Since 1981 Health School
Chapter 501 Milky T-shaped Unidentified Protrusion
The curtains were drawn tight, the lights were turned off, and the entire ward became dark.
Chen Qi, a convenient B-ultrasound machine similar to a laptop, once again played a role.
I saw him holding the probe in his right hand, irradiating the painful part of the patient non-stop, and manipulating the mouse left and right, taking screenshots and recording from time to time; neither eye left the screen for a moment.
Including Dean Bagri, Director Mombetto, and Piet and Callema are all staring at the screen.
Doctors are professionals, so it is easy to tell the advanced level of this "color ultrasound machine".
The B-ultrasound machine was invented in the 1950s. By the 1980s, the mainstream of the world was still dominated by black-and-white B-ultrasound, even if the black-and-white machine has not been completely eliminated by 2022.
The color Doppler ultrasonic detection technology, that is, "color Doppler ultrasound machine" was just launched in the early 1980s, so it is also an advanced medical instrument in European and American countries.
As for the color ultrasound machine in Chen Qi's hand, it can no longer be described as advanced, it can only be said to be a product of a cross-generational era.
Everyone has never seen this high-definition LCD screen. With the movement of Chen Qi's probe, everyone can see the internal organs very clearly.
B-ultrasound diagnosis is to display the reflected echo signal on the instrument in the form of gray scale, and the strength of gray scale reflects the strength of echo interface reflection and attenuation of ultrasound in tissues and organs of the body.
These two-dimensional plane images composed of reflected gray-scale light spots are common ultrasound images.
Therefore, it is very important to look at the echo performance of B-ultrasound, and it is one of the basis for the doctor's judgment.
For example, strong echoes refer to enhanced echoes accompanied by rear acoustic shadows, which are common in stones, the interface of air-containing lungs, and the surface of bones.
Hyperecho is different from strong echo, and there is no sound shadow behind it, which is found in the capsule of liver and spleen.
There is also a kind of echo called iso-echo, that is, a medium-level echo, which is found in the parenchyma of the liver and spleen.
The typical hypoechoic is more common in subcutaneous fat.
The last one is anechoic, and typical anechoic is seen in pure liquid substances such as bile, urine, pleural effusion, and transudate.
When Chen Qi's probe was fixed at the position of the bile duct of the gallbladder, everyone could clearly see the abnormality.
Kalema was a little excited: "Look, this intrahepatic bile duct is slightly dilated."
The secondary dilatation of the bile duct strongly suggests that the bile duct is obstructed or space-occupied, and it seems to further confirm the possibility of cholangiocarcinoma.
When the doctor is excited, the patient is nervous, especially Dr. Kalema, who can't spit out ivory from his dog's mouth.
Vice President L of Mbeki asked nervously: "Doctor Chen, is this dilated bile duct good or bad?"
Chen Qi hesitated a bit, and decided to tell the truth:
"Uh, this doesn't seem to be a friendly gesture, don't worry, keep checking..."
Chen Qi still wanted to comfort the poor little African old man, but Kalema exclaimed excitedly at this time:
"Look, look here."
Kalema yelled while poking the screen with his fingers, his whole demeanor changed.
On the B-ultrasound screen, a papillary hyperechoic mass protruded into the dilated bile duct lumen.
To describe it this way, it was originally a smooth tube, but suddenly something protruded from the inside of the tube, which was clearly visible under Chen Qi's advanced color ultrasound.
Even if the doctor didn't need to answer, no matter how stupid Mbeki Vice President L was, he would know something was wrong.
"Doctor, is it really, really bile duct cancer?"
When talking, the little black old man's originally a little black face has turned into a little white face, and he feels like he is about to fall down.
Different from Calema's excitement, and with certainty, Chen Qi still has a different opinion:
"Dr. Calema, look around here. I just scanned around, and I didn't find any swelling or abnormal increase in the surrounding lymph nodes. If this bulge is bile duct cancer, it's impossible for the lymph nodes to develop so obviously. normal."
Dr. Calema is clearly not convinced:
"That's not necessarily true. Not all cancers have problems with the lymph nodes around them, right? Maybe this is a sign that the few cancer cells have not spread?"
Chen Qi continued to retort:
"There is another one. The B-ultrasound can only know that there is such a thing in the bile duct, which may be the obstruction caused by this thing, but the B-ultrasound cannot determine the boundary of the bulge and the internal blood flow, so now It's too early to say it's cholangiocarcinoma."
