My medical skills add experience

Chapter 242 Ask the imaging department to work overtime
The human nervous system is the most unpredictable, and sometimes even a small abnormal discharge can have a great impact on the patient.

Epilepsy and sinus node abnormal discharge are the most common neurological abnormal discharge diseases.

The vagus and sympathetic nerves of the human body are sometimes even like naughty children. When they have problems, neurological diseases will also appear.

This patient had undergone 24-hour EEG monitoring in another hospital, and no major abnormalities were found.

Moreover, the brain CT was checked, and the tumor can basically be ruled out.

"I have seen the patient's blood routine results, the white blood cells are normal, but the eosinophils are slightly elevated."

Zhou Can was not in a hurry to express his diagnosis, but began to describe some abnormalities he found.

"There are too many reasons for the increase of eosinophils! For example, common allergic diseases, bronchial asthma, urticaria, drug allergy, allergic purpura, etc., can all cause the increase of eosinophils. There are also skin diseases , Cancer can also cause... Wait, you don't suspect that the patient is infected by parasites, do you?"

Director Shang suddenly realized the direction of Zhou Can's suspicion.

High eosinophils are mainly seen in allergic diseases or parasitic infections, including schistosomiasis, ascariasis, and hookworm disease.

However, the patient's eosinophils were only slightly elevated, and the patient had a stool test, and parasites had been found long ago.

Therefore, not only Director Shang, but even other doctors immediately ruled out the possibility of parasitic infection after seeing the results.

Furthermore, parasitic infections generally present with a variety of symptoms.

Rather than simply vomiting irregularly.

"I think the patient is very likely to have a parasitic infection, and it is a very scary but easily overlooked parasite. They often parasitize in snakes and frogs."

Zhou Can said with a smile.

He is the only Gui Peisheng who dares to talk and laugh with the chief physician like this.

Even sold a small pass.

"Doctor Zhou suspects sparganosis infection?"

Xie Lin hurriedly asked.

"That's right, it's this bug. Of course, I'm only tentatively suspicious, and I'm not sure. The specifics will have to wait for further inspections to be clear."

Zhou Can is not completely sure, but just suspects the disease.

After all, the patient had already had a brain CT scan, and it was entirely possible that he had sparganosis.

"It shouldn't be possible!"

Director Shang's expression became more serious, his brows furrowed.

He has seen all the medical records and brain CTs of patients treated in other hospitals.Although he is not very good at brain diseases, but with his decades of experience in diagnosis and treatment, if there is an abnormality in brain CT, he will definitely find it.

"Did you notice that the patient raised his right hand and scratched his head many times? Before the patient left just now, I took a close look at it. There was a small piece of his scalp that bulged slightly and then fell back. Under normal circumstances, this kind of movement of the scalp is impossible .Reminiscent of his wife saying that he had the habit of scratching his head before the accident, I particularly suspect that it is a parasite operating under the scalp."

Zhou Can continued to explain the basis of his diagnosis.

Director Shang secretly admired this kid for his meticulous attention to details.

After listening, Shensi raised his head and stared at Zhou Candao for a moment, "Even if there are parasites in the patient's brain, it may not be sparganosis. How can you conclude that it is this kind of parasite?"

Every doctor looks at the problem from a different angle, and has a different way of thinking about diagnosis, and the final diagnosis results are also very different.

There are many parasites that can infect humans.

Can't count.

Zhou Can directly targeted the sparganosis, which made Director Shang very curious.

"Uh...probably from several aspects of differentiation! The infection site is in the brain. Although parasites such as cerebral schistosomiasis, cerebral roundworm, and cerebral cysticercosis can also enter the head, the symptoms and volume they cause do not match. There is only The latent ability of sparganosis is the most outstanding, and its existence is not noticed until it causes obvious symptoms. Even if there are symptoms, it is easy to be misdiagnosed as diseases such as brain glioma."

Sparganum is very different from roundworms.

They have very high requirements on the living environment.They don't like to stay in the dirty intestines, but find ways to enter the host's brain through blood and other channels.

Living in a 'high' position, not only the living environment is clean, but also not easy to be found.

Looking at roundworms, they are much lower-end. As long as there is a sign of trouble, the patient can immediately find eggs and larvae when he goes to the hospital to check the feces.Even sometimes there are more adult worms in the patient's body, and the live worms can be pulled out directly when he poops.

This will undoubtedly greatly increase the risk of them being discovered.

Sparganum is hidden in the brain, and eating, drinking and laxatives do not pass through the digestive tract at all, so the risk of being discovered is much smaller.

