My medical skills add experience

Chapter 241 Can't find out the cause, an unexpected discovery
A total of three MRIs were performed on the patient, and MRI examinations were performed on the heart, abdominal cavity, and lungs.

But no problem was found.

As for the CT examination and X-ray examination performed by the patient, they also focused on the two major areas of the chest and abdomen.It is strange to say that the patient is fine except for mild gastric ulcer and mild fatty liver.

The gastric ulcer has healed after treatment.

This can be seen from the latest examination of the patient.

The first hospital where the patient received treatment was a municipal hospital in another province.After the doctor examined the patient, the column of the diagnostic opinion stated gastric ulcer and mild fatty liver.

Suspected gastric ulcer causing vomiting.

However, after the gastric ulcer was cured, the patient's condition still did not improve much.The attending doctor of the Municipal People's Hospital was afraid that he would be treated to doubt his life in the end.

One head and two big ones, that's for sure.

While the two superior doctors were thinking about the cause, Zhou Can picked up a CT scan of the brain that he thought was suspicious.

This is also the only CT of the brain taken by the patient.

Everything looks fine, nothing wrong.

However, he did not put down the film immediately, but continued to observe carefully.

This brain CT was taken at the provincial people's hospital where the patient lived.After searching the gastrointestinal tract, including the chest and abdominal cavity, but no cause can be found, it is estimated that the receiving doctor has begun to change the way of diagnosis, and wants to see if there is a brain tumor.

As a result, no obvious abnormalities were found.

Zhou Can also suspected that there was a problem with the patient's brain.

In addition to the great damage to the liver, kidney and other organs, drunkenness can also cause serious damage to the brain.

It can cause vasoconstriction of the brain, decrease of blood flow, hypoxia of cerebral cortex, mental retardation, inattention, decline of memory and judgment, and even visual impairment.

People who have had the experience of being drunk will find that things are spinning around, or even upside down.

Or ghosting occurs.

In addition, alcohol can also affect the blood supply and nerves of the brain, shrink the brain, and accelerate the aging and death of brain cells.

According to medical research, alcohol is particularly serious for nerve damage.

This patient often needs to socialize and drink, and the damage to the brain is definitely not small.

Zhou Can was suspicious in this direction.

Like the attending doctor at the Provincial People's Hospital, when Zhou Can checked this brain CT, the first thing he did was check whether the patient had a brain tumor.

In this era of high incidence of cancer and hemangioma, the probability of brain tumors in the brain is too high.

But after a careful inspection, Zhou Can was finally slapped in the face.

Surprisingly, even a small tumor with a diameter of less than 0.5cm was not found.

Even a small hemangioma is fine!
None of them.

At this moment, Zhou Can couldn't help thinking of a difficult case he had successfully diagnosed.The patient was a student. Because of the excessive pressure of the senior high school entrance examination, he developed symptoms similar to enteritis.The final diagnosis was nervous digestive dysfunction.

Could this patient also be a nervous digestive disorder?
This possibility cannot be ruled out.

He subconsciously looked at the patient.

It can be seen from the medical records that the patient is now 41 years old, which is the most stressful age in a man's life.

Is it because of the high pressure that non-parenchymal pathological vomiting eventually occurs?

There is such a possibility.

"May I take the liberty to ask, was your family under great financial pressure before he became ill?"

Zhou Can asked the woman.

"It's okay! My husband's annual income is not bad, and I also had a stable job at the time. Basically, the combined annual income of our husband and wife will not be less than seven figures. As for work pressure, there must be. But my husband This person is very optimistic and has a cheerful personality, and he often takes me and my children on trips to release stress."

The woman thought for a while and replied seriously.

Zhou Can looked at the couple several times in an instant.

Those who can achieve a stable monthly income of more than [-] yuan are basically the elite class of this society.No matter what method is used, as long as it is not illegal, as long as this income can be achieved, it is very remarkable.

The combined annual income of the couple exceeds seven figures, at least over one million.

With such a high income, one can live comfortably in any city.

It is true that people cannot be judged by their appearance, and sea water cannot be measured.

Judging by the attire of the couple, they are both extremely ordinary.

Who would have thought that their income would be so high!

People, what they are most afraid of is getting sick.

This male patient, as you can imagine before he got sick, must be high-spirited, the kind of dragon and phoenix among people.

As a result, after just over a year of illness, he was already out of shape.

Many successful people emphasize that physical health is the most important thing.They compare physical health to one and career success to one or more zeros.

When the 1 that represents health does not exist, no more zeros after that are useless.

"All the tests that should be done have already been done, and it is not very meaningful to do it again. His cause is too complicated. I can't diagnose his cause with decades of experience in diagnosis and treatment. With his current condition , I am afraid there is no way to hospitalize and observe. Even if the cause is not found, our hospital is helpless."

Director Shang thought for so long, but he couldn't find out where the patient's disease was.

So I can only tell the family members frankly, please ask someone else to be smart!

Some people may think that it is a very shameful thing that experts cannot find out the cause of the disease.

In fact, whether it is ancient or modern, it is very common to find no lesions.The imperial physicians and famous doctors in society in ancient times are already powerful enough!

