Back in 2002 as a doctor

Director Wen was stunned.

This is what he believes is the most critical factor for a child to "fake illness", but Zhou Congwen said that this is the key point of diagnosis.

Could it be that I missed something?

He frowned as Zhou Congwen put on disposable PVC film gloves and took off the child's pants.

Upon seeing it, Director Wen felt cold all over, and was stunned for a while.

There is a red maculopapular rash similar to erysipelas near the child's YN. Although it is not big, it is only between 1-2cm, but it looks shocking.

How is this going? !Director Wen's heart was grasped by invisible hands, and he squeezed it tightly.

Zhou Congwen looked around the child's YN, and quickly put on the child's pants and took off the gloves.

Before Zhou Congwen could throw the gloves into the trash can, Xiao Kai immediately reached out.

Zhou Congwen was stunned for a moment, Xiao Kai smiled lightly, took the gloves and turned to throw them away.

Damn it, Zhou Congwen cursed in his heart, look at Dean Xiao!

Compared with Dean Xiao, the postgraduates and doctoral students I used to lead were as stupid as a piece of wood.

But Zhou Congwen didn't say anything. After handing the gloves to Xiao Kai, he said to Director Wen, "Let's do an inspection. We can't check here. I'll ask 912. I guess 912 can't do it either. I have to contact Xiehe."

"!!!" Director Wen was stunned, and his mind became confused for a while.

What happened to the child? !

"Director Wen? Director Wen?" Zhou Congwen called twice.

"Ah?!" Director Wen came back to his senses, restraining the panic in his heart, "Professor Zhou, what disease does the child have?"

"I think familial Mediterranean fever."

"..." Director Wen didn't seem to hear clearly, he said ah, "What's wrong?"

"Family Mediterranean fever." Zhou Congwen said affirmatively, "young age of onset, repeated periodic attacks, inflammatory indicators significantly increased during attacks and decreased between attacks, gastrointestinal endoscopy and imaging examinations could not explain the patient's symptoms. "

"When encountering a similar situation, the first thing to consider is Mediterranean fever. Although this disease occurs frequently in foreign countries, you can tell from the name of the disease that there are more outbreaks around the Mediterranean Sea, but we also have it in our country, and the number is not small."

"It's just that familial Mediterranean fever is a rare disease and is generally misdiagnosed."

Misdiagnosis!

These two words slapped Director Wen's face like a slap in the face.

For doctors, these two words are extremely fatal, as if killing Director Wen.And this time it was different, it was my son who was misdiagnosed.

This can't be explained, it can only be said that my level is not enough.

He was about to refute, but he swallowed the words in an instant.

The patient is my son, do I want to say that Zhou Congwen's diagnosis is wrong, or do I want to say that his diagnosis is right?

Although he didn't know what the hell familial Mediterranean fever was, Director Wen would rather have a definite diagnosis than just have a vague fever.

The appendix has been cut, and the child's illness has been repeated for so many years...

Compared with the child's confirmed diagnosis, his old face seems to be of little importance.The level is not enough, and it seems to be acceptable in front of the child's definite diagnosis.

Director Wen looked at Zhou Congwen in confusion, and finally nodded.

"Uh, let me make a phone call." Zhou Congwen said, "I need a genetic test, but 912 doesn't seem to work. Alas, this test is very troublesome."

Hearing what Zhou Congwen said, Director Wen's complicated mood was even more complicated.

"Director Deng, I want to ask you something." Zhou Congwen called Deng Ming.

Looking at Zhou Congwen's young figure, Director Wen felt a little emotional.

Look at other people, open and close is 912, Xiehe, look at yourself.

He knew very well that Zhou Congwen wasn't bragging... the world's number one cardiothoracic surgeon was able to stay in the academician workstation of the Second Hospital of Medical University because of Huang Lao's stubbornness, otherwise he would have left long ago.

Director Wen corrected his mentality and unconsciously bent a little.

"Can we do genetic testing on 912? To be precise, it is to check the pyrin protein related to Mediterranean fever."

"Oh, please help me to ask if Xiehe can do it. I'll wait for your call. The child of Director Wen's family from the Department of Hepatobiliary Surgery has an inexplicable fever. It has been several years. I suspect it is familial Mediterranean fever."

