Gou is practicing medicine in the clinic

Chapter 227 Tumors that cannot be detected by CT, imaging
Fortunately, the four employees and his boss each performed their duties, but they were able to complete it in time.

As long as there are not too many patients, there is generally no need to work extra overtime.

Selling medicine and so on basically doesn't take much time.

At this time, Li Jingsheng's cell phone rang several times.

It's the voice of WeChat messages.

After checking, it turned out that Director Lian Tao sent it.

"I checked the patient's abdominal B-ultrasound twice more, and once I did it myself, no abnormality of the pancreas was found."

"CT and enhanced abdominal aortic and pancreatic scans only showed multiple low-density lesions of different sizes and uneven densities in the right, left, and caudal lobes of the liver, and no pancreatic space-occupying lesions were found."

It seems that Director Lian Tao still suspects that there is something wrong with the patient's pancreas!

Li Jingsheng was also skeptical.

Because the patient continued to lose weight inexplicably, it was either a malignant tumor or diabetes.There is a problem with the pancreas that can cause poor absorption by the body.

Regardless of the size of the pancreas, it is only [-] to [-] centimeters long and [-] to [-] centimeters wide, but it is a very important digestive organ of the human body.

Can help the body digest fat, protein and glucose.

When it goes wrong, it can not only lead to poor digestion ability of the human body, but even cause death.

It belongs to a very special existence among all digestive organs.

If you regard a group of digestive organs as martial arts people, you can describe it as both internal and external.

Its exocrine function is mainly to secrete pancreatic amylase, protease and other substances needed for human digestion by pancreatic vesicles and pancreatic ducts, including some important digestive juices.

The endocrine function mainly secretes the glucagon needed by the human body to control blood sugar, and insulin is used to control the decrease and increase of blood sugar.

It can be seen from here that it plays an extremely important role in controlling the digestive function of the human body, controlling and regulating blood sugar in the human body.

The patient's stool is fine, indicating that the possibility of intestinal problems is relatively small.

Liver function is also normal.

Urine routine is also normal.

It really makes people suspect that something is wrong with the pancreas.

However, the patient's fasting blood sugar is normal, and now two abdominal B-ultrasound examinations show that the pancreas is normal.

So what could be the problem?
Although no pancreatic space-occupying lesions were found in the patient's abdominal enhanced CT, there were low-density lesions in the liver, which indicated that there must be a problem.

"Why not get an angiogram?"

Li Jingsheng replied to Lian Tao.

"Could it be some beautiful woman who invited you to dinner?"

Ou Qinglan saw Li Jingsheng holding the phone with a very caring expression on her face, and even left her aside, feeling somewhat disgusted.

In fact, she is considered very good, and belongs to the kind that is not easy to be jealous.

Some girls are always not confident, worrying all day long that their boyfriend will be snatched away, and they can't help but watch.Answering a phone call, sending a message, or coming home late, you have to dig to the bottom.

It was unbearable.

Ou Qinglan almost never interfered with Li Jingsheng's private life.

Of course, maybe the two are still in the early stages of dating, and when they get married, they will probably be more strictly controlled.

"It's a doctor from the People's Hospital. He encountered a difficult case. The three basic routine tests of the patient were all normal, but he became inexplicably thin, weak, and unable to walk. He discussed it with me."

Li Jingsheng explained.

"You're not so good, are you? Is it our Lijiang City People's Hospital?"

Ou Qinglan didn't care about her condition, but was surprised by the doctor's identity.

"What's wrong with this! What's wrong with the doctors at the People's Hospital? Don't they have two eyes and one nose like us?"

Li Jingsheng was very calm.

That is to say, his strength has become stronger now, and he has an attribute panel, and he is still continuously improving various medical skills.In the future, there is a high probability that he will become the chief expert in the medical field of Jiangli City, and even become the top existence in the country.

At least in his field of expertise, he should be able to rise to the top level.

