Come on, Dr. Wu

Chapter 282 Fishbone Cause and Effect

Good thing!
Wu Xiaofu couldn't help but walk a lot faster. Who doesn't like good things? He just didn't know what kind of surprise Yu Shifu had prepared for him.

in the office.

Yu Shifu looked at Wu Xiaofu and became more and more satisfied. It was a pity that he was just a disciple and not a son, otherwise he would wake up laughing in his dreams. But it was okay, he was half a good disciple.

"Xiao Fu, I heard that your birthday is next week?"

"Yes, teacher, I will stay at my grandfather's house at that time. You and your senior brother should come together. I will send you the seat in advance."

Grandpa’s house!

Yu Shifu's heart trembled. Isn't that Wu Xiaofu's grandfather?
He immediately spoke in a cautious tone, "Is it convenient?"

"That's not inconvenient. Grandpa has long said that he wants to invite the teacher and senior brothers to come over. After all, you take care of me so much."

Yu Shifu was also happy to hear this, "Okay, then I'll have to ask your mistress to choose a gift for you."

"Then I'll just wait."

Yu Shifu was even happier at this time, "Well, in addition to this, I'm also giving you a birthday present in advance."

Ah!
Is there really more?
Wu Xiaofu looked at Yu Shifu with some anticipation, and Yu Shifu did not keep him in suspense.

"Xiao Fu, you should also know about the annual selection of the top ten outstanding young people in Donghai City."

Top Ten Outstanding Young People in Donghai City!
Wu Xiaofu was a little excited. What did that mean? He was chosen? Of course Wu Xiaofu knew about the Top Ten Outstanding Young People. After all, outstanding young people were something worth showing off no matter where they were placed.

Previously, Wu Xiaofu was named one of the top ten outstanding young doctors of the First Affiliated Hospital of Donghai University.

Now, he has taken a step forward and is expected to be one of the top ten outstanding young people in Donghai City.

Although they are only the top ten outstanding young people at the provincial level, this is a municipality directly under the central government, and they are second only to the national level.

Moreover, even in the selection of various awards, the Young Outstanding Scholar is a very good award.

Outstanding Young People are generally the professional role models of a city.

They often select from various industries, and it doesn't mean that they have to be young people. It's just because young people are the future and hope of the nation, and the backbone of national prosperity, so this is the core of the award.

Over the years, there have been people in their fifties and sixties among the outstanding young people selected.

Those elected are basically leaders in various industries, including business, law, politics, medicine, etc.

If Wu Xiaofu is elected, he will be the doctor representative of Donghai City.

"Teacher, what do you mean?"

"Haha, you have performed well recently. The hospital recommends you to participate in the selection. Now you are one of the candidates. Prepare well and go to the meeting next Monday."

"Ah! Just a candidate?"

Ah!
Yu Shifu's smile faded and he started looking through the photos on the table. He was not satisfied with any of the candidates. This kid really needed a beating. He was too arrogant.

Who do you think he is? A high-ranking official in Donghai City? No, even if he is a high-ranking official in Donghai City, he can't give this outstanding young man to anyone he wants. No, this kid must be beaten. It's too infuriating.

Yu Shifu was thinking that Wu Xiaofu would be extremely happy with such good news, but who would have thought that Wu Xiaofu looked a little disappointed.

Wu Xiaofu quickly begged for mercy, "Teacher, I was wrong, I was wrong."

After having his hands pressed down by Wu Xiaofu, which were searching for something to hold onto, and watching Wu Xiaofu begging for mercy, Yu Shifu finally calmed down a little.

"You kid, you've pissed me off. Come with me to the conference next Monday."

Wu Xiaofu naturally couldn't leave in a hurry, so he took out the best tea from Yu Shifu's cabinet and started to make tea for Yu Shifu.

"Alright, alright, that's enough. You're such a waste. Drinking tea like a cow chewing a peony is enough for you. Just drink the tea on the table and don't ruin my fine tea."

Yu Shifu looked at Wu Xiaofu who was scattering tea leaves like candy, and hurried forward to stop him, his eyes full of heartache. This was the tea that he usually couldn't bear to drink, but Wu Xiaofu scattered a handful of it at once, which was simply like a son selling his father's land without any pain.

