When the Doctor Uses A Hack

Chen Cang looked at the medical records and various test reports in his hand, recalling those countless appendix surgeries, and suddenly frowned slightly.

“The patient is only 12 years old, with transferred pain in the lower right abdomen accompanied by nausea and vomiting for 2 days, fever for one day, abdominal pain originating around the navel, which transferred to the lower right abdomen after 24 hours, presenting as persistent pain with episodic intensification. From previous physical examinations, there are no similar medical histories, upon inspection… the abdominal muscles are tense, there’s tenderness in the lower right abdomen, rebound tenderness, a clearly noticeable McBurney’s point, weak bowel sounds, positive psoas sign, positive colon inflation test, negative obturator internus test…”

Appendicitis was undoubtedly the issue!

But still… Chen Cang remained somewhat puzzled.

Could it be a suspicion of ureteral calculi?

But there were no symptoms of stones?

Could it be…

Chen Cang thought of a peculiar form of appendicitis!

At that moment, the anesthesiologist who was an old acquaintance, Liu Jian, came in to prepare the anesthesia.

However, as today was a competition, Liu Jian just nodded slightly without much conversation and proceeded to prepare for anesthesia.

Chen Cang quickly intervened, saying, “Brother Liu, hold on a moment, I want to recheck.”

Liu Jian paused slightly, but he stopped nonetheless.

Chen Cang approached the boy, who was visibly nervous. Seeing Chen Cang come over, he seemed at a loss and decided to simply close his eyes.

Chen Cang said, “I’m going to touch your stomach in a moment, tell me if it hurts.”

After speaking, Chen Gang’s right hand began to press in a clockwise direction starting around the navel…

“It hurts!”

As soon as he pressed down, the boy cried out in pain, frowning.

Chen Cang nodded, and then he changed to a different position!

A few minutes later, Chen Cang had an idea.

This was likely a rare case: “Extraperitoneal appendicitis!”

Such cases are exceedingly rare, caused by abnormal evolution of the cecum during the embryonic period, with an incidence rate of only 2°/o-8%.

If this type of extraperitoneal appendicitis is not treated promptly, inflammation can easily spread and accumulate, affecting nearby organs such as the ureter, kidneys, pelvic blood vessels, causing very serious complications. In simple terms, this condition was somewhat tricky!

But that’s what it was for others.

For Chen Cang, there was no pressure.

He turned to Liu Jian and said, “Brother Liu, it’s all good.”

Liu Jian looked puzzled and nodded, “This appendix?”

Chen Cang calmly replied, “It’s likely ectopic appendicitis, and moreover, extraperitoneal ectopic appendicitis!”

Upon hearing this, Liu Jian immediately frowned.

Because extraperitoneal appendicitis is extremely difficult to diagnose before surgery, and it is often only discovered during the exploration in surgery.

Therefore, this disease often leads to major issues due to the surgeon’s lack of preparation.

Liu Jian cautiously asked, “Are you sure?”

Chen Cang nodded!

When administering the anesthesia, Liu Jian was also extra cautious, after all… extraperitoneal appendicitis was something he remembered hearing about in school in Kyoto, but he had never seen it before.

At that time, several people in the office who were watching the screen in the office were smiling and discussing among themselves. As for the scores, everyone had their own opinions, but that didn’t obstruct their interaction with each other.

“Number one is very skilled, huh? Very precise techniques, the young lad is decent!”

“Number two is also good, but there’s a bit of a gap compared to number one’s grasp on the appendix.”

“Eh? Why hasn’t number three started yet? What’s going on… why are they still performing a physical examination?”

As expected, after the man spoke, the others also began to pay attention to number three.

Because at that moment, everyone else had already begun surgery, and number one had already located the appendix and was preparing to remove it.

Whereas number three had not even started!

To a layperson, the verdict would have seemed obvious at a glance!

But these were veterans experienced in the field; seeing this situation, their first reaction was to pick up and look at the medical records of the patient in the number three operating room.

A brief glance seemed to reveal nothing unusual.

This was a typical case of appendicitis, wasn’t it?

Liu Siqi naturally recognized that number three was Chen Cang. He held Chen Cang in high regard and even… upon seeing Chen Cang, he felt like giving him a very low score!

Then, he could take the opportunity to recruit Chen Cang.

Of course, this was merely a thought.

