Come on, Dr. Wu

Chapter 325 What hollowed out the liver?

To be honest, Wu Xiaofu has seen many liver abscesses, but this is the first one of this degree.

Compared with the findings on CT scans, the patient's symptoms seem insignificant.

It was not just a liver abscess. Wu Xiaofu also saw many tumor-like structures on the wall of the liver abscess, and the wall was very thick.

In this case, if Master Wang is not treated promptly, his life and health may be threatened at any time.

Wu Xiaofu immediately asked Peng Xia to write a prescription, admit the patient to the hospital, and complete relevant examinations first.

Wu Xiaofu returned to the department after finishing his outpatient clinic at around eight o'clock in the evening and found that the ward was still very bustling with nurses, patients, and patients' families coming and going, and it seemed extremely busy.

Whether it was the nurses, the patients, or their families, they all knew Wu Xiaofu, and when they saw Wu Xiaofu, they all hurried to greet him.

Lu Xiaoyue had not yet gotten off work and was busy with the nurses in the department.

"Boss."

Wu Xiaofu nodded and said, "Sister Xiaoyue, how are things going? We admitted quite a few patients today. Have they all been settled?"

It's more than just a bit too many. Lu Xiaoyue was a little surprised at this time. She knew what the situation would be like if Wu Xiaofu didn't control his workload and admitted as many patients as he wanted. There were thirty-two patients, plus five patients transferred from other departments. Thirty-seven of the fifty beds in the department were occupied in an instant.

More than half of the wards were occupied by patients, and various examinations, medications, and admission work piled up at the same time. Lu Xiaoyue divided the nurses into two groups, and they were busy for a whole day before they managed to settle all the patients.

Hearing Wu Xiaofu's question, Lu Xiaoyue nodded hurriedly.

"Everything has been settled, don't worry, boss."

Wu Xiaofu naturally knew the intensity of today's work. Seeing that Lu Xiaoyue was able to treat all the patients very well, it also indirectly showed that his trust in Lu Xiaoyue was worthwhile.

"I bought some midnight snacks and drinks for everyone. They will be here soon. I left your phone number. When they arrive, please send someone to pick them up."

It's such a busy afternoon, I'm afraid these nurses haven't had dinner yet. As the boss, it's only right that I show some appreciation.

When the nurses heard Wu Xiaofu's words, they all smiled.

In fact, these nurses are easy to satisfy. Just a midnight snack can actually make all the resentment they have accumulated from a day's work disappear, and turn their grief and anger into appetite.

"Thank you, boss."

……

In the medical office, Feng Lingling and Yuna did not leave. Feng Lingling was on duty today, but there were too many patients, so Yuna, her good sister, took the initiative to stay and help. After Peng Xia came back, she also hurried to help.

There are also Deng Yimin and Lu Xu. They are interns, so now they can only be subordinate doctors to Feng Lingling and Yuna and can be considered as workers.

Thirty-two patients mean thirty-two admission records, thirty-two physical examinations, doctor's orders, treatment plans, etc. These are not time-saving or labor-saving tasks.

Even with so many doctors, they couldn't get everything done at this time.

"How is it, isn't it a big problem?"

In fact, Wu Xiaofu knew all the critically ill patients. After coming back, Wu Xiaofu took a few glances in the ward and found that nothing serious had happened. It should be just some routine problems. It's just that the patients are piled together and the work is a bit too much. However, for Feng Lingling and the others, it shouldn't be a big problem.

"It's almost the same. There are 32 patients, 16 of us each. All that's left is to fill in some medical records and then everything will be done."

Wu Xiaofu nodded.

"Peng Xia will be assigned ten patients. There will be a few more patients in the future. You will have to work hard for the next two days. The new doctor will be in place soon."

"Okay boss."

"I ordered something. Peng Xia will bring it over in a while. Let's eat together first."

"Thank you, boss."

Not only the nurses did not have dinner, Feng Lingling and the others did too. They were already starving at this time. Wu Xiaofu's words were simply life-saving. Of course, it was basically impossible for those who wanted to lose weight.

"How much did Master Wang's examination reveal?"

Wu Xiaofu told Feng Lingling that all the examinations and tests done by Master Wang were urgent. Some of the simple tests should be almost ready by now. Some of them were checked in the emergency department but had not come out yet. They should be almost ready by now.

"Boss, take a look. The situation is not optimistic."

Feng Lingling's face also turned serious. In fact, there was no need to look at too much. The patient's blood routine, biochemistry, erythrocyte sedimentation rate and so on were all out at this time. A careful look would tell how bad the patient's condition was.

