis. Doctor Li, don’t you agree?" Liu Banxia said.

"Yes, we were just discussing it. But she’s too demanding of herself, saying that if it were you, such a thing would never happen." Li Liwei also spoke up.

"But I’m the one who diagnosed it as appendicitis, and now the appendix, although there are some issues, is only slightly swollen at the tip." Liu Yiqing said.

"Silly girl, do you think spreading a rumor about me makes you comparable to me? Who am I? I’m Liu Banxia from the emergency center, the big figure you all talk about." Liu Banxia said.

Everyone in the operating room was stunned, not understanding why Liu Banxia would bring this up at such a time.

Even more so for Liu Yiqing, who couldn’t believe he was in the mood to joke at this moment.

"Today is your lucky day; not only did you spread rumors about me, but you also get to learn a very valuable lesson." Liu Banxia continued.

"I trust your medical knowledge, and I saw the patient’s condition when they came for a consultation. Your diagnosis of appendicitis means the bedside ultrasound at the time must have supported this judgment, and McBurney’s point tenderness was also positive, which is consistent."

"So, the issue now is, when you opened the abdomen and extracted the appendix, it wasn’t as severe as you imagined, which doesn’t match the ultrasound images. What should you think of first?"

"What you’re thinking of is a misdiagnosis. Oh no, how do I explain this to the patient, how do I explain it to the handsome and capable Teacher Liu?"

Li Liwei smiled, knowing that Liu Banxia was trying to help Liu Yiqing stabilize her emotions and rebuild her confidence. The development of this surgery wasn’t just about misdiagnosing the patient; it could also lead to Liu Yiqing’s collapse in confidence.

This is very important, not only for Liu Yiqing’s future ability to perform surgeries but also in affecting her ability to diagnose patients correctly in the future.

Because she would first doubt herself, wondering if she’s misdiagnosed again, regardless of whether this misdiagnosis was intentional or not, it would have an influence.

Liu Yiqing remained silent, but tears began to fall.

"So what we need to consider now is what symptom the patient actually has, which caused us to make a misjudgment during the ultrasound." Liu Banxia pretended not to see, continuing to speak to himself.

"An originally swollen appendix won’t suddenly become okay when on stage, so the next thing we need to do is find the reason. How do we do that? Continue exploring."

"Others might change the incision, enlarge it, or conduct an exploratory laparotomy. But I trust your ability; with just one finger, even without a line of sight, you can explore clearly and then make a decision."

"You don’t have much time left, the patient is in pain, which means there must be a very serious underlying condition. The longer you delay, the more the patient’s condition will worsen."

After speaking, Liu Banxia stopped talking and just stood there watching.

The entire operating room became very quiet in an instant, with only the sound of the instruments.

After a full half-minute, Liu Yiqing began to move, carefully putting the patient’s appendix back into the abdominal cavity, then extending her finger to explore attentively.

"Ah... I feel something like an appendix again. No, it doesn’t feel like an appendix. It’s thicker, shorter, slipperier, and there’s some fluid leakage," said Liu Yiqing questioningly.

"What’s your diagnosis?" Liu Banxia asked.

"I... I... I don’t know, we can’t have two appendixes, right? The ultrasound only showed one," Liu Yiqing replied nervously.

This was something she hadn’t encountered before. How could it be possible for someone to have two appendixes?

"Ah... I got it, it’s Meckel’s diverticulum. It was overlapping with the appendix on the ultrasound, which is why the appendix appeared severely swollen." Liu Yiqing suddenly exclaimed.

"That still seems off. Why was I able to locate the appendix directly once we were on the table? If their positions overlapped, I should’ve felt both immediately. How could it move on its own?"

She talked to herself, completely lost in her own world, oblivious to the fact that her loud exclamation softened into mumblings.

Li Liwei gave Liu Banxia a thumbs-up because, thanks to his intervention, Liu Yiqing wasn’t too concerned about the misdiagnosis anymore.