Chen Qi's point of view obviously did not convince Dr. Kalema, he continued pointing to the screenshot on the screen and said:
"There is a bulge in this place. It's either a tumor or a stone or inflammation. Doctor Chen, looking at the echo, it doesn't match the possibility of a stone or inflammation at all. So I can't think of any other possibility besides a tumor?"
Chen Qi continued to retort:
"As you said just now, there may be only a few cases. Does this inflammation look like cancer? Now except for a bulge, other symptoms do not support cancer."
Seeing the two doctors quarrel, everyone dared not breathe.
This is an obvious opinion analysis in front of the vice president of a country. Does this really make the vice president L a cadre?
But Mbeki was happy in his heart. What he was most afraid of was that all the doctors agreed, just like the jury in the court unanimously found guilty. There was really no hope at all.
The doctor has analyzed it, which means that the diagnosis of cholangiocarcinoma cannot be determined.
Then it may not be cancer, can it survive?
Patients are psychologically fragile and want to hear good things, so the vice president gave Dr. Kalema a white look, but when he looked at Chen Qi, his eyes were full of hope.
"Doctor Chen, do you think this is not like cancer? That's good, then how do you treat it next?"
While packing up his portable color Doppler ultrasound machine, Chen Qi replied:
"Let's install the CT machine tonight. Let's do the CT first tomorrow morning. It's hard to say whether it's cancer. I just had an argument with Dr. Calema. I just went through all the possibilities. I can't arbitrarily say it's cancer." , but the cancer cannot be ruled out."
Doctors always talk like this, and they will never talk full of words. This is cloudy, and it is as if they have not said anything.
After hearing this, Mbeki was rather disappointed, and lay back on the bed to think about things.
Mrs. Mbeki was in a hurry: "Dr. Chen, since we are not sure whether it is cancer, let's not check it, just have an operation to remove it."
Chen Ji said with a little embarrassment:
"Madam, it's okay if it's not cancer, but if it's confirmed to be bile duct cancer, then the scope of this operation needs to remove four nearby organs, and the operation may actually exacerbate death.
Moreover, the operation time is more than 10 hours, and many people may not be able to get off the operating table. It is not an exaggeration to say that it is the most difficult operation in surgery, especially the medical conditions in Sierra Lean, which is even less optimistic. "
It would be fine to hear that there is no operation, but if the operation is performed, she may die on the spot. Mrs. Mbeki covered her mouth in fright and dared not ask any more questions.
Coming out of the ward, Dean Bagley was a little anxious:
"Doctor Chen, even if you bring the CT, but the computer room of our hospital is not able to install a CT for the time being, and we will have a CT tomorrow, what should we do?"
Chen Qi obviously has a plan in mind:
"It's important to have a priority. There is no CT machine room, so we will temporarily use an X-ray machine room instead. Although it is not safe, we will only do one CT, so that all unrelated personnel will stay far away, and there will be no major problems. of.
Besides, look at Mr. Mbeki's appearance, he can't wait to start doing CT tonight. It's okay to say that there was no CT before, but now it will take a few days to delay with this machine. fuck off? "
Bagley realized the seriousness of the matter as soon as he heard it.
There are thousands of things, no matter how big the leader's opinion is, especially in this kind of country with imperfect laws, the leader can not only determine your future, but even your life and death.
"Okay, okay, I'll listen to Dr. Chen, and I'll immediately organize all the plumbers and logistics personnel in the hospital to ensure that they will work all night and overtime."
Chen Qi patted Dean Bagley on the shoulder:
"That's right, that's the kind of attitude you need. Just wait. I'll bring the CT over in the evening. Prepare forklifts and loading and unloading personnel. The machine weighs several tons, and it's dead heavy."
Nonsense, this is related to extra money of 250,000 US dollars, how can we not hurry up in time?
It sells for 50,000 US dollars in China, and 250,000 US dollars is sold to a big dog in Africa. Where is such a good business? The cost is almost zero.
With so much money, it’s a lot of fun to buy US stocks. In the future, they will be worth hundreds of millions, okay?
That night, Chen Qi drove to the beach alone, and then got out of the space in a second-hand truck with CT loaded on it to go to Freetown National Hospital.
