Chapter 368 I hope
I can question other things, but now not many people are willing to question Wu Xiaofu’s ability to see doctors and perform surgeries.
Especially the doctors in the First Affiliated Hospital knew how powerful Wu Xiaofu was.
So many people have questioned before, but in the end they will only get slapped in the face. If you have that time, you might as well take a closer look yourself and try to find out the underlying symptoms of the patient.
Wu Xiaofu was speechless when he saw everyone acting like a good student and curious about the baby.
Looking at the hepatobiliary surgeons behind him, they were all here to join in the fun. Chen Zhendong was also there, as were several doctors from the D area, and four or five doctors from other wards.
“What do you think?”
Unlike doctors from other departments, Chen Zhendong and the others were a little nervous at this moment. After all, this was a question Wu Xiaofu asked, and they inexplicably didn’t want it. Disappointing Wu Xiaofu made him want to show off in front of Wu Xiaofu.
A doctor in Area B looked at it for a while and then spoke slowly.
"Cheng Shi can definitely detect gallbladder cancer, but he is not making a diagnosis now. I guess he is thinking that this case cannot be so simple, so he is so hesitant."
Everyone was stunned when they heard this, and then laughed again.
"Don't tell me, it's really Cheng Shi's previous cases. It doesn't seem that difficult. There should be one that is difficult to benchmark against other interns. I guess it's this one. Director Wu, you really don't know. The diagnosis of these cases?”
Some people have begun to question Wu Xiaofu and the others for being pretentious here.
“I don’t know. We just took a look at the patient’s physical condition and asked a few questions to see how much we could know.”
Who would have thought that as soon as Wu Xiaofu said this, the others would shake their heads. .
"We certainly can't see much like this, but you are the top doctors in our First Affiliated Hospital. One glance is enough. You must know it. How about you tell us what this disease is? We are really curious. "
Lin Dongping also laughed when he heard this, "Don't accuse us wrongly. I don't know about others. Anyway, I can't do it."
"I can't do it either."
Miao Qingyan hurriedly admitted that the diseases in the cardiology department are so complicated, and even all the examinations are not good, let alone just one look, which is impossible. Minor illnesses are fine, but serious illnesses cannot be seen at all come out.
“I definitely can’t do it. The more complicated the disease, the more confusing it is. I dare not draw a conclusion. In fact, they, the interns, also depend on their luck. We just divide the difficulty based on experience. It’s easy, and then I pick five, maybe there are mistakes and omissions, or they are really difficult, and there’s nothing you can do about it.”
Jiang Yuankai also said, this is the truth. If you are unlucky, there is nothing you can do. However, most of them are still inseparable.
As of now, what these interns have seen is almost the same, and there are basically no errors or omissions.
As for Cheng Shi.
“What are you looking at me doing? I can’t see it.”
“Can’t you see it? We don’t believe it. We can’t see it. You just took a look and said this is difficult. , regarding this case, Dr. Chen, can you tell me whether it is gallbladder cancer?”
Chen Zhendong also laughed when he heard this.
"Director, look at your current reputation. No one wants to believe you. However, it seems that it may be another disease.
To be honest, if it is really another disease In other words, there are some out-of-class manifestations of common diseases and common manifestations of rare diseases. These have always been difficult for us in clinical diagnosis and give everyone a headache."
Everyone nodded, but. Still continue to say, "We know this, what we want to know is whether this is another diagnosis."
Chen Zhendong pondered for a moment, "If we want to talk about other diagnoses, it may be biliary ascariasis, but this We have to complete the examination before we know that the examination at this lower-level hospital is indeed unqualified. There is no color Doppler ultrasound, just an MRI. I would say that Cheng Shi's best choice is to admit him to the hospital with abdominal pain and then check it out. < br>
Although this is not outstanding, it does not make mistakes. Based on his previous performance, the results are still good. "
Biliary tract ascariasis!
Everyone frowned when they heard this, roundworms? This examination is so bad that people want to scold you. You have done MRI examinations, but you don’t do color ultrasound. This is not harmful. What about people?
The most important thing is to check one first and then push the patient out. It’s not that urgent.
If it’s really biliary ascariasis, actually check for color Doppler ultrasound. I can see that it is almost the same. However, if this is really biliary ascariasis, that hospital should really go back. Although a roundworm is not a good disease, it can be regarded as the same level as gallbladder cancer. Scared to death.
