This Doctor is Great

For the next few days,

Zhou Mo began to cycle around from the gastroenterology department, outpatient department, and emergency endoscopy... continuously.

Senior brother Qian Feng was very open-minded, because Zhou Mo is really good at doing endoscopy.

Every patient Zhou Mo can take care of, there is no need to do it by himself, and the rest is refreshing.

It's a pity that these good days will soon be gone, because Teacher Zhang Luojia knew that Zhou Mo had already learned endoscopy, so he asked Zhou Mo not to come to the emergency department.

Senior Brother Qian Feng: "???"

I wipe?

Pull D ruthlessly?

Ten thousand grass and mud horses galloped past in my heart.

...

a new day,

Week 5, Monday.

Zhou Mo received a new patient.

76 beds,

Patient, male, 35 years old, named Fang Xiaozhong.

He is a courier, rough guy.

I usually deliver couriers every day, and I am extremely busy, but in the past six months, I have been tossed to death by abdominal pain.

"Mr. Fang, you can just call me Dr. Zhou."

"Hello, Doctor Zhou." Fang Xiaozhong greeted with respect.

"Could you tell me about your illness? Just be more specific."

"Okay, okay."

Soon, Fang Xiaozhong began to talk about his illness.

Since half a year ago, he has experienced repeated severe abdominal pain, mainly in the lower right quadrant.

Right lower abdomen, the first reaction is appendicitis.

Occasionally diarrhea may occur.

When I went to the hospital to see a doctor, the doctor made an interrogation, a physical examination, and after the B-ultrasound examination, the first reaction was appendicitis.

Once, twice, he didn't want to do this operation because it was too painful.

But at the third and fourth time, he wavered, and finally decided to have his appendix removed.

That is, 3 months ago, the doctor said that he had repeated abdominal pain, which was a bit dangerous. If appendicitis progressed, gangrene, or even peritoneal perforation, it would be troublesome.

In the end, Fang Xiaozhong agreed to have an operation to remove the appendicitis.

result,

After the operation, the abdominal pain still appeared.

And the pain is exactly the same.

At this time, Fang Xiaozhong couldn't help but began to suspect: the appendicitis that the doctor said at the time was fake. There is no problem with the appendix at all, and I had my appendix cut off inexplicably.

Fang Xiaozhong was very angry and went to the hospital to ask for compensation. Finally, he checked the operation records and found that he had cut the wrong appendix. The appendix was fine and he got the compensation.

However, the matter still could not be resolved.

Abdominal pain still recurs.

Still lower right abdomen.

In addition, it seems that I want to spread around the belly button, and the number of times I go to the toilet has also increased.

"????"

Fang Xiaozhong was dumbfounded.

But yesterday, because of severe abdominal pain and sweating profusely, he couldn't bear it anymore, so he called 120 and came to the emergency department.

Well, being single is really miserable, and there is no one to accompany you when you are sick.

The emergency department is divided into three areas, the red area, the yellow area, and the green area. The red area is basically the kind that needs to be rescued immediately, the yellow area also needs to be rescued, and the green area can be checked slowly.

He was triaged to the yellow zone by the emergency department.

The doctor in the yellow zone first performed an electrocardiogram on him and confirmed that it was not a myocardial infarction, so he was relieved.

Then I checked, there was no hard stomach, it was not acute peritonitis.

Then the patient's abdomen was examined, and there was tenderness in the entire abdomen, but the tenderness was the most obvious in the lower right quadrant, and the abdominal muscles were still soft overall.

Then there was no shock.

I went to ECG monitoring, measured blood pressure, heart rate, blood oxygen saturation, etc., and everything was normal, except that the blood pressure was a little high, but the pain would cause the blood pressure to rise, so there was no 'big problem'.

Given that the vital signs are still stable,

The emergency doctor arranged him to the yellow zone for observation.

The right lower quadrant is the main lesion, and peptic ulcer or even perforation is generally considered.

If the appendix is ​​not removed, the main consideration is appendicitis.

Then arrange abdominal B-ultrasound and chest and abdomen X-ray to do it again,

Blood draw, routine blood test, liver and kidney function, electrolytes, four items of coagulation, two items of pancreatitis, etc.

soon,

The inspection results came out.