But when members of the royal family fell ill, they often knelt together and pleaded guilty.

Because they can't find out where the lesion is.

There is simply no way to start.

If the lesion cannot be diagnosed, the best way is to take the initiative to admit it.

Forcing medication is wrong on top of wrong.

It's easy to move your head.

The woman became anxious when she heard it.

"Professor Shang, I beg you to find a way to save my husband! I have taken him to many big hospitals, and they told me that Tuya Hospital has a high level of treatment for digestive tract diseases. I took my husband not far away. Wanli is here, please think of a way. I can kowtow to you."

The woman's determination to save her husband is moving.

Director Shang also hesitated for a while, and hospitalization would definitely not work.

The patients were already so sick, and the cause of the disease could not be found out, most of them would die in the hospital.

Even if the family members don't make trouble at that time, it will be extremely detrimental to the doctor involved.

"Get up, get up! Our Tuya Hospital is really limited! As long as it can be cured, we will never let it go. Renhe Hospital in the imperial capital, no matter the level of doctors, or the advanced level of equipment, is better than ours. Tuya Hospital is better. You can take your husband to the capital to have a look."

Director Shang tried hard to push the patient out.

I recommended Imperial Renhe Hospital to family members.This move is exactly the same as those small hospitals that push patients to Tuya Hospital.

"My husband is like this, where else can he go? Even if we go to the imperial capital, we don't know each other well, I'm afraid it's still the same, and we can't find out the cause. Professor Shang, please, show mercy and save my husband. ! I beg you!"

The woman burst into tears, and in order to save her husband, she did not hesitate to kneel and kowtow to Director Shang.

Seeing all this, Zhou Can felt very moved.

Husbands and wives are birds of the same forest, and when disaster strikes, they fly separately.

If the husband is so sick, if it were a cooler wife, he would have run away long ago.

It would be great if we could find out the cause of the patient.

Not to mention anything else, just the attitude towards this woman to save her husband is worth doing my best to help.

"I will open a hospital for you, and then find an opportunity to invite other experts from the hospital to conduct a hospital-wide consultation. If the cause is still not found, then we really have nothing to do. At that time, you can go to other hospitals to see Look, can you see it?"

Director Shang looked serious, but his heart was soft.

When the patient's family members knelt down like this, he had no choice but to bite the bullet and admit the patient to the hospital first.

In fact, with his rich experience in diagnosis and treatment, it is clear that for diseases that cannot be diagnosed, it is difficult to get any results in hospital.

"Thank you, thank you!"

When the woman heard that the doctor finally agreed to take her husband to the hospital, she was very happy and thanked her repeatedly.

Many family members and patients panic and fear in the face of terrible diseases.At this time, doctors are their only reliance.

When they live in the hospital, even if they don't do any treatment, they will feel more at ease.

In fact, after a hospital admits a person to the hospital, it needs to be responsible for the safety of the patient.

We will do our best to save patients.

"According to the hospitalization process, some basic examinations need to be done again, such as blood routine and electrocardiogram, do you think it will work?"

"Okay! We understand."

It's not the first time she brought her husband to the hospital, and she is quite clear about the hospital's procedures.

Director Shang was not in a hurry to apply for an examination, but turned to look at the assistant physician Huang Xinggui.

"Are there any beds in the inpatient department?"

"I'll call and ask. The beds have been very tight, I guess not. Because I still have a dozen patients in line, waiting for the beds to be vacated for hospitalization."

Huang Xinggui called the inpatient department on the spot.

I asked, and sure enough, no.

"Come on, let me tell you!"

Director Shang could hear it clearly.

Facing the earnest eyes of the family members, and the fact that they came from other provinces, I really couldn't bear to send them away.

"Hello, I'm Shang Feng! There is a patient here who came here from other provinces. He went to many hospitals but failed to find out the cause. I think it is really difficult for them. A woman is carrying more than 100 catties. It's really inconvenient for the husband, can you think of a way to get him a bed?"

Arranging a bed is not easy.

Even if Director Shang is the director of the department, he still speaks with a cheeky face.

"All right, all right, thank you!"

Director Shang hung up the phone.

It seems quite satisfied with the result.

"The inpatient department said, let's coordinate first. If there is really no bed, we can only add a temporary bed in the corridor first. When a bed comes out tomorrow, we will arrange it for you first."

It was already afternoon, and it was extremely unlikely that there would be a bed available.

It is more reliable to add a temporary bed in the corridor.

Based on the principle of humanization, the hospital sometimes has special measures to deal with some situations, and can only temporarily add a bed in the corridor.After the patient is arranged to stay, at least there will be medical care to manage the patient.

You can also take normal medication and infusions.

"Thank you, thank you so much!" The woman knew that the result was not easy, and thanked Director Shang with tears of gratitude.

If it hadn't been for Director Shang to say hello, her husband would have to wait in line for a bed like other patients.

After the arrangements were made, Director Shang issued an examination application for the patient.

Zhou Can has been studying the blood routine done by the patient not long ago.All the examination applications for patients here have been completed, and he has no intention of letting go.

