This doctor has a system

Chapter 482 546. Strange Abdominal Pain
"It's not that I don't want to say it, it's just that there's no need to. Everyone is so busy." The head nurse explained, but she was still very happy about Gao Feng's arrival.

"Thank you for your hard work, Director Gao." The head nurse's husband came forward and greeted everyone. He was wearing glasses, was thin, and looked gentle and refined.

The head nurse was attracted by his gentle and scholarly temperament and jumped into the pit without hesitation.

"What's wrong with the child?" Gao Feng asked.

The head nurse has a boy named Jiakang, who is in the first grade of junior high school. His face looks very fair and he is sitting on the bed reading a book.

He greeted everyone shyly.

Speaking of this, the head nurse was a little dissatisfied.

"It's all his father's fault!"

The head nurse's husband was a little embarrassed, but he did not dare to refute his wife's accusations.

The reason was simple. The child wanted to eat hotpot, so his father took him there.

The two of them went to the bottom of the sea for a good meal and returned home satisfied. The next day, Jiakang had paroxysmal abdominal cramps, accompanied by severe nausea and vomiting.

The head nurse and the other nurse thought that they had eaten too much and too many kinds of food last night, and they also drank too much. So they took some omeprazole, gastritis granules and other drugs for treating acute gastritis from the hospital, thinking that the abdominal pain would soon go away.

However, this is just their wishful thinking.

One day later, his son's abdominal pain did not ease at all, and his nausea and vomiting became more and more obvious. The head nurse felt something was wrong and quickly took the child to the hospital for treatment.

"Look! You just took the child to eat randomly, now look what happened!" The head nurse was very angry. It would be fine if he just ate hotpot, but he didn't take her with him. Something must have happened!

When we arrived at the Department of Gastroenterology, the doctor performed a simple physical examination: mild tenderness in the upper abdomen and right lower abdomen, with no rebound pain, considering that the child had a recent history of unclean diet.

Initial consideration: Acute gastroenteritis? Acute appendicitis?

"Let's do a color ultrasound, make sure it's not acute appendicitis." The gastroenterologist was more cautious. After all, the child had symptoms of tenderness in the right lower abdomen, which is more common in appendicitis.

The color ultrasound was completed quickly, indicating: no obvious abnormal changes were found.

Before the head nurse could even feel happy, Jiakang felt severe pain in his abdomen again, and he was sweating all over.

The gastroenterologist could not determine what the disease was and suggested that the child be hospitalized to find out the cause. This was exactly what the head nurse thought. Although she was also a medical worker, she was also very nervous when her son became a patient.

If her husband was like this, she might just be slightly worried.

But my son can’t do that, because this is a precious egg that fell from my body.

Therefore, Jiakang was assigned to the gastroenterology ward.

Although the abdominal ultrasound did not find any lesions, the doctor was still worried. What if it was a small digestive tract perforation? That would require emergency surgery.

Get an upper abdominal CT scan now!

CT scan of the upper abdomen: the wall of the gastric antrum is slightly thick.

At this time, the routine inspection results also came back:

The results of rheumatology series and immune combination (-) ruled out immune system diseases.

No abnormalities were found in tumor markers and liver and kidney function.

However, the fecal occult blood test was positive!

When there is a small amount of bleeding in the digestive tract, the red blood cells are digested and destroyed, and there is no abnormal change in the appearance of the stool. At this time, the bleeding cannot be confirmed by the naked eye or microscope.

But a fecal occult blood test can detect tiny amounts of blood in the stool that are invisible to the naked eye.

"How about doing a gastrointestinal endoscopy?" suggested the attending physician. Thanks to the improvement of anesthesia levels, gastrointestinal endoscopy has now become a routine item in the annual physical examination.

The head nurse will definitely actively cooperate with this.

"I've prescribed bowel cleansing medicine. I'll do it tomorrow."

"Okay, have a good rest in the afternoon so you won't be unable to get up the next day." Gao Feng said.

Bowel cleansing medicine is usually taken at night and in the morning. You should drink plenty of water while taking it, and you will have to run to the toilet after taking it.

The excrement in the intestines must be cleared out, otherwise once the mirror is inserted, the lens will be blocked by the excrement and you won't be able to see anything clearly.

The gastrointestinal endoscopy on the second day went smoothly. The gastroscopy results showed that there were multiple small erosions in the stomach, multiple congestion and edema in the descending segment, and pathology showed chronic mucosal inflammation. The colonoscopy results showed that there were multiple scattered spots of mucosal congestion and erosion in the terminal ileum.

