The Enhanced Doctor

Chapter 1119: Chapter 1119: What You Fear Comes True

(Thanks to book friends 75185340, Feiying, book friends 20210711151807290 for the monthly ticket encouragement)

"Teacher Liu, the child’s bowel sounds are quite weak right now. Should we do an X-ray or go straight to a CT scan?"

Xu Yino asked after listening for a moment.

Liu Banxia frowned, leaned in to listen carefully, and then gave the child a thorough examination.

"Little one, if it hurts when uncle presses, let him know," Liu Banxia said.

The little boy obediently nodded.

Checking the McBurney’s point first showed no rebound tenderness, which made Liu Banxia’s heart tighten.

If it’s appendicitis, it’s just a minor surgery. The most worrisome thing is that the intestinal flora has already started causing trouble, which would make treatment very difficult.

"The abdominal wall is soft, the current bowel sounds are somewhat weak, and the temperature seems a bit high. Proceed with hospital admission, then perform a complete blood count, blood chemistry, stool test, and urgent abdominal CT," said Liu Banxia after the examination.

"Director Liu, is it very serious?" Wulei asked nervously.

"At the moment, it’s hard to say; although the examination can rule out appendicitis, a CT scan is more prudent," Liu Banxia said.

"With weak bowel sounds now, we are concerned about some intestinal diseases, such as Crohn’s disease and colitis. There’s a high chance of occurrence on his case, so I directly requested admission."

"Given the current situation, he’s not fit for long-distance travel anymore. For his safety, our hospital has the necessary equipment."

"Dalei, should we call Dr. Clarke for advice? Didn’t he say we can call him anytime?" the child’s mother anxiously asked, holding Wulei’s arm.

"Calling now won’t help either, distant water can’t quench present thirst. It’s better to come to the hospital," Wulei said.

"Director Liu just informed me of possible situations. Hasn’t there been persistent abdominal pain symptoms lately? I’m afraid it started a while ago."

"Xu Yino, bring in the supplies, I’ll draw blood from the child," Liu Banxia spoke.

It’s natural for a mother to be worried about her child. However, given the situation, he genuinely doesn’t want the child’s mom to be overly anxious and cause additional stress.

This is a common issue when admitting children; everyone wishes for the best diagnostic approach for their child, naturally leading to some skepticism towards doctors.

Xu Yino was quick, and surprisingly, the little guy immediately raised his arm and turned his head aside upon seeing the supplies.

A sensible and well-behaved little one, accustomed to the routine and pain from continuous examination. The more it’s like this, the more heart-wrenching it becomes.

Wulei turned his head and just wiped his tears.

He felt sorry for the child but understood these examinations were necessary.

"Alright, follow this sister to get checked. Which of you two will accompany?" Liu Banxia asked after collecting blood.

"I will go; she’s already too exhausted," Wulei said.

"Once the examination is complete, I’ll call for pediatric and internal medicine consultations," Liu Banxia said.

That’s about all he can do; the child’s abdominal pain appears to have intensified compared to before, evident from his expression.

Liu Banxia followed and went straight to pediatrics.

"Is your young patient here?" Chen Hongyang asked.

Liu Banxia nodded, "An obedient and lovely little girl, tugging at one’s heartstrings. Her intestines seem to be causing some trouble, abdominal pain is quite severe, bowel sounds are weak."

"Going for tests? What do you need me to do?" Chen Hongyang directly asked.

"Join us for a consultation later, mainly concerning medication. The intestines surely have inflammation, see if there’s a chance for saving them," Liu Banxia said.

"I’ll call Wang Huan over later; if it’s indeed severe dysbiosis, we should discuss the possibility of fecal transplantation."

"Afraid it’s quite challenging, too risky. Shall we proceed with urgent measures?" Chen Hongyang asked.

"Completed, will you come with me?" Liu Banxia asked.

"Alright, you call Wang Huan, I’ll head directly to your office and wait," Chen Hongyang agreed readily.

Even though Liu Banxia received the patient, she would be admitted to their pediatrics department. The child’s luck will determine if conservative treatment is possible.

Liu Banxia didn’t pause and headed straight to Wang Huan’s office. Upon hearing the situation, Wang Huan’s brow furrowed into a deep knot.

"My dear Director Liu, even though we’ve done quite a number of fecal transplants and gained some experience, we’ve never performed it on a child," Wang Huan said with a bitter smile.

"It’s merely a contingency plan for now; I see the possibility. So come with me to assess the situation, saving the hassle of calling you again," Liu Banxia said.

Wang Huan nodded, "Going with you is no problem, but it’s probably hard for you to get any constructive opinions from me."