Actually, since coming in, he had been constantly monitoring Chen Cang, but seeing that he had not started the surgery for a long time, and even stopped the anesthesiologist from proceeding with anesthesia, he also became curious. What was he planning to do?

Did he have doubts about the diagnosis?

Impossible, right!

Can’t the hospital tell the difference between an appendectomy?

That’s why Liu Siqi had repeatedly reviewed the copied medical records three or four times from the start, but it was always those templates—there was nothing different!

Could it be that Chen Cang can only suture tendons? Did I overestimate him?

Liu Siqi couldn’t help but doubt Chen Cang.

Five judges, plus Hao Xuliang, all picked up the medical records to examine them closely.

They checked everything from the medical records to the lab tests to the abdominal ultrasound and still couldn’t figure it out!

Even Hao Xuliang felt somewhat embarrassed; after all, Chen Cang was the legitimate one, the rightful person. It was a good thing he hadn’t spoken, otherwise… how embarrassing.

They flipped through the medical records inside and out one or two times, and all came up empty-handed.

However, Liu Siqi, who had reviewed the records five or six times, suddenly grasped a detail!

That was that the patient’s symptoms were very similar to those of urolithiasis!

The ultrasound scan showed no signs of stones

This…

Liu Siqi suddenly froze!

Retroperitoneal appendix???

Upon thinking this, Liu Siqi had an epiphany.

At this moment, it seemed everyone else had given up and already started shaking their heads.

Seeing this, Liu Siqi spoke excitedly, “What do you all think, is it possible that this patient has a retroperitoneal appendix?!”

As soon as he said this, frowns formed on everyone’s faces.

At this time, Chen Cang had already started the surgery!

His incision was light and shallow, seemingly simple, but it precisely cut through the abdomen…

Chen Cang had to be careful; if it was a retroperitoneal appendix, it was best to be cautious and avoid spreading the inflammation.

The incision was not large, 4cm.

This was something Chen Cang had considered; too small an incision could lead to mistakes, but at 4cm, neither too large nor too small, it was enough for Chen Cang!

After cutting open, a sudden stench wafted through the air!

Chen Gang’s eyes suddenly displayed a red arrow, and he was taken aback!

The system had this function too? Helping him find the site of the lesion?

Chen Cang looked at the indicated area and saw a dark red appendix; it was congested and swollen, with pus oozing around it, and the foul odor hit instantly.

[Retroperitoneal purulent appendicitis monster, lv29, boss monster! Traits: High concealment, prone to inflammatory spread. Warning: Handle with care, do not act recklessly.]

It was indeed retroperitoneal ectopic purulent appendicitis!

And what’s more, it was a big one!

29th level, a boss monster!

Would killing it drop a legendary item?

Chen Cang couldn’t help but be thrilled, as after all, it was him who had diagnosed and discovered it. Nothing made a doctor happier than such a moment.

Meanwhile, the office was dead silent!

Everyone held their breath and focused on the scene inside operating room number three.

This is way too fake, right?

This is a performance, isn’t it?

Out of hundreds of appendectomy surgeries, you hardly ever see such a thing, and today, I happened upon it, and it seems… it was diagnosed by this young doctor?

How is that possible!

Several senior experts all frowned.

Suddenly, a man couldn’t help asking, “How did he know it was a retroperitoneal ectopic appendix? Such ectopic appendices are hard to diagnose…”

With that remark, he expressed everyone’s thoughts!

Hao Xuliang was also stunned, his eyes full of disbelief, thinking, how unlucky was this kid to encounter such a strange thing!

Liu Siqi didn’t know what to say, realizing it was indeed retroperitoneal appendicitis. It was a good thing he hadn’t acted rashly; otherwise… inflammatory spread would have been completely detrimental to recovery later on.

People around looked at Liu Siqi, their eyes filled with curiosity.

Finally, someone couldn’t resist asking, “Old Liu… are you a shill?”

Liu Siqi glared angrily, “You’re the mop! How am I a shill!”

The person wasn’t offended and just smiled, “Then how did you discover the possibility of a retroperitoneal ectopic appendix?”

Liu Siqi scoffed and pointed to the medical record, “Naturally, it’s by skill! As the saying goes, ‘read a book a hundred times, and its meaning will come to you’… if you just think carefully about the medical record, look it over and over, naturally…”

Seeing Liu Siqi put on such a pretentious act, the crowd exchanged looks, and after three seconds, they finally couldn’t hold back, “Speakhuman!”