This doctor has a system

Chapter 314 303. The three-layer bracket of ghosts and sorrows
"We all agreed, but suddenly something else went wrong." The tattooed brother held up a urine bag for everyone to see, "His urine changed color for some reason."

Mr. Wang's urine is turquoise. Since the lower half of his urine bag is also the same color, no one noticed this for the first half of the day.

The family members noticed it when they were pouring urine. The son was shocked and quickly reported the situation to the doctor on duty.

"Did you eat anything special?" The doctor on duty had never seen anything like this before.

"I just drank some gruel." Mr. Wang was a little worried, "I didn't seem to eat much else."

"Let's draw blood to check the liver and kidney function." The doctor on duty did not dare to neglect. When encountering such an unexplained situation, he must immediately check whether there is any problem with the patient's liver function and biochemistry.

If there is a major problem, then continue to look for the cause based on the problem. If there is no problem, you can put your heart in your stomach for the time being, but you must also find out why the urine turns turquoise.

"Do you want to take a blood test? Take more, I have more blood." Mr. Wang is very cooperative, but there is nothing he can do. Anyone who suddenly urinates green urine will feel a little panicked.

The doctor on duty also called the second line over. At this time, it was really uneasy not to come over and take a look.

"Could it be a urinary tract infection caused by Pseudomonas aeruginosa?" The second-line doctor was obviously more experienced. "This bacterium can cause green urine by producing pseudomonas aeruginosa."

"But it doesn't look like it."

"The old man has just been hospitalized not long ago. Pseudomonas aeruginosa will not grow in the urethra immediately."

"It's strange."

Soon, the blood test results came out. Liver function, electrolytes, cardiac enzymes, and coagulation function were all normal. Kidney function showed a slight increase in creatinine.

"We have never encountered such a situation." The second-line doctors feel it is a bit tricky. Their level can only be said to be average, and some high-end games are really impossible to win.

It’s not that the doctor’s skills are not good, it’s that the testing skills can’t keep up.

Mr. Wang has many basic diseases, including high blood pressure and diabetes. If something goes wrong here, they cannot afford it.

And if the family members have so many tattoos, they are not promiscuous, right?This is more stressful.

"It is recommended to transfer to a higher-level hospital." He gave his opinion.

After some discussion, the family members also felt that it would be safer to transfer to a higher-level hospital. The old man was in good health and it would be best if he could live for a few more years.

So I contacted someone, and I didn't know who found Dean Guo, so he fell into Gao Feng's hands.

Generally speaking, green urine is a rare clinical phenomenon, which may be related to dyes, drugs, infection and other factors during clinical diagnosis and treatment.

Absorption of sufficiently high concentrations of food coloring additives from the gastrointestinal tract can also result in dark green urine.Drugs such as promethazine, thymol, cimetidine and propofol contain phenol groups, and the phenolic metabolites after hepatic metabolism are excreted by the kidneys in the form of green urine.

In addition, bile pigments (such as biliverdin in gastrointestinal fistulas) in patients with chronic obstructive jaundice can also be absorbed into the blood and excreted through the kidneys, resulting in green urine.

Gao Feng thought of a lot in an instant, but Mr. Wang's situation didn't seem to be consistent with any of the above.

He contacted the urology department. The other party dealt with this all day long and had a specialization in the surgery.

"It probably has something to do with drugs." The urologist who came for consultation took a closer look at the urine bag. He even smelled it, and he looked very professional.

"Go through all the medications he has been taking these past few days, and I think we can find the cause."

His consultation opinion was the same as Gao Feng's.

Bu Zhengyang carefully wrote down all the medications that Mr. Wang usually took, and also asked the local urologist about the medications.

But disappointingly, there were no obvious findings.

"Could it be a mutual reaction between drugs?" Bu Zhengyang guessed, "Or it may be something that has not been discovered yet."

It is indeed possible, but Gao Feng feels that the probability is relatively small.

"Did he take any medication in the emergency department over there?"

"The family said no." Bu Zhengyang replied.

"Let's confirm with the doctor over there." Gao Feng said, "The situation must have been quite chaotic at that time. The family members had to pay and register, so they may not be able to remember it."

Bu Zhengyang hurriedly called, and soon the news came.

"I really used medicine!" He said excitedly, "The doctor in the emergency department said he used Ulibel."

"Uribel?" Gao Feng's eyes lit up, "Damn, it turns out it's the methylene blue!"

