"Did the patient have a heart attack?!" Doctor Ma exclaimed, "That's impossible. The patient is on ECG monitoring and the ECG shows no obvious abnormalities."

If he really had a heart attack, we could have found out by taking an electrocardiogram. How could he, who was on duty, not have seen it and gone to find the professor?

"No." Xie Wanying shook her head. "What I mean is that it's probably not the patient's original disease that caused this condition, but the complications after endoscopic treatment."

"What complications are you talking about?" Fang Xueqing and Dr. Ma anxiously asked her to explain clearly.

This is a technical problem related to internal medicine, which is very serious. Moreover, endoscopic treatment is much safer than surgical treatment. The most terrible complications of endoscopic treatment should be heavy bleeding or perforation, but the patient's symptoms and signs do not support the occurrence of these two serious complications.

Xie Wanying said: "It's pulmonary embolism."

Fang Xueqing and Doctor Ma stared at her for a long time, then looked at each other. As gastroenterologists, they had never heard of this complication.

"There are papers reporting such cases," Xie Wanying told them.

"Professor Fang?" Doctor Ma asked Professor Fang. He was completely unsure. Pulmonary embolism was extremely rare in the clinical practice of gastroenterology. He, a young man, had never seen it before. He could only ask the professor whether the patient's symptoms could be suspected of pulmonary embolism.

...

...

Fang Xueqing frowned. She had never seen pulmonary embolism before. She was a gastroenterologist, not a respiratory doctor or a cardiothoracic surgeon.

Most importantly, this extremely rare case after gastroenterology endoscopic surgery can be published as a special case report in a journal. But it is indeed too rare to be used to infer clinical practice. It can only serve as a reminder that clinicians may need to pay attention to the existence of such special cases.

How can we be sure whether what Xie Wanying said was just a random guess based on a paper? Some medical students who like to do research and study papers and are away from clinical practice are like this. When they see similar cases in clinical practice, they immediately become suspicious. In the eyes of clinical teachers, such medical students seem to be deliberately showing off their talents and skills, which makes clinical teachers not very fond of them.

Guessing is fine, but it needs to be supported by evidence. Guessing a rare case means that the patient needs to do extra tests. The cost is all paid by the patient and the patient's family. If the suspicion is wrong, the money is wasted. Once a medical dispute arises, the patient's family will use this to attack the doctor. Now the patient's family is already dissatisfied, and the patient is randomly tested? Fang Xueqing frowned and couldn't untie her brows. Doctor Ma was waiting for her decision, and occasionally looked at the family outside and was very anxious.

"Doctor Song." Fang Xueqing asked Song Xuelin for his opinion again.

Song Xuelin said, "Do as Dr. Xie says."

Fang Xueqing's eyes flashed with surprise: "Do you support her opinion, Doctor Song?"

Dr. Ma was more anxious than anyone else and asked urgently: "If it is suspected to be pulmonary embolism, what tests should be done? Should we send him for CT scan right away?"

Things are too rare in their department, and it is easy for doctors to suddenly forget the more obscure knowledge points in the textbooks.

"You can try a blood gas analysis first," Xie Wanying suggested. "It's not expensive, and the results are available quickly. In the case of acute pulmonary embolism, the patient's body is hypoxic and stuffy, and blood gas analysis typically shows low blood carbon dioxide and blood oxygen. Such an examination report can distinguish a lot of diseases and is an important reference indicator. After having data support, consider doing other tests to further confirm it."