"Okay, then I'll wait for your call."

After hanging up the phone, Zhou Congwen saw Director Wen standing hunched over at the door of the emergency room, so he came over and said, "Director Wen, wait a moment, my elder brother is in touch."

Eldest brother, Director Wen almost spit out his old mouthful.

I saw the ghostly senior brother, but when he thought that the 912 chest department director was on the phone, Director Wen couldn't help but bend a little.

Zhou Congwen's seniority is really high. Director Wen thought of Mr. Huang and realized helplessly that he might have to call Zhou Congwen a junior uncle.

Fortunately, this thing is not popular now, otherwise it would be so embarrassing.

"Professor Zhou, I heard you say what kind of protein it is..."

"The pyrin protein, which is caused by the mutation of the MEFV gene, is closely related to the innate immune system and is a functional protein that regulates the inflammasome."

Director Wen felt dizzy when he heard this.

What kind of protein, what kind of genetic code, he doesn't understand at all.

Zhou Congwen also felt that he had talked too much. He turned his head to look at Director Wen and smiled, "Director Wen, when you were not divided into departments, you were in general surgery, and you never encountered acute abdomen. patients without."

"!!!"

Director Wen was stunned for a moment, his eyes were fixed, and there was only one thought in his heart—how did Zhou Congwen know!

"It's all right after opening it, but the patient still has a stomachache after the abdomen is closed, and it's more troublesome in the end." Zhou Congwen continued, "Your child's condition is relatively mild. An appendix was removed, and there are no signs of peritonitis.

The trouble is that severe patients feel terrible pain and have clear signs of peritonitis, but they can't see anything after surgery. "

"Generally, most of these cases are considered to be Mediterranean fever."

Chapter 1309 So I Have Met Before

"Director Wen, what happened to you?" Zhou Congwen asked.

Director Wen recalled several strange cases he encountered when he was young, and compared it with his son's situation, his hands and feet felt a little numb.

The word misdiagnosis hovered in his mind, like two crows, croaking, which upset Director Wen.

Seeing that Director Wen was in a daze, Zhou Congwen didn't urge him.

Xiao Kai listened to what Zhou Congwen said, and carefully recalled his experience and various things in the hospital. The prostate suddenly swelled up, and the strong stimulation followed the nerves to the brain, and the urge to urinate surged.

Signs of peritonitis, laparotomy, but nothing was found during the operation, the surgeon nervously checked over and over on the operating table and dared not step down...

You can't even think about this kind of thing. As a doctor, as long as Xiao Kai thinks about it, the adrenaline in his body will be secreted in large quantities, and even the prostate gland will respond.

Xiao Kai immediately got in touch with a medical dispute at Baishui Central Hospital a while ago.

It was so!

Judging by Director Wen's expression, he probably encountered a similar situation when he was young.

It's just that the relationship between doctors and patients was relatively good at that time, and patients and their families would at most slander in private that the doctor's level was really poor, and I was unlucky to have such a doctor.

But now, the family members of patients have to pay compensation, and it is difficult for doctors to explain clearly.

It took a full 15 seconds before Director Wen regained his composure. He bent his waist a little more, and said respectfully and cautiously beside Zhou Congwen, "Professor Zhou, is this all Mediterranean fever?"

"Not necessarily." Zhou Congwen is an old hooligan, how could he say such a thing for sure.

Director Wen was taken aback, then smiled wryly.

Zhou Congwen's speaking style is very familiar, and so is he himself.The old clinic always talks like this, and now it's my turn, I really feel disgusted.

"I still remember something happened to me when I was young." Director Wen began to recall, "A teenage child had a stomachache and signs of peritonitis, but the examination was all right, and he was going to be operated on."

"I didn't see anything after I opened it. At first I thought it was intestinal perforation and irritation; or something like intestinal twist. But there was nothing, and cold sweat came out at that time."

"What happened later?" Zhou Congwen asked.

"After 3 hours, it was almost cold. I had no choice but to close my abdomen. After going down, the child still hurt, and I was so worried. But there was no way, I could only bite the bullet and explain the condition to the patient's family."

"I said it tactfully. I apologize first and admit that I am not good enough. But when I explained the condition, I found that the patient's father was also holding his stomach. I thought it was something bad, so I went to the gastroenterology department for consultation."