However, Wu Xiaofu finally got to drink this precious tea.

The two of them sat together and talked about professional matters. Yu Shifu also taught Wu Xiaofu his experience in winning awards. After all, according to Yu Shifu's estimation, Wu Xiaofu's chances of winning the award this time were really great.

If he really wins the award, he has to make Wu Xiaofu look more promising and not like a headless fly.

"By the way, when will RC1 be released?"

"Next week, on my birthday."

On your birthday!

Yu Shifu nodded when he heard this. This was indeed a good day and had some commemorative significance.

"How are you going to arrange it?"

To be honest, even Yu Shifu was a little envious of such a great achievement. Yu Shifu had enough ability and talent in improving the technique, and he could also devote some energy to the research of some projects. But for someone like Wu Xiaofu, who directly conducted drug research on RC1, Yu Shifu was really incapable of it.

It's not just Yu Shifu, other surgeons are basically the same.

To be honest, surgeons have always been regarded as carpenters or blacksmiths in the eyes of internists. When they talk about surgeons, they always say, "Aren't you just good at performing two operations?"

Well, in the eyes of internists, surgeons are just rough guys. The delicate work of developing drug mechanisms and pathological mechanisms is not something that rough guys like them can do.

This time, Wu Xiaofu really stood up for them. And not only this time, the last time Wu Xiaofu developed Buji Ling, many people said that who doesn't eat dumplings during the Chinese New Year, but this Buji Ling plus rc1 is different, this is not just a matter of eating dumplings.

This means you need to eat fine grains every day.

Yu Shifu just wants to see who dares to look down on them, the surgeons, this time.

"Forget about the arrangements. I'm not going to show up. Just let Binan Pharmaceutical arrange for someone to go public. I've already had enough of the limelight. The credit belongs to me anyway. It's better to avoid those kinds of occasions."

Ah!
Yu Shifu couldn't help but be surprised when he heard this. Wu Xiaofu could actually resist showing off. This was a great opportunity to shine in the medical field. Was he still a 26-year-old young man?

Even an old man like him may not have this awareness.

Originally, Yu Shifu wanted to persuade Wu Xiaofu not to indulge in such false honor and flattery. After all, for doctors, besides their own abilities and skills, any other halo would actually bring them more troubles.

People are afraid of becoming famous just like pigs are afraid of being fat. This is not just talk. Even if Wu Xiaofu has a sufficient background and will not have too much trouble, but with all the invitations, meetings, and programs that flatter you, will you refuse or agree?
If you agree, it will be a waste of time. If you disagree, you will offend people. If you don’t plan to become famous for this, it is better to keep a low profile, concentrate on the hospital’s affairs, and leave everything else to professionals.

Anyway, because of these projects, there will definitely be plenty of awards and opportunities to be gained.

Wu Xiaofu's rationality made Yu Shifu take back all the words of persuasion he wanted to give him.

Alas, this apprentice is so easy to take care of.

Friday is Wu Xiaofu's outpatient day.

"Doctor, here is the checklist."

Wu Xiaofu looked up at the female patient who was in her forties. He was quite impressed. After all, she came from another place and complained of abdominal pain. She said that she had been checked everywhere in the local area but could not find the cause. There was no other way, so she came here.

Wu Xiaofu looked at her past medical records. Some hospitals had already defined her abdominal pain as physiological. After all, she had done gynecological, internal and external medicine examinations. There were basically no problems with the organs related to abdominal pain, including the liver, gallbladder, pancreas, spleen, stomach and intestines. Even her uterus and ovaries were normal.

After eliminating all the causes one by one, if the pain is not pathological or organic, then it can only be a mental illusion.

The situation of Ms. Yu who came for treatment an hour ago flashed through my mind.

"Doctor, please help me. I feel chest tightness and abdominal pain. I feel very uncomfortable..."

Ms. Yu was rushed to the hospital accompanied by her family. The upper abdominal discomfort made her mental state very bad.

