I'm just a veterinarian! You've unlocked the Great Physician System!

Chapter 436 The head of the ultrasound department's head was buzzing; a murderous seed, a bizarre heart condition! [Thank you for your blessings]

If it really is what they're thinking, how did Junior Brother Zhang figure it out?!

You should know that this is an extremely rare occurrence!

Some obstetricians and gynecologists never see this in their entire lives.

Most people have only seen it in textbooks or some other materials.

Zhao Lingyun almost missed connecting with Sister Lan's brainwaves.

It just so happens that her current research topic is ectopic pregnancy.

"Teacher Li, senior sister, what's going on here?"

Zhang Lingchuan looked at the two who seemed to have suddenly realized something.

In fact, Director Li Tinglan realized that what he said made perfect sense.

But my senior sister also understood, which was a little surprising.

I'd like to know what answers the two of them have come to.

"Xiaoyun, tell me your analysis. I remember this is also the research direction of your doctoral dissertation."

Li Tinglan looked at Zhao Lingyun.

"Normally, pregnancy occurs either in the uterus, the fallopian tubes, or even the ovaries. The former is a normal pregnancy, while the latter is an ectopic pregnancy. However, in addition to this, there is an extremely rare situation in clinical practice, which is pregnancy in other areas inside the body!"

Zhao Lingyun said.

If the HCG test indicates pregnancy.

However, no gestational sac could be found in the uterus or fallopian tubes.

A full-body check-up must be conducted immediately.

"Ah."

Li Tinglan nodded.

Xiaoyun's analysis is correct.

Zhang Lingchuan suddenly realized the truth.

It turns out that Senior Sister Xiaoyun specializes in research on ectopic pregnancy; no wonder she could tell.

"The most common site of ectopic pregnancy is the fallopian tube, accounting for about 98%, followed by the ovary and cervix, which are extremely rare, accounting for about 1.99%. The rarest location is the abdominal cavity, intestines, peritoneum, liver surface, etc. Once it occurs, it can easily lead to massive bleeding, endangering life and requiring emergency surgery or interventional treatment!"

Zhao Lingyun said.

Because when Director Long called earlier, he clearly stated that there was no ectopic pregnancy!
She has already had her fallopian tubes checked, and even her ovaries.

I guess they also checked the cervix.

One is common, the other is rare!

There's another rare one!

Just like malignant hyperthermia!
Who would normally look up this kind of thing!

However, if a woman becomes pregnant again but cannot find a gestational sac, a thorough investigation is necessary.

So she is worried about this Yunman girl, how could the ectopic pregnancy have spread to the abdominal cavity? But she is also a little excited, as if it is a doctoral dissertation material sent by God.

You must take good care of yourself.

We absolutely must not let anything go wrong.

I inexplicably felt like a female graduate from an agricultural college protecting her crops from being cut down.

"Hmm, very good analysis, Ogawa. Can this pulse diagnosis also determine whether something is inside the uterus?"

When Li Tinglan heard that her student's analysis was reasonable and well-founded, she immediately nodded.

No wonder he is a student who has qualified for a doctoral degree in just three years.

Overall, their abilities are still acceptable.

how to say.

Doctoral programs are characterized by easy entry but strict exit requirements.

After all, your doctoral graduation represents your supervisor's future reputation. If you graduate with a mediocre degree, although you pose no threat to your supervisor in academia, you can ruin their reputation in the education field.

Therefore, Li Tinglan has two doctoral positions available each year.

But she only recruits one doctoral student.

Because my energy is limited, one doctoral student per year is enough.

There are simply too many questions to answer.

After all, she herself is very busy.

However, if all students were like Xiaochuan, she felt that even ten doctoral positions wouldn't be enough.

Because it was just a matter of getting to know the other person, they quickly got into the swing of things.

It can even work according to its own state.

I'm just asking you, how strong is it?

That's absolutely terrifying.

Moreover, there is a high probability that such students can also motivate teachers to improve.

I love it so much.

At the same time, Li Tinglan was also very curious about Xiao Chuan's confident expression; how did he know all this?

