Chapter 165 The cause of the disease is found, but it is difficult to take medicine

Author: Jiangbian Yuweng

Chapter 165 The cause of the disease is found, but it is difficult to take medicine

Dr. Chi didn't pay too much attention at first because Zhou Can was just a graduate student.

He thought it was a doctor from the Department of Critical Care Medicine who summoned Zhou Can to understand the patient's diagnosis and treatment.

"The patient was examined and found to have intestinal bleeding. Can you describe the details?"

"The patient underwent angiography at that time, and the bleeding was mainly concentrated in the colon segment of the large intestine. Multiple and diffuse bleeding." Dr. Xia Ping introduced the situation at that time.

He is the treating doctor and the patient's attending physician, and he knows the patient's condition best.

Diffuse hemorrhage is most dangerous when it occurs intracranially.

It spreads the bleeding area like smoke. It often refers to bleeding at multiple points at the same time, and is more common chronically. This kind of bleeding is mostly related to superficial capillary lesions or dilation. There is also sepsis, which is the most common.

"What about other intestinal segments? Is there any bleeding?"

Zhou Can continued to ask.

Making this call was very rewarding.

At least he has initially asked about what he wants to know.

"There was almost no bleeding in the cecum, and there were some signs of bleeding in the rectum. No bleeding was found in the anus or rectum. Later, unable to withstand the repeated pleas of the family, I took the risk of performing a colonoscopy on the patient. Consistent with the results of the angiography, the bleeding was mainly concentrated.

There was also a small amount of bleeding in the colon and rectum segments. Thrombin treatment and cryotherapy were used, but the results were not good."

"Through observation and comparison, I also found that the location of the bleeding point found during endoscopy was different from the location of the bleeding point found during angiography. I am sure that the location of the patient's bleeding point is constantly changing."

Dr. Xia described all his findings.

After Zhou Can heard this, he became even more convinced that there was something wrong with his small intestine.

The details I learned from Xia Ping are so precious.

"Do you think it is possible for a malignant tumor to infiltrate the intestinal wall and cause bleeding?"

Zhou Can is making the final elimination.

If malignant tumors can also be ruled out, then he can further narrow down the diagnosis.

"The possibility of malignant tumors is extremely small. At least colon cancer and rectal cancer can basically be ruled out."

Xia Ping is quite conservative in his speech.

This is also a speaking skill that experienced doctors were forced to practice through various beatings.

Only doctors who are really capable and have full confidence in their field of expertise can dare to speak with certainty.

Otherwise, it’s usually a conversational skill that can both retreat and advance.

"Dr. Zhou, who is your superior doctor? Did he ask you to inquire about the patient's condition?" Xia Ping seemed to hear something was wrong and began to question Zhou Can in turn.

"My superior doctor is Hu Yiba from the Department of Critical Care Medicine. Dr. Hu doesn't know about this. It's just that I want to know the patient's condition, so I take the liberty to disturb you."

Zhou Can didn't dare to talk nonsense.

Many doctors in the hospital know each other, and they will know whether something is true or not as soon as they ask about it.

He would never dare to be accused of dishonesty.

"So that's it! I'm busy here. If there's nothing else, let's talk about this!" When Xia Ping heard that it was Zhou Can's own idea, his attitude immediately became much colder.

Senior doctors often encounter novices like Zhou Can who ask questions.

Like a curious baby, he always goes to the superior doctor to ask various questions.

Senior doctors may still have a little patience when facing the junior doctors they are responsible for teaching. This attitude is basically the same for junior doctors who have nothing to do with them.

"Can you also tell us about the specific treatments you have performed on patients?"

Zhou Can also wants to know more about the situation.

In particular, the treatment methods used by the treating doctors, as well as the effects after treatment, and the patient's reactions.

These data are very valuable and can help him better diagnose the cause of the patient's disease.

Why is it difficult to diagnose some difficult and complicated diseases?

Just because all the common causes have been ruled out one by one, the doctor needs to be like a pony crossing a river, trying it himself and finding a path that no one has ever walked before.

"You can directly check the medical records for specific treatments. I have something to do here. Goodbye."

The words fell before Zhou Can could say anything more.

The other end of the phone hung up immediately and heard a busy signal ending the call.

This Doctor Xia is really realistic.

Zhou Can was speechless for a while.

Fortunately, I have already asked for a lot of key information, and the harvest from this trip was pretty good.

"It's a good thing for novice doctors to be diligent in asking questions, but they should pay attention to moderation. We attending doctors are often very busy, and few of us are willing to spend our spare time to answer miscellaneous questions."

What Dr. Chi said to Zhou Can was more of a warning.

Nothing malicious.

Just tell Zhou Can not to be so arrogant next time. It is very disgusting to bother the superior doctor casually.

Zhou Can didn't argue with him.

Instead, he thanked him and left quickly.

Now it has been basically determined that the patient's lesion is in the small intestine.

As for the specific cause of the disease, after ruling it out one by one, a light suddenly flashed in his mind.

Could it be a parasite? Moreover, this parasite is not in the large intestine, but hides in the small intestine.

[Pathological diagnosis experience value +1.]

The experience points have been received, indicating that his diagnosis is correct.

If you want a final diagnosis, you need to conduct further examinations on the patient.

Zhou Can was excited for a while.

The hard work paid off, and the patient's diagnosis finally took a big step forward.

At this point, the cause is basically clear.

There is a parasite in the patient's small intestine.

As for the method of causing trouble, further dialectics can be done.

The patient's stool has been routinely tested. If there are parasites, they can usually be found. At least the eggs can be found.

However, no parasites or eggs were found during the stool routine, which means that the parasites are probably hiding in the small intestine, absorbing the patient's nutrients like crazy, and then producing substances that can cause large intestine bleeding.

It may be larvae, or it may be some kind of hormone or harmful substance that can stimulate intestinal bleeding.

Considering that the patient suffered from diffuse bleeding, which was concentrated in the colon segment.

Zhou Can prefers that parasites lurk in the small intestine, absorb the nutrients they need from intestinal juice, and then excrete irritating and harmful substances that can cause large intestine bleeding.

After the small intestinal fluid enters the large intestine, the cecal segment is very short and its function is similar to that of the small intestine. It mainly absorbs nutrients that the small intestine has not absorbed, as well as impurities.

Those small intestinal fluids stay in the cecum for a shorter period of time.

On the contrary, the colon is 1.1m long. When food passes through the stomach and small intestine and reaches the colon, it secretes some alkaline substances to protect the intestinal mucosa and lubricate the intestines. At the same time, it absorbs water, sodium and other electrolytes.

After food residue reaches the colon, it slowly forms stool through water absorption.

With the continuous peristalsis of the colon, stool is discharged into the rectum.

Finally it is expelled from the body through the anorectum and anus.

It can be seen from here that the liquid discharged from the small intestine stays in the colon segment for the longest time.

And it also has the process of turning feces from liquid to solid.

During this process, harmful substances that can cause bleeding in the intestinal wall are absorbed by the intestinal wall, causing capillary dilation and diffuse bleeding.

The diagnostic idea has reached this point and is very clear and definite.

That harmful substance can cause telangiectasia in the large intestine.

Maybe because the irritation is not particularly strong, it only causes mild chronic bleeding.

[Congratulations to you for successfully diagnosing a very difficult case, the pathological diagnosis experience value is +100.]

At this moment, the truth is revealed to the world.

Zhou Can clenched his fist hard and raised his arm.

Very excited inside.

Not only was he rewarded with 100 pathological diagnosis experience points, but he was also able to save a life.
To be continued...