Come on, Dr. Wu

Chapter 228: Bugs that like to drill holes

Starting the day after tomorrow, Wu Xiaofu will be able to speak easier when facing Min Chun later.

Of course, starting the day after tomorrow, there is still work to be done today and tomorrow.

Jingle Bell!
"Boss, there is a patient in the emergency room. Come and take a look."

emergency!

Wu Xiaofu came out of Yu Shifu's place and hurried to the emergency department, saying hello all the way and entering the emergency observation room. At this time, Wang Hu and a couple with their children were standing next to Yuna.

The patient should be a child. At this time, the child was curled up on the diagnosis and treatment bed, shivering. Because it was facing the door, Wu Xiaofu could still see the sweat beads on his forehead flowing down.

Fever and chills!
"Boss."

Seeing Wu Xiaofu come in, Yuna hurriedly stepped forward, and Wang Hu also hurriedly said hello. After seeing Wu Xiaofu, the child's parents also looked excited and said, "Director, please help take a look at my child."

In fact, adults may not be too nervous when they have the symptoms they are experiencing, but it is different for children. The child in front of them looks like he is about five or six years old, curled up on the bed, which is really distressing.

Even Wu Xiaofu couldn't bear it, let alone the child's parents.

"what happened?"

Yuna heard the words and quickly replied, "Boss, the boy is six years old. He has been suffering from intermittent upper abdominal pain for a week. During this period, he also had vomiting and fever. At first, the patient's parents thought that the child just ate the wrong thing and took anti-inflammatory drugs on their own. After taking the medicine, the symptoms are relieved and you don’t take it seriously anymore.

However, the patient's abdominal pain recurred later and became more and more severe. However, the patient's father was not around at the time and his mother was still pregnant, so it was difficult to come to the hospital. So he treated himself for a week until the child developed jaundice today. The patient's mother hurriedly called After the patient's father came back, he came to the hospital. I had already arranged for color ultrasound and blood drawing, and the results have come out. "

Wu Xiaofu nodded when he heard this. The medical history was very clear. He glanced at the patient's mother and had some guesses in his mind. He walked to the child and looked at the child's eyes. It was indeed jaundice.

"According to the patient's mother, during this period, the child's temperature was above 38 degrees. However, the temperature did not rise until he was in pain. When he was admitted to the hospital, his temperature was checked at 38.5 degrees."

Temperature is a very intuitive data for doctors to diagnose diseases. An increase in body temperature, especially if it persists for a long time, is basically caused by inflammation in the body. If a patient has jaundice, the pain is also located in the upper abdomen and large intestine. The probability is that it's a bile duct problem.

Reach out and take the patient's exam sheet.

Routine blood tests showed that the patient's white blood cell count was slightly elevated and the number of eosinophils was increased.

White blood cells are inflammation-sensing cells. Generally, an increase in white blood cells in the blood corresponds to an increase in body temperature, indicating that there is indeed inflammation in the patient's body, and the body has begun to regulate and protect itself.

Eosinophils are cells in the human body that contain eosinophilic granules. They are derived from hematopoietic stem cells in the bone marrow. They have a killing effect on bacteria and parasites. They are important for immune responses and allergic reactions. They are also a type of white blood cells.

High eosinophils may be caused by allergic diseases, parasitic diseases, malignant tumors or infectious diseases, blood diseases, etc.

Looking at the color ultrasound, the bile duct is moderately dilated, the wall is thickened, two echogenic light bands can be seen on both sides of the bile duct, and a strip-shaped anechoic area appears in the middle of the bile duct.

Biliary ascariasis!
After watching the color ultrasound, Wu Xiaofu already had a diagnosis in his mind. Children of this age are also considered to be susceptible to biliary ascariasis.

It’s just that in recent years, the concept of hygiene has been deeply rooted in the hearts of the people. The first lesson taught by basic teachers is to wash hands before meals and after using the toilet. These children are also very obedient. After paying attention to hygiene, the incidence of biliary ascariasis is very low. Wu Xiaofu I haven’t seen much of it, and I didn’t expect to see it today.

