Come on, Dr. Wu

Chapter 368 Hope
Other things can be questioned, but not many people are willing to question Wu Xiaofu's ability to treat patients and perform surgery.

Especially the doctors in the First Affiliated Hospital, they all know how powerful Wu Xiaofu is.

So many people questioned it before, but in the end they only got slapped in the face. If you have that much time, you might as well take a closer look yourself and try to find out the patient's deeper illness.

Wu Xiaofu was speechless as he saw everyone acting like good students and curious babies.

Looking at the hepatobiliary surgeons behind him, they were all from the hepatobiliary surgery department who came to join in the fun. Chen Zhendong was also there, as well as several doctors from area D, and four or five doctors from other wards.

"What do you think?"

Unlike doctors in other departments, Chen Zhendong and others were actually a little nervous at this moment. After all, this was a question asked by Wu Xiaofu. They inexplicably did not want to disappoint Wu Xiaofu and even had a desire to show off in front of Wu Xiaofu.

A doctor in Area B looked at it for a while and then spoke slowly.

"Cheng Shi is definitely able to see that it is gallbladder cancer, but he is not making a diagnosis yet. I guess he is thinking that this case cannot be that simple, so he is so hesitant."

Everyone was suddenly enlightened upon hearing this, and then they started laughing again.

"Don't mention it. It's really Cheng Shi's first few cases. They don't seem that difficult. Compared with other interns, there should be a difficult one. I guess this is it. Director Wu, do you really not know how to diagnose these cases?"

Some people have begun to question whether Wu Xiaofu and his team are just pretending here.

"I don't know. We only took a look at the patient's physical condition and asked a few questions. How much can we know?"

Who would have thought that as soon as Wu Xiaofu said this, the others just shook their heads.

"We certainly can't see much like this, but you are the top doctors in our First Affiliated Hospital. One glance is enough. You must know it. Otherwise, can you tell us what this disease is? We are really curious."

Lin Dongping also laughed when he heard this, "Don't blame us. I don't know about others, but I can't do it anyway."

"I can't do it either."

Miao Qingyan quickly followed suit and admitted that cardiology diseases are so complicated that even if a full examination is done, it will not look good, let alone just a glance. It is simply impossible. Minor illnesses are okay, but major illnesses cannot be detected at all.

"I definitely can't do it. The more complicated the disease, the more confusing it is. I dare not make a conclusion. In fact, these interns also rely on luck. We just divided the difficulty based on experience and then picked five. Maybe there were mistakes and omissions, and they picked up the omissions, or maybe it was really too difficult. There is nothing we can do about it."

Jiang Yuankai also followed up and said that this was the truth. If you have bad luck, then there is nothing you can do. However, most of the time, it is pretty close.

As of now, these interns have read almost everything and there are basically no mistakes or omissions.

As for Cheng Shi.

"I can't tell what you're looking at me for."

"Can't tell? We don't believe it. We can't tell. You just took a look and said it's difficult. In this case, Doctor Chen, tell me whether it is gallbladder cancer or not."

Chen Zhendong also laughed when he heard this.

"Director, look at your current reputation. No one is willing to believe you. However, it seems that it is possible that it is another disease.

To be honest, if it is any other disease, it would be a bit beyond the scope. Rare manifestations of common diseases and common manifestations of rare diseases have always been difficult for our clinical diagnosis. It is a headache for anyone who encounters it. "

Everyone nodded, but continued, "We know this, what we want to know is if this is another diagnosis."

Chen Zhendong hesitated for a moment, "If we want to talk about other diagnoses, it may be biliary ascariasis, but we can only know this after a complete examination. The examination of this lower-level hospital is indeed unqualified. There is no color ultrasound, just MRI. In my opinion, the best choice for Cheng Shi is to admit him to the hospital for abdominal pain, and then check it out before making a decision.

Although this is not outstanding, it is not a mistake. Based on his previous performance, the result is still good. "

Biliary ascariasis!
Everyone frowned when they heard this. Ascaris? This examination is really annoying. You have done an MRI but not a color Doppler ultrasound. Isn't this harming people?

The most important thing is, you should check one case first and then push the patient away. Is it that urgent?

If it is really biliary ascariasis, it can actually be diagnosed almost completely by doing a color ultrasound. However, if it is really biliary ascariasis, that hospital should be called back. It's just a healthy roundworm, and although it's not a serious disease, it can be considered on the same level as gallbladder cancer. It's really scary.