Some people may think, how did you get this CT? By what means of transport? Is there any customs declaration? People will definitely check you, and they won't be able to tell by then.
In fact, this is all too much to worry about.
Not to mention this kind of country without much legal order and normal trade, even in a certain country in the 1980s, the gray business along the coast should not be too prosperous.
The car you "go ashore" directly can still have a license plate. Did people ask you where it came from?
Unless you offend someone and someone wants to punish you, you will search your source, otherwise no one will be full enough to do this kind of thing that is not good for others or self.
In particular, Chen Qi's CT machine was used by senior officials such as Mbeki, who would dare to check?
Chen Qi hummed a ditty and drove a large truck to transport the machine to Freetown National Hospital. As expected, there were bright lights and a lot of people were waiting.
Dean Bagley is the most excited. Which dean or doctor would not want to have this kind of advanced medical equipment, which can improve the overall clinical level by several levels.
Many diseases that could not be treated or dared to be treated before can now be treated with the assistance of CT.
This time, if he hadn't taken advantage of L, the vice president of a wealthy family, otherwise, he didn't know when this CT dream would come true, so Bagri looked at Chen Qi, and the more he looked at it, the happier he became.
Chen Qi is not a staff member of the equipment, so it's done after sending the machine and installation drawings, how to install it is his business.
On the premise of not considering safety and radiation, the installation is also simple, that is, you need to fix the machine and arrange the wires. The instructions of the Mayo Clinic are very detailed.
Mbeki's secretary was waiting at the scene, seeing that Chen Qi had delivered the CT machine as scheduled, and quickly handed over a box.
"Dr. Chen, this is 250,000 US dollars, which is the payment for the purchase of CT. You need to sign a few names here."
The necessary procedures still have to be followed, Chen Qi didn't care, picked up a pen and directly signed his English name on the contract
"Jack Chen".
Carrying the heavy box of money in his hand, Chen Qi laughed so hard that his molars were almost exposed:
"Hehehe, okay, okay, your country's efficiency is really high, and it really is a good ZF with a clean and honest government."
I vomit in my heart.
When Secretary Mbeki heard that foreigners praised his country, he was of course very honored, and the smile on his face became even bigger.
"Everywhere, this is what we should do. By the way, Dr. Chen, Mr. Vice President L has one more thing for me to pass on to you. I hope you can bring more benefits to everyone in the next diagnosis and treatment process. information."
After speaking, the secretary took out a wooden box from the handbag.
Chen Qi opened it and smiled so much that not to mention the back molars, even the tonsils were almost exposed, because the box contained two rough diamonds the size of pigeon eggs.
It has been a year since I came to Africa, and Chen Qi can be regarded as a knowledgeable person. It is absolutely no problem to cut such a large rough diamond, and get 2 or 30 carats each.
Decades later, it will be a small case to sell to the upstarts of the coal bosses for a few hundred or even tens of millions.
At that time, it will be more than enough to sell these two rough diamonds and replace them with a 3.0T MRI machine.
I want to thank that China's economy has not yet developed at this time, and the hype price of diamonds around the world has not reached its peak. It is estimated that in a few decades, killing black people will not give away such a large rough diamond.
Taking other people's money and doing things for them has always been Dean Chen's greatest strength.
"Don't worry, Mr. Secretary, please tell Vice President L, I will do my best to serve him, for the friendship between the two countries!"
At this time, the secretary looked around and asked in a low voice:
"Doctor Chen, do you think Mbeki's condition is optimistic or not?"
Chen Qi was a little surprised, thinking that this little secretary is also very active in thinking, is it possible that the master is unreliable and ready to retreat?
"The possibility of cancer still exists. It's hard to say now. According to my judgment over the years, it is at most half and half. Tomorrow's CT can be more clear, but it is not a diagnosis. A pathological section or other examinations are required for a diagnosis."
The secretary nodded thoughtfully.
Early the next morning, the original X-ray machine room was surrounded by doctors. Everyone wanted to come and see what the first CT machine in Sierra Lean was like and how it worked.
Dean Bagley has been chasing people away, "Go away, go away, and those who don't want to take the radiation, get out of the way, what's so good about this thing."
Accompanied by a large group of people, Mbeki's vice president L came here in a mighty way. When he saw Chen Qi, he tightly held the hand of the Huaguo doctor:
"Dr. Chen, only you can operate CT here, please~~~~"
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