The white blood cell count was ten higher, the lymphocyte percentage was over ninety, and the eosinophils, monocytes, etc. were basically all high.

In other words, the patient's infection indicators indicate that the patient may have a mixed infection.

Bacteria, viruses, etc. are all possible.

Of course, there is another possibility, that is, none of these are true, and these are just secondary data increases caused by its pathogens. If that is the case, the situation can only be said to be more complicated.

There are also patients whose liver function has soared to 200, which means that the patient's liver function has been severely damaged. It is very likely that even if the disease is curbed, the liver function may not be restored.

The electrocardiogram showed that the heart rhythm was also affected.

If it is transient, it is fine. But if it is a damaging change, it will be more troublesome.

Wu Xiaofu watched the tests and examinations, frowned, and led them to the ward. At this time, Master Wang was lying on the bed, and he looked very uncomfortable. However, Master Wang was used to doing hard labor and had a high level of endurance. Even though he was in pain, he did not make a big fuss in the ward, but just endured it silently.

After seeing Wu Xiaofu, he also struggled to get up and greet Wu Xiaofu, but Wu Xiaofu stopped him and said, "I want to do a puncture and drainage for you."

That's right, Wu Xiaofu decided to perform puncture and drainage of the abscess on Master Wang under the guidance of ultrasound. The exact condition of the abscess could not be clearly seen by CT and MR alone. If one wanted to truly understand the condition, one still had to rely on pathology.

Since they have already arrived at the hospital, Wu Xiaofu doesn't want to let Master Wang's condition drag on any longer. Many changes may happen overnight, so it is better to determine the condition and treat it as soon as possible, so that Wu Xiaofu can feel at ease.

Master Wang trusted Wu Xiaofu very much and expressed his full cooperation. Even if it was an invasive examination, as long as Wu Xiaofu felt it was necessary, he would check it. In the operating room.

With a large amount of grayish white pus flowing out, the puncture and drainage were successfully completed. Wu Xiaofu did not delay. The department was equipped with a set of machines for pathological examination. This was Wu Xiaofu's special request. Although pathological examination is difficult, for Wu Xiaofu and others, as long as you are willing, it is actually very easy to master.

Even if you are not that proficient, you can still understand the simple situations.

Wu Xiaofu began to explore the pus directly under the microscope, but strangely, no bacteria, fungi, tuberculosis, or malignant tumors were found after the examination.

So what is the cause of the disease?

Wu Xiaofu also shook his head. In fact, there are only so many possible causes of abscesses. Since it is not bacteria, fungi, viruses or the like, the only answer left is the one that Wu Xiaofu least wants to get.

"Think carefully about what you've been eating lately. It's mainly things you wouldn't normally eat."

Upon hearing this, Master Wang was also in deep thought for a minute. After a minute, he seemed to have thought of something and hurriedly said that it turned out that when Master Wang was in his hometown, he once made pickled fish. At that time, in order to make the taste more tender, he simply rinsed the fish fillets with hot water and ate them.

Sashimi!
The condition suddenly became clear. The cause was identified, the examination also had supporting evidence, and the results also had corresponding hints, so it was estimated to be almost certain.

"Master Wang, I'm afraid the entire left half of your liver will have to be removed."

Master Wang came here on his own, so Wu Xiaofu had no way of notifying even his family members about this matter and could only discuss it with him personally. When Master Wang heard what Wu Xiaofu said, his face was filled with pain.

It required surgery, and half of the liver had to be removed. How could Master Wang, who had never even worked in a hospital before, accept such a major surgery?

"Is there no other way?"

"Master Wang, sashimi is not suitable for direct consumption, especially raw fish from poor water quality, which contain a large number of parasites. Your liver is now being eroded by these parasites, which is different from bacterial, fungal or viral infections.

The damage caused by parasites is almost impossible to heal by itself, and we don’t have many ways to treat it, especially when the parasites have been in your body for too long, the abscesses are very large, and your condition progresses rapidly. Conservative treatment may not only fail to completely expel the parasites in your body, but may force those parasites to move to other parts of your body and aggravate your condition.

If I want another surgery at that time, it may not be as simple as just cutting half of the liver.

In fact, the current situation is relatively good. By removing half of the liver, the source of the disease has been completely cut off. Combined with medical treatment, you should be able to recover soon. Moreover, the source of the disease is in the liver. After removing half of the liver, you will be able to recover in a while."

In fact, conservative treatment can be tried first. However, as a doctor, you always know which plan is the most effective and direct when making a treatment plan. The possibility of conservative treatment curing the patient is very small. On the contrary, it is more likely to aggravate the condition. There is really no need to try, so Wu Xiaofu directly suggested surgery to the patient.