After Wu Xiaofu took over the consultation, he did not directly diagnose the patient's condition based on her medical history and examinations, but instead carefully inquired about her medical history. According to Ms. Yu herself, this was her seventh hospital.

A lot of tests were done and a lot of money was spent, but nothing was found.

After such a long time, Ms. Yu was scared that she had some difficult-to-diagnose disease that even the instruments couldn't diagnose. She was so anxious that she dared not delay any further. After all, if it wasn't a serious illness, she couldn't have delayed it for more than a month. It must still be painful.

During this period, she combined Chinese and Western medicine and took painkillers, but they only worked for a while. It was fine if she didn't move, but it hurt if she moved.

In addition to Western medicine, I also took Chinese medicine and tried various folk remedies, such as scraping. The symptoms seemed to ease, but the pain soon came back.

In the past few days, she felt that her condition was more serious than the previous times. The dull pain was in the same place as before and radiated to the back, with obvious soreness and swelling. Occasionally, she also felt nauseous and wanted to vomit.

During this period, because she was always watching videos related to abdominal pain, the software had muscle memory for it and pushed similar videos to her. Ms. Yu accidentally came across Wu Xiaofu's video. After seeing Wu Xiaofu's miraculous resume, she immediately felt like she had grasped a life-saving straw, so she did not dare to delay and directly called Wu Xiaofu in advance and then rushed to Donghai.

Wu Xiaofu carefully observed the patient's symptoms and to be honest, it was different from physiological illness.

After all, there is a difference between physiological pain and pathological pain.

Physiological pain is when one thinks that one is in pain, but in fact the body is not. This kind of pain will be affected by words and other situations. However, when patients are affected by Wu Xiaofu, not only will the pain not be alleviated, but they can also clearly see changes in their condition.

This is more like another kind of pain, pathological pain, which is the so-called pain that the body tells you that something is wrong and it should hurt. The patient said that the initial pain was in the gastrointestinal tract, but the most painful point seemed to have begun to shift, and until now, there has been radiating pain, and it is obvious that the condition is getting worse.

The so-called radiating pain refers to the pain symptoms that occur in places far away from the pathological site of the patient.

Just like the patient in front of us, the core pain area is clearly in the liver and gallbladder, but even the shoulders and back are starting to hurt.

When palpating the patient's liver, gallbladder, intestines and stomach, Wu Xiaofu discovered that the patient's pain increased with his palpation.

This situation may only occur when there is a clear pathological change or the influence of foreign matter.

Wu Xiaofu simply asked the patient to get another check-up. Although the tests in tertiary hospitals are universal, to be honest, for patients from other hospitals, after coming to the First Affiliated Hospital for treatment, Wu Xiaofu and his colleagues would still request re-examination of some important tests.

Because they don't know the imaging level of other hospitals, but they are confident enough about the impact level of their own hospital.

Wu Xiaofu did not ask the patient to undergo too many additional tests, just a chest and abdominal CT scan. However, after ordering the test, he also called the imaging department to ask them to take a closer look at the gastrointestinal tract and the area around the gallbladder.

The results will be very different if you inquire about the imaging department or not.

If you don't explain, the routine checks are just to see if there are polyps, gallbladder, foreign bodies, tumors, etc. There is a chance that some small things will be overlooked.

But it’s different if you give the instructions. The Radiology Department will even find an experienced director to take a closer look, especially since Wu Xiaofu gave the instructions himself. The Radiology Department takes it very seriously now, not because of Wu Xiaofu’s great reputation.

But Wu Xiaofu's professional reputation has spread. If there are any areas that are emphasized, there are most likely problems. If they find problems when they check, it's fine. If there are no problems, it's best to ask a senior doctor to review it again or twice.

After all, they didn't want Wu Xiaofu to find out that there was indeed a problem around the stomach, intestines and gallbladder, but they didn't notice it. That would be very embarrassing.

Just like now, Wu Xiaofu looked at the CT image and saw that there was indeed a long, dense shadow about 2.7 cm long between the gallbladder, stomach and duodenum.