Is there a difference in pulse signs between a normal pregnancy and an ectopic pregnancy?

"There are indeed some differences, but I don't know how to describe them; they're rather subtle."

Feelings are the easiest things to hide.

Therefore, he is not afraid of being investigated further and thus exposing himself by describing it in this way.

people.

Still have to be cautious.

"Amazing! Amazing! I apologize to Xiaochuan for my previous distrust. Also, Xiaochuan, please don't call me Teacher Li anymore, it sounds too formal. Just call me Sister Lan, like Xiaoyun and the others. That way, it will make me seem younger."

Li Tinglan apologized to Zhang Lingchuan.

There's no such thing as a teacher being too proud or putting on airs.

Do what you have to do.

As for titles, "Teacher Li" or "Director Li" are a bit too formal.

I'll just call myself Sister Lan like the other students.

This will also make you look a little younger.

"Sister Lan, there's no need to apologize. Actually, this result is indeed a bit unbelievable, so it's normal that you didn't believe it at first."

Zhang Lingchuan said.

Sister Lan actually apologized.

"Of course, teachers should set an example. If the gestational sac is indeed inside the abdominal cavity, we would probably need to perform emergency surgery!"

Li Tinglan's eyes were serious.

No matter where the parasite takes place, it will be fatal for that girl.

There is something to say.

A gestational sac is only a true gestational sac when it is inside the uterus.

It can ensure the safety of the mother.

Outside the womb, it is a seed that kills.

It may take the mother's life at some point.

Ultrasound Department.

"Gulu——"

Long Yujie swallowed.

"???"

The assistant doctor next to him stared at the screen in disbelief.

"How...how could this happen! How could this be?!"

Long Yujie murmured.

His tone was filled with disbelief.

"Doctor... what's wrong with me??"

Yunman was completely bewildered.

Because these doctors just started examining her stomach.

Just as she was wondering what was going on, the director seemed to have lost his soul.

She couldn't understand it at all.

Confused.

"Girl, I've found the gestational sac..."

Long Yujie looked at Yun Erman.

The other person's face was incredibly grim.

"They found the gestational sac? I'm pregnant? Didn't they say they couldn't find it before? Was it too small?!"

Yunman was completely unaware of the seriousness of the situation.

She asked with a hint of curiosity.

"No, we didn't find it in the fallopian tubes, ovaries, or even the cervix before. It has nothing to do with size. We can detect abnormalities in these areas no matter how small they are, but these areas were completely clean in the previous examinations."

Director Long replied.

She was quite confident in her technical skills.

You can definitely tell if it's true.

"So where was it found now?"

Yunman was a little confused.

It's not in the uterus, nor in the fallopian tubes, nor in the ovaries; even cervical doctors say it's not there.

Where could my child possibly run off to?

Of course, while I was still confused, I quickly came to my senses.

To my utter surprise, the doctor was right.

She really is pregnant.

She even went to Little Green Book to expose this doctor.

I'll have to delete it when I leave.

Otherwise, it wouldn't be good if someone found out.

outside.

Qu Zixiang is browsing Little Green Book.

"what?"

Suddenly, she realized that her best friend's post seemed to have gone viral.

In just over an hour, the number of views has reached 50,000!
There were even more than three thousand comments.

Do so many people hate quack doctors?

Because my best friend's post included topics like quack doctors and misdiagnosis.

"Damn it! The most annoying thing is quack doctors! I've been misdiagnosed before! Their pulse diagnosis is inaccurate too. Wasn't there a TV show where even the best pulse diagnosis accuracy for pregnant women was only 50%?!"

"A normal TCM doctor's consultation probably accounts for 50%, but this sign says Zhang Lingchuan! Holy crap! Are you sure it's Zhang Lingchuan?!"

"I also find it incredibly strange. How could Zhang Lingchuan be associated with terms like misdiagnosis and quack doctor! It's unbelievable!"

"Is it possible that they just have the same name? Isn't Dr. Xiao Chuan at the Provincial People's Hospital? Is this hospital affiliated with the Provincial People's Hospital or the Department of Obstetrics and Gynecology?"

