This Doctor is Great

Teacher Zhang Luojia judged that it was a liver problem.

Then a lot of questions were asked.

Did you drink? (Alcohol needs to be metabolized and decomposed in the liver, which will increase the burden on the liver.)

Did you take any medicine before you got sick? (Medications can also tax the liver.)

Have you had the hepatitis B vaccine before? (There are vaccines and antibodies to rule out hepatitis B)

Have you ever had a blood transfusion?

The answer given by the patient Duan Zhang was: no alcohol, no medicine, no blood transfusion, and hepatitis B vaccine...

Next, Teacher Zhang Luojia gave the patient Duan Zhang a physical examination.

A key change was found: the patient had pain on percussion in the liver area of ​​Duanzhang, and the liver appeared to be enlarged.

From this, it is concluded that there is a problem with the liver!

Then blood was drawn to check blood routine, liver and kidney function, electrolytes, coagulation indicators, viral hepatitis, abdominal color Doppler ultrasound... and so on.

At that time, the patient Duan Zhang was very resistant to so many examinations.

"Why does your hospital always open so many tests? Isn't this a waste of money?"

"I knew I was going to the clinic, just prescribe some liver-protecting medicine!"

Faced with this kind of doubt from the patient Duan Zhang, Mr. Zhang Luojia looked calm at that time: "If you don't want to do these tests, you can go to the clinic to see a doctor, you can make up your own mind. But your liver is a little swollen. , it may not be a trivial matter, I suggest doing more inspections."

Duan Zhang looked disdainful: "You big hospitals know how to intimidate patients, go, wife, let's go to the clinic to see!"

His wife persuaded him, but Duan Zhang was so angry that he took her and left the clinic directly.

Then, Duan Zhang went to the clinic.

Soon, the doctor at the clinic let him breathe a sigh of relief: the doctor at the clinic believed that the possibility of acute hepatitis was very high, and he could use some drugs to reduce jaundice and protect the liver, and the infusion would improve in a few days.

The patient Duan Zhang's wife was a little worried and asked if she wanted to go to the hospital?

The doctor at the clinic said that of course you can go to the hospital, but this acute hepatitis is not a big deal, and it can be controlled by taking some medicine.

Now,

The wife is relieved.

Duan Zhang is proud of his choice.

It is said that there is no need to go to the big hospital, saving a lot of examination fees.

Next, the patient Duan Zhang took liver-protecting medicine, anti-yellowing needles, and anti-fever medicine for 2 consecutive days.

Although the fever is no longer there, the person's spirit is still relatively tired, and the jaundice has not improved, but it seems to be more yellow. And the appetite is even worse, and he vomits from time to time.

This time, the wife couldn't help it.

You can't take your life as a joke!

Pulling her husband Duan Zhang, he came to the Second Provincial Hospital again. It was a coincidence that the other doctors were full this morning, and only Zhang Luojia, who was attending, had 2 doctors left.

So, the husband and wife sat in front of Zhang Luojia's clinic again.

It is still the same process of consultation, physical examination, and issuance of examination orders...

Then an admission order was issued.

So, after lunch, the couple went to the gastroenterology department and were admitted to the hospital.

Entered the 77 beds in charge of Zhou Mo.

Zhou Mo stood at the head of the bed.

"Hello, I'm your bed doctor, just call me Doctor Zhou."

The husband and wife hurriedly said politely, "Hello, Doctor Zhou."

If it was before, Duan Zhang might have looked down on a young doctor like Zhou Mo, but after going through the previous clinic, he realized the gap between the clinic and the big hospital.

He dared not despise the big hospital.

At this time, the wife looked at Zhou Mo, scrutinized it a few times, and suddenly asked:

"Are you the very popular Doctor Zhou Mozhou on the Internet?"

husband:"???"

Zhou Mo was stunned for a moment, then smiled and said, "Yes, it's me."

"It's really you!" The wife was overjoyed: "Doctor Zhou, I heard that your medical skills are very good!"

Zhou Mo hurriedly said modestly: "I won the prize. Every doctor in this department is a professional doctor with excellent medical skills."

The wife is enthusiastic: "Dr. Zhou, my husband's illness is so much trouble to you."

Zhou Mo nodded: "Don't worry, it's fine."

Duan Zhang, her husband, looked at his wife curiously: "Dr. Zhou is famous?"

Wife: "Of course you're famous..."

Then let's talk about Zhou Mo's TV appearance.

Zhou Mo sweated profusely and quickly interrupted: "Well, how about I check your husband first?"

The wife is embarrassed: "Doctor Zhou, you need to check first, please..."

Next, Zhou Mo walked through the consultation process, which was basically similar to that of Teacher Zhang Luojia, and then did a physical examination. The patient Duan Zhang's liver had indeed grown a little bigger. The final diagnosis was hepatitis, or liver abscess.

"What time did you draw your blood?"

"Around 11 o'clock."

"Then the results should come out soon... Let's wait for the blood test results to come out... By the way, you still have an abdominal ultrasound, have you done it?"

"I haven't done it yet, we make an appointment to do it at 3 o'clock tomorrow..."

Zhou Mo was helpless: "Tomorrow at 3 o'clock, it's been too long, I'll make one for you later..."

The wife thanked again and again: "Thank you, Dr. Zhou!"

soon,

Zhou Mo brought the B-ultrasound machine by the bedside and performed a liver ultrasound on the patient.

Final conclusion:

- Abdominal color Doppler ultrasound: The liver is slightly enlarged, and there are 3 multiple low-density foci.

At the same time, the size and depth of the three low-density foci can be measured.

The largest one is as big as 2*2.5cm.

Judgment - liver abscess! !

B-ultrasound, the diagnostic rate of liver abscess, is as high as 96%, which is the preferred method of examination, a little higher than CT.

(picture of liver abscess)

Liver abscess and hepatitis are not the same thing.

When the patient's resistance decreases, or there is celiac disease, various microorganisms such as bacteria, fungi or amoeba histolytica can enter the liver through the biliary tract, blood vessels, etc., first causing local infection, and then forming abscesses.

...

13:40,

The patient's blood test results came out:

- High white blood cell count, obviously inflammation.

- The levels of bilirubin and transaminase were significantly increased, indicating that the liver cells were destroyed, and the inference - liver inflammation.

- Hepatitis indicators (hepatitis A, hepatitis C, hepatitis D, hepatitis E): all negative.

Zhou Mo looked at these inspection results,

Combined with the abdominal ultrasound results just now,

Therefore, to determine the patient in front of you should be:

- Liver abscess!

Reviewing the clinical manifestations of the patient: fever ~ www.readwn.com ~ liver pain, nausea and vomiting, etc., it is indeed a bacterial liver abscess performance.

But there are also unexplainable places. If it is a bacterial liver abscess, the white blood cell count in the blood should be significantly increased.

But the patient's white blood cell count was only slightly elevated.

"Isn't it a bacterial liver abscess?"

"But amoebic liver abscess?"

"Amoebic liver abscess" is a liver abscess caused by the amoeba. Because it is an abscess caused by amoeba, not bacteria, the increase in white blood cell count in the blood will not be obvious.

Zhou Mo was hesitant.

Because of the B-ultrasound results, it is not very consistent with amoebic liver abscess.

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ps: (There are two types of liver abscesses: bacterial liver abscesses and amoebic liver abscesses. The two are very different.)

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