My Medical Skills Give Me Experience Points Chapter 1376 546: The Most Dangerous Are Those Without Symptoms—Fog-Clearing Diagnosis (Part 2)

Severe pain can exhibit a continuous spread to surrounding areas or even radiate to distant parts of the body.

For instance, treating a headache by focusing on the foot implies that a foot ailment might be the source of the head pain.

Zhou Can began to palpate the patient's abdomen.

"Ow... it hurts, it hurts..."

When Zhou Can't fingers applied pressure to the upper middle abdomen, just above the navel, there was initially little reaction. However, with a slight increase in pressure, the patient suddenly cried out in agony, his body stiffening, and veins bulging on his neck.

"It appears the focal point of the pain is precisely here. Not on the surface of the upper middle abdomen, but deeper within the abdominal cavity. This region houses the stomach and pancreas. The stomach lies more superficially in the upper abdomen, with the adjacent pancreas situated deeper towards the back. Considering his symptoms, a pancreatic issue seems more probable."

While contemplating the patient's condition, Zhou Can turned to the on-call Dr. Xie.

"Have the patient's temperature and blood pressure been recorded?"

During a physical assessment, blood pressure and temperature provide crucial reference data.

"Yes, the temperature is 37.8 degrees Celsius, and the blood pressure is notably low, with systolic pressure around 80."

Dr. Xie, having served in the emergency department for over a year, demonstrated considerable improvement from his initial days. At least, he managed such details competently after admitting a patient.

Nevertheless, he typified the doctors who, while possessing extensive medical knowledge, often lacked flexibility and rigidity in their diagnostic approach.

The patient's temperature indicated a mild fever.

A systolic pressure below 80 mmHg explained Dr. Xie's evident anxiety.

Chest pain coupled with hypotension immediately brings to mind aortic dissection.

The typical systolic pressure range is between 90 and 140 mmHg; readings below this are clinically defined as hypotension, while those above are termed hypertension.

Conversely, numerous factors can lead to the manifestation of low blood pressure in a clinical setting.

Examples include chronic malnutrition, diminished thyroid function, or the intake of antihypertensive medications.

Hypotension accompanied by chest pain is particularly concerning, as most emergency physicians would first suspect a ruptured aortic dissection and subsequent internal hemorrhage.

Zhou Can's Level 6 Hemostasis Skill and Level 6 Pathological Diagnosis grant him a distinct advantage in identifying various forms of internal bleeding.

Based on his preliminary assessment, he deemed the likelihood of massive internal bleeding to be relatively low.

While many symptoms of a ruptured aortic dissection overlap with the patient's presentation, this does not definitively confirm the diagnosis.

Clinically, a multitude of conditions share overlapping symptoms.

A physician's diagnostic acumen is revealed by their capacity to swiftly and accurately synthesize numerous symptoms, conduct targeted examinations systematically, then differentiate between suspect diseases with similar presentations to pinpoint the actual underlying cause.

This process sounds straightforward but is exceedingly challenging to execute.

Most physicians dedicate their careers to this pursuit, perpetually learning and accumulating diagnostic experience. Ultimately, only a select few, less than one in ten, attain a high level of proficiency.

Leveraging his system's unique advantages, Zhou Can can achieve in a year or two what others might take twenty or thirty years, or even longer, to accomplish – his most significant current benefit.

Many doctors, after two to three decades, might only elevate their Hemostasis Skill to Level 6, while failing to simultaneously advance multiple other medical skills to comparable levels.

This results in diagnostic biases and an inevitably narrow scope of expertise.

However, Zhou Can defies this norm, elevating numerous medical skills to Level 6 and beyond concurrently. This is akin to integrating the diagnostic capabilities of multiple chief physicians with over thirty years of experience, a truly formidable prospect.

The synergy far exceeds a simple additive effect.

Indeed, he has recently demonstrated near invincibility in the emergency, pediatrics, and cardiothoracic surgery departments, resolving complex cases that had stumped chief physicians even after consultations. This attests to his exceptional mastery of multiple Level 6 medical skills.

The pursuit of knowledge is boundless.

He has not become complacent due to these achievements.

On the contrary, he continues to strive for further advancements in his various medical skills, aiming to reach Level 7.