After a struggle between himself and others, the patient nodded helplessly.

"Then do it."

Wu Xiaofu explained the pros and cons. Although Master Wang was not well educated, he could still understand what he said. Moreover, because he had been at the bottom of society for too long, he was more sensitive to feelings. How could Master Wang not feel whether Wu Xiaofu was truly doing this for his own good?

Wu Xiaofu breathed a sigh of relief when he heard Master Wang agree.

Sometimes, it is really frustrating to encounter patients who are unreasonable. In this world, of course, there are a few doctors who do not care about their patients, but most doctors are kind to their patients and hope that they can recover and be discharged from the hospital.

The best medical situation is when doctors are dedicated and patients cooperate.

Master Wang had already met the fasting standards, so Wu Xiaofu didn't delay and worked overtime to perform the surgery. It was just a liver cut, and it was done in half an hour. Today was Friday, and there were many surgeries in the operating room. He took the opportunity to add another one while the nurses and anesthesiologists on duty in the operating room had not yet left work. Otherwise, if an additional surgery was added tomorrow, the weekend, they would blame Wu Xiaofu again.

Peng Xia is still following, and now Peng Xia’s main feature is hard work and dedication.

After a day of seeing patients with Wu Xiaofu, Peng Xia still had to fill in medical records and see patients after coming back. Now, Wu Xiaofu is dragging him to perform surgery. After the surgery, he will probably have to work overtime until late at night. Well, he is really a chosen worker, but Peng Xia is still very active.

Wu Xiaofu originally wanted to take the others to perform the operation first so that Peng Xia could have a rest, but Peng Xia said that no one else could perform the operation except him.

For a motivated young doctor, enduring is not a big deal, but not seeing his own progress is. Every moment with Wu Xiaofu, Peng Xia can feel his own progress. He is fascinated by this state and likes it very much. Even if he is very tired, he feels relaxed when he thinks about his own progress.

Operating room.

Wu Xiaofu chose laparoscopic liver resection, and he was very careful during the operation.

It was only half of the liver being cut, and Wu Xiaofu was very familiar with the process. In order to prevent the contents of the abscess from flowing to other places and causing an incomplete operation, Wu Xiaofu cut off the entire half before opening it for inspection.

However, the situation after the liver was cut open made Wu Xiaofu a little frightened.

It was previously believed that there were a large number of tumor-like structures on the walls of the abscess, but after opening it, it was discovered that these structures were actually granulomatous inflammatory masses, which were densely packed with bulb-shaped, thick-shelled Clonorchis sinensis eggs, so numerous that they were countless.

When these parasites were drained before, due to their habits, they could not be drained out at all, and they all tried desperately to drill back.

Now that the liver has been opened, we can see clearly what's inside.

Clonorchis sinensis, in terms of biological type, is a species of trematode in the genus Clonorchis in the family Opisthorchidae in the order Digenea.

Adult worms are also known as liver flukes.

Adult worms of Clonorchis sinensis can parasitize in the hepatobiliary ducts of humans and a variety of animals, causing clonorchiasis, the main manifestation of which is liver damage. It can also cause hypersensitivity and inflammatory reactions in the bile duct lining and around the bile duct.

Chronic infection may lead to hyperplasia of fibrous connective tissue around the hepatobiliary ducts, atrophy of liver parenchyma, and even cirrhosis.

In 2009, WHO clearly stated that Clonorchis sinensis can cause bile duct cancer in humans.

Wu Xiaofu has done more research on bile duct cancer and knows more about Clonorchis sinensis. But it is precisely because he knows more that he knows how terrible this parasite is. Fortunately, it was discovered early and the surgery was performed early, otherwise it might not be as simple as cutting half of the liver.

Clonorchiasis is a foodborne infection. The key to prevention is to keep a close eye on your mouth, especially changing the habit of eating raw fish and shrimp.

The knives and chopping boards used for raw and cooked food should also be kept separate.

Not only yourself, your family members, but also your pets, it is best not to feed cats and dogs with raw fish.

Because patients who can excrete Clonorchis sinensis eggs, infected people, infected livestock and wild animals can all serve as sources of infection. In other words, if your pet is infected with Clonorchis sinensis, it is very likely that you will also be infected.

The operation took no more than half an hour. When the patient woke up, Wu Xiaofu showed him his liver without saying anything. He immediately understood everything. There was no point in cutting the liver. It had to be cut quickly. It was terrifying.

(End of this chapter)