Chapter 394: Chapter 198: This Isn’t a Tumor, It’s Actually Intussusception (Part 2)

There might be quite a bit of urine accumulated inside.

"Let me check that lump again; it might hurt a little, so please bear with it."

Out of a sense of medical responsibility, Li Jingsheng decided to examine it once more.

The texture of the lump felt relatively soft and could be moved. Fortunately, its boundaries were clear, and it didn’t feel as hard as a tumor, so an initial diagnosis could rule out the possibility of a tumor.

"Have you vomited?"

Li Jingsheng asked the patient.

"No!"

The patient shook their head slightly.

Li Jingsheng couldn’t help but frown and ponder; from the feel of it, this lump didn’t resemble a bladder enlarged with accumulated fluid.

If the bladder had enlarged with so much urine, it would certainly be heavy when moved.

But at the moment, the sensation was very light.

Therefore, he thought the likelihood of the bladder enlarging with urine accumulation was very small.

So what exactly is this lump?

Also, the patient’s severe pain wasn’t located at the lump but rather around the navel.

This was indeed puzzling.

As a rule, these kinds of patients often experience shifting abdominal pain, but this patient has never shown this phenomenon.

Numerous doubts constantly arranged themselves in his mind, and he synthesized them with the patient’s medical history, symptoms, and results from tests such as temperature, blood pressure, and X-ray imaging for a comprehensive diagnosis.

The skill of a minor achievement level in gastroenterology combined with the practical ability of a senior attending physician made him not find diagnosing this case particularly arduous.

Diseases matching the above symptoms flashed through his mind one by one, only to be dismissed again.

"Have you had a bowel movement from yesterday to today?"

Li Jingsheng suddenly thought of an important question.

He asked the patient on the spot.

Previously, he thought the lump was likely due to bladder enlargement from urine accumulation, so he only inquired about the patient’s urination, overlooking the bowel movement.

Doctors are human too, and omissions often occur during diagnosis.

That’s also why when faced with a challenging case, the primary doctor, when uncertain, will ask other doctors for a consultation.

Pooling collective wisdom can minimize the risk of misdiagnosis and missed diagnosis.

"No. Perhaps it’s because I didn’t eat much after my stomach started hurting yesterday!"

The patient explained weakly.

Li Jingsheng just nodded, but didn’t think so in his heart.

After food enters the stomach, it doesn’t immediately form stool. It goes through a relatively long process.

The duration can be as short as eight to ten hours or as long as over twenty-four hours.

This depends on an individual’s gastrointestinal digestion capability.

"Let me listen to your bowel sounds again. Lie down and don’t move."

Li Jingsheng had only performed an abdominal palpation outside, simply inquiring about the patient’s symptoms and medical history, without conducting more detailed examinations.

Now, out of trust and having paid a hundred yuan, the patient just wanted a preliminary diagnosis result.

So he definitely needed to give his best effort.

He immediately took off the stethoscope from around his neck, and after putting it on, pressed the probe against the patient’s abdomen.

The bowel sounds were distinctly audible and quite active.

However, the bowel sounds were somewhat low, giving a sense of feebleness.

It was like a dancer who was evidently sick, still exerting herself to dance to please the judges.

But because she was ill, no matter how hard she tried, she still seemed feeble.

At this moment, the patient’s bowel sounds gave him this kind of feeling.

They were very active, but the noise they made sounded subdued.

"Could it be an intestinal obstruction?"

Reaching this point, Li Jingsheng immediately had a relatively clear diagnostic direction.

However, he quickly ruled out this diagnosis.

The lump felt soft upon touching.

If it were an intestinal obstruction and had lasted this long, it should be very hard.

Even if a blockage occurs, the intestine’s absorption function continues to operate. This causes the feces blocked in the intestine to become increasingly dry and hardened.

Upon touching, it should certainly feel harder than this.

Moreover, the patient hasn’t vomited.

In the vast majority of cases, patients with intestinal obstruction will exhibit symptoms of vomiting.

There would also be abdominal distension, colicky abdominal pain, and so forth.

One disease after another was ruled out by Li Jingsheng, and his diagnosis didn’t fall into a predicament.

Because now his doctor level had reached that of a senior attending physician, his thinking became broader during diagnosis.

"Could it be an intestinal polyp?"

That thing really feels like a piece of lard when palpated.

Or rather, like an enlarged, soft-intestine mass.

He quickly dismissed this idea as well.

Intestinal polyps with a diameter of 1 cm were already very alarming, and the size of that lump far exceeded the maximum diameter of the intestine.

Such a large intestinal polyp?

It would be shocking.

If there were indeed such a large polyp, the patient’s intestine would have been completely blocked ages ago.

Since it’s not a polyp, then what exactly is that lump?

Li Jingsheng believed that once the nature of the lump was clarified, all doubts would be resolved. 𝚏𝕣𝕖𝚎𝚠𝚎𝚋𝚗𝐨𝐯𝕖𝕝.𝕔𝐨𝕞

Tumor, intestinal obstruction, bladder enlargement from fluid accumulation, intestinal polyp—all were ruled out.

The possibility of appendicitis was ruled out early on.

For diseases matching the symptoms, he really couldn’t think of any at the moment.

"This patient’s illness certainly isn’t a common intestinal disease; it’s likely a rare intestinal disease."

After careful consideration, he arrived at such a conclusion.

There are numerous rare intestinal diseases.

Moreover, his current level and ability were limited, and he hadn’t mastered many rare diseases.

At least his doctor level needed to be promoted to associate chief physician or higher to gradually master a vast number of rare and complex diseases.

Having diagnosed the patient’s etiology to this extent, he naturally wouldn’t give up easily.