At present, he has mastered several of the most important medical and surgical diagnostic skills, as well as prescription medicine and surgical skills.

He is not going to expand the scope any further.

It is not easy to be a general practitioner, and even if he has an attribute panel that can improve his medical skills, it is by no means easy to develop general medical skills.

The various medical skills he already possessed made him very strenuous.

"The doctors in the People's Hospital aren't good enough? We doctors in ordinary tertiary hospitals can only look up to them. Did the other party ask you to discuss it? Or did you ask for it?"

In Ou Qinglan's mind, the People's Hospital is definitely a top existence.

"Hey, I found out that our doctor Ou also has a gossip side! He took the initiative to discuss it with me. We are friends, and he is a male doctor."

"I didn't ask you whether the other party was a man or a woman. Besides, I'm not such a stingy person."

She said so, Li Jingsheng took the initiative to reveal the other party's gender, which still made her feel happy and relieved.

I was really afraid that the other party was a young and beautiful female doctor from the People's Hospital, who discussed the illness with Li Jingsheng, and became a couple after discussing and discussing.

Ou Qinglan is very confident in her appearance, but when it comes to medical skills, she is still a master's student in graduate school.

Medicine is very general.

While the two were talking, Lian Tao texted back again.

"You also think an angiogram should be done?"

"Sure!"

Li Jingsheng replied.

"Percutaneous Femoral Selective Angiography."

He added another sentence.

After sending this message, Li Jingsheng himself was surprised, when did he become so powerful?

After thinking about it for a while, he was relieved again.

It is probably because he has a certain level of cardiovascular medical diagnosis and extracardiac diagnosis, so he can use clinical medical knowledge in various fields in the face of this digestive tract disease.

"I found that Jingsheng's clinical knowledge is more profound than I imagined. I really don't know that you are so good, why don't you enter a big hospital to develop?"

Lian Tao felt that Li Jingsheng's strength and level were very high, even in the top three of the People's Hospital, he was an outstanding existence.

"Don't make fun of me, my knowledge is no more than a finger of yours. My girlfriend is here, so I won't talk to you anymore."

Li Jingsheng didn't dare to push himself in front of Lian Tao.

"I value sex over friends! I despise you! I'll tell you when the results come out."

Lian Tao seemed satisfied with the discussion.

In the future, when encountering difficult cases, Li Jingsheng may be the first thing that comes to mind.

After Tang Ping and the others finished their work, Li Jingsheng checked the accounts and found that there was nothing wrong.Then I checked the medical records of the day again, and there was no problem.

He locked the door in peace and went to eat with Ou Qinglan.

This time, he didn't choose to eat fried rice with eggs, but took her into the restaurant.

She seems to have really changed.

When ordering, I only ordered two cheap vegetarian dishes, one fried tofu and one cabbage.

"At least order some meat!"

Li Jingsheng said to her.

"I want to lose weight, otherwise I will gain weight and be disgusted by you, what should I do?"

"Then order some shrimp!"

Li Jingsheng ordered a stir-fried leek with shrimp.

When eating, she is very delicate, but the shrimp is very popular with her.

Seeing that she loves to eat, Li Jingsheng basically didn't stretch out his chopsticks much.

At this time, her cell phone rang.

I glanced at it, then picked up the phone and went to a distant place to answer it.

This kind of thing has never happened.

Li Jingsheng felt that there must be something wrong with her avoiding him.

Judging from her performance, the possibility of stepping on two boats is extremely slim.

She seems to have become a lot more frugal recently. Could it be that the economy is in trouble?

It shouldn't be possible!
The bag she carried and the watch she wore were all famous brands, and her family background should not be bad.

And not long ago, when Li Jingsheng was worried about the appearance, she went back to her hometown, probably to ask her parents for money, and planned to buy a facade for him to use.

Li Jingsheng faintly heard her say, I got it... I'll give it to you in two days.

What is it?
This little girl makes people worry!
In two days, isn't it just the day when the Second Hospital pays salaries?

