My medical skills add experience

Chapter 466 The rich and powerful are treated the same, some diseases may be 'wealthy diseases'

"Since Director Tang has said so, then I have nothing to worry about."

Zhou Can sat down with peace of mind.

In order to exchange work, male and female colleagues get along alone. This kind of thing is almost common in large industrial companies.For example, subordinates report work to their superiors, or like Zhou Can come here for consultation at this moment.

"Hehe, let's not be afraid of the oblique shadow when we are upright! Let's get down to business. This is the patient's medical record. We have basically checked all the examinations that should be done. I have been treated in another hospital for a long time, but the curative effect is not satisfactory. My organization Relevant experts in the department even invited experts from the Department of Gastroenterology to consult together, but the real cause of the disease still could not be found out.”

Director Tang Fei showed the child's information to Zhou Can for review.

It is customary in medicine to refer to patients under the age of 14 as children.The patient is male and has turned 14 years old this year.The main complaint symptoms at the first visit were lower extremity edema for more than half a year and abdominal distension.

Nausea, vomiting and other symptoms were also mentioned when admitted to the hospital for treatment.

"The parents of this child are really big-hearted. The edema of the lower limbs has been swollen for more than half a year, and they have not taken the child to the hospital for examination."

Zhou Can shook his head and sighed after reading the medical history.

Many intractable diseases are dragged out little by little.It's really similar to raising tigers.

"You can't blame the child's parents entirely. The child's father is an official, and the mother is the female president of a large company. The family is considered rich and powerful. With just such a child, it is natural to look at it like a baby. It’s like that. I heard that there are several tutors just for the children, and there are also special nannies. The only downside is that the parents of the children are very busy and don’t have much time to spend with the children.”

No wonder Director Tang Fei was so caring.

Any country in the world is a humane society, even since ancient times.Whether it is the previous feudal dynasty or the modern society ruled by law, human relations are always the unspoken rules of social rules.

The sons of nobles in feudal society, the children and relatives of officials got into trouble and committed crimes. Would the county magistrate dare to arrest them?

Even if it is really because of public anger that people are arrested, it is difficult to withstand the pressure from all sides, and finally let people go secretly.

The county magistrate and the noble son who committed the crime may not know each other at all, nor do they know his family.Then why put people away at the risk of violating the king's law?
The uncle of the noble son is the magistrate, and his official position is much higher than that of the county magistrate.

This alone is enough for the county magistrate to release him.

Your son's uncle is also a sensible person, secretly sent a sum of money to the magistrate without telling him, and told him that he will take care of anything in the future.As long as the county magistrate is not stupid, most of them will 'gladly' accept it.

It is an instinct of human beings to survive in society after thousands of years of evolution.

It's a bit similar to seeking good luck and avoiding bad luck, but it's more complicated and advanced.

The parents of this patient had probably already had contact with Director Tang Fei, and even greeted the dean or hospital leaders.In this case, Director Tang Fei needs to actively treat this child even more.

Healed, a great achievement.

Even if it can't be cured, it must be positive.

Zhou Can nodded and continued to check the patient's medical records and medical history information.

After the child's nausea and vomiting symptoms appeared, the nanny worried about the child's mistakes and quickly informed the child's parents.Only then did he quickly take the child to the hospital for treatment.

The hospital for the first diagnosis is the Provincial Children's Hospital, and the number of experts is linked.

Look at the children of rich people, this treatment is almost no different from the sons of the rich and powerful in ancient times.

In ancient times, when princes and princes were sick, they would immediately invite imperial physicians to treat them.Use the best doctor and take the best medicine.

The children of the rich and powerful in modern times go to the top hospitals in the province to find experts.

Experts performed three routine examinations on the child, namely blood routine, urine and stool routine, and then an abdominal ultrasound examination.

The blood routine showed that the WBC result was 3.3*10 to the 9th power per liter.

PLT189*10 to the 9th power per liter is routinely normal.

Abdominal ultrasonography revealed an enlarged spleen.

The child showed fatigue, flat and soft abdomen, no tenderness and rebound tenderness, and no palpation under the ribs of the liver.About 3cm below the ribs of the spleen was soft, and a shifting dullness was heard.

Then it was found that the child's lower limbs were mildly edematous, which was not serious.

When the experts did a physical examination on the child, the underside of the liver was not touched. I don't know if it was because they were worried about causing the child's resentment and resistance, and they did not dare to check it, or what happened.