The shadow is very faint. If you don't look carefully, you may not notice it. Moreover, this is an image specially processed by the imaging department. If it was an ordinary image, it would probably be ignored.

Looking at this long and dense shadow, Wu Xiaofu was also guessing in his heart. According to his inference, the high-density shadow and long strip-shaped object between the patient's gallbladder, stomach and duodenum were most likely the patient swallowing a foreign body.

After all, according to the patient's own account, the first part that hurt was in the stomach, followed by the intestines, as if something was swallowed, then passed through the gastrointestinal tract and landed in the gallbladder.

2.7 cm is not short, so it is understandable that it is painful.

And every time I move, it hurts.

As for what it is, wire? Toothpick? But its shape doesn't quite match the image.

Or was it a fish bone? Wu Xiaofu was most inclined to this conclusion. After all, apart from some adults with pica and some children, who would swallow something that was obviously harmful to the body?

"Have you eaten fish recently?"

"No, I haven't had it in months."

Haven't eaten fish for a few months? Then it's not the case? Or is it an accidental ingestion? However, even if it is an accidental ingestion, it is not easy for the fish bone to move between the gallbladder, stomach, and duodenum.

Well, for ordinary fish bones, you don’t need to go to Wu Xiaofu for a checkup, because most of them are stuck in the throat or esophagus, and rarely enter the gastrointestinal tract, where they are digested. Even if they enter the gastrointestinal tract, they will be eliminated by gastroscopy.

It is really rare to see a weapon like this one that is hidden so secretly and can penetrate the gallbladder.

However, when Wu Xiaofu asked her if she had eaten other strange things, Ms. Yu shook her head. In the end, Wu Xiaofu still preferred fish bones.

"Then do you remember the last time you ate fish?"

"Even if it's been more than half a year."

"Oh, so you had abdominal pain after that period of time?"

“No, I actually had a dull pain three or four years ago, but at that time, I didn’t pay much attention to it. After all, the pain was not severe. It might only hurt a few times a day or even for several days.

If it wasn't for the severe pain this time, I might not even remember the pain during that period. Doctor, do you think there is a connection?"

Wu Xiaofu looked at the film in his hand and suddenly had a bold guess. Could it be that it got stuck at that time?

Wu Xiaofu couldn't figure it out, and he didn't think much about it. Anyway, this problem must be solved, so Wu Xiaofu simply admitted him to the hospital.

"Peng Xia, after the outpatient clinic, come with me to see what's going on."

This is Wu Xiaofu's voluntary overtime. After all, it is the first time he has seen such a strange case, and he also wants to see what is going on. As for whether Peng Xia is willing to work overtime, that is unknown. Looking at his interested expression, it is likely that he is.

The day's outpatient clinic ended at seven o'clock in the afternoon.

Without even eating, Wu Xiaofu went straight to the operating room to take Ms. Yu.

Wu Xiaofu used laparoscope for the operation, after all, this part can be fully reached by laparoscope.

After the mirror was inserted and the surgery was done, Wu Xiaofu finally saw the view he wanted.

My goodness, isn’t this just a fishbone?

After the exploration, Wu Xiaofu found that a fishbone-like foreign body about 1 cm long had pierced the patient's gallbladder. The distal end of the foreign body was wrapped by the greater omentum. Under the microscope, the foreign body was still very obvious. Based on Wu Xiaofu's experience in eating fish, he was 3% sure.

Without delay, the foreign body was removed directly after being freed.

Wu Xiaofu poked at the tray.

Yes, that’s right, it is indeed a foreign object.

"Boss, what's going on? Didn't the patient say that she hadn't eaten a fish bone for more than half a year? Could it be that the patient got stuck by this fish bone when she ate it more than half a year ago?"

Facing Peng Xia's question, Wu Xiaofu slowly shook his head.

“It may not be half a year ago, it may be three or four years ago.”

“Three or four years ago!”

Peng Xia and everyone else in the operating room were all shocked. How could a fish bone stay in a person's stomach for three or four years?
They really had never heard of this.