"Isn't he a student at the University of Science and Technology of China? He even got into the University of Science and Technology of China's medical school for his doctorate. Maybe no one even knew he was studying there! And look at this picture, even though he's wearing a mask, the eyes are definitely his!"

"Who is Zhang Lingchuan? Why are you all so excited?"

"Although I know Mr. Zhang might not be that famous, you can easily search him up with a click of your finger. He's a major influencer with 30 to 40 million followers on the internet, and he always manages to break into the top 50 on Douyin every time he goes live. Most importantly, he's been a guest on the Spring Festival Gala! Needless to say, his prestige speaks for itself!"

"Actually, I can talk about the time when I saved a child's life at an international event by a top emergency medicine expert, and also about being invited to a world-class emergency medicine forum."

"Those who aren't medical professionals wouldn't know the value of this; talking about that is less meaningful than mentioning his tens of millions of followers and his role as a guest on the Spring Festival Gala!"

……

Little Green Book.

Many people are talking about it.

However, aside from one top-rated comment supporting her best friend, almost 50% of the comments expressed shock, wondering how the name Zhang Lingchuan could be associated with quack doctors and misdiagnosis.

Of course, more than 49% of them are paying attention to their best friends.

"Sister! Seriously, this Dr. Ogawa is really weird. He said you're pregnant, and you probably are."

"Indeed, his diagnosis hasn't been wrong. I suggest you switch to another hospital if this one can't find the problem; what if their ultrasound machine is broken?"

"You guys would rather believe the hospital equipment is broken than believe Dr. Ogawa made a mistake. It's really outrageous, but believe it or not, there's actually a possibility!"

"Here's a little-known fact: the gestational sac... can actually move around quite freely."

……

[Baidu search: Zhang Lingchuan]

Qu Zixiang quickly opened Baidu.

I plan to do some research.

Because she was indeed somewhat unfamiliar with the name Zhang Lingchuan.

However, she was stunned when the searched photos came up.

Especially the other person's name.

[Douyin Account: Zhang the Veterinarian's Daily Life]

[Alternative names: Veterinarian Zhang, Dr. Xiao Chuan, Boss Zhang, God Zhang, Teacher Zhang...]

"Zhang the veterinarian!!"

The next moment.

A flood of memories rushed into Qu Zixiang's mind.

She still remembered the name because she frequently uses her phone.

There was even a poll on Xiaolvshu (a Chinese social networking site) where someone voted for the "Nation's Husband," and this Dr. Zhang was one of the winners.

No wonder he's so handsome!!
And she's so outspoken!

Even the director didn't stop it.

Yes, why didn't I realize this connection back then?

If he were just an ordinary person, would the director have let it go unchecked?

"But, but that can't be right! Are ectopic pregnancies really that dangerous?!"

As I flipped through the pages...

The more I looked, the more terrified I became.

Things like the gestational sac is estimated to be in the abdominal cavity, and there's a high probability of heavy bleeding.

"Perhaps the machine is broken!!"

After looking at it, she felt that the machine was very likely broken, and she was willing to believe that the machine was broken, and prayed that it was definitely broken.

At the same time, his gaze unconsciously drifted towards the ultrasound room.

Inside the ultrasound room.

No one knew that at that moment, Long Yujie, as the director, was having a very loud and rapid brainwave.

She swore that this was the first case she had ever seen in her career.

"Girl, your gestational sac is located on your liver."

As Long Yujie spoke, her tone was more complex than ever before.

"Liver, liver area? What does that mean???"

Yunman hadn't quite grasped what was going on yet, and asked, somewhat bewildered, "What does this mean?"
"That means the gestational sac that should have been in your uterus is actually in your liver. That's why your HCG test showed you were pregnant, even though I couldn't find it in your fallopian tubes, ovaries, or even your cervix."

Who in their right mind would imagine that it's actually in the liver?

Long Yujie also offered an explanation.

She only remembered it after seeing this HCG test result. Since the result showed she was pregnant, it was highly likely she was.

If it's not in the uterus, it must be somewhere else.

Normally, each case should be checked one by one.