The use of methylene blue is also a common cause of green urine. Its blue pigment can be excreted by the kidneys and combine with normal yellow urine, ultimately causing green urine.

Uribel (Methenamine, Sodium Phosphate Monobasic, Phenyl Salicylate, Methylene Blue, and Amphisamine Sulfate) is a prescription medication used to reduce bladder spasms.It contains methylene blue, which is excreted by the kidneys as colorless methylene blue.

Now the truth became clear. Because the patient had diabetes and high blood pressure, his kidney function was not very good. There was something wrong with the metabolism of methylene blue, so he had green urine.

"Is this serious? What should I do next?" The tattooed brother asked anxiously.

"It's not serious. The color will change back on its own in two days." Gao Feng explained to him, "You can go back now."

"Isn't this appropriate? You're here already!" Mr. Wang was obviously a little worried.

"That's right, doctor. My dad still wants to have surgery. If it doesn't work, let's do it here." His son said.

"Then I'll contact you to the Department of Urology. Our department belongs to the Department of Internal Medicine, so it's not possible to stay here." Gao Feng called the urology surgeon who had just consulted and explained the current situation.

"The key is that there are no beds now." The other party was a little embarrassed, "We have to queue up, at least two days later."

Bu Zhengyang discussed with Mr. Wang and decided to let him stay here for two days. It happened that his blood sugar was not well controlled. He would adjust and wait until there was a bed there before transferring him.

Not surprisingly, the patient's urine color changed the next day.

These days, Gao Feng has led everyone to treat many patients with difficult and complicated diseases. Many people, including Dean Guo, have been sending patients to him.

Most of them are patients with low quality like this, but the diagnosis process consumes more brain cells.

"I feel like I haven't achieved much lately, I'm quite confused." Gao Feng sighed, "I have to find something to do, post articles to increase my reputation or something."

Bu Zhengyang on the side didn't know how to answer, and finally had to curl his lips.

"Teacher Gao, I have a complicated patient here." Li Xun called, "Please come over and take a look."

Zou Fenchan, male, 34 years old, occupation: farmer.

Three years ago, Xiao Zou suddenly had difficulty breathing, especially after activities.

His dyspnea did not just go away, it would last for a while every time, and sometimes he would cough twice.

After holding on for a long time, he couldn't bear it anymore and went to the hospital for treatment.

The doctor who received the diagnosis prescribed a chest CT examination for him, and soon the results came out: there was an abnormal density shadow in the left bronchus, and bronchoscopy was recommended.

"Your situation is quite serious. There should be something growing in the bronchus here." The outpatient doctor explained to him, "You need to do a bronchoscope and take a piece from it for testing."

Zou Fengshan didn't understand very well, but he chose to believe the doctor.

The bronchoscopy went smoothly. The doctor saw abnormal tissue under the microscope. He removed it and sent it to pathology. The result showed: bronchial adenocarcinoma.

I contracted lung cancer at such a young age!
This result was a huge blow to Xiao Zou, but fortunately he finally accepted this reality.After eliminating relevant taboos, the doctor immediately performed "tracheal tumor resection + caroplasty" for Xiao Zou.The operation was successful and Xiao Li quickly returned to his life.

Only half a year after the peaceful days, Xiao Zou suffered from chest tightness and difficulty breathing again.

Xiao Zou immediately went to a higher-level hospital to seek treatment accompanied by his family.Unexpectedly, this was just the beginning of his long journey to seek medical treatment.

After completing relevant examinations at the hospital, experts decided to implant a silicone stent in him to help open his trachea and restore smooth breathing.

Soon, Xiao Zou could breathe freely again.

But soon, Xiao Zou had trouble breathing again.

Three months later, Xiao Zou came to the hospital again feeling unwell.After the examination, experts found that the stent placed last time by Xiao Zou had granulation hyperplasia, making the stent narrow.The doctor decided to remove the old stent and implant a new one.

Another three months passed, and the same situation occurred again, with the same solution.

In this way, the same scene repeated every three months, happened to Xiao Zou four times.

Xiao Zou was clearly arranged.

In August this year, Xiao Zou's troubles escalated when he came to the hospital.

This time, the lumen of the left main opening of Xiao Zou's trachea collapsed, and the granulation hyperplasia completely wrapped the stent, making it particularly difficult to remove.

There was no other way. The experts could only nest a new stent into the original stent to open his breathing passage as much as possible.

Unexpectedly, no solution could stop the speed of Xiaozou's granulation hyperplasia.