"Furthermore, the symptoms caused by other parasites are more diverse. For example, schistosomiasis, eggs deposited in the liver, intestine or bladder and reproductive organs lead to egg granuloma and fibrosis. Adult worms can also cause weight loss, anemia, abdominal pain, liver Swelling, pot belly disease, etc. These symptoms are very obvious and can be easily diagnosed. Only the sparganosis secretly hides in the human body and develops indecently, which is very difficult to be detected."

"The last point is that patients will often participate in various entertainments, and eat all kinds of delicacies from mountains and seas. Frog and snake meat are very popular specialties. If you eat too much, the chance of being infected will increase greatly."

Often walking by the river, how can there not be wet shoes.

Often eat frog meat and snake meat, even if it is cooked, but as long as the boiling time is too short, or if it is not cooked thoroughly, sparganosis may survive.After eating it in the stomach, don't think that stomach acid can kill it.Almost all parasites have excellent abilities, such as high temperature resistance, acid and salt corrosion resistance, low oxygen resistance and so on.

It can be said that if they do not have these excellent skills, they are not qualified to be parasites at all.

Some people think about killing them with stomach acid, or thinking about eating them in the stomach and excreting them with the peristalsis of the digestive tract. It is best not to have such illusions.

Their survivability and adhesion ability are super strong.

"Based on the above information and comprehensive dialectics, I suspect that sparganism is causing trouble."

Zhou Can's analysis is detailed, reasonable, and extremely practical.

Director Shang and Huang Xinggui both nodded repeatedly, not to mention the two female graduate students Xie Lin and Luo Jingyi.Even Qiu Chengyu, who was disturbed by Zhou Can's "good things", had to admire Zhou Can's diagnostic ability.

It's too strong.

His graduate student is hard to come by.

"The examination room should not be off work yet, right?"

Director Shang turned to ask Huang Xinggui.

"Probably not yet, ordinary medical technology departments have to get off work at six o'clock." Huang Xinggui seemed to know Director Shang's intentions, and he was also full of anticipation and excitement. "Director Shang, are you going to give the patient another head imaging examination now?"

"That's right! Many things can be delayed, but illness cannot be delayed. This patient's condition is so serious, early diagnosis and early treatment."

Director Shang not only has superb medical skills, but also has a benevolent heart.

Thinking of finding out the cause of the patient earlier, he couldn't wait for a moment.

"Call the imaging department immediately and ask the comrades in the CT room to work overtime. After I communicate with the family members, I will immediately apply for an examination. You can also follow along to see the dynamic examination of the brain image and increase your experience in diagnosis and treatment."

All regular trainees are usually rotated to the medical technology department for one month training.

The purpose is to increase the clinical experience of ultrasound, CT, X-ray and other items, including inspection principles, methods, skills, and key points of watching films, etc.

Zhou Can has not been rotated to the medical technology department for training yet. He plans to finish the internal medicine training and then work in the medical technology department for a month.

It is estimated that the 36-month training period just expired at that time.

It's just right to go straight back to the emergency department to start working.

Director Shang is a vigorous and resolute person, so he immediately went to communicate with the family members.

Zhou Can and the three graduate students all went together.

On the one hand, it can help to find family members. I don’t know if the other party has arrived in the inpatient department now.On the other hand, when senior doctors communicate with family members, many of the conversation skills are worth learning for novices.

I didn't expect the speed of the woman to be quite fast.

It may be because she has been taking her husband around for a long time to seek medical advice and medicine, and she is already familiar with various procedures in the hospital.Even if I changed to another hospital, the hospitalization procedures were completed very quickly.

At this moment, under the arrangement of the nurse, her husband has been settled in the temporary hospital bed.

This temporary hospital bed is the kind of folding bed that is convenient for storage.

It is smaller than a normal hospital bed.

Just enough room for an adult to lie on it.

However, for patients, as long as they can have a bed and be admitted to the hospital, they are already very happy.

I don't care if the bed is comfortable or not.

Hospitals are not hotels and hotels. The purpose of patients coming to the hospital is to treat diseases.

If you go to a hotel to take your girlfriend to open a room, you must pursue enjoyment, and you need a comfortable big bed.

"Is he all right?"

Director Shang went to the hospital bed and asked the woman.

"Thank you for your special help. My husband's condition is still relatively good, not much different from usual. I am really grateful to you and the doctors and nurses in the inpatient department for being admitted to the hospital so quickly."

The quality of women is very high.

Sincerely thank Director Shang.

Director Shang brought four young doctors to the bedside to check on her husband's condition, which flattered her even more.

"It's not easy for you to come here from other provinces. As doctors, we can help as much as we can."

Director Shang chatted with the family members for a few words, and when the timing was almost up, the topic changed.