"In the end, the Department of Gastroenterology said that there were signs of peritonitis, which must be a matter of surgery; I think it is enteritis, which is a matter of internal medicine. After a long dispute, everyone disliked each other, thinking that the other party's level was poor."

"..." Zhou Congwen looked at Director Wen helplessly.

It is true that familial Mediterranean fever is relatively rare, but it is a bit too much for internal medicine and surgery to blame each other.

"In the end, I contacted the patients in Imperial Capital and asked them to go to the higher-level hospital for treatment." Director Wen sighed. "At that time, there were no mobile phones, so it was inconvenient to contact. I don't know what happened to the patients and their families."

"Oh, that's right." Zhou Congwen nodded, and did not criticize Director Wen's handling at that time.

What Director Wen said was rough, it may be because it's been a long time, and I can't remember many things clearly.And there's absolutely no need to go into such detail, it's a rather embarrassing thing after all.

"Now that I think about it, it might really be the familial Mediterranean fever you mentioned." Director Wen said.

"The main symptom of familial Mediterranean fever is periodic fever, accompanied by abdominal, chest or joint pain." Zhou Congwen explained.

"Yes! The patient had a fever at the time, and it got better after taking the medicine, but it didn't take long before he started to have a fever again." Director Wen began to follow Zhou Congwen's words to explain the patient's condition at that time.

"Fever usually lasts for 1 to 3 days, and peritonitis may be present, and constipation is more common than diarrhea. Pleurisy is also relatively common. If not diagnosed in time, peritonitis in familial Mediterranean fever often leads to unnecessary emergency abdominal surgery."

"..."

Director Wen was shocked when he heard the diagnosis of pleurisy.

"Professor Zhou, I have pleurisy!" He said, "I was also diagnosed with other diseases, which felt like tuberculosis."

Zhou Congwen smiled, "That's about it. We don't have many encounters here, and it's normal to have no experience. Not to mention the provincial capital, when you meet a patient, the imperial capital can't diagnose it."

Although Director Wen knew that Zhou Congwen was trying to comfort him, he said it warmly and made him feel very comfortable.

That is, it is strange that the imperial capital could do genetic testing in the 80s of the last century, Director Wen thought to himself.

Although it is a misdiagnosis, but in the face of this rare disease...

Thinking of the misdiagnosis he had received, and thinking of the patient's family, Director Wen's face immediately became ugly.

"Professor Zhou, you said... I shouldn't..."

"Probably not. How old are you? If you haven't been sick, nothing will happen. I won't talk about the specific genetic explanation. I'll wait for Director Deng's letter."

Zhou Congwen looked at Director Wen with a smile and said.

Director Wen scratched his head. He knew that Zhou Congwen didn't explain because he didn't understand, but because he couldn't understand the explanation.

This is the rhythm of being disgusted.

But if you dislike it, you also dislike it. I really don't understand.

If the patient can't understand it, it may be said that it is a matter of responsibility.But the patient in front of him was his own son, and he hadn't given a definite diagnosis for so many years.

This is not a sense of responsibility, or even technology, it can only be said that I don't understand this disease.

Director Wen is in a complicated mood. If Zhou Congwen is right, then his son will be treated accordingly, and the doubts he has had for many years will disappear.

This is a good thing.

But the label of not being able to see a doctor was attached to him, which made Director Wen feel extremely uncomfortable.

Soon, Zhou Congwen's cell phone rang and he answered the call.

"Director Deng, are you ready?"

Deng Ming's voice came from the phone.

Zhou Congwen waved to Xiao Kai, Xiao Kai understood, took out a pen and notebook from his handbag, and handed them to Zhou Congwen.

After recording the name and phone number Deng Ming said, Zhou Congwen tore off the paper and handed it to Director Wen after hanging up.

"This is Xiehe's phone number. Director Wen, please contact him yourself." Zhou Congwen said with a smile.

"Oh oh oh." Director Wen took the paper with trembling hands.

"Let's say Director Deng Mingdeng asked you to go, Xiehe is also more interested, after all, is it Mediterranean fever?" Zhou Congwen said, "Usually it is abdominal pain with no known reason, so screening is only done. We have a tendency now, That side said you hurry up and send the specimens there."

"!!!"

Chapter 1310