It’s just that it came a little late, but the symptoms of biliary ascariasis are very obvious. The strip-shaped anechoic area in the middle of the bile duct is the body cavity of the roundworm. The bile duct is moderately dilated and the wall is thickened, indicating that the patient’s inflammation comes from the bile duct. , it is now moderately expanded, which means that the inflammation has been going on for some time.

It is not difficult to understand when jaundice appears. It is feared that the bile duct has been obstructed at this time, and the child has changed from intermittent pain to the current continuous pain, which is also caused by obstructive cholangitis.

Adult roundworms basically parasitize in the middle and lower parts of the small intestine. When the body's whole body and digestive tract function disorders, such as high fever, diarrhea, hunger, reduced gastric acidity, improper diet, improper deworming, surgical stimulation, etc., it can cause abnormal parasites Activity, up the bile duct.

This is how the agitation syndrome comes about.

In addition, roundworms are alkali-loving and acid-averse, and have the habit of drilling. In cases of cholangitis, stones, and sphincter relaxation, the adult worms are more likely to burrow into the bile. Moreover, the parents of the patients also said that they thought the child had a bad stomach, so they gave him Cephalosporin.

This is actually an irritation to roundworms.

After the occurrence of biliary ascariasis, antibiotics can be used, but there are also options. Basically, antibiotics such as aminoglycosides, quinolones, metronidazole or tinidazole are used. Cephalosporins not only have little effect, but also It may cause irritability and worsen the patient's symptoms.

Generally speaking, biliary ascariasis rarely causes jaundice symptoms. Nowadays, the pupils are yellow, which may be caused by drug abuse.

Shaking his head, Wu Xiaofu no longer delayed and looked at the patient's parents.

"Hello, I am afraid that ordinary internal medicine methods are no longer possible and surgery is needed. The child suffers from biliary ascariasis. Because the time was delayed for too long, the roundworms drilled holes and entered the biliary tract, causing severe bile duct inflammation.

The use of cephalosporins in children for several days has also caused the death of some roundworms. Now they should be blocked in the biliary tract and have obstructive symptoms. In such a situation, medical deworming alone is definitely not enough.

The patient's symptoms are severe, and if surgical treatment is not performed in time, more serious complications may occur later. "

Operation!

The mother of the child was already crying. A six-year-old child was about to undergo surgery. How could they accept it?

"It's all my fault, it's all my fault. I should have brought Tongtong to the hospital early. Tongtong, mother, I'm sorry for you..."

Looking at the crying mother, Wu Xiaofu was a little helpless and could only look at the child's father.

The child's father had an idea and nodded quickly.

"Doctor, whether it is surgery or anything else, I will listen to you. You must cure Tongtong."

Seeing that the patient's father agreed, Wu Xiaofu also nodded, "I will try my best, Yuna, to prepare for the operation."

After saying that, he looked at the child's mother again.

"Does your child pay attention to hygiene?"

Because the patient's father often runs business outside, he may not know much about the child's situation as the child's mother, and questions must be targeted. In such a case, the mother's opinion will naturally be asked.

"Tongtong pays great attention to hygiene. He washes his hands before eating and after going to the toilet. I usually wash vegetables and fruits before giving them to the child. I don't know why, but these damn roundworms appear in the child's body. "

Wu Xiaofu nodded to express understanding and fixed his gaze on the child's mother.

"I suggest you also take a blood draw, do a color ultrasound, and have a regular stool check to see what's going on. It's not just the child. You may also have symptoms of roundworm parasitism, but the symptoms are not as severe as the child."

Biliary ascariasis originates from patients with ascariasis in the intestines. Intestinal ascariasis is an infectious disease. The source of infection is usually patients with ascariasis or carriers. Infectious eggs are swallowed into the intestines through the mouth and become carriers.

Pregnant mothers are also most susceptible to roundworm attacks and become carriers. Since the child usually has good hygiene conditions, you have to consider whether it came from the patient's mother.