For example, the fallopian tubes are the most common site for this.

Then there are the ovaries and cervix.

Although rare, it has happened before.

If all these areas have been checked and the problem is still not found, then the only option left is to look inside the abdominal cavity.

There are many areas in the abdominal cavity where a gestational sac can implant.

For example, the peritoneum, the mesentery in the pelvic cavity, the serosal layer on the surface of the uterus, the pelvic peritoneum, and the parametrial tissues.

For example, in the digestive system, the mesentery, including the small intestine, large intestine, surrounding tissues of the rectum, and even the intestinal wall, can be extremely rare and extremely dangerous.

The urinary system, the surface of the bladder, or the peritoneal reflection are also possibilities, although they are very rare, but they still need to be investigated.

And the area below the diaphragm, the greater omentum, and the abdominal wall.

The most dangerous area is undoubtedly the liver, gallbladder, and spleen region.

Because of their extremely rich blood supply, the surface of the spleen or the surface of the liver, or within the liver fissures, can easily lead to fatal massive bleeding during surgery.

Unfortunately, that's the case.

The gestational sac is currently implanted on the surface of the liver.

Without surgery, he would surely die.

There are no reported cases worldwide of someone surviving a liver development disorder.

Both the unborn child and the mother herself will die.

However, if surgery is performed, there is a high probability of massive bleeding.

There is also a high possibility that they will die on the operating table.

"This, how is this possible? How could this gestational sac be on my liver! Shouldn't it be in my lower abdomen, inside my uterus? Or at least in the surrounding ducts? Aren't they closed off?!"

Yunman didn't know much about the structure of the uterus.

But normally, shouldn't it be closed?

How could it possibly end up inside my stomach and even implant in my liver?

This is utterly unbelievable!!

"Well, this is a rather technical question. It would be more appropriate to ask Director Li from the Obstetrics and Gynecology Department."

……

The consultation room.

"I'll explain from a clinical and embryological perspective why a gestational sac appears in the abdominal cavity. Under normal circumstances, after ovulation, the egg is drawn into the fimbriae of the fallopian tube, which is the opening of the fallopian tube..."

Li Tinglan spoke.

In short, the egg combines with sperm in the fallopian tube to become a fertilized egg, which then moves along the fallopian tube toward the uterine cavity and eventually implants.

"The most common cause of ectopic pregnancy is obstruction of fallopian tube transport."

Inflammation of the fallopian tubes, surgical adhesions, tuberculosis, and malformations can damage the activity of the fallopian tube cilia, preventing the fertilized egg from successfully entering the uterus. Instead, the egg may remain in the fallopian tube or be forced to fall from the fimbriae into the abdominal cavity.

Li Tinglan explained.

Besides this kind.

Abdominal pregnancy is also the most common source of pregnancy.

A ruptured or miscarried ectopic pregnancy can lead to a secondary abdominal pregnancy.

The specific process is as follows.

The fertilized egg had already implanted in the fallopian tube, but due to insufficient blood supply or limited space, the embryo detached or ruptured.

The gestational sac is released into the abdominal cavity and "drifts" again to find a new implantation site on the abdominal organs or peritoneum.

This is also a common cause of abdominal pregnancy.

There is also a less common type.

It is called primary abdominal pregnancy.

This allows the fertilized egg to directly enter the abdominal cavity.

The specific reason is that the fimbriae of the fallopian tube did not successfully capture the egg. Fertilization may occur in the abdominal cavity or near the surface of the ovary, with the fertilized egg attaching directly to the peritoneum/organ surface.

To establish a primary abdominal pregnancy, the following criteria must be met: 1. The fallopian tubes and ovaries are completely normal; 2. There is no uterine-abdominal fistula; 3. The pregnancy is implanted only in the abdominal cavity.

"Your fallopian tubes are probably inflamed, which is why you have an abdominal pregnancy."

After explaining the facts, Li Tinglan also gave the cause of the incident based on the examination report.

That's a typical case of fallopian tube inflammation.

"Director Li, what kind of treatment should I receive for my condition?"

Confused.

