Sleepless Doctor

After a scolding, the meeting room went quiet.

Zhuang Yongzhi and Zheng Qingmu looked at each other, only then did they really perceive Doctor Wu's aura.

Swearing, although vulgar, but Doctor Wu has his own reason. Moreover, he was very strong, because Dean Sun refused to listen to Dr. Wei's report, Wu Mian turned his face without hesitation.

"I don't even look at the most basic thing. I can imagine that you round the ward every day, see the patients, sit in the office to see the results of various examinations, and look at various pathological descriptions. If this is the case, what use is it for you?!" Wu Mian's finger tapping on the tabletop speeds up, and his sound is like a war drum.

"The nurse writes the nursing record. It was written by the nurse. People have different perceptions. Why don't you take a look at it yourself?"

Dean Sun didn't know why Wu Mian knew that no one had seen the patient's stool, but he was telling the truth. Dean Sun knew the interest and didn't dare to refute, so he could only lower his head and listen, cursing inwardly.

"Dr. Wei, you continue talking." Wu Mian said.

Wei Dabao stared at Section Chief Wu's back in a daze. Although he knew he was supporting himself, but...now he is scolding, and he will tell his own judgment later. When he is damaged by a meal, he will lose face and lose face even more. .

Silence, silence in the meeting room.

Chu Zhixi smiled and broke the embarrassment, "Dr. Wei, you say boldly, it's okay. With your brother, you have basically confirmed the condition of your illness."

"Uh..." Wei Dabao was stunned. Isn't Section Chief Wu the same as he thought?

"Report the medical history." Wu Mian tapped his fingers on the table, and the sound of dong dong pulled Wei Dabao's thoughts back.

"Yes, Section Chief Wu." Wei Dabao said respectfully, "I found a problem. I haven't read the previous medical records yet, so I am not sure. The patient had diarrhea yesterday morning and his stool volume was about 2000ml, but it improved in the afternoon. "

"Yesterday's treatment was a pig tail... a ureteral stent, and some medications were replaced."

Chu Zhixi then flipped the tablet computer in front of him and said, “I have received the ureteral stent three times. Yesterday was the last. Every time I finished the diarrhea, the diarrhea got better.”

"That's because every time a ureteral stent is needed, the world's top experts are invited to consult and modify the drugs for the treatment of diarrhea." Dean Sun said.

"Doctor Wei, continue." Wu Mian said in a deep voice.

"I observed the patient's defecation and found that although the stool is formed, there is still about 200ml of watery stool." Wei Dabao said the biggest gain when he observed the stool, "This is difficult to explain."

With that, Wei Dabao looked at Wu Mian.

"The treatment at the Sanatorium and Hospital was initially suspected to be an infection. The replacement of several antibiotics did not work. Later, after a consultation, I found a rheumatology expert to see that it was suspected to be systemic lupus erythematosus, and hormone shock treatment was given." Wu Mian He seemed to see Wei Dabao's gaze and began to describe the treatment process.

He didn't look at the tablet computer in front of him. Dean Sun and other doctors looked at Wu Mian in surprise, wondering how this person knew so much detail. He did flip a few times on the tablet just now, but what is enough for those few times? !

"Every time after the ureteral stent is put on, the amount of urine increases, the renal failure is relieved, and the amount of diarrhea decreases. But about 3 days is the limit, and then the diarrhea will get worse." Wu Mian ignored the gazes of other people, he looked. Ahead, said lightly, "Dr. Wei, continue to say your judgment."

Wei Dabao was determined in his heart, he could feel the encouragement from Section Chief Wu.

Stabilizing his mind, Wei Dabao said, "I suspect that the patient's ureter and intestine are connected."

"Boom~~~" There was a sudden uproar in the meeting room.

"It's impossible!" a foreign doctor stood up and said loudly.

"Radiation damage, leading to long-term inflammation and stimulation, uretero-intestinal fistula, although rare, it is not impossible." Wu Mian smiled at the person and said, "What evidence do you have that this kind of guessing is impossible?"

"The location of radiotherapy is in the pelvic cavity!"

"This is not a reason." Wu Mian said, "You, sit down. In case discussion, if you want to speak, raise your hand first. How did your teacher teach you? Your superior doctor would allow you to be so rude?"

The man was startled for a moment and murmured, "I am the superior doctor."

"It's not anymore, sit down." Wu Mian said, "Dr. Wei just put forward his considerations, and the initial diagnosis is uretero-intestinal fistula. I will first say a few points why it is possible, and then we will discuss."

"Radiation enteritis is basically certain.

Secondary colon and proctitis often occur within 6 to 18 months after radiotherapy. Symptoms such as diarrhea, blood in the stool, mucous stools and tenesmus, thinning of the stool, and progressive constipation or abdominal pain suggest that the intestinal tract is narrow.

Severe lesions and adjacent organs form a fistula, such as a rectal fistula, and stool is discharged from the vagina; rectal small intestinal fistula can cause chyme to be mixed in the stool to be discharged ~ www.wuxiaspot.com~ It can also cause peritonitis due to intestinal perforation. Abdominal or pelvic abscess. "

"The possibility of sinus tracts in the ureter and intestine is not high, but the periodic changes according to the patient's diarrhea volume cannot be ruled out."

"One thing recorded in the medical record, I believe everyone has noticed it." Wu Mian returned to a gentle attitude, Lang Lang said, "every time after the ureteral stent is put on, the patient's diarrhea will get better.

Although different doctors will consult and formulate a treatment plan, every time the ureteral stent is put down is an inevitable treatment, and then the medicine is changed. We can say that it is the effect of drugs, but the urination is smooth and the amount of diarrhea is reduced. This obvious change cannot be ignored. "

"If according to Dean Sun, it is the effect of drugs, then there is no way to explain the subsequent changes in the condition. After each ureteral stent, the urine output will decrease within 2-3 days, and the diarrhea will increase."

"Please note that the patient's daily diarrhea volume is 5000ml. Except for cholera, I can't think of other diseases that can cause such serious consequences."

"And with such a large amount of diarrhea, the patient's serum ion changes are not cliff-like. I don't know if you have ever treated cholera patients. I have relevant experience." Wu Miankan talked, "After a large number of diarrhea. The changes in serum ions are quite large, and the patient’s laboratory results deny this."

"Such obvious evidence was ignored by everyone." Wu Mian said, shook his head.

"Furthermore, there are three consecutive records of formed stool...twice, and the third time Dr. Wei observed it." Wu Mian revised his own statement, "all appeared after the ureteral stent, so we can't rule out the ureter. Possibility of intestinal fistula."

"These days, the Sanatorium and Hospital has ruled out many causes. Although it is difficult to believe, in the end, there is only one diagnosis! Even if it is rare."