"It hurts like a drill!"

At this moment in the clinic, Cheng Shi was cheered up. After listening to the patient's description, he felt that what the patient said was very similar to the classic symptom of biliary ascariasis: drilling-like pain.

This is something that other diseases do not have. After all, ascaris is alive and likes to move around and drill holes. When systemic or local factors in the human body cause changes in the intestinal environment, such as fever, pregnancy, hunger, surgery, decreased gastric acid secretion, chronic inflammation of the bile duct, etc., the intestinal environment is disordered and intestinal peristalsis is abnormal, ascaris becomes active frequently and begins to move up and down the duodenum and drill into the bile duct.

In addition, ascaris likes alkali and hates acid. When ascaris ascends to the duodenum, it likes to drill into the bile duct with alkaline bile. After entering the gallbladder, due to the stimulation of ascaris, the sphincter of the bile duct opening spasms, resulting in sudden and severe pain in the right upper abdomen or under the xiphoid process.

This is what is called drilling pain.

This type of pain is very specific and completely different from other types of pain. However, based on this point, can we be sure that it is biliary ascariasis?
At this moment, Cheng Shi was probably in the same mood as the other doctors outside the clinic, complaining about the hospital that examined the patient, asking why they couldn't just do a color ultrasound!

However, since biliary ascariasis is suspected, let's ask about this aspect.

However, there are really not many people suffering from biliary ascariasis in China. It is a very rare disease. Therefore, the symptoms and signs, except for the drilling-like pain, are really atypical.

Looking at the hepatic hilar infiltration on the MRI, Cheng Shi was now in a dilemma.

Should we confirm one of the conditions and admit the patient to the hospital, or should we first admit the patient to the hospital for abdominal pain and conduct a complete examination?

The former is risky, the latter is more stable.

Outside the clinic.

Everyone was a little surprised when they heard the pain like drilling into the top of the head. They looked at Chen Zhendong differently, "You are worthy of being a hepatobiliary surgeon. You can see this."

However, the most authoritative answer is still in Wu Xiaofu's hands.

"Director Wu, now that it's like this, just announce the correct answer."

Everyone watched eagerly. Now, other interns had basically finished the outpatient assessment, and only Cheng Shi was left. Cheng Shi's assessment would probably be over soon as well. They wanted to see if Cheng Shi could pass this test.

Wu Xiaofu faced everyone's gaze and, not wanting to keep it a secret any longer, nodded.

This is a common manifestation of a rare disease. Hepatic portal infiltration is actually quite common. When it appears, people first think of tumor infiltration. However, if you think about it carefully, many other diseases may also cause such a result, such as biliary ascariasis. Seeing Wu Xiaofu nod, everyone started to discuss it.

"If that's the case, then this case is even more difficult than Song Tiantian's. It's too confusing. I'm afraid anyone who takes a look at it would think it's a tumor, let alone Cheng Shi. Even we are the same. Cheng Shi has persisted until now and raised so many doubts. He is really amazing."

"We should be thankful that this was during the assessment. If it was in any other situation, he wouldn't be so cautious and would probably just follow his first impression and get gallbladder cancer."

"That being said, this child's calmness shows its advantage here. Others may not be so careful and ask questions like this."

……

As everyone was discussing, they stared at Cheng Shi, wanting to see what choice Cheng Shi would make.

To be honest, the safest option is to admit the patient to the hospital for abdominal pain. Otherwise, any other choice would be risky. They were so sure only because Wu Xiaofu had given his nod, but Cheng Shi did not have this condition.

If Cheng Shi can diagnose it as biliary ascariasis, then this achievement is truly remarkable.

"Doctor, how is it? Is my husband's illness easy to cure?"

The patient's family members were crying. The doctor was watching so hard. Just thinking about it, you can imagine how difficult this disease is. Thinking about the results given by the local hospital, the patient's family members felt discouraged. Gallbladder cancer, if he gets this disease, is there still life? My husband is only 51 years old.

At this time, the patient also lowered his head, as if he had accepted his fate.

Yes, he had indeed guessed it a long time ago. His wife's performance was too obvious. Moreover, now is the Internet age. With a little research, one can actually know the truth. He just didn't want to make his wife worry, so he didn't say much or ask many questions. However, he still had hope in his heart.