I'm completely baffled.

Yunman never imagined that her child would end up on her liver.

The doctor had already mentioned that.

Such places are usually very dangerous, and children have almost no chance of survival.

Even mother and child might die together.

So now she's curious about what kind of treatment the doctor needs.

"Ectopic pregnancy surgery is a high-risk procedure that requires multidisciplinary teamwork."

First, there's their obstetrics and gynecology department, responsible for managing pregnancy lesions and assessing HCG changes. Second, there's the hepatobiliary surgery department, responsible for performing surgeries, managing liver bleeding, and performing partial hepatectomy when necessary. There's also the interventional radiology department, which performs hepatic artery embolization when necessary to control intraoperative/postoperative bleeding.

In addition, the anesthesiology department is indispensable, including the use of floral hats for deep vein puncture, central venous catheterization, and rapid blood transfusion preparation.

In addition, there is an ICU for postoperative monitoring to prevent hemorrhagic shock.

Li Tinglan told her all of this.

"Wow, so many departments are working together!"

Yunman originally thought that the surgery could be done in the obstetrics and gynecology department.

I never expected that so many departments would collaborate.

As for Qu Zixiang standing next to him, she didn't dare to say a word.

Because what we see before us is beyond our comprehension, and just as the sisters in the little green book said, it has become a synonym for endangered.

Oh my goodness.

Now she only feels difficulty breathing.

The tumor has reached the liver area.

She actually knew that!

"Your condition is very dangerous. We need to coordinate with various departments to ensure your safety to the greatest extent possible. Okay, now go and complete the admission procedures and notify your family to come over. This surgery can't be done immediately."

Li Tinglan said.

A surgeon needs to prepare, and so does the patient.

For example, you should fast and abstain from drinking for at least 6–8 hours before surgery.

At the same time, risk communication and informed consent should be conducted, explaining in detail to the patient and their family the risks of bleeding, even fatal massive bleeding, the possibility of partial liver resection, the possibility of transfer to the ICU during/after surgery, and the priority of saving the patient's life, as well as the inability to preserve the pregnancy.

Multiple consent forms must be signed before surgery, including those for surgery, blood transfusion, ICU, and possible secondary surgeries.

In short, it's very complicated.

"Okay, thank you Director Li and Dr. Zhang. I exposed you on Xiaolvshu, but I've already deleted the post. I'm really sorry."

All that could be seen was Yunman sincerely apologizing after expressing his gratitude.

She genuinely didn't expect her post to become so popular and attract so many views.

Even after I deleted it, many people still sent me private messages.

The number of followers skyrocketed from just a few people to several thousand.

"It's alright, it's alright. After all, most normal people misunderstand things, even ultrasound technicians do. I've developed a strong heart now."

Zhang Lingchuan smiled and said.

He really didn't care about that.

And so the two of them left.

I went to the hospital for surgery.

"Xiao Chuan, you'll definitely have to come to this surgery, right? You can't run away!"

Li Tinglan looked at Zhang Lingchuan.

"Uh, definitely, definitely."

Looking at his master's wife, Zhang Lingchuan's expression turned bitter.

"Junior Brother Zhang, no matter where you are, I will definitely come and pick you up!"

Zhao Lingyun also said it half-jokingly.

After all, this was her doctoral dissertation.

Just like the grass grown in the lawn of the agricultural college, if someone steps on it and kills it, that's the end of the world, and graduation is hopeless!

Didn't a freshman accidentally step on the grass that killed a PhD student before, causing the PhD student to have to delay graduation?

Although she also wanted to extend her studies.

But research needs to keep up.

We must not delay graduation without any results.

Only extensions that result in tangible outcomes are truly controllable.

"..."

Zhang Lingchuan remained silent.

[Ding! Congratulations, host, for completing the consultation mission. You have received 1 Common Treasure Chest and 500 Professional Reputation.]

Because at this time.

A notification popped up in front of him.

It turns out that Yunman proactively examined and prompted her, and now she is being rewarded.

[Ding! Host, would you like to open a regular treasure chest?]

Just at this time.

The words before Zhang Lingchuan appeared again.