"It's like a pain in the roof!"
In the consulting room at this time, Cheng Shi perked up. After listening to the patient's description, he felt that what the patient said was very similar to a classic symptom of biliary ascariasis: drilling in the roof. Such pain.
This is something that other diseases do not have. After all, roundworms are alive and like to wander and burrow. When systemic or local factors in the human body cause changes in the intestinal environment, such as fever, pregnancy, hunger, etc. , surgery, reduced gastric acid secretion, chronic inflammation of the biliary tract, etc., the intestinal environment is disordered, intestinal peristalsis is abnormal, and the roundworms begin to move upstream and downstream to the duodenum and burrow into the biliary tract.
In addition, roundworms like alkali and acid. When the roundworms ascend to the duodenum, they like to burrow into the biliary tract of alkaline bile. , after entering the gallbladder, due to the stimulation of the roundworm, the biliary orifice sphincter spasms, resulting in sudden and severe pain in the right upper abdomen or under the xiphoid process.
This is the so-called piercing pain.
The specificity of this kind of pain is still very strong, and it is completely different from other types of pain. However, based on this, is it necessary to determine that it is biliary ascariasis?
At this time, Cheng Shi was probably in the same mood as the other doctors outside the clinic, complaining about why the hospital that examined the patient couldn't just do a color ultrasound!
However, since you suspect biliary ascariasis, let’s ask about it.
However, there are really not many people in China suffering from biliary ascariasis. It is a rare disease. Therefore, the symptoms and signs, except for a pain like a drill, are really atypical.
Looking at the portal infiltration on the MRI, Cheng Shi was also in a dilemma at this moment.
Should one of them be diagnosed and the patient be admitted to the hospital, or should the patient be admitted to the hospital with abdominal pain first and complete the examination.
The former is risky, the latter is more stable.
Outside the clinic.
Everyone was a little surprised when they heard the pain, and looked at Chen Zhendong differently, "As expected of a hepatobiliary surgeon, you can see it all."
However, , the most authoritative answer is still in the hands of Wu Xiaofu.
"Director Wu, now that it's like this, please announce the correct answer."
Everyone looked on eagerly. Now the other interns have basically finished the outpatient assessment, only Cheng Shi is left, and Cheng Shi's situation would probably end soon. They wanted to see if Cheng Shi could pass this test.
Wu Xiaofu faced everyone's gaze and nodded, not wanting to show off any more.
This is a common manifestation of rare diseases. Portal infiltration is actually quite common. It is so common that when it appears, people first think of tumor infiltration. But if you think about it carefully, many other diseases may also cause this. The result, such as biliary ascariasis. Seeing Wu Xiaofu nodding, everyone started discussing.
"If that's the case, then this case is really more difficult than Song Tantan's. It's too confusing. I'm afraid anyone who looks at it will think it's a tumor. Not to mention this Cheng Shi, even us, this Cheng It's very impressive that Shi can persist in seeing so many doubts."
"It's lucky that it's an assessment. If it were on other occasions, he wouldn't be so cautious, I guess. According to the first impression, gallbladder cancer is here."
"Having said that, this child's calmness shows an advantage here. Others may not be so careful. Ask here."
...
Everyone was discussing, looking directly at Cheng Shi, wanting to see what Cheng Shi would choose.
To be honest, it was safest to admit him to the hospital with abdominal pain. Otherwise, any choice would be risky. They were only so sure because Wu Xiaofu nodded. Cheng Shi did not have this condition.
If Cheng Shi could diagnose biliary ascariasis, then this achievement would be truly remarkable.
"Doctor, how are you? Is my husband's disease easy to cure?"
The voices of the patient's family members were filled with tears. The doctor was looking at him so hard, and I couldn't even think about it. You know how difficult this disease is, and then think about the results given by the local hospital, the patient's family members feel disheartened. Gallbladder cancer, if you have this disease, can you still live? My husband is only fifty-one years old.
At this time, the patient also lowered his head, seeming to accept his fate.
Yes, he had indeed guessed it a long time ago. His wife's behavior was too obvious. Moreover, this is the Internet age. After a little research, you can actually know that he just doesn't want his wife to worry. Talk more, don’t ask too many questions, but you still have hope in your heart.