"After you left just now, I discussed and analyzed your husband's condition with several doctors. Finally, based on the elevated eosinophils and his constant scratching of the head, we suspected that he might be infected by parasites. If you agree, I will immediately apply for a brain CT scan to see if we can find out the real culprit."

After hearing this, the woman was stunned for a moment, and then showed a happy expression.

"I agree, of course I agree! I chose to take my husband here for medical treatment because I believe in you and this hospital. Thank you for being so attentive to my husband's diagnosis and treatment, thank you!"

The woman bowed to Director Shang, Zhou Can and others.

Especially when looking at Zhou Can, there was a deep sense of gratitude in his eyes.

With her intelligence and rich social experience, it is not difficult to guess that Zhou Can must have contributed a lot to her husband's diagnosis of the cause of the disease so quickly.

Because when she was leaving with her husband, Zhou Can asked her husband about scratching his head.

At that time, she stared at the right side of her husband's head for a long time.

At this moment, one of Director Shang's diagnostic criteria was that the patient was always scratching his head.

After the inspection application was opened, the woman paid directly by mobile phone.

Zhou Can and others helped transfer the patient to the CT room.

The woman was waiting for the results outside, while Director Shang brought Zhou Can and others into the CT room to watch the dynamic images of the patient's brain.

Attending Physician Huang Xinggui also has a strong learning attitude and came to watch along with him.

This is a very rare accumulation of diagnostic experience.

At the beginning, brain imaging showed no abnormalities.Time passed by every minute and every second.

With so many people following the radiation, and mobilizing a large number of people, if it is not found out, it may make the doctors in other departments laugh.

Outside the CT room, the patient's wife was waiting anxiously.

She was praying for a miracle to happen.

For more than a year after her husband fell ill, for more than 400 days and nights, she supported the family with her weak shoulders, and her life was very difficult.She fantasizes about miracles all the time.

"It's moving, it's moving, look at this part, there's something moving!"

Luo Jingyi's eyes were very sharp, and she immediately noticed the abnormalities in the dynamic images of the patient's brain.

After the strip's head moved twice, it returned to calm.

"Good guy, it really is a parasite. It's just that this guy is too cunning. It only moves after a long time. If it is lurking when the brain CT is taken, coupled with its location, it is really difficult to find it This time, we can finally give a very good explanation to the family members. I saw that woman in her 30s and brought her husband to seek medical treatment, and I felt really uncomfortable."

Director Shang said something from the bottom of his heart.

Not to mention him, Zhou Can, Xie Lin and others, who would feel better?
It's just that everyone's abilities are limited, and they are all mortals, no matter how uncomfortable they are, they can only be bored in their hearts.No one can diagnose the cause of the patient, let alone cure the patient.

The thick door of the CT room was opened, and Zhou Can and others pushed the patients out of the CT room, with triumphant smiles on their faces.

The cause of the patient was finally diagnosed.

This time it was saved.

"Doctor, how is it? Have you found out?"

The woman was full of anticipation, and stepped forward with a nervous face.

"It's hard work, God pays off. Congratulations. Just now, by observing the dynamic images of the patient's brain, it can be basically determined that there is a high probability that he is infected by parasites. But there is no way to confirm the diagnosis. You can arrange an operation for him to remove the brain. Abnormal organisms inside, and then a biopsy can confirm what kind of bug it is.”

Director Shang said to her.

Usually, if you are infected with sparganosis, it is difficult for drugs to kill them.

Surgery is performed to remove the worms, and then local injection of drugs to consolidate the curative effect and prevent recurrence is a relatively common treatment method.

It can also be seen from here that the old doctor's words are tight, and he has already found out what kind of parasite it is.

But because he couldn't make a diagnosis, Director Shang only said that it might be a parasitic infection.

Never mentioning what kind of bug it is.

There are no affirmative statements throughout.At the same time, it can also take into account the emotions of the family members, so that they will not be disgusted.

This is very worthwhile for newcomers to learn.

"Great! I knew that a miracle would happen in Tuya. It seems that my sixth sense is very accurate. Professor Shang, can I arrange surgery for my husband now?"

She wished that her husband's illness would be cured immediately.

"Well... definitely not right now. We are in the Department of Gastroenterology here. We are not capable of performing his operation. We can only invite experts from general surgery or general surgery to come for joint diagnosis and treatment. In addition, an anesthesia interview and risk assessment are required before the operation. Wait. It will be very fast if the operation can be arranged tomorrow."

Director Shang patiently explained to her.

I can understand the anxiety of the family members.

It's just that the hospital has hospital regulations, and this kind of joint diagnosis and treatment involving multiple departments, Director Shang can only do his best to coordinate and request.

The gentlemen in the neurosurgery room are all extremely proud, but it is not so easy to coordinate.

(End of this chapter)