"Allow me to report this situation to you, Director Ding." Doctor Gu spoke incoherently.
"What's the diagnosis?"
"Diagnosis--" Doctor Gu no longer dared to say the acute appendicitis that he had been so confident about before.
"Maybe we need to ask all the departments to consult again." Dr. Qian hurriedly patched it up. If he and Dr. Gu couldn't come up with a diagnosis, they could ask more colleagues to help.
"Difficult and complicated diseases." Ding Conghong quickly understood what they meant. He pondered in his throat and turned back to the person, "Doctor Xie Wanying, what is your diagnosis?"
There was a sudden silence between the two groups of people at the scene.
Zeng Wanning's breathing became rapid. His leader asked Xie instead of him.
Doctor Gu and Doctor Qian exchanged glances again: This female doctor looks very young. What made Director Ding ask her about the patient's diagnosis?
Cao Yong's eyes narrowed.
...
...
Song Xuelin bit the straw in his mouth.
Pan Shihua's eyes were full of warning lights.
"You are Teacher Tan's top student." Ding Conghong explained the reason why he asked, "I hope you can give me some advice so that I can make a decision quickly and help the patient."
It must be said that the temperament of doctors in large hospitals is completely different from that of doctors in small hospitals. Regardless of whether this person is a member of the Ding family or not, it is obvious that the other party will never make the petty mistake that her cousin's husband showed on his face.
The diagnosis must be made clear to the other party. The consequences of misdiagnosis are disastrous. Some diagnoses are difficult to identify, and may even only be confirmed during surgery. So you can't say that the doctor at the other hospital is wrong. If it is true, this disease is extremely difficult to diagnose.
"I suggest that the patient be given a CT scan immediately, Director Ding," Xie Wanying said, "focusing on the appendix and small intestine."
"Does the patient have a small intestine disease?" Dr. Qian turned and asked Dr. Gu.
Doctor Gu calmed down and pondered some rare diseases. Then he seemed to be shocked and said, "No way?"
What is it? Zeng Wanning looked nervously at all the seniors present.
"The second appendix of the human body." said Doctor Gu.
"What is that?" Dr. Qian asked since he was not a general surgeon and it was difficult for him to think of these rare diseases that were not his specialty.
"Meckel's diverticulum." Dr. Gu wiped his eyebrows and admitted, "I only saw one case in pediatrics during my internship."
Meckel's diverticulum is a congenital malformation of the small intestine, which is not uncommon. The reason why it is rarely seen in clinical practice is that this disease will not occur in many patients throughout their lives.
Meckel's diverticulum, known as the second appendix of the human body, is certainly similar to the appendix in some ways, mainly in its anatomical structure. It is an extra diverticulum at the end of the ileum, which can be imagined as an extra pouch in the ileum. So like the appendix, if feces or other objects are stuck in the diverticulum, or inflammation and ulceration occur, acute abdomen will occur. In severe cases, perforation and intestinal obstruction will cause massive bleeding.
Because it is located in the ileum and its anatomical position is close to the appendix, and because it is rare for adult patients with Meckel's diverticulum to seek medical treatment with clinical symptoms, clinical doctors rarely think of this disease first.
For differential diagnosis, as Xie said, CT scan is needed. Other tests, including ultrasound, are very likely to misdiagnose. There is no recommendation for CT scan for patients who are almost diagnosed with acute appendicitis in the emergency department. In many cases, this kind of disease turns out to be not acute appendicitis after the doctor opens the patient's abdominal cavity on the operating table.
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