We have arrived at the First Affiliated Hospital, the authority in the country, what if something unexpected happens?
Cheng Shi's eyes became firmer at this time, "I am a little different from your local hospital's opinion. It looks like biliary ascariasis, but you don't do color ultrasound locally, so it doesn't look like that. Obviously, it is best to be hospitalized for further examination, because whether it is biliary ascariasis or the one you mentioned before, surgery is required.
What’s your opinion?”
Biliary ascariasis!
The patient and his family members were shocked when they heard this. They suddenly raised their heads and looked at Cheng Shi, and in the blink of an eye they were a little surprised.
They actually don’t know much about biliary ascariasis, but they know one thing, that is, no matter what disease, it is better than gallbladder cancer. If it is really biliary ascariasis, it is simply the blessing of the goddess of luck. They are.
"Really! Doctor, are you telling the truth?"
"We are not sure yet. We need to have a color Doppler ultrasound or even an angiography to know."
"We cooperate, we cooperate, we will do the color Doppler ultrasound and other things now, do it now."
Although Cheng Shi didn't give a definite answer, they were happy enough. Even if it was just a hope, that would be enough, what if it really wasn't the case!
Now they just want to cooperate with the doctor in hospitalization and get checked quickly.
"Okay, then I will prescribe hospitalization and examination orders for you, and you can do it as soon as possible."
After making the diagnosis, Cheng Shi's follow-up actions were very smooth. Outside the clinic, Wu Xiaofu They looked at it and nodded.
Whether Cheng Shi was sure of this diagnosis or whether he was betting, he was undoubtedly right. Of course, unless Wu Xiaofu was wrong, but could Wu Xiaofu be wrong? Probably not.
Everyone was thinking, but if this is the case, Cheng Shi's assessment this time will really go against the grain.
Ward.
The five people left the outpatient clinic and returned to the ward. As the first-visiting doctors, they were responsible for the patient's follow-up until the patient was discharged, or even for the rest of his life.
And this is also the second stage of their assessment.
The work after admission is no simpler than outpatient care. It includes medical orders, medical records, review of the initial diagnosis, and the most important treatment.
Wu Xiaofu and the others were also gathered together at this time.
Eight people, during the outpatient assessment, all the diagnoses were correct except for Pan Ying who made a wrong diagnosis. If Pan Ying had not realized it after the patient's examination was complete, What needs to be told is that after all, the patient's life cannot be joked with. Even if it is an assessment, the patient must get the best treatment.
Although eight people were asked to formulate a treatment plan, it was just a treatment plan.
The real treatment still has to be based on Wu Xiaofu’s plan. The treatment plan for the eight people is just for evaluation.
Color Doppler ultrasound was performed very quickly. While Cheng Shi was seeing other patients, the fifth patient and his family members came back quickly.
Holding the color ultrasound sheet, he handed it to Cheng Shi with an excited expression.
“That’s right!”
Cheng Shi looked at the checklist and felt his heartbeat. That’s right, that’s right, it’s really biliary ascariasis.
On the color ultrasound sheet, there was a line written at the bottom: Bile duct roundworm?
Although it is a question mark, it is only because the ultrasound department is an auxiliary department and is not suitable for diagnosis. However, based on the experience of the doctors in the ultrasound department, once it is written, it is inseparable, and so are the patients and their families. I shed tears of excitement.
"Doctor, thank you, Doctor Cheng, for saving us."
Cheng Shi hurriedly supported the two of them, "This is what I should do. You don't need to do this. However, although color ultrasound is like this But if you want a thorough diagnosis, it’s best to do an imaging. After all, the MRI you brought over is also questionable.” We all cooperate. "
At this time, the two of them have completely trusted Cheng Shi. As for whether the inspection is expensive, it is not within their scope at all.
When they were most desperate, it was Cheng Shi who gave them hope.
Let alone a check-up, they were willing to give it to Cheng Shi.
Moreover, on the way back to the ward, the two of them had already checked on their mobile phones. Although biliary ascariasis is rare, it is not comparable to gallbladder cancer. If they cooperate well with the treatment, they don't even need surgery. , just take medicine and infusion.
This makes them unhappy.
Cheng Shi was very happy to see the two of them cooperating so well, "Okay, I will make arrangements for you now."
(End of this chapter)