If this is really the case, then the patient's mother should also see her early. After all, it is during pregnancy. If severe symptoms occur due to biliary ascariasis, it is not a good thing for the child. What's more, such carriers will also Affect the child's recovery later.

After all, after deworming, it does not mean that nothing will happen. On the contrary, after the operation, the immunity declines. If you live with the parasite carrier for a long time, you will soon recover. Not to mention whether it is good for the patient or not, if it happens again later Repeatedly, I am afraid that the patient’s family members will also suspect that Wu Xiaofu’s surgery was not done properly, so all aspects must be considered.

Therefore, only by controlling the source of infection and cutting off the transmission route can the occurrence of intestinal roundworms be completely eradicated.

This!
The child's mother was shocked when she heard this, she was too!
The child's mother wanted to say that she wasn't feeling uncomfortable either, how could she be, but when the words came to her lips, she stopped again. She was a doctor, so since she was talking like this, there was a reason for it, and at this time, she actually felt I felt a little uncomfortable too.

The child's mother felt even more uncomfortable when she thought that she might have passed the bug on to her child.

Wu Xiaofu winked at the patient's father. The child's disease must be treated, and the child's mother's disease must also be treated, but the child's mother's emotions must also be taken into consideration. Emotions are prone to fluctuations during pregnancy. Wu Xiaofu didn't want to do it because of his own reminder. , what happens to pregnant women.

The child's father also quickly understood, nodded quickly, and persuaded his wife to do the examination together. It was not difficult at all. It was just a blood draw, a stool test, and a color ultrasound. It was quick.

On the other side, the child had already begun preparations for surgery and was pushed into the operating room.

Wu Xiaofu did not delay and went directly into the operating room.

The operating room is uniformly prepared with disposable surgical gowns and surgical drapes. Although it is not an infectious disease like hepatitis B, syphilis, and AIDS, for the operating room, there is no big mistake, so for this kind of biliary ascariasis surgery, , basically all use disposable items.

"Doctor Wu."

After entering the operating room, the medical staff in the operating room greeted Wu Xiaofu. So far, Wu Xiaofu has become the most popular doctor in the operating room. The success rate of the operation is 100%. There is no risk in operating with Wu Xiaofu, and the operation is safe. If you do it quickly, it can make people get off work early, which is really not a good thing.

The surgical method for biliary ascariasis is similar to that for bile duct stones.

Laparoscopic cholecystectomy, bile duct exploration and drainage are enough.

Yuna serves as an assistant and the operation begins soon.

After the mirror enters the abdominal cavity, the situation inside the abdominal cavity becomes clear. The condition of the biliary tract can be seen at a glance. Due to inflammation, some white lines can even be seen above the gallbladder. Although the obstruction caused by roundworms in the biliary tract is incomplete, it is almost inevitable that the gallbladder will undergo purulent changes over time. What's more, the number of roundworms will only increase. At this time, the effect of deworming will even be reduced. Worse symptoms of biliary ascariasis.

Shaking his head, Wu Xiaofu stopped delaying.

Under laparoscopy, Wu Xiaofu cut open the bile duct. The roundworms were very small and difficult to see with the naked eye, even under a microscope. If you want to really see them, you can only use a microscope. But if others can't, it doesn't mean that Wu Xiaofu can't. no.

These eyes have long been invincible.

Under Wu Xiaofu's powerful mental induction, the roundworms were almost invisible. The purpose of bile duct exploration was to clean out all the roundworms in the bile ducts. The method was simple, just flush them.

However, during the flushing process, it is very likely that the roundworms will be flushed into the abdominal cavity. Such a situation will be detrimental to later recovery and prone to recurrence. The best way is to flush in a bag. However, this kind of flushing The method is a test of the operator's operation.

In Wu Xiaofu's eyes, the patient's bile duct was filled with dense roundworms. Not to mention, even Wu Xiaofu was well-informed. At this moment, his scalp was numb and he was suffering from trypophobia.

