Back in 2002 as a doctor

The condition worsened, and the family members of the patient rushed to send the patient to the emergency department of the second year of medical school.

After I came, I checked an emergency abdominal plain film and found no abnormalities, excluding intestinal obstruction.

Abdominal B-ultrasound showed: after cholecystectomy, the inner diameter of the common bile duct was 8mm, and a parallel light band with a diameter of about 3mm was visible in the lower segment, and the intrahepatic bile duct was not dilated.

The diagnosis is relatively clear, after cholecystectomy, biliary ascariasis.

Director Geng received a general report from the hospital, and it was also the same patient.

Abdominal pain, but the final diagnosis is biliary ascariasis, this kind of patient is really rare.

The two directors looked at each other, Director Geng scratched his head, "What a coincidence."

"This... I'm afraid it's not good." Director Wen said.

"What's wrong, just ask." Director Geng said, "Do you have a good solution?"

Director Wen shook his head.

"Anyway, patients should be sent to higher-level hospitals. It just so happens that Academician Chu built an academician workstation. Isn't it appropriate to ask him for consultation?"

"It's picking up the wind." Director Wen said hesitantly, "If academician Chu can't...he definitely won't."

Having said that, Director Wen shook his head resolutely.

This is really a big pit.

Dean Chen repeatedly wanted to cooperate with Academician Chu and wanted to establish an academician workstation.The purpose of the boss is not to cure the disease, but to put on a face and annoy the dean next door.

Academician Chu came all the way here, and when he came up, he "pasted" a patient with biliary roundworms on Academician Chu's face.

What a mess!

Moreover, he slapped Dean Chen several times while smashing the field.

If I really do this, in the next three years, I will wait for countless pairs of small shoes to wear.

Why only three years?Director Wen felt that he would not be able to survive for three years before being forced to leave his hometown by Director Chen and Director Han.

Director Han's chubby but eerie face appeared in Director Wen's mind.

Don't be dead!Director Wen warned himself.

"No, absolutely not." Director Wen shook his head repeatedly.

"Old Wen, you look like you have a heart and no guts." Director Geng said contemptuously.

What kind of evil heart and courage, he just wanted to push himself forward, Director Wen's heart is as clear as a mirror.

He didn't answer Director Geng's words, but called the hospital chief.

"Tell the patient that there is a high probability that it is biliary roundworm. We can't cure it. Let the patient go to the imperial capital." Director Wen directly admitted.

……

……

Dean Chen raised his glass frequently, and his ears were full of wine.

"Ring Ling Ling ~"

Dean Chen's cell phone rang.

He and Academician Chu made an embarrassed expression and picked up the phone.

"Hey."

"what?"

"Ascaris? Why can't it be cured."

A lot of words were said on the other side, and Dean Chen gradually fell silent.

"Wait for my call." Dean Chen hesitated after hanging up.

"What patient?" Academician Chu understood, but still asked.

"After the cholecystectomy, the biliary roundworm was so painful that two injections of pethidine were useless. Our hepatobiliary surgery department said that there is no cure, so I sent it to the imperial capital." Dean Chen asked, "Academician Chu, you see this disease..."

Dean Chen also knows that biliary roundworms are quite troublesome, and they used to use surgery to solve the problem.

However, the patient had undergone surgery, and the local adhesions were severe. The surgery probably lacked confidence, so the patient was sent to the imperial capital.

And the means of medication have also been tried. Last year, a major incident happened, which made the liver and gallbladder dare not treat it anymore.

"You can try it with ERCP."

Academician Chu didn't speak, and Zhou Congwen's voice came.

"Huh?" Academician Chu was startled, and looked at Zhou Congwen.

His hands are a little numb.

At my current level, I know in my heart that whether the roundworms are dead or alive, no matter how many there are, they cannot be taken out by themselves.

What did Zhou Congwen mean by saying that?

After all, he is not one of his own, and Chu Yuntian and Zhou Congwen still have some grievances, so Academician Chu still can't let go of his guard.