"Let’s not talk about anything else, I’ve only heard of PANDAS, never seen it. You should be cautious when the time comes, especially when it’s introduced by a friend. Don’t start saying things recklessly."

"I’ve said almost everything necessary; the child’s father seems to understand. The child’s mother is a bit different, overly worried about her child, too tense." Liu Banxia said.

"When I came out just now, I saw she didn’t go with the child for the examination. It seemed she was heading to the restroom. It’s likely the stress over the past two years has been too much for her, and she truly can’t hold on much longer."

"You arranged for the emergency procedures, so the CT results should come out quickly. Let’s go wait for them." Wang Huan said.

From Liu Banxia’s expression, Wang Huan could also tell that Liu Banxia was not in a good mood. Just after having two lovely little babies, a young patient now has PANDAS.

In Liu Banxia’s office, Chen Hongyang was already waiting early, the three of them briefly communicated, and Xu Yino also returned with the child and Wulei.

"Director Liu, I’m really grateful, the CT went very smoothly." Wulei said.

"No need to thank me, our child has already met the criteria for expedited handling. Symptoms are present, and the child is still young. Let me introduce you, this is Dr. Chen from Pediatrics and Doctor Wang from Internal Medicine, both are top experts in the industry." Liu Banxia said.

"Thank you, doctors, thank you." Wulei hurriedly said.

Chen Hongyang and Wang Huan nodded in acknowledgment, there wasn’t much time for pleasantries, researching the child’s condition was more urgent.

Xu Yino also brought up the child’s CT images on Liu Banxia’s computer.

"Oh no, what you fear is what you get."

Seeing the displayed images, Liu Banxia couldn’t help but exclaim.

"Director Liu, what’s going on?" Wulei immediately became tense.

"Hold on, what are your opinions?" Liu Banxia looked at Chen Hongyang and Wang Huan.

"Immediately stop feeding and start expelling gas, the colon is still experiencing segmental dilation, we have time." Chen Hongyang said.

"I agree, not only should we decompress the gastrointestinal tract but also use a rectal tube for gas relief. Fortunately, we’re in a hospital, otherwise, it would be truly dangerous." Wang Huan nodded as well.

Liu Banxia frowned, "The child’s situation is quite tense now. The images show three segments of the colon with obvious dilation."

"Based on the child’s medical history, we consider it to be toxic megacolon. It might be related to long-term use of antibiotics, leading to intestinal flora imbalance and causing secondary infection."

"Now, what we need to do first is quickly decompress the child’s gastrointestinal tract, otherwise, excessive pressure could potentially result in intestinal perforation."

"Then we’ll also need to use medications for antiviral treatment and perform enema dripping, so the medications can directly exert their effects in the intestinal tract. From the current situation, it appears to be in the early stage of onset, and there’s hope."

"However, the situation is still not very optimistic; this disease progresses extremely fast and urgently, we’ll need to monitor it constantly."

"If, and I mean if, our medications don’t manage to control it, and the symptoms advance to the next stage, to save the child’s life, we’ll only have the option of surgical treatment to remove the colon."

Upon hearing Liu Banxia’s words, Wulei staggered, almost falling on the spot.

After the CT scan, upon seeing Xu Yino’s expression, he already had a bad feeling.

He just didn’t expect it to come so quickly and suddenly, as soon as it was mentioned, it already became apparent.

Even with some mental preparation, it’s not easy to digest.

"Dr. Chen, let’s requisition No. 5 rescue room to perform decompression and the enema drip. It has bedside X-ray, which allows for more timely monitoring." Liu Banxia said.

"Alright, the child’s situation is indeed urgent at the moment. Normally, it meets ICU standards, but even if we were to transfer to ICU, this would still be the treatment plan, which we can handle." Chen Hongyang nodded.

This condition is dangerous enough when it occurs in adults; in children, its manifestations are even more severe.

Because during the flare-up of this disease, it’s accompanied by high fever, and we also need to consider using both medication and physical cooling for the child.

However, these details needn’t be explained in such depth to Wulei, who is already quite overwhelmed. Besides, the other complications of toxic megacolon are even more severe; for now, treating the child is most urgent.

"Hang in there, the child is in the early stage of the illness; we discovered it timely, and the chances of conservative treatment success are high." Liu Banxia looked at Wulei and said.

"Although we can’t compare to famous hospitals in big cities, when it comes to handling this condition, I can confidently say we’re absolute top-notch domestically."

"Director Liu, I’m already losing my mind, Yuan Yuan... you must save Yuan Yuan..."

By the end, Wulei was already crying uncontrollably.

Liu Banxia could only pat his shoulder, then picked up the little one and went straight to the rescue room.

PANDAS can’t be cured, but this life-threatening toxic megacolon must be controlled.