At that juncture, while he might not claim to be the world's foremost expert, within the country, finding a peer would prove exceedingly difficult.

Dr. Xie watched as Zhou Can examined the patient, but he dared not rush him, only feeling a secret anxiety.

Good heavens, the patient's condition is already critical, displaying symptoms that strongly overlap with a ruptured aortic dissection, yet Dr. Zhou is still lost in thought?

He truly doesn't seem anxious at all!

Neither Dr. Xie nor the surrounding nurses dared to push Zhou Can.

In the absence of a chief physician, Zhou Can held absolute authority.

He was the highest-ranking doctor present.

Even if a resident physician had been there, the situation would remain the same.

"A high fever, low blood pressure, and severe pain deep within the upper abdomen..." Zhou Can knitted his brows, needing to swiftly pierce through the confusion to uncover the true cause.

At the very least, a clear diagnostic path was required.

If it wasn't a ruptured aortic dissection, but was treated as such, it would undoubtedly squander vital rescue time.

As everyone's patience began to wear thin, the patient's family members finally voiced their frustration.

"The patient is practically fading away! Can't you find a more experienced doctor? Young doctors are inexperienced and dilly-dallying, producing no results and just wasting precious time. You aren't anxious, but we, the patient's family, are extremely anxious!"

The family members were quite emotional.

"A doctor's youth doesn't automatically equate to a lack of experience or skill. Dr. Zhou is among the exceptionally talented physicians in our department and is currently concentrating on diagnosing your relative's condition. Please refrain from disturbing him. Any delay in the patient's treatment would not be the outcome you desire."

Jiang Wei stepped forward once more to shield Zhou Can.

Like a steadfast shield, she absorbed the onslaught of criticism and dissatisfaction from the family.

"Our chief physician is currently occupied in the ICU attending to a critically ill patient. As soon as the situation there stabilizes slightly, he will come over. Although Dr. Zhou appears young, his medical prowess is not inferior to the chief physician's. Please exercise a little more patience."

Dr. Xie also chimed in, bolstering Zhou Can's reputation and standing.

These abilities aren't explicitly taught.

They are skills that naturally develop through academic progression. Those who master and apply them effectively can rapidly ascend in rank and responsibility, advancing steadily. The less adept may languish at the bottom of the hierarchy throughout their entire careers.

Following the reassurances from both individuals, the family's agitation subsided considerably.

While Zhou Can remained engrossed in deciphering the patient's underlying cause, he paid no mind to the family's murmurs.

"Do you feel thirsty?"

He abruptly posed the question to the patient.

"Mmm, I truly desire to drink water!"

The patient responded with great effort.

At this juncture, the patient's breathing grew noticeably more rapid and labored, intensifying the surrounding worry.

"When did you begin feeling unwell?"

"I believe I started feeling somewhat off when I woke up the morning before yesterday."

"Have you urinated today?"

"Not yet."

"Do you currently perceive any urge to urinate?"

"It doesn't seem like it!"

Upon hearing the patient's replies, Zhou Can nodded.

"His pulse is faint, his heart rate is accelerated, he has a mild fever, low blood pressure, and experiences prolonged, worsening severe pain deep in the upper abdomen, which also radiates to his back and shoulders. Coupled with thirst and reduced urination, this strongly indicates a severe pancreatic issue. My initial suspicion is acute pancreatitis. Let's immediately conduct a complete blood count and test his fasting blood glucose. Following that, promptly arrange for an abdominal ultrasound."

With a diagnosis in hand, Zhou Can issued a series of commands with the decisiveness of a military officer.

He efficiently arranged for a battery of laboratory and imaging tests for the patient.

"So, it wasn't an aortic dissection after all!"

Dr. Xie expressed utter astonishment upon hearing this!

Indeed, he had not foreseen that Zhou Can's initial diagnostic hypothesis would be acute pancreatitis.

Dr. Xie acutely sensed the considerable chasm between his own abilities and Zhou Can's.

"Once all arrangements are in place, proceed with the examinations without any delay. You will escort the patient for these tests. As soon as the results are available, bring them directly to me or the on-duty chief physician."

Zhou Can was acutely aware of the alarmingly high mortality rate associated with acute pancreatitis and refused to be complacent.