Liver, gallbladder, pancreas, and spleen showed no obvious abnormalities.

Chest and abdomen X-rays were also not found, which does not support gastrointestinal perforation.

B-ultrasound did not find cholecystitis, hepatitis, liver abscess and so on.

Two items of pancreatitis are also normal.

Blood routine, that is, the number of white blood cells is a little high.

Emergency doctor: "..."

I am too difficult.jpg

then,

Send it to gastroenterology.

It was accepted by Zhou Mo.

...

before the bed,

"Are all the tests normal?"

While listening to the patient's statement, Zhou Mo opened up the patient's various examination results.

read it again,

Sure enough, there is no abnormality.

Can't see any problem.

However, the patient showed repeated abdominal pain for half a year, and there must be a special reason.

"Or, let's do a colonoscopy..."

Zhou Mo said.

At this time, colonoscopy is undoubtedly the most direct and intuitive.

The problem can be found with the greatest probability.

Of course, CT can also be done to see if there is any tumor or the like.

At the same time, leave a stool routine to see if there is anything. Of course, this possibility is very small, because the patient Fang Xiaozhong has been to the hospital too many times, and the stool has been left many times, but no reason has been found.

However, most hospitals will not use each other's examinations (it will involve the issue of accountability), so it is still necessary to re-examine.

"Doctor, that's all about my condition."

"Okay, did you bring your appendicitis and surgery with you last time? At present, it can't be ruled out that the operation was unsuccessful and caused pain such as adhesions."

"There are some."

Quickly took out a stack of materials from the schoolbag and gave it to Zhou Mo.

"Also, I'm going to do a colonoscopy for you, so you'd better fast from today, and then take laxatives to clear your intestines... The specific nurse will explain it to you later..."

"Colonoscopy?"

"Yes, there's just a pipe poking through your steel door..."

"..."

Patient Fang Xiaozhong suddenly felt the chrysanthemum tighten.

...

the next day, in the afternoon,

Zhou Mo took the patient Fang Xiaozhong to the endoscopy center and performed a colonoscopy on him.

Zhou Mo can do the surgery by himself this time, without the help of colleagues from the Endoscopy Center.

"Zhou Mo, can you do endoscopy?"

"Familiar?"

"Do you want to help?"

Several doctors gathered around curiously.

Zhou Mo naturally refused their help.

soon,

The patient Fang Xiaozhong made a good posture, and then felt the chrysanthemum tighten, feeling that he was not pure.

Once the colonoscope goes in, it passes through the rectum (up) and then to the sigmoid colon. (Both in the lower left abdomen.)

very slow,

Zhou Mo looked carefully, but found nothing special.

Then (up) through the descending colon (left abdomen), also found.

Then (to the left) through the transverse colon (upper abdomen), still not found.

Then (down) through the ascending colon (right abdomen),

(digestive system diagram)

This time,

Found the problem.

Ascending colonic mucosa, severe inflammation!

And some ulcers formed!

And the location is not at the location of appendix surgery.

The colonoscope continued to advance and came to the ileocecal.

A more serious ulcer appeared in front of Zhou Mo.

Zhou Mo thought about it, took some, and sent it for a pathological biopsy.

Colonoscopy is done,

"I'm going, it's done so soon?"

"It's very fast."

"Zhou Mo, did you grow up eating Shennong 9+9? Why are you so familiar with colonoscopy?"

Under the "shocked" eyes of many gastroscopy center doctors,

Zhou Mo took Fang Xiaozhong away from the gastroscope center, leaving behind a handsome back.

on the way

Zhou Mo considered the patient Fang Xiaozhong's illness.

"Crohn's disease?"

Crohn's disease (as written earlier) is a chronic intestinal inflammation that can occur from the mouth, anus, and the entire digestive tract. Often the most common predilection sites are the ileocecal and small intestines. Its main clinical manifestations are Manifestations are abdominal pain, abdominal mass, fistula formation, and intestinal obstruction.

Although Zhou Mo couldn't see the location of the small intestine, but the ileocecal area was so severe, it might also be present in the small intestine.

Just came back to the ward,

Zhou Mo checked the test results,

A new result came out:

PPD test - strong positive!

.