I really don't want to be a doctor

Chapter 175 Appendicitis

Jing Xiaoran pondered for a moment and said: "This uncle is very likely to be the mirror person."

"You actually know the man in the mirror?"

Deng Ying looked surprised, with a hint of approval in her eyes.

"Mr. Deng, I happened to read a report on a medical record, which was written about the person in the mirror. This kind of medical record is very special. After reading it once, you will basically never forget it."

Jing Xiaoran can only attribute these things to the occasional medical reports.

"Well, but." Deng Ying nodded, "Student, what's your name?"

"Jing Xiaoran."

It seems that for those who are not outstanding, the teacher will not deliberately remember your name, and will use "classmate" instead.

"Xiaojing, how should he explain the tenderness and rebound pain in his lower left abdomen?"

Deng Ying began to test Jing Xiaoran with the attitude of a teacher.

Jing Xiaoran said with a smile: "Uncle's cause is most likely the acute attack of chronic appendicitis, complicated by perforation, resulting in peritonitis."

Normally, the appendix should be on the right side. The internal organs of "mirror man" patients are completely opposite to those of normal people, so the appendix of "mirror man" is on the left side.The middle-aged uncle's left lower quadrant pain is consistent with appendicitis.

"Very good." Deng Ying smiled, "Xiaojing, which subject are you a graduate student in?"

"Teacher, I'm still a junior intern." Jing Xiaoran said.

"Are you still a third-year student?"

Deng Ying couldn't believe it.

Just looking at Jing Xiaoran's proficient physical examination and auscultation ability, this is obviously not the ability that a junior should have.

"Wait a minute, junior student, Jing Xiaoran..."

Deng Ying's expression froze suddenly, "Are you a student who reported fraudulent thesis?"

Jing Xiaoran nodded slowly.

Deng Ying really did not expect this time that such a student is not only familiar with clinical skills, but also familiar with scientific research work.

"Xiaojing, where are you going to be a graduate student?" Deng Ying asked with a smile, "How about considering a graduate student in the emergency department of our city hospital?"

"This one……"

Jing Xiaoran was at a loss for words for a moment.

Just then, the middle-aged uncle came back.

"Doctor, I've already done blood draws and CT scans." The middle-aged uncle said.

"Well, okay, let me see the result."

In front of outsiders, Deng Ying returned to her usual coldness.

"Sure enough, he is the mirror man!"

Jing Xiaoran saw the chest CT image clearly at a glance:
The positions of the heart, liver, spleen, and gallbladder are opposite to those of normal people. The heart, spleen are on the right, and the liver is on the left. The positions of the heart, liver, and spleen seem to be the mirror images of normal organs.

At the same time, on CT, the appendix wall of the patient was thickened, showing a ring shape, symmetrical thickening, uniform density, and a double halo or target sign.Flocculate or streaky slightly high-density inflammatory exudates appear in the fat layer around the appendix, edema and thickening of adjacent fascia (such as conus fascia or retrorenal fascia), mesentery, and local exudate (such as Fluid in the right paracolic groove), cellulitis, air bubbles outside the appendix lumen, abscess formation, and regional lymphadenopathy.

These are the CT manifestations of acute pancreatitis!

"Your situation is a bit special, we call it a mirror person among medical students!"

Deng Ying pointed to the CT image on the computer and explained to the patient: "Mirror person is also called mirror person, that is, the positions of the heart, liver, spleen, gallbladder and other organs are opposite to those of normal people."

"Ah? This, this, this..."

The middle-aged uncle was shocked when he heard it.

After living for so long, this is the first time I know that I am different.

The cause of the "mirror man" phenomenon has not yet been scientifically determined in medicine.Medical experts believe that "mirror man" is related to mutations in the development of human embryos, and the probability of occurrence is about one in a million.

"Then why did this happen? We have four brothers and sisters, none of them are like this!"

Jing Xiaoran explained from the side: "Mirror people are related to the simultaneous mutation of a site in the parent's gene during the development of the human embryo. The body organs can be seen. And the physiological function is the same as that of normal people. If the various organs do not produce diseases, it will not affect the normal life of people. But most of the mirror people will have multiple congenital deformities, and few of them can survive .”

During the development of the embryo, the development time of different viscera is different.

However, within eight weeks of pregnancy, the primordia of various viscera are established, which is a qualitative change. After eight weeks, quantitative changes begin, and the viscera develop and grow.

There is no doubt that the internal organs of the "Mirror Man" are determined within eight weeks of pregnancy.How did the guts in inversion develop after eight weeks?

Take gut development, for example.Under normal circumstances, the intestines, which were originally just a straight section, continue to grow during the development process, and the abdominal cavity can no longer accommodate them in a straight line, so it needs to be rotated.The intestines will first protrude toward the abdominal wall, then rotate 180 degrees counterclockwise, and then rotate [-] degrees counterclockwise.Instead of rotating counterclockwise, the gut with transposition of primordium rotates clockwise or does not rotate.

If the intestines are reversed, it is very likely to drive other internal organs, such as the heart.

Because the viscera are connected, the reverse position of one part of the viscera will definitely affect the position of other viscera.

"Well, this is the first time I've seen such a situation in my life." The middle-aged uncle said, "Will the normal life of this mirror person be affected?"

"The daily life of mirror people will not be affected." Jing Xiaoran said, "Under normal circumstances, if the internal organs are intact, even though the position has changed, the relationship between them has not changed. There is no significant impact on their health and life."

"However, you should have regular physical examinations, and have a basic understanding of your own physical condition. If you have a special physiological structure like a "mirror man", you should clearly inform the people around you, and inform the doctor as soon as possible when a disease occurs, so as to avoid misdiagnosis , missed diagnosis and delayed treatment.”

Although the surviving mirror people have no physical defects except for visceral transposition, medical diagnosis and surgical operations have become more difficult.For example, in the gastroscopy examination of a mirror person, the normal person is in the left lying position, while the mirror person is in the right lying position, and the operator must have reverse thinking; for common appendicitis, the normal person is in the middle and outer position of the line connecting the umbilical cord and the right anterior superior iliac spine. 1/3, and the mirror person is about 1/3 in the middle and outside of the navel and the left anterior superior iliac spine. A little bit can relieve his pain early.

"Okay, thank you doctor." The middle-aged uncle said, "Then my pain this time is because..."

"The CT report should be perforation complicated by acute appendicitis, and I will give you the hospital admission form for general surgery." Deng Ying said.

"Appendicitis?"

The middle-aged uncle suddenly realized: "No wonder I have been in pain these days, and it doesn't get better after taking anti-inflammatory drugs."

(End of this chapter)