He was startled, it seemed that Ou Qinglan's economy might really be in trouble.

After the two of them finished their meal, if it was the same as before, she would definitely rush to pay the bill.

This time, Li Jingsheng paid for it.

"Qing Lan, it seems your birthday is coming soon, right?"

Li Jingsheng took her hand and walked down the old street in the south of the city.

"You know all about this!"

She responded with a smile.

"That is necessary! I am very busy at work every day, you know that! I have a bad memory, and when I am busy, I only have patients in my mind. If you forget your birthday, that crime will be nothing big."

Li Jingsheng told her.

"Look at what you said, what does it matter! Besides, when it's my birthday, I'm going to treat you to dinner! I can call you on my own initiative then!"

She said indifferently.

"No, no, it is your intention to invite me to dinner, and it is my intention to give you birthday gifts and blessings. I will send you 3000 yuan, and you can buy what you like. You don’t need to make up for less, and you don’t need to make up for more. Retire, can you see it?"

If Li Jingsheng gave the money directly, she would definitely not accept it.

It also hurt her self-esteem.

Just thought of such a way.

Because he wanted to save money to buy this small yard, he didn't give much.

There is 3000 yuan, a little saving, enough for her to spend a month.

If you want to buy expensive clothes and cosmetics, it is definitely not enough.

Li Jingsheng can only guarantee her food and clothing now, but cannot satisfy all her material desires.

"I don't want your money. And you don't need to give me any expensive gifts on my birthday, even if you write a love letter, I will be very happy. Haha, speaking of this, we have been in love for a while, and you have never written me a love letter Woolen cloth!"

She is easily satisfied.

"You have to listen to me in this matter, unless you treat me as an outsider."

Li Jingsheng took out his mobile phone and transferred it to her three thousand times.

She swiped open the screen and wanted to return it on the spot, but Li Jingsheng stopped her.

"Accept it! Whether we usually go shopping or eat in the hospital, you are basically paying the bill. This little money is my little care. You can buy whatever you want on your birthday."

Li Jingsheng looked into her eyes sincerely.

"No, I don't want your money. My mother taught me since I was a child that girls must respect themselves and not accept money and expensive gifts from men. If you respect me, don't force me to accept this money."

She strongly disagrees.

The two had already walked to the front of the clinic, opened the door, and Li Jingsheng pulled her in.

"Qinglan, am I your boyfriend?"

"What do you say?"

She rolled her eyes.

If you don't admit that he is a boyfriend, is it possible to give him a hug and hold hands?
Maybe send him a message every day, chat?
Maybe for him, he ran home to ask his parents for money to buy a facade?

"I love you very much, and it's only natural to take care of you. It's also natural for a man to earn money to spend on his wife and children. Although we are not married yet, as long as you want, I can get a certificate with you at any time. But you have to go through the barriers of your parents If so, you have to give me some time, I'm just starting my career now, you know that."

Li Jingsheng hugged her and faced each other.

"That's when we get married later. We're not husband and wife yet."

She refused again.

"You... Have you encountered any difficulties?" Li Jingsheng swallowed this sentence, but finally did not ask.

Because he was worried about hurting her self-esteem.

"Well, if you need money, you can ask me to get it at any time. If you really don't want to accept my gift, then just make an IOU. The more you borrow, the better. If you can't pay it back, I will send you Pawn it to me as my wife."

Li Jingsheng said in a joking tone.

Puchi!

"You're the only one who has many bad ideas!" She covered her mouth and couldn't stop laughing.

The time when the two of them are together seems to be so happy forever, Li Jingsheng can make her smile happily every time.

……

It was almost eight o'clock, and Director Lian Tao sent another message to Li Jingsheng.

"Angiography showed that the patient had multiple space-occupying lesions in the liver, a mass in the tail of the pancreas, and calcification in the middle. It seems that my hunch and the direction of the first diagnosis were correct. There was really a problem with the patient's pancreas. I just didn't expect it to be in the tail. B-ultrasound can't find it at all."