"I've been drinking..." Academician Chu sighed, "Why don't I ask the Imperial Capital."

"I didn't drink it. It just so happened that you, Academician Chu, taught me some techniques in the afternoon. I can try it. You can just watch from the back." Zhou Congwen said.

"!!!"

Academician Chu's mind was full of garbled characters, and he made a thick mosaic.

Zhou Congwen's words confuse right and wrong, but there is nothing wrong with it.

In the afternoon, Zhou Congwen taught him how to do ERCP surgery by holding his ears, but when the words came out of Zhou Congwen's mouth, he taught him.

What is Zhou Congwen going to do to save face like this?

"Can ERCP do it?" Dean Chen was surprised, but was overjoyed immediately.

"Can...can do it." Academician Chu hesitated, but Zhou Congwen's gaze was firm. In the end, he was also curious, so he could only grit his teeth and agree with Zhou Congwen's statement.

Picking up roundworms seems to be extremely difficult. Academician Chu became more and more curious about where Zhou Congwen learned these techniques.

Could it be that this kid really proved the saying that there is a gift from heaven.

"Then I'll write back." Dean Chen looked at Academician Chu with a smile, "Then it will be hard work for Academician Chu."

"It's not hard, I can't go on stage after drinking, it's up to Professor Zhou." Academician Chu threw the pot to Zhou Congwen.

Zhou Congwen didn't mind, just smiled slightly.

A sudden patient interrupted the welcome banquet, and after contacting the patient's family, the party ended, and they rushed back to the Second Hospital of Medical University by car.

At the same time, Director Wen received a call from Dean Chen.

The phone in his hand had already been hung up, Director Wen stared blankly at the table in a daze.

"Old Wen, is that Dean Chen?"

"What did Dean Chen say?"

"Yeah, you did talk."

Director Wen hesitated for a few seconds, then said in a harsh voice, "Academician Chu said that the operation can be done, and ERCP can remove the biliary roundworm without damage."

"!!!"

Chapter 1165

"Academician Chu actually said yes." Director Wen's autobiographical scrolls fluttered slightly, as if they had transformed into shapes, expressing their surprise.

All the directors frowned in thought.

They don't understand what ERCP means and how to do it, and no one even remembers the abbreviation.

But Director Wen said it himself—there should be no damage to the insects.

"Director Wen, are you sure it's taken out, not insect repellent, exorcism?" A director asked suspiciously.

"Well, yes... um? What you said makes sense." Director Wen said in surprise, "Maybe I misheard."

"What will you do if you encounter a similar patient? If the patient does not agree to go to the imperial capital." One person asked.

Hepatobiliary surgery used to treat biliary roundworms, but something happened last year, and everyone kept it secret, and not everyone knew the details.

"To relieve spasm and relieve pain, deworming and anti-infection should be done in the early stage. Generally speaking, atropine plus pethidine is used, and deworming can be taken orally with albendazole or mebendazole." Director Wen said, "But this patient uses pethidine. The effect is not good, it is estimated that the bugs are relatively large, and the infection is also serious, so I dare not keep them."

"So albendazole or mebendazole has the effect of deworming when taken orally," the director asked.

"Yes." Director Wen nodded.

"Then it's possible that I heard it wrong. It's really expulsion, not removal." The director said, "What about surgery? How to do it."

"It's quite difficult to do." Director Wen still shook his head sadly, "It's just anti-infection, antispasmodic analgesic, and anthelmintic internal medicine that sometimes cause accidents."

"Oh? What's the matter? Isn't the worm in the bile duct..."

"It's not that simple." Director Wen said, and glanced at Director Geng next to him.

Director Geng sighed, "Last year, there was a patient with the same condition. There were roundworms in the bile duct and severe abdominal pain."

"Fasting was given after admission, anisodamine and pethidine were used to relieve spasm and relieve pain, and the abdominal pain improved after symptomatic treatment with anti-inflammatory rehydration."

