According to the patient’s family description and the diagnosis from the hospital below, there is no issue.

The patient had a bit of seafood two days ago and experienced abdominal pain and vomiting that night.

After undergoing a medical examination at the hospital and receiving some intravenous fluids, she improved. After all, the patient is pregnant, and the treatment must be extremely cautious to avoid harming the child.

Considering the patient’s current reactions and physical examination, it’s most likely a gallbladder or gastrointestinal disease.

The hospital below hasn’t found out the cause; now let’s see their test results.

"It’s killing me~ It hurts so much~"

On the hospital bed, the woman was tossing and turning in pain, her face pale as paper.

The pain seemed to be intensifying, but there was nothing that could be done at the moment.

Outside the emergency room, Xiaoxiao, after a detailed inquiry, pushed open the door with furrowed brows and walked in.

"Dr. Han, the patient has fainted!"

At that moment, a nurse suddenly shouted.

Upon hearing this, Xiaoxiao’s heart tightened, and she rushed over, quickly checking the woman’s heartbeat and pupils.

"Physiological saline and glucose intravenous infusion."

The test results haven’t come out yet, and the patient’s vital signs are still relatively stable; it should be a syncope due to excessive pain.

"Notify the gastroenterology and obstetrics departments to come in for consultation."

Quickly, the saline was hung, and the doctors from obstetrics and gastroenterology who received the emergency message hurried over.

Upon learning about the patient’s condition, the two looked at each other in confusion.

They hadn’t heard of this type of pain, and the test reports provided were brought from outside hospitals.

"Dr. Han, the test results are out."

Meanwhile, a doctor from the laboratory came over, running all the way, and handed over all the test reports.

Xiaoxiao hurriedly took them, and the three doctors simultaneously started the consultation.

However, a few minutes later, all three were stunned.

All the test results were completely normal!

"What’s going on here?"

The gastroenterology doctor was dumbfounded, muttering to himself.

Despite B-ultrasound, imaging, and relevant tests, all indicators were completely normal!

The patient also showed no signs of food poisoning, and the test results agreed with the external hospital’s report.

Normal!

"Dr. Han, this is...."

The obstetrics doctor also looked helpless.

Crash~

Just then, as the three were confused, the woman suddenly opened her eyes and sat up abruptly.

This situation startled them, but they quickly calmed down.

"How are you feeling? Does it still hurt?"

Xiaoxiao approached the woman and asked.

...

The woman’s expression appeared stiff; hearing her words, she only glanced and didn’t respond.

Xiaoxiao sensed that something was off and raised her voice to ask a few more times.

Still no reaction!

The woman’s pupils dilated and contracted, her mind seemed somewhat disoriented as if she didn’t hear anything.

"Could it be pregnancy syndrome?"

The female obstetrics doctor couldn’t help but wonder.

Pregnancy syndrome possibly resulting from emotional anxiety, can cause symptoms like depression or mild nerve disorder, leading to a state of distraction.

This is possible in medicine.

"Ouch~ It hurts!"

Suddenly, as if she came to, the woman clutched her abdomen and began to cry out in pain again.

Xiaoxiao and the other two were completely bewildered, and their expressions grew even more serious.

Unable to find the cause, there’s no way to solve it!

"B-ultrasound showed no anomalies, liver and gallbladder are normal, and there’s no sign of pelvic effusion. How about doing a gastroscopy?"

The gastroenterologist asked, knitting his brows.

"Could it be a cornual pregnancy?"

The obstetrics doctor pondered aloud at this moment.

Cornual pregnancy, a special form of ectopic pregnancy, is where the embryo implants near the junction of the uterus and fallopian tube at the cornual section.

Cornual pregnancy generally has three scenarios.

First is embryonic arrest and miscarriage;

Second is expansion of the gestational sac in the cornual section eventually leading to rupture;

Third is extension of the embryo into the uterine cavity for complete delivery in later stages. Due to the thin muscular tissue of the cornual section, which coincides with uterine blood vessels and nerves, it’s rich in blood supply.