By November, the three-month "curse" appeared again.The sudden difficulty in breathing made him realize that it was "time" again.

When I came to the hospital for a checkup, it turned out to be true.Experts can only implant new nests in this double-layered stent.At this point, Xiao Zou has a rare combination of "three-layer stent" in his trachea.

After this operation, the "curse" was broken. Xiao Zou's life gradually became normal. He was also able to do farm work at home. Everything seemed to be getting better and better.

but……

A few months ago, dyspnea came again with no apparent cause.The disease again selected Xiao Zou as the target of "teasing".

After going to the hospital for examination, experts found that there was almost no shadow of the stent in Xiao Zou's trachea, and the granulation was full of tangles and crowded his large airways.Experts don't know where to start.

In order to get treatment, Xiao Zou, accompanied by his mother, searched for famous doctors in China.

The experts shook their heads when they saw Xiao Zou's condition. The operation was too difficult and risky, and no one could guarantee that the "three-layer stent" could be removed.

"If it doesn't work, go to the Hnan Provincial People's Hospital for consultation. There seems to be someone there who does a good job with hard lenses. Maybe there is a good way." An expert mentioned at the end.

With the attitude of treating a dead horse as a living horse, Xiao Zou came to the Provincial People's Hospital accompanied by his family.

"This situation is a bit complicated." Gao Feng also frowned. The "three-layer bracket" is simply a ghost.

At present, there are two most difficult parts of taking out this "three-layer stent".

First, the excessive granulation hyperplasia makes it difficult to see the boundaries of the stent, making it difficult to start. Second, the situation inside the stent is complex, and the risk of bleeding is very high with the slightest movement.

The first place can be solved slowly. At most, it can be cleaned slowly under the mirror. Gao Feng felt that he had no problem at all.

The second difficulty is that the risk of bleeding in Xiao Zou's case is too great. If he is not careful, he may die in the bronchoscopy room due to bleeding in the airway.

"I think it's better not to do it." Liang Congyue from the bronchoscopy room said, "The patient is too young, and the expectations of his family members are also very high."

"What if I leave this behind?"

The follow-up is indeed more troublesome.

An ordinary person would definitely give in, but when Gao Feng saw the patient's painful face, he hesitated again.

"If I also retreat, then this patient will probably have to wait to die from repeated suffering."

Thinking of this, he hurriedly entered the system space.

"Major bleeding occurred during the removal of the stent, and the patient died." The system prompted.

“Death with stent removal.”

"die."

It seems that this three-layer bracket is indeed a ghost. Although Gao Feng was very careful in operating it, he did not succeed even once.

Because it had been left for too long, dense granulations and blood vessels surrounded this ghost thing. With just a light touch, bright red blood kept oozing out.

Then there's nothing we can do about it.

Gao Feng also felt very powerless.

"What do you mean about cardiothoracic surgery? Can we perform surgery directly?" Bu Zhengyang asked from the side.

"I'm afraid it would be unrealistic for the patient to undergo surgery in this situation, because in this case the entire left lung will be lost, and his dyspnea symptoms will not be relieved."

In this case, the meaning of treatment is lost.

Xiao Zou's family members were very disappointed and decided to be discharged from the hospital and go home tomorrow.

So many days of tossing had consumed their energy, and disappointment spread throughout the room.

After returning home, Gao Feng's desperate face repeatedly appeared in his mind, and he couldn't sleep for a while.

Gao Feng got up quietly and went to the living room, making himself a cup of tea. Gao Feng entered the system space again.

The result was still failure, dozens of attempts without any hope.

It seems that this is Xiao Zou's fate.

Just as he was getting ready to go to bed, an idea suddenly popped into Gao Feng's mind.

"It seems like it can be combined with vascular surgery!"

Since Xiao Zou suffers from severe bleeding every time, can the vascular surgery department tie Xiao Li's bronchial artery in advance to reduce the blood supply, thus reducing his bleeding amount?

The more he thought about it, the more he thought this was a good idea. Gao Feng couldn't help but call Director Liu of the Vascular Surgery Department.

Director Liu was preparing to pay the public salary at this time. This was not a particularly pleasant thing for him at this age. When he received the call, he couldn't help but smile.

"Hello? Emergency surgery???"

"I'm not on duty, you can find someone else."

"What? No one else can take action?"

"Okay, I'll go there immediately!"

Gao Feng on the other end of the phone was stunned for a moment, what was Director Liu doing?

(End of this chapter)