"The patient had recurrent abdominal pain, and he was treated with antispasmodic pain relievers, and he got better after deworming drugs."

"On the 4th day after admission, the patient had severe abdominal pain again, and the blood amylase was 1201U/L. The plain film of the abdomen showed that the small intestine was dilated and inflated in the middle and upper abdomen, and there may be an atypical liquid level. No obvious free gas was found under the diaphragm. Abdominal pain did not improve significantly after antispasmodic pain relief."

"Huh? It's getting worse? Or is it that the roundworms are wandering in the body, and new problems have arisen?" The director asked with a question mark.

Although he was very skeptical in his heart, this was the big event that happened last year, and he couldn't help but believe it.

"Let's go, talk while walking." Director Wen stood up, put on his clothes and went to pay the bill.

Director Geng said while tidying up, "This patient lives in the liver and gallbladder. After experiencing abdominal pain, Lao Wen called me and I will go for a physical examination."

"During the physical examination, I saw that the patient had a painful expression, distended middle and lower abdomen, drumming sounds, hyperactive bowel sounds, and tenderness and rebound tenderness in both lower abdomens.

The puncture of the right lower abdomen did not draw out the exudate, so I asked for an abdominal CT scan, which was diagnosed as intestinal obstruction.

There was no hesitation at that time, and an exploratory laparotomy was performed urgently in the afternoon. During the operation, part of the ileum was found to be compressed by a band, and the intestinal wall was congested, so intestinal adhesion release was performed. "

"I'll go!!!" Several directors who were not engaged in this matter all looked confused.

"how did it get here?"

"Is it about the bugs?"

"I guess it's roundworms... I heard that the longest one is more than one meter."

"More than one meter... It's not that exaggerated." Director Geng said cautiously, "On the fourth day after the operation, two roundworms about 10cm in diameter came out of the patient's defecation. I studied it for a long time, and it didn't smell bad at all."

"..." A director smiled wryly, "Old Geng, you are really good at it, are you addicted to digging?"

Gastrointestinal surgery is also called the department of removing excrement, but it is much more tragic than the anorectal department.

"Don't make trouble, this is research." Director Geng said seriously, "This disease is very rare, but you can see it once or twice a year. It has nothing to do with our stomach and intestines. After all, roundworms in the stomach... belong to the gastroenterology department Whatever."

"What happened later? How did you get there?"

"Roundworms generally live in the middle and lower parts of the small intestine. They have the habit of scurrying around, loving alkali and anorexia acid, just like earthworms." Director Geng explained, cursing bitterly.

"When the parasitic environment changes, such as gastrointestinal dysfunction, starvation, improper deworming, etc., roundworms can move up to the duodenum, and if complicated with Oddi's sphincter dysfunction, roundworms with the habit of drilling into the biliary tract. "

"What is the habit of drilling the roof?"

"Old Gu from the Onychomycosis family is just a roundworm, and he wants to drill it at the first sight." Director Geng said contemptuously.

"Hahaha." The surrounding directors laughed at the same time, with a smile that men could understand.

This explanation is easy to understand, and everyone immediately understands how the roundworms reach the biliary tract.

"I guess the patient has a gastrointestinal disturbance."

"By the way, there was a movie in 01 called Slimming Men and Women, have you watched it?" one person asked.

"Look, the female star in Xiangjiang swallowed roundworms raw, just to lose weight." Director Geng said, "When I saw it, I thought, she swallowed roundworms raw, and the worms must go to the pylorus. It’s interesting when the intestines go into the bile duct.”

"Television, don't take it seriously." One person said, "Old Geng, is it because of last year's patients that the bosses of your two departments called at the same time?"

"Yeah." Director Geng nodded, "Similar patients are in critical condition and suffer from strangulation pain. I recalled that when the school opened at the end of last year, I also asked several directors from other prefectures and cities, and they said In one case, the clinical observation was not timely, and the operation was performed late, resulting in intestinal necrosis, and the patient did not survive for a few days."