"Doctor Zhou, why don't you give him the patient's examination information first, and let them go for the examination first!"

Director Shang reminded Zhou Can.

"Oh well!"

Zhou Can was so engrossed in thinking about things that he really didn't notice them.

He quickly put the blood routine results into a plastic bag and handed it to the patient's wife.

"Anyway, we are going to be hospitalized. If you are willing to study it, you can just put these inspection materials here. I will come and get them when you are about to get off work."

The woman didn't despise Zhou Can just because he was young.

Instead, he was very happy to let him study the inspection data of her husband.

"Well... After you have completed the hospitalization procedures, it will be the same when I go to the inpatient department. It's getting late, so take him for a check-up! If necessary, you can go to the corner of the outpatient hall Borrow a wheelchair for temporary use under the stairs. I think it is very difficult for you to carry him on your back, and it will be much more convenient to push him in a wheelchair."

Zhou Can suggested to her.

I don't know if the family members are taboo about this. They think it is unlucky for a person without paralysis to sit in a wheelchair or something.I would rather carry such a heavy person around to see a doctor than buy a wheelchair to deal with it.

"Ok, thank you!"

The woman struggled to carry the patient on her back and nearly fell down. Zhou Can hurried over to help her.

"Be careful, be careful!"

Zhou Can had been helping to escort the patients and their families out of the house until Zhou Can turned around.

He has been thinking about the cause of the patient in his mind.

Diagnosing such a super-difficult case requires doctors to constantly search for the real lesion from the clues, discarding the false and preserving the true.

This process is extremely difficult and complicated.

……

Around five o'clock, the woman pushed her husband in a wheelchair.

All the examinations in the hospital were completed and the results were obtained.

Director Shang took the result and looked at it. There was no major problem and he could be hospitalized.

It must be explained here that inpatients must undergo some necessary examinations before they can be admitted to the hospital. This is due to various considerations.It is mainly divided into two aspects.

One is to prevent patients from getting infectious diseases.If the patient has an infectious disease, he cannot be admitted to the hospital for treatment, or he can be directly sent to the infection department for treatment.

Another consideration is to screen patients for hidden high-risk conditions.

In case he died as soon as he was admitted for treatment, even if the hospital jumped into the Yellow River, he would not be able to clean up.

This must be guarded against.

Director Shang personally issued a hospitalization certificate to the patient.

Before the patient left, Zhou Can called them to stop.

"Wait! Let me ask, he raised his hand and scratched his head many times, is it itching?"

Zhou Can walked over and looked at the patient's head while asking.

If you don't wash your hair for a long time, it may cause itchy scalp.

The parts where the patient scratched were all on the right side of the head.I don't know if it is because I am too weak and have no strength, so I can only scratch this area or what is going on.

The patient stayed in the outpatient room for the first time, and Zhou Can noticed that the patient scratched his head four times in just three to ten minutes.

Although this was just a very inconspicuous action, it made Zhou Can suspicious.

Just now, the patient scratched his head again, and Zhou Can asked aloud.

"I don't know. Because he is so sick, I can't move him, and I can't wash his hair. I can only shave his head and wipe his head with a wet towel. Maybe it will be a little bit if he doesn't wash his hair for a long time. Itching. But I remember that before my husband got sick, he often raised his hands and scratched his head. This seems to be a habit of his. "

When the woman talked about the past, her eyes were full of fond memories.

Zhou Can carefully inspected the patient's right side of the head, which was unobstructed by the hair.

Not much to discover.

At this moment, Zhou Can noticed a slight bulge on the patient's scalp, which then collapsed.The scalp of normal people may also produce pulse beating phenomenon.

Just after the scalp slightly raised and then quickly collapsed, the patient raised his hand to scratch again.

But because it was too difficult, I soon gave up.

Zhou Can originally wanted to observe for a while, but he was in a hurry to go through the hospitalization procedures, and it was almost time to get off work.

He had to give up.

Anyway, after the patient is hospitalized, he will have the opportunity to observe carefully.

Near the end of get off work, there are basically no new patients.Basically, they came back to Director Shang with the test results for further diagnosis.

Director Shang treats every patient very seriously.

After careful reading, a certain answer will be given.

Zhou Can stood behind and studied, but he learned a lot.

Soon, it's time to get off work.

At this time, no patients came back.

Basically, the patients who can get the test results on the same day have already rushed over before the off-duty time.

"Doctor Zhou, I have been studying in the outpatient clinic for an afternoon. How did you gain? Can you adapt?"

Director Shang kindly asked him how he felt.

"I have learned a lot from you. I have learned a lot of experience in diagnosing gastroenterology diseases from you. The patient who couldn't find out the cause of vomiting, do you think his problem is in the brain?"

Zhou Can has been thinking about the cause of this patient. Now that he is off work, he finally has the opportunity to discuss it with Director Shang.

"Are you suspecting neuropathy?"

Director Shang asked.

"It's kind of like it, but it's not like it. I suspect it's another disease that's easily overlooked."

Zhou Can expressed his point of view.

(End of this chapter)