Anyway, it can be seen from the inspection done that it is a very regular one.

quite conservative.

It can also be inferred from this that the experts at the Provincial Children's Hospital were under a certain amount of pressure when they received the patient.

Is it difficult for the parents of the child to speak?

Because the father of the child is an official, the mother is the president of a large company, rich and powerful, and there is only such a son.Now that my son is sick, I am unavoidably anxious.

It is also possible to put a certain amount of pressure on the receiving doctor in terms of words and attitudes.

In short, the experts who received the consultation only did a few basic checks, and they didn't dare to prescribe more checks.

The treatment is even more interesting, and the child is fasted for two days.

Leng didn't prescribe any targeted treatment drugs, but let the child fast for two days, and then a miraculous thing happened, and the child's condition improved significantly.

An expert is an expert, and the level is really high.

There is no medicine, just let the child fast for two days, and the child's illness will be cured.

It's a pity that the good times didn't last long. Less than two weeks later, the child fell ill again.I found that expert again, and this time the diagnosis result was a preliminary suspicion of duodenal ulcer.Experts let the child fast for two days.

This expert is truly a god-like expert.

After two days of fasting, the child's condition improved again.

When Zhou Can saw this, his head suddenly became a little big.It has been a long time since I encountered such a bizarre and difficult case.He intuitively knew that this case was definitely a rare disease with hell-level difficulty.

No wonder Director Tang Fei consulted so many experts without any result.

The expert from the Provincial Children's Hospital even resorted to fasting therapy twice but failed to cure the child.After each fasting, the child's condition improved significantly, and then repeated.

Zhou Can was thinking to himself, could it be that there is something wrong with the child's diet?
Some wealthy families are very willing to spend money on food, all kinds of delicacies, big fish and meat, and supplements until they get tired of eating.

Could this child be suffering from food accumulation disease?
Next, when the child relapses for the fourth time, the family members may feel that the expert is unreliable and change a doctor.But still in the Provincial Children's Hospital for treatment.The newly replaced specialist couldn't resist the pressure and began to treat the children with medication.

The drugs and methods of treatment are all in accordance with the standard treatment plan for duodenal ulcer.

However, after treatment, the child's condition did not improve significantly.

This is really interesting.

Without taking medicine, just fasting for two days, the condition can actually improve.Now the serious medication, but it has no effect.

It is estimated that the newly replaced expert is cursing in his heart, it is really evil.

The previous expert did not use any medication, and his condition improved significantly with just fasting.Why do you switch to doing it yourself and carefully prescribing medicines to treat the symptoms, but there is no effect?

While scolding himself for being unlucky, the expert ordered a new examination for the child.

Nothing more than that.

The blood routine showed that the WBC had risen to 5.62*10 to the 9th power per liter. LY, about 51%, HB about 104g/L.

Considering that the child's lower limbs have been edema, but not serious.

In addition, after treatment, the condition did not improve, and I began to suspect that there was something wrong with the kidneys.

Under normal circumstances, a 14-year-old boy's kidneys are at the best stage of his life.Boys at this time generally have no sexual life, and the first nocturnal emission may not even appear.

The kidneys are as clean and intact as a piece of rough jade.

After urine examination, the 24-hour urinary protein was normal.Note that the 24-hour urine protein quantification is checked.

This shows that the renal function of the child is normal.

Considering that the child has symptoms such as nausea and vomiting, the stool routine was checked again.

This time there is a new discovery, the stool OB is intermittently positive.

What does that mean?

Stool OB means stool occult blood.Intermittent positive, indicating that children sometimes have blood in the stool.

There are many reasons for blood in the stool, the main one is gastrointestinal bleeding.

And most likely intermittent bleeding.

After the second expert made this discovery, he was very excited.Finally, there has been some new progress.

According to this clue, another stool stain was checked, and the result was negative this time.

Seeing that the result was negative, the expert probably breathed a sigh of relief.

If the stool Sudan stain is positive, it is likely to be a malignant disease.

Normal Sudan staining results were negative.

When the neutral fat is excreted too much, the result of Sudan's trichrome staining will be positive.This indicates the patient's hepatic compensation dysfunction, pancreatic lesions, acute diarrhea and steatorrhea.

Commonly seen in acute and chronic pancreatitis, cancer of the head of the pancreas, malabsorption syndrome, small intestinal absorption dysfunction, diarrhea in children, etc.