These roundworms can be long or short, some are still moving, and some are just lying on the corpse.

Some parts even gathered into a ball, and even a small white ball could be seen with the naked eye, blocking the bile duct. Under Wu Xiaofu's operation, the cannula was placed under the opening of the bile duct and flushed directly with water.

If you can't see the specific situation clearly, flushing is actually very difficult. Generally, after flushing three to five times, the bile duct will be flushed clean and the roundworms can be basically flushed out. Later, bile duct drainage will be performed. Don't worry, there are really one or two. Residue.

However, Wu Xiaofu now looked directly at the cleaning and rinsed it twice. When he saw that it was clean, he stopped directly. After all, the roundworms are not stones, so flushing is not that difficult. As long as salt water enters them, they will all flow out along with the water flow.

But with so many roundworms in the bile duct, the situation in the gallbladder is definitely not much better.

After all, some roundworm corpses will definitely flow down the bile duct into the gallbladder.

These insect corpses are not slowly eliminated, but will continue to breed infection, and gallbladder inflammation will gradually complicate. Therefore, in severe biliary ascariasis, the gallbladder will usually be removed together.

Wu Xiaofu cut off the gallbladder and took it out directly.

After placing the T-tube, the operation was handed over directly to Yuna, while Wu Xiaofu placed the gallbladder on the tray and cut it open directly.

"microscope."

Wu Xiaofu found the roundworm, asked for a microscope, and then motioned to the doctor next to him to check.

"come and see."

With such a numbing feeling, such a numbing scene, and such a rare opportunity, Wu Xiaofu couldn't just disgust himself and not let others enjoy it.

"I regret!"

"Dr. Wu, you must have done it on purpose. I feel like I'm about to leave for lunch."

"Well, I'm pregnant."

……

After the nurses anesthetized them, they all spoke up. The eyes they looked at Wu Xiaofu were full of resentment. They felt that Wu Xiaofu did it on purpose. They really didn’t want to look at this thing, but this situation aroused Yuna and the others. Curious.

Obviously, the nurse's anesthesia experience was not good at first glance, but curiosity still drove Yuna, who had just finished the finishing work, to look over, but she regretted it after one glance. That's it, no need to eat dinner.

"Boss, you are so bad."

Wu Xiaofu just gave her a look. It didn't matter the nurse or the anesthetist. He was the one who invited her to take a look. It's okay to say he's bad. It doesn't count if you took the initiative to take a look, driven by your curiosity.

After walking out of the operating room, the patient's family members rushed to greet him.

"Director, how are you? Is Tongtong okay?"

It was too fast. They were all holding their watches. It was only an hour, and it came out. It was too fast. It was so fast that they couldn't help but worry.

He shook his head and said, "It's okay. The operation is over. Just go back to the ward. The roundworms in the biliary tract have been cleaned up, but the source of the roundworms in the patient is in the intestines. After returning to the ward, he will need to undergo deworming treatment for a period of time. Follow-up You still have to keep an eye on the medicine, by the way, have you checked it? "

The patient's mother nodded quickly, "Thank you so much, Dr. Wu. I've checked it out, and sure enough, there are roundworms. What do you think I should do? I'm still pregnant and can't take medicine, but the roundworms are so scary. What will happen next?" It won’t have any impact on my baby.”

Saying that the patient's mother was already worried, Wu Xiaofu shook his head and said, "It's okay. Don't worry too much. The physiques of adults and children are different after all. You can go to the obstetrics clinic later to have a look. You are here." It’s not an isolated case, the obstetrics department can help you deal with it.”

There is a specialization in the surgery, so Wu Xiaofu will not get involved in the treatment of the patient's mother's illness.

The next day was a day of outpatient service. After leaving the outpatient clinic, Wu Xiaofu flew directly to the North District on Saturday.

Sitting on the plane, Liddell was in a much better mood.

Wu Xiaofu looked at Liddell and said with a smile, "Grandpa, you can't wait to leave me."