"This situation is rare, but it is not impossible. We know that after swallowing a fish bone, it will pass through the esophagus into the stomach and duodenum. During this period, if there is no obstruction, the fish bone will most likely penetrate the duodenal bulb little by little under the peristalsis of the gastrointestinal tract.

Since it did not pierce all at once, there was no bleeding and no severe abdominal pain, but only upper abdominal discomfort. This can explain the patient's pain history. Three or four years ago, the patient showed intermittent stomach pain, which was obviously the stimulation of the fishbone. It was also the process of trauma, penetration, and self-healing of the duodenal bulb.

It’s just that the patient did not go for examination at that time. If he had done so, the gastroenteroscopy would most likely have found the fishbone. However, due to the delay, the fishbone might have slowly reached between the gallbladder, stomach, and duodenum.

This area is relatively hidden and cannot be seen by gastroenteroscopy or ordinary color ultrasound. We usually do CT scans only after the problem is found by color ultrasound. In this patient, we did a CT scan because we couldn't find out the cause, but it was a good opportunity to miss it.

The patient's pain has worsened this month, most likely because the fishbone has been constantly irritating the gallbladder, triggering an attack of cholecystitis. In fact, if you look closely, the patient's gallbladder is showing signs of inflammation.

If the problem is not resolved in time, the infection may worsen and even lead to rupture of other organs, which may endanger the patient’s life.”

Peng Xia and the others were stunned. What was this? The Adventures of Fishbone?

A fish bone did not stay in the digestive tract and almost ran into the internal organs. Now it has pierced into multiple gaps. Well, in reality, this guy is hiding in the blind spot of surveillance.

That is Wu Xiaofu. If it were any other doctor, I’m afraid he would have missed it.

After all, there are so many outpatients and the pace is so fast. If they don’t have some guesses before the results are checked, I’m afraid they won’t look at it carefully, let alone like Wu Xiaofu, who asked the imaging department to take a good look.

"Boss, then we need to check if there is any perforation in the gastrointestinal tract and gallbladder."

The location of the fishbone is obviously irritating to the gastrointestinal arm and gallbladder, and the organ wall membrane may have been penetrated.

Wu Xiaofu nodded and carefully examined the stomach wall and duodenum, but found no obvious perforation.

"no!"

Peng Xia was a little surprised. Could it be that this fish bone had passed through the wall?

"It's not that there is no wound. I'm afraid it has healed. The fish bone must have passed through the folds of the intestinal wall. The fish bone is thin and it caused some damage to the intestinal wall. It should have healed soon. I have to say, I don't know whether to say it's good luck or bad luck."

Peng Xia also laughed when he heard this, "That must be good luck. If it weren't for you, Boss, I'm afraid the next time the patient came to the hospital, he would be suffering from peritonitis or even shock."

Wu Xiaofu asked Peng Xia to finish. In fact, one must be careful when eating fish and other foods. Many people, when encountering fish bones or other foreign objects stuck in the throat, will force them down by gulping down rice, tofu, etc., or they will add vinegar or wine to try to push the fish bones down.

However, this will only cause the foreign body to penetrate deeper into the body. Even drinking vinegar in large gulps as the elderly often advise will not soften the fish bone. On the contrary, drinking large amounts of vinegar may worsen gastrointestinal ulcers and even induce heavy bleeding.

Therefore, if a foreign object gets stuck in your throat, do not force yourself to swallow it. If you find that you cannot cough it out, go to the hospital as soon as possible to remove it. This is the safest and most convenient way.

If the foreign body cannot be removed or is stuck deep in the body, you should go to the hospital immediately. In addition, even if the foreign body is swallowed by chance, it does not mean that the problem is solved. On the contrary, it may have already caused hidden dangers.

Just like the situation this time, three or four years have passed, and the fishbone from three or four years ago has found itself again, and the little thing almost caused a big disaster.

After passing through the throat, foreign objects may perforate the esophagus, stomach, and intestines, making it very difficult to digest. Especially in narrow sections of the digestive tract such as the entrance and exit of the stomach, perforation is most likely to occur.

The patient this time was really lucky in misfortune. If perforation had occurred, this would not be a simple foreign body removal operation.

(End of this chapter)