The reason for the misdiagnosis at the primary care clinic is probably that Xie Wanying looked at the pregnant woman's belly. Perhaps the general doctor is not a gynecologist and is afraid that casually touching the pregnant woman's belly will cause harm to the fetus. The primary care clinic may only have an X-ray machine but no ultrasound machine. Doctors are afraid that using the X-ray machine will cause harm to the fetus, so they fail to perform relevant examinations on the patient, resulting in an inaccurate diagnosis.
Doctors know a lot, so they have a lot of concerns. Ordinary people don’t know much, so they just keep asking why they didn’t see it.
"Yingying, what's wrong?" Noticing that her expression was not right, Wu Lixuan pulled her childhood friend's sleeve and asked in a low voice, "Do you need to be hospitalized?"
Hospitalization is necessary, and it must be done immediately!
Xie Wanying took out her cell phone and called Teacher Sun to discuss the matter first.
"Aren't you off work?" Sun Yubo was surprised to receive her call, thinking that all the students had left.
"Teacher Sun, there is a patient who is four months pregnant. I initially suspect she has acute appendicitis. She has been delayed in treatment at the primary outpatient clinic for almost a week. The situation is quite serious. I would like to discuss it with the teacher. Isn't bed 7 going to be discharged tomorrow? Can we admit her tonight?" The situation was urgent, and Xie Wanying explained the situation directly to the teacher.
Sun Yubo asked her to wait: "The bed issue is not something I can decide. It needs to be decided by Teacher Tan. Teacher Tan went to a meeting this afternoon and happened to be still here. I'll ask him."
As he was speaking, Tan Kelin on the other side received the message and asked the key point: "Pregnant woman, acute appendicitis?"
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"Yes!" Sun Yubo was surprised to find that his student was going to take on an extraordinary case. Pregnancy complicated by acute appendicitis is rare. He had to ask the student: "How do you know for sure that she has appendicitis?"
"I performed the Bryan and Alder tests on her in the right and left lying positions. It was obvious that the abdominal pain was aggravated when she was in the right lying position, and it was also aggravated when she pressed the appendix point with her fingers when she was in the left lying position. In addition, her initial symptoms were stomach pain, which later turned into abdominal pain, a typical transfer of right lower abdominal pain."
The student's clear description came out over the phone, and the teachers listening here all raised their eyebrows.
They didn't teach this to students. Because it was a rare case, Xie Wanying had just started clinical practice for three months, and the chance of seeing a rare case was like luck. The clinical instructor didn't expect that he wouldn't teach the cases that he had never encountered.
All I can say is that this student has learned and memorized quite firmly and comprehensively, and can quickly associate things. Even if this case is mentioned in the textbook, it must be a knowledge point hidden in the corner.
This is a patient with acute appendicitis during pregnancy. Primary hospitals are helpless with this kind of patient and must be transferred to a tertiary hospital. Sun Yubo asked: "Where is the patient now? At home?"
"She came to our hospital's emergency department, but couldn't get a number," Xie Wanying said. "Maybe our hospital's emergency department was full and we couldn't admit her. She took antipyretics and had injections at the primary care clinic, but the primary care clinic didn't diagnose her with appendicitis, and the anti-inflammatory injections they gave her may not have been strong enough. Now, it's clear that her condition has worsened again."
Hearing this, Tan Kelin said without further ado: "Collect!"
Sun Yubo ran out and asked the nurse to prepare an extra bed.
Fortunately, Teacher Tan was there and was willing to take the patient. Xie Wanying breathed a sigh of relief. Seeing that the patient couldn't move, she needed a lathe. Instead of going back to the general surgery department to push the lathe up and down, it would be better to borrow a lathe from the department on the ninth floor to transport the patient faster.
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