My Medical Skills Give Me Experience Points Chapter 1245: 491: Unexplained High Fever Reaction and Multifocal Hemorrhage

Chapter 491: Unexplained High Fever Reaction and Multifocal Hemorrhage

Following an emergency endoscopy performed on the patient, the clinical findings were quite alarming.

The patient’s entire gastric lining appeared deathly pale, a clear manifestation of severe gastritis.

This pathological state typically develops when the stomach mucosa suffers from persistent erosion, deep ulceration, or inflammatory edema and exudative fluid.

It is hardly surprising that the patient looked so frail; his father admitted the boy spent all his time playing games and roaming around, rarely eating proper meals at home. Given the gravity of his gastritis, symptoms like nausea, vomiting, indigestion, acid reflux, and heartburn were practically unavoidable.

Under such conditions, how could the boy be expected to keep any food down?

Gastritis is almost always a result of chronic, poor lifestyle choices. Whether it stems from skipping meals, overindulging, consuming alcohol on an empty stomach, or relying on a diet of spicy and grilled foods, the damage is cumulative.

In essence, most cases of gastritis are entirely self-inflicted.

People rarely prioritize their well-being until the damage has already been done.

Eventually, the most overworked organs reach a breaking point and fail to function correctly. That is the exact moment when the illness takes hold.

The endoscopy revealed historical linear bleeding lesions on the posterior wall of the gastric fundus, along with superficial erosion across the greater curvature and gastric folds, which were coated in fluffy secretions and fresh blood spots.

Meanwhile, the antrum and the duodenal bulb appeared perfectly healthy.

A rapid urease test was conducted, which ultimately returned a negative result.

At this junction, the diagnosis was essentially confirmed: it was a case of gastric hemorrhage.

After consulting with Zhou Can, Dr. Ali elected to initiate treatment via blood transfusions and intravenous delivery of hemostatic agents.

Virtually all conscientious physicians exhaust conservative pharmacological options before considering invasive surgical intervention, as the latter invariably carries physical risks to the patient.

“Dr. Zhou, would implementing Batroxobin as a primary hemostatic agent be sufficient?”

“Relying on a single agent is likely too weak. We should augment the regimen with tranexamic acid,” Zhou Can advised.

Batroxobin serves as a rapid-acting hemostatic, vital for acute internal bleeding. Tranexamic acid, however, provides a potent, long-term effect by inhibiting the fibrinolytic system; it is primarily indicated for surgical bleeding linked to hyperfibrinolysis or gynecological complications. Furthermore, its ability to cross the blood-brain barrier makes it indispensable for managing bleeding within the central nervous system.

Once the patient was stabilized, Zhou Can hurried toward the operating theater, instructing Ali to devise a secondary plan immediately should the initial treatment fail to secure results.

…

Shortly after the noon hour, Zhou Can concluded his surgery and headed toward the canteen with his team for a meal.

As he passed the triage station, Dr. Ali called out to him.

“Dr. Zhou, have you just come out of the theater?”

“That is correct! The emergency surgical volume was quite high today, which delayed my departure.”

Certain surgeries remain time-sensitive and demand immediate attention.

This is especially true for tasks like securing traumatic wounds or conducting finger replantations.

In years past, the Emergency Department rarely undertook finger replantation because the procedure requires an incredibly high level of technical prowess, a skill held primarily by Dr. Xu, and the operation times are notoriously lengthy. If a critical patient arrived while Dr. Xu was occupied, the department would find itself facing a severe shortage of capable hands.

However, the Emergency Department must manage its own wound suturing, dog bites, and trauma cases effectively. Pushing these patients onto specialized departments only invites resentment and reprimands.

Years ago, a major conflict erupted between Director Xie and Vice Director Ye precisely because the Emergency Department began performing its own procedures.

In truth, Tu Ya never struggles to find patients for minor surgical procedures. As a renowned top-tier hospital with both provincial and national prestige, the volume of emergency and outpatient visits is increasing at a breakneck speed.

Every department is well-funded, and many specialized fields even suffer from an overflow of patients, leading them to turn away simpler cases.

Consequently, specialized departments face a strange dilemma: they prefer to avoid simple, minor cases while clamoring for patients with moderate to high surgical complexity.

For the sake of generating revenue, departments prioritize severe, high-difficulty cases, as these ensure that their ward beds remain occupied at maximum capacity.

Should the Emergency Department offload treatable patients onto specialized units, they are certain to face stern rebukes; at the end of the day, hospital politics are driven by interests.

Today, the Emergency Department’s operating suite is thriving, featuring a standard ward, a class-100 aseptic suite, and a specialized endoscopic theater currently nearing completion.

The surgical team has burgeoned into a robust group of twenty-five or twenty-six, including over a dozen surgeons and a similar number of operating room nurses.

At this stage, even if Zhou Can or Dr. Xu were to take leave, the emergency operations could continue without disruption.

“Dr. Zhou, could you take another look at the patient with upper gastrointestinal bleeding? After the 1000ml transfusion, he’s shown slight improvement, but the hemorrhaging hasn’t fully ceased, and he has developed a high fever peaking at 39.4 degrees.”

Ali appeared somewhat sheepish as she made the request.

As an attending physician approaching her fifties, she had sought guidance from this young Resident countless times, though she had become well-accustomed to relying on his judgment.

“Lead the way; I will examine the patient immediately,” Zhou Can replied, placing the patient’s well-being above all else.

“Dr. Zhou, would you like me to prepare a plate for you while you check on the patient?” Qiao Yu asked, quietly tending to Zhou Can’s daily necessities.