Could it really be a simple digestive tract problem? The gastroenterologist was somewhat puzzled.

Acid suppression and stomach protection treatments were continued, however, there was no significant effect.

Seeing Jiakang sweating from the pain from time to time, everyone became a little anxious.

The gastroenterologist in charge of the patient was also very concerned. After all, the patient was a family member of our hospital's staff, and it was quite embarrassing that he could not find the cause of the disease.

We simply organized a multidisciplinary consultation to bring everyone together to brainstorm.

"Could it be porphyria?" a director said, but this possibility was quickly ruled out. The blood porphyrin index was not high, and the urine did not turn red or dark brown after being exposed to the sun.

Some people suspected that it was lead poisoning, but this possibility is not high. Because the patient had an acute onset of the disease, there was no obvious lead line on the teeth during physical examination. Although the blood lead index has not been checked yet, lead poisoning can basically be ruled out.

One director suspected it was a thrombotic disease, but this possibility is smaller. The child is young and has no family history or cardiovascular disease.

"Director Gao! Please tell me." Director Ding of the Department of Gastroenterology said with a smile, "The patient is a family member of your department."

Gao Feng had no idea at this time. At first he thought it was just a simple gastroenteritis, but it was obvious that gastroenteritis could not explain such obvious pain.

"Is there a possibility of abdominal epilepsy or abdominal purpura?" he considered.

"There is no evidence of this at present," the doctor in charge replied, "How about I do a 24-hour EEG for him?"

24-hour EEG is mainly used to rule out abdominal epilepsy.

Abdominal epilepsy is a type of epilepsy with paroxysmal transient abdominal pain as the main clinical manifestation.

The abdominal pain of this disease recurs periodically and lasts from a few minutes to a few hours. It comes on and ends suddenly. The pain is mostly around the navel and may also involve the upper abdomen, often accompanied by nausea, vomiting, and diarrhea.

There is no loss of consciousness during the attack, but there is often some degree of disorientation, mental confusion, etc. The cause of the disease is unknown, and it mostly occurs in children and is rare in adults.

Gao Feng also proposed this possibility after looking up information. He had never seen such a case before. As for abdominal purpura, it is a type of allergic purpura.

Henoch-Schonlein purpura is a vasculitis associated with allergic reactions. Its pathological changes are fibrous necrosis of the walls of capillaries and arterioles, serous exudation and inflammatory cell infiltration around the blood vessels.

It can be triggered by infection, drugs, food, etc. It is more common in children and adolescents, and males are more likely to suffer than females. The lesions mainly occur on the skin, but can also occur in the gastrointestinal tract, joints, kidneys, heart, lungs, liver, and blood vessels in the head, causing organ damage and bleeding.

Allergic purpura caused by any reason can affect the gastrointestinal tract. When gastrointestinal symptoms are typical symptoms, it is called abdominal allergic purpura.

I have met this Gao Feng before, also when I was studying for my master's degree.

However, the patient's symptoms were very typical, with millet-like rashes and dense red spots visible all over the skin.

Jiakang was clean, so to be honest, this possibility was very small.

However, Gao Feng's reputation in the hospital is extremely high. No matter what the attending physician and the directors present think, at least on the surface everyone agrees with this possibility and agrees to investigate further in these two directions.

When a person's position reaches a certain level, your every word and action will have an impact on the people and things around you.

If someone farts and you say it smells good, a bunch of people will immediately come up to agree with you and say that the fart smells good.

Yes! That’s right! I just smelled it too! It smells like osmanthus!

Some people will even write an article to analyze this issue, asking why other people’s farts are smelly, but this person’s are fragrant?

Those who feel that the smell is bad will most likely not dare to say anything, and may even privately suspect that there is something wrong with their nose.

After the multidisciplinary consultation, the attending physician took the patient to do an electroencephalogram (EEG) without delay. He also planned to retest various indicators to see if he could find any clues.

But at night, something magical happened.

That evening, Jiakang developed a miliary rash and dense red spots on his limbs, buttocks, and back, as well as migratory pain in his limbs.

"Is this an allergy?" The head nurse's husband was very worried and quickly pressed the bell to call the nurse.

When the doctor on duty saw the patient's abdominal pain, his eyes suddenly became clear and he quickly called the attending physician and Director Ding who was on the second line.