"Open!"

Without almost any hesitation, Zhang Lingchuan opened the ordinary treasure chest.

[Ding! Congratulations, host, you have obtained 1 Hidden Item Card Fragment and 1 Precise Scan!]

The next moment.

Zhang Lingchuan was stunned.

Because he discovered that he had actually obtained a hidden item card fragment.

This is good stuff again!!
[Fragment Quest: Please collect 10000 class reputation points within ten days.]

"???"

The task pops up.

At first, he thought it was some kind of emergency.

He was dumbfounded the next moment.

It's professional reputation!
Wow, 10,000 professional reputation!
[Professional Reputation: LV8: 79980/10w (Resident Physician)]

What does he want to do?

Do you want to become an attending physician as soon as possible?
They did introduce a new gameplay mode with hidden item cards, though it's possible they were just too ignorant about it before.

I always thought it was some kind of emergency rescue mission.

But I have a feeling this thing is up to no good.

Over the course of ten days, you will receive two free regular scans per day under normal circumstances. Each scan grants ten points of professional reputation, so two scans would grant twenty points of professional reputation.

In ten days, you can only gain a base 200 points of professional reputation.

If you activate one task every day and are guaranteed at least 500 professional reputation points, it would only take ten days to accumulate 5,000 professional reputation points.

You also need to find treasure chests to do this.

Normally, opening a treasure chest will give you 1,000 professional reputation.

Of course, it's also possible that it won't.

It mainly depends on what the reward is.

Like now, three items are enough to give you a chest reward of 500 profession reputation.

Sometimes, two items can give you 1,000 professional reputation points, and if you're lucky, you can get 2,000.

In summary, over these ten days, I must activate the tasks every day and obtain at least three to five treasure chests!

Oh shit!

These hidden item cards are quite difficult to obtain.

"Dududu-"

Just as Zhang Lingchuan opened the treasure chest and answered his senior sister's question, Li Tinglan's phone rang.

"Is it an urgent consultation? Okay, okay, I'll be right there!"

The other party responded quickly after I answered the phone.

"Xiaoyun, you stay here. I need to go to the emergency department for an urgent consultation. Xiaochuan, come down with me!"

Li Tinglan immediately called Zhang Lingchuan.

"understand!"

Emergency consultations in the emergency department are usually very urgent.

After all, I also came from the emergency department.

Often, a consultation with a specialist is required.

This is especially true in smaller places.

For example, in Qingxian County, whenever there's an emergency, they call for a specialist consultation.

Sometimes, when the disease is unclear, various departments are called in to identify whether it is a disease belonging to their department.

"Sister Lan, what's the reason for this emergency consultation?"

Zhang Lingchuan asked curiously in the elevator.

"They said a woman in her thirties or forties was rushed to the hospital with a heart attack, and her condition is not optimistic. Let's go and take a look."

Li Tinglan said.

"Does the cardiology department have to call our gynecology department too?"

This area was indeed a blind spot for Zhang Lingchuan.

"Well, often when it comes to women, it's called gynecology, and it's true that it can indirectly cause or aggravate heart disease through hormones, inflammation, metabolism, blood vessels, and other pathways."

Li Tinglan explained.

"Oh I see."

Zhang Lingchuan suddenly realized something.

In the emergency room lobby on the first floor, there was a rather thin woman.

His face was pale at this moment.

"This is Sun Yuyu, the daughter of Professor Sun, the former deputy director of the Department of Internal Medicine at our hospital. According to her medical records, she started experiencing frequent dizziness two years ago. After various examinations, the cause could not be found. It was suspected that she had a congenital heart problem, but the specific problem was still unknown."

"Today, after taking a shower, she started having difficulty breathing and became unconscious. She was then rushed to our hospital, suspected of having a severe heart attack. Therefore, we have convened a consultation with the heads of various departments in hopes of finding out the cause and quickly providing emergency care!"

The doctor next to them described the patient's condition.

"wrong?"

Zhang Lingchuan approached.

After the scan, he frowned, because it wasn't a heart attack at all!

……

(End of this chapter)