Lian Tao was very excited when he successfully found out the lesion.

The diagnosis of this case is really not easy. Fasting blood sugar, liver, kidney, and pancreas B-ultrasound, blood, stool, and urine are all normal.

Who can have some lesions inside the liver.

Then there was a mass in the tail of the pancreas.

"This patient's tumor may have metastasized!"

Li Jingsheng replied.

"You are really awesome, and you are right again. There are multiple space-occupying lesions in the body and tail of the pancreas, and bone scans show multiple bone metastases. At present, it is initially suspected to be glucagonoma in the body and tail of the pancreas, a very It's a rare tumor. Our gastroenterology department can't handle this disease, so we arranged to transfer it to surgery overnight."

After checking here, the cause of the disease is revealed to the world.

It's just that the results of the treatment are quite worrying.

Multiple metastases have occurred, and the effect of surgical treatment is still a question mark.

This patient must be at an advanced stage.

"Jingsheng, do you know why even CT and B-ultrasound failed to detect pancreatic tumors?"

"Please enlighten me. My guess is that the tumor density should be similar to that of the pancreas."

All Li Jingsheng could think of was this result.

This kind of thing is rarely encountered, but he also encountered a case in the department of internal medicine.

It's just that the patient's tumor was in the liver.

At that time, the patient was coughing, and the superior doctor took a film of the patient and treated it as a lung infection.

As a result, no treatment was effective.

And on the third day, the patient started coughing up blood.

Later, the patient died, and the family members thought that the treatment in the First Hospital was not effective, so they requested an autopsy.

An autopsy revealed tumors in the patient's liver that had metastasized to the lungs.

The patient's death was not from terminal cancer, but from respiratory failure combined with asthma.

The First Hospital lost that lawsuit, and it is said that they lost more than 80 yuan.

Li Jingsheng only knew that the deputy chief physician's face was gloomy for more than two months.A little thing can cause a big rage.Later, Li Jingsheng resigned, so he didn't have to look at the face of the deputy chief physician.

The First Hospital should bear part of the compensation, but the deputy chief physician must have also paid a lot.

Otherwise, if you pay tens of thousands or even thousands of dollars, you won't have a gloomy face for more than two months.

Doctors are a high-risk profession. From this point, we can see that the income accumulated for more than ten years may be paid out if a patient has an accident.

Lian Tao directly sent a thumbs up emoji.

"You guessed it right again. Director Jin of the oncology department said that this pancreatic endocrine tumor cannot be detected by CT and B-ultrasound because it has the same density as the pancreas. When you encounter similar cases in the future, you must leave more mind."

Through the discussion and exchange of this case, Li Jingsheng learned a lot from it.

Doctors spend their whole lives studying because there are so many types of diseases.

All kinds of weird diseases, I can't think of it.

Ou Qinglan was with him in the clinic, he really hoped to marry her sooner, the two of them got tired of being together every day.

Living alone in Nuoda's clinic is really empty.

Sometimes I feel empty in my heart.

If you can marry her, you can live together in the clinic, and then have two or three children. A new family will be perfect.

"By the way, Qinglan, let me teach you to practice sewing and knotting!"

"Okay! I managed to get a skin suture opportunity from Professor Wu during my operation today. The suture was poor and I was severely criticized in public."

She was a little depressed about it.

Basically every novice doctor came here like this.

"Then you have to practice hard. When you finish practicing, give them a big surprise."

Li Jingsheng's sewing skills were at the proficient level at the worst level.

It is definitely top-notch in Professor Wu's group.

It can only be said that the suturing level of Professor Wu and others is really not flattering.

Taking out tweezers, sewing needles, needle holders, and suture thread, Li Jingsheng began to teach her how to sew.

It's different to have a good boyfriend. I taught her intermittent stitching, and she only practiced for less than two hours, and her level has improved significantly.

(End of this chapter)