Implantation here may lead to base layer rupture and increased bleeding as the pregnancy progresses, which poses a life-threatening risk if diagnosis is delayed.

If it truly is cornual pregnancy, considering the woman’s current situation, it’s very likely the third type.

Additionally, once pregnancy reaches mid-term, cornual pregnancy is hard to detect by ultrasound.

Upon hearing her words, Xiaoxiao and the gastroenterologist’s expressions changed.

If it’s indeed cornual pregnancy, there’s a high risk of uterine wall rupture, potentially posing a life-threatening situation.

A planned termination must be done ahead!

"How about doing a gastroscopy first for exclusion?"

The gastroenterologist quickly suggested.

"I agree."

Upon hearing this, the obstetrician nodded.

First exclude, if there’s a significant possibility, further exploration is needed.

Given that the patient is already in mid-pregnancy, it’s not a good idea to do a CT scan without confirmation.

"Should I call the director to take a look?"

Xiaoxiao hesitated, saying reluctantly.

Upon hearing this, the other two doctors nodded.

It’s best to have leadership at this time, especially since this is the emergency department, so the duty leader of the emergency room should be involved.

After speaking,

Xiaoxiao swiftly walked to the office.

"Director Qin, can you take a look? There’s a difficult case, and we can’t determine the cause."

Upon hearing the request, Qin Feng raised his head, then stood up to ask.

"What is the situation?"

"The patient is female, 35 years old, 16 weeks pregnant, suddenly experiencing abdominal pain. She has undergone examinations at three hospitals below, but no problems were found, thus transferred to us."

Xiaoxiao quickly explained the situation.

"We’ve conducted thorough examinations, but all results seem normal — ultrasound, blood tests...."

As they walked and talked, upon hearing the whole process, Qin Feng also showed a surprised expression.

Couldn’t identify the cause?

The obstetrics department suspects cornual pregnancy.

If it’s true, then it would indeed be troublesome!

"Oh dear~"

Inside the rescue room, Qin Feng observed the woman clutching her bloated abdomen in pain while sweating profusely.

"Don’t move, let me examine you."

He donned a stethoscope, speaking as he reassured her.

"Does this hurt? How does it hurt?"

...

After a brief physical examination, Qin Feng grabbed the test reports and reviewed them.

No anomalies found, abdominal migratory severe pain, mental disorientation....

This situation is extremely difficult to diagnose!

Abdominal pain is a basic symptom for many conditions such as acute abdominal syndrome including renal stones, gallbladder and bile duct stones, acute pancreatitis, stomach or duodenal ulcers, acute appendicitis, bowel obstruction, etc.

If the cause is unknown, it’s impossible to determine a treatment plan.

His examination also confirmed that it was unrelated to the patient’s digestive system.

What’s left includes the cornual pregnancy that the obstetrics department suggested.

But before that examination, every possible exclusion must be done!

"Let’s check PAS, blood biochemistry, conduct a urine PBG, ALA test and request the laboratory to expedite the process, additionally call a neurologist to see."

Qin Feng pondered for a long time, and after doing everything that could be done, he decided to approach from other aspects to see if a clue could be found.

At this moment, in his mind, he continually organized and excluded various possibilities, considering the patient’s age, lifestyle, recent circumstances, examination results, and other factors comprehensively to sort out the diseases most likely manifesting abdominal pain symptoms.

Among these, he soon narrowed it down to three possibilities.

Neuropathic pain induced reflex, the rare acute porphyria, acute biliary disorder.

Start the examination first!

Biliary issues require a CT scan, which cannot be done now.

Neurological issues need assessment by the neurology department, and porphyria is a rare disease that most people wouldn’t consider.

However, acute symptomless abdominal pain is precisely one of the manifestations of acute porphyria!

What’s most notable is that, during his examination of the woman, Qin Feng discovered unexplained nervous system dysfunction, particularly local muscle weakness and stiffness in the arms and legs.

He speculated that if the current situation is not due to neurological issues,

then there’s a high likelihood of issues with blood or the biliary system!