The second expert began to focus on the digestive tract based on the clues that the fecal occult blood was intermittently positive.

First, a total gastrointestinal radiography was performed on the patient.

Zhou Can can infer that the expert at this time must be full of confidence and simmering in his heart, and I will definitely be able to find the cause of the child.And it will be found immediately, making a great contribution.

The total gastrointestinal radiography was not in vain, and it was found that the duodenal mucosa of the child was obviously thickened.

Such a young child is at the same age as Hua, and the duodenal mucosa has thickened, which means that the disease has occurred for a long time.

Just like our palms, if we only do heavy physical work for a day or two, it is impossible to wear calluses.

Only by doing some hard work for a long time can it be possible to grind out cocoons.

The more and thicker the cocoons, the longer the hard work.

The roughness of the duodenal mucosa often means that the patient has long-term chronic inflammation, which is related to factors such as long-term irregular diet and inattentive exercise.

This is not a big problem, at least in Zhou Can's view, it is not a big problem.

If only the duodenal mucosa is rough and there are no other symptoms, there is no need to deal with it at all.Just be observant and check back regularly.

If you have the rules, you can insist on soothing and gentle exercise, and the diet should be light and easy to digest.

For example, eating porridge, noodles, lotus root starch, milk, soy milk, oranges, etc. As long as you eat on time, you can live a regular life.

The situation can also be improved quickly.

The second expert made great efforts to check the child's entire gastrointestinal tract, and finally found only such a small discovery. It can be imagined that he must be extremely unwilling and very disappointed.

It's like seeing a fish pond, the water is deep and the area is large, and you can even see fish jumping out of the water from time to time.

I thought to myself, there must be a lot of fish in this fish pond, not to mention catching tens of thousands of catties, at least a few thousand catties would be no problem.

Then the water was drained, and it took a lot of effort to catch a few buckets of small fish and shrimp.

The expert from the Provincial Children's Hospital originally wanted to catch a 'big fish', but he only caught a 'small fish'. No wonder he was not disappointed.

Doctors are sometimes like this when they check up a disease. They lock on the target with full confidence, and then go through a lot of trouble to check a blank.

This expert must not be reconciled if he didn't find out the problem, and he couldn't explain it to the family.

Then started the next inspection.

What are you looking for?

gastroscopy.

Intermittent occult blood in the stool, it means that there must be a bleeding point.

Zhou Can once broke through such a similar case. The patient also had gastrointestinal bleeding, but the cause could not be found out.After Zhou Can's unremitting efforts, it was finally discovered that the patient was infected with a rare parasite.

Because of this case, he also wrote a paper with Dr. Shi from the Department of Critical Care Medicine, and it was first published in a core medical journal in China.

Later, it was also included in SCI medical journals.

Dr. Shi also took this opportunity to successfully get the title of deputy senior professional.

Zhou Can's benefits are also not small.With his qualifications and knowledge, it was beyond his imagination that he could reach such a high level by writing a thesis for the first time.It also greatly increased his potential points.

Later, when he went to Xinxiang Maternal and Children's Hospital for consultation, he was selected by the hospital as a reserve talent sequence of the Hall of Famous Doctors. That SCI paper has a certain credit.

Since the invention of gastroscopy, it can help doctors accurately detect many diseases of the upper gastrointestinal tract.

Including lesions that are difficult to detect by CT, ultrasound, and even MRI, gastroscopy can detect them.

After the expert checked the gastroscope on the child, he really made a new and important discovery.

The child had atrophic gastritis and duodenal mucosal edema.

Kind of like gyral edema.

When doing gastroscopy, duodenum specimens were randomly taken for pathology.

To be honest, after checking this step, I have already begun to suspect whether it is cancer.

It is very necessary to be a pathologist.

Because the duodenal ulcer has been treated in the early stage, it has no effect at all.

According to clinical experience, it is obvious that there is a lesion in this area, but the drug treatment according to the disease is ineffective, which often indicates that the result may be very bad.

After pathological examination, it was determined that the child had severe acute and chronic inflammation, and villous atrophy also existed.

At this time, a disease name popped up in Zhou Can's mind, celiac disease.

Celiac disease, also known as glutenous enteropathy and non-tropical steatorrhea, has a relatively high incidence in developed countries abroad, but it is rare in my country.

What Zhou Can can think of at this time is that rich people have the sufferings of rich people, such as 'richness disease'.

(End of this chapter)