Director Ding instructed: Please ask the dermatology and hematology departments for an emergency consultation immediately. Perhaps the cause of the abdominal pain has been found.

Soon, dermatologists and hematologists had a comprehensive consultation and considered the diagnosis: Henoch-Schönlein purpura!
"Director Gao, I, Old Ding, have finally given in!" Director Ding called over and asked, "How did you figure that out?"

He was extremely curious. During the multidisciplinary consultation, the patient's body was clean. Why did they say he had abdominal purpura?
"I'm just guessing." Gao Feng told the truth. Because symptomatic treatment had no effect after several days, he subconsciously thought of these rare diseases.

"Is it that simple?" Director Ding expressed his disbelief. How could such a coincidence happen?

But it was such a coincidence that Gao Feng was still looking through the information when he received the call, and he didn't know that the final diagnosis was really abdominal purpura.

Once the diagnosis is clear, anti-allergic treatments such as hormones, large doses of vitamin C, and calcium gluconate will be given immediately.

After active treatment, Jiakang's abdominal pain was quickly relieved. After 3 days, the abdominal pain basically disappeared, and after 2 weeks, he was cured and discharged from the hospital.

Gao Feng had already arrived in the capital at this time. He first went to pay a visit to his teacher, Academician Bao.

"Has the Lasker Award Selection Committee contacted you recently?" Academician Bao was very concerned about this.

"No." Gao Feng answered truthfully.

"Is that so?" Academician Bao was a little disappointed, but he felt that he shouldn't release negative energy in front of his disciples, so he forced a smile and said, "It's okay, it's okay. You are young and have many opportunities."

"It's not what you think." Gao Feng understood that the teacher was trying to comfort him. "The selection committee has decided to give the Basic Medical Science Award to me."

The reason why we haven't contacted him recently is that the competition for this year's Clinical Medicine Award is quite fierce and the situation is still not very clear.

"They will have to hold a final vote in half a month to determine the final outcome." Gao Feng told Academician Bao the news he had received.

"So your winning the award is a sure thing?!" Academician Bao was a little excited when he spoke. He felt that his mood was a bit similar to when he was elected as an academician.

"It may be a bit arrogant to say this, after all, the results have not been announced yet," said Gao Feng.

"Yes, it's a bit early to publicize it now. It doesn't conform to the modest character of the Chinese people." Academician Bao said cheerfully, "You are calmer than me, really."

He felt a little ashamed that he was going backwards as he grew older.

"That's because my teacher cares about me and has high expectations for me." Gao Feng stood up and poured some tea for Academician Bao. "How is your health recently?"

"Very good." Academician Bao said with a smile. Having accepted such an outstanding disciple, he couldn't help laughing even in his dreams.

Some time ago, several old academicians were chatting together and mentioned the issue of successors. Several old friends looked embarrassed and sighed.

In the past, Academician Bao was also one of them, but this time he was leisurely and happy, and gave all kinds of advice, such as "children and grandchildren will have their own blessings", "you must learn to reconcile with yourself", "don't rush, take it slow", and "accept the mediocrity of your disciples".

But it can be broken for him.

There was a person with a bad temper who scolded him on the spot, but Academician Bao was not angry at all. He was very tolerant and could fit the Liaoning ship directly inside.

"I am also a very charming person. In fact, I don't want to accept any more disciples." He said, "But Gao Feng is new here and he admires me very much. I think he has good qualifications, so I want to train him."

"Just brag." Someone said, "They use you to teach them? You're taking advantage of them, so just hide under the covers and laugh."

"That's right. I feel like everyone among us has put in more effort than you. You just got lucky!"

Finally, a few people talked about the selection of academicians.

"His performance is good enough, but his age is a disadvantage." One person said, "But we still have to push for it, let's let him show his face in advance."

"Yeah, I'm only 27 this year, I estimate I'll have to sit on the bench for another 3-4 years."

Academician Bao also thought so. It was too exaggerated to have an academician under 30 years old. I'm sure those old guys would never agree with it.

But he was not in a hurry at all. It was just a matter of time. Gao Feng was so young and could definitely wait.

"However, if you won the Lasker Award for Medicine," Academician Bao swallowed his saliva. After all, the Lasker Award for Medicine is known as the weather vane of the Nobel Prize in Medicine.

just in case
Oh my, I dare not think about it!

If this really comes true, it would be
"You are better at imagining the future than I am." Gao Feng couldn't help laughing.

(End of this chapter)