Grandpa didn't hold back his smile, "Don't talk nonsense, you're back too. Donghai is good, but it's not as good as home. My old friends probably miss me."

Yes, the air in my hometown is sweet.

The temperature in the northern region at the end of December is not just talk. It was broad daylight, the sun was shining brightly, and the temperature was more than ten degrees below zero. It had snowed in the northern region two days ago. At this time, there was still a layer of snow on both sides of the road. .

He tightened his down jacket, but it still couldn't stop the cold wind from attacking his sleeves and collar. He shivered and quickly took two steps. Wu Bin had already come to pick them up and took them away in a car.

However, Wu Xiaofu made an appointment with Min Chun and asked Wu Bin to put him in the First Affiliated Hospital.

On Saturday, Min Chun worked overtime.

Lunch was at Min Chunding's restaurant. After meeting Wu Xiaofu, they walked towards the restaurant together.

"I have made an appointment with Director Lin from the Centers for Disease Control and Prevention. The matter is almost settled. There are basically no problems. This is a good thing for both of us. He has no need to refuse."

After listening to Min Chun's words, Wu Xiaofu was completely relieved, with a smile on his face and thanked Min Chun. Min Chun said it simply, but Wu Xiaofu knew that the situation was not as simple as Min Chun said.

Some things don't mean that they will be done for you if they are beneficial to both parties.

There is a responsibility issue. Director Lin asked Wu Xiaofu to use the Centers for Disease Control and Prevention as a pilot, and he would have to bear the risk of drug problems. It was a great achievement for Director Lin, but if it failed, the problem would be big or small. .

Under normal circumstances, not agreeing is the correct answer.

If Wu Xiaofu were an ordinary pharmaceutical company representative, if he wanted to facilitate this matter, he might have to go to Director Lin's network again and again. Treating him to dinner and sending gifts were all trivial matters. In this way, he could get the matter done in a month. , even if it is good.

But it’s different now. If we follow Minchun’s path and both sides give face, it will be done. Director Lin doesn’t believe in Wu Xiaofu, he just believes in Minchun. With Minchun’s guarantee, he is relieved, even if something goes wrong Problem, with Min Chun's help, Director Lin will be fine.

This is the importance of worldliness.

Although Wu Xiaofu didn't like this either, sometimes he really had to leave. He sent the hotel location to a team sent by Binan Medicine to accompany him, and they followed.

This meal is also an opportunity for both parties to establish contact.

"Uncle, I told our dean several times. Before I came back, I tried to harden the dean several times. The designated support hospital you mentioned before has finally been implemented. In the future, you can just ask someone to contact our hospital directly. ”

Oh!
Min Chun was a little surprised when he heard this. Helping Wu Xiaofu this time was actually just a little effort. It was not a difficult task for him, but he did not expect that Wu Xiaofu was so helpful and reciprocated, giving him such a big surprise.

After becoming a designated support hospital of the First Affiliated Hospital of Donghai Medical University, the reputation of the First Affiliated Hospital of North District Medical University will be directly improved by more than one level, which will be of great benefit in attracting patients to come for treatment.

Not only that, after becoming a designated support hospital, the First Affiliated Hospital of Bei District can invite experts from the First Affiliated Hospital of Donghai District to come for consultations and surgeries, allowing patients in Bei District to receive the most high-end technical treatment at their doorstep. Doctors from the First Affiliated Hospital learn the most cutting-edge technology in China.

Moreover, the First Affiliated Hospital of North District can more conveniently send doctors to the First Affiliated Hospital of Donghai for further studies. All these benefits combined, Min Chun, who facilitated this, is enough to add a large sum of money to his credit book.

Maybe you can plan to join the ministry before retiring. Even if it doesn't work out, you can also plan to improve your salary after retirement.

What a great thing.

He smiled more and saw Wu Xiaofu's influence. At the same time, Min Chun valued Wu Xiaofu even more.

Although designated hospitals are good, the more important thing is the bridge of Wu Xiaofu.

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(End of this chapter)