Let’s just call it intuition
Don Zacarías senses that he is ill. Fever, chills and exhaustion torment him. His stomach is soft. Slight pain in the lower area. Nothing more. He travels from the far south of Peru to the metropolis of Cusco and consults one doctor after another. “Don’t worry about it. You’ll be fine!” The doctors’ reassurances cannot calm him down, as he realizes that he is going downhill. So he travels another three hours further west to the Diospi Suyana Hospital.
Surgeon Dr. Lukas Steffen is on duty. Hm, the patient’s abdomen has normal palpation findings. The ultrasound results also show no abnormalities. The computer tomogram shows that the superior mesenteric vein is blocked by a thrombosis. The liver parameters are elevated in the laboratory. That’s strange. What does all this mean?
The Swiss doctor ponders and ponders. And – even though it’s Saturday evening – he decides to perform a laparoscopic operation. A direct hit. Although the clinical findings were fairly unremarkable, as was the ultrasound examination, an acute appendicitis was found. Removal of the corpus delicti is exactly what the patient needs. The patient is now treated with medication for the blocked vein on an outpatient basis.
The case once again underlines the fact that the “intuition” of an experienced doctor ultimately counts more than the most modern imaging procedures.
(Caption: The green circle shows the superior mesenteric vein closed by a coagulum. The superior mesenteric vein and the splenic vein together form the portal vein. All food from the gastrointestinal tract is supplied to the liver via the portal vein).