I’m now at the First Affiliated Hospital, a national authority. What if something unexpected happens?

Cheng Shi's eyes became more determined at this time. "I have a different opinion from your local hospital. It looks like biliary ascariasis, but you don't do color Doppler ultrasound locally, so it's not so clear. Therefore, it's best to be hospitalized for further examination, because whether it's biliary ascariasis or the one you mentioned before, surgery is required.

What do you think? "

Biliary ascariasis!
When the patient and his family heard this, they were all stunned. They both looked up at Cheng Shi, and then they were surprised again.

They actually didn't know much about biliary ascariasis, but they did know one thing, that is, no matter what disease it was, it was better than gallbladder cancer. If it was really biliary ascariasis, then they were simply blessed by the goddess of luck.

"Really? Doctor, are you telling the truth?"

"It's not certain yet. We need to do a color Doppler ultrasound or even angiography to know."

"We will cooperate. We will cooperate. We will do the color Doppler ultrasound and other things now. We will do it now."

Although Cheng Shi did not give a positive answer, they were already happy enough. Even if it was just a hope, it would be enough. What if it really wasn't the case!
Now they just want to cooperate with the doctor to be hospitalized and get checked out as soon as possible.

"Okay, then I'll write you a hospitalization and examination form, and you should do it as soon as possible."

After making the diagnosis, Cheng Shi's subsequent movements were very smooth. Outside the clinic, Wu Xiaofu and the others watched and nodded.

Regardless of whether Cheng Shi was confident in this diagnosis or just taking a gamble, his gamble was undoubtedly right, unless, of course, Wu Xiaofu was wrong. But would Wu Xiaofu be wrong? Probably not.

Everyone thought, if that was the case, Cheng Shi’s performance in this assessment would really be incredible.

Ward.

The five people left the outpatient clinic and returned to the ward. As the first-visit doctors, they were responsible for the patient's follow-up until the patient was discharged, or even for life.

This is also the second stage of their assessment.

The work after admission to the hospital is no simpler than that in outpatient clinics, including medical instructions, medical records, review of the initial diagnosis, and most importantly, treatment.

Wu Xiaofu and the others were also gathered together at this time.

There were eight people during the outpatient assessment. Except for Pan Ying who made a wrong diagnosis, the diagnoses of others were all correct. If Pan Ying had not realized the mistake after the patient's examination was complete, he should have been informed. After all, we cannot joke with the patient's life. Even if it is an assessment, the patient should receive the best treatment.

Although eight people were asked to develop a treatment plan, it was just a treatment plan.

The real treatment still has to follow the plan of Wu Xiaofu and others. The treatment plan for eight people is only used for evaluation.

The color ultrasound was done very quickly. While Cheng Shi was seeing other patients, the fifth patient and his family came back soon.

Holding the color ultrasound report, he handed it to Cheng Shi with an excited look on his face.

"correct!"

Cheng Shi looked at the examination list and his heart was lifted. That's right, it was really right, it was indeed biliary ascariasis.

There was only one line of words written at the bottom of the color ultrasound report: Biliary Ascaris?
Although it is a question mark, it is only because the Ultrasound Department is an auxiliary department and is not suitable for diagnosis. However, based on the experience of the doctors in the Ultrasound Department, since it is written, it is almost correct. The patient and his family members also shed tears of excitement.

"Doctor, thank you, Dr. Cheng, you saved us."

Cheng Shi hurriedly supported the two of them, "This is what I should do, you don't need to do this. However, although the color Doppler ultrasound reported this, if you want a thorough diagnosis, it is best to do an angiography. After all, there are doubts about the MRI you brought over."

"Do it. We will listen to you. We will cooperate with you in whatever you say."

At this time, the two of them had completely trusted Cheng Shi. As for things like how much the examination would cost, it was not within their consideration at all.

When they were most desperate, it was Cheng Shi who gave them hope.

Not to mention doing an examination, they would be willing to give it to Cheng Shi.

Moreover, on the way back to the ward, the two of them had checked on their mobile phones. Although biliary ascariasis is rare, it is nothing compared to gallbladder cancer. If they cooperate with the treatment well, they don't even need surgery, and can just take medicine and receive intravenous drips.

How could they not be happy?

Cheng Shi was also very happy to see the two of them working together so well, "Okay, I'll arrange it for you right away."

(End of this chapter)