And judging by the current situation, Liu Banxia had likely pinpointed the possibility of Meckel’s diverticulum with the patient upon his arrival.

"Teacher Liu, what should we do?" Liu Yiqing asked after pondering for a while.

"How to explain to the patient? That’s your problem, not mine," Liu Banxia replied nonchalantly.

"No, I mean what should we do about the patient?" Liu Yiqing was getting anxious.

"Do whatever needs to be done, you’re the main surgeon, it’s your call." Liu Banxia replied casually.

Liu Yiqing was so upset; she didn’t care if he was the big boss, she just shot a glare at him.

"Actually, I was about to go for lunch. Sigh... I wonder if there will still be any hot food left when I get there," Liu Banxia said.

"After exploration, discovered mild edema at the tip of the appendix, and touched another structure similar to appendix tissue, identified as Meckel’s diverticulum. Considering the patient’s pain and the current anesthesia, the patient cannot be awakened for a second round of anesthesia," Liu Yiqing stated.

"The procedure is now being amended to a median incision exploration with suture to the small incision. Teacher Li, this may increase the operation time. Director Liu will assist," she declared loudly, visibly frustrated, effectively appointing Liu Banxia as the first assistant. Despite the tense atmosphere, everyone couldn’t help but find it amusing.

Liu Banxia was helpless. It seemed he had provoked her a bit too much. She wasn’t focusing on the misdiagnosis anymore but was directing her frustration at him.

Liu Banxia had no choice but to take the scalpel and continue enlarging the incision.

He did trust Liu Yiqing’s judgment, assuming that it was merely a case where Meckel’s diverticulum was misdiagnosed as appendicitis.

During his time at Jinshui District Hospital, he encountered a similar situation; it was something only discovered during surgery, akin to today’s scenario.

This is what experience is for; otherwise, he might have been flustered too.

However, Liu Yiqing hadn’t encountered this before and felt she had let the patient down since the appendix seemed normal, which rattled her.

"Exploration shows part of the patient’s ileum is torsioned, and on the terminal ileum wall, there is a finger-like projection with a thin base, and some fluid leakage. Diverticulectomy is feasible," reported Liu Banxia after completing the incision.

Being the first assistant, he needed to act the part.

His serious reporting amused everyone in the operating room.

Now, they had a clear understanding of the patient’s condition. Although misdiagnosed as appendicitis, it wasn’t problematic anymore.

Liu Yiqing visibly relaxed, though she glanced nervously at Liu Banxia, "Teacher Liu, I’ve never done a diverticulectomy before."

"Where did your confidence from earlier go?" Liu Banxia asked with a smile.

"Look at the shape of the diverticulum compared to the appendix, then think about what should be done. You can’t rely on me for everything, you need to use your own imagination."

"The diverticulum is thicker than the appendix. I was thinking of doing a purse-string suture like with the appendix, but I’m a bit uneasy since it’s so thick," Liu Yiqing said, watching Liu Banxia’s facial expression closely.

But for the big boss, wearing a mask now, how could she gauge his expression?

"A purse-string suture won’t work; embedding the stump could lead to bowel narrowing. After diverticulectomy, you can perform a full-layer suture on the ileum," Liu Yiqing continued.

"See, you’re smart. Would you still need me to assist you?" Liu Banxia asked.

"Hehe, no need. Cui Jia, quickly take Teacher Liu down. We can handle this small task ourselves, no need to bother him," Liu Yiqing responded quickly.

"At this moment, I almost thought Xu Yino took possession of you," Liu Banxia commented.

"Did you realize how lucky you are today? Many people couldn’t even dream of such a valuable lesson. You just struck it big. Shouldn’t you consider adding a dish for everyone at lunch?"

"Sure, definitely," said Liu Yiqing cheerfully, but then she changed her tone, "Teacher Liu, would you accompany me to talk to the patient’s family?"

Everyone in the operating room turned to look at Liu Banxia.