Since 1981 Health School

Both Chen Qi and Qi Damin believed that this patient should have upper gastrointestinal bleeding, and the most likely site was gastric bleeding, which is also common in clinical practice.

Especially this kind of middle-aged women, who have come here hungry in the past few decades, and seldom have a full meal, so the proportion of stomach problems is quite high.

At this time, Wang Fang shook her head lightly:

"The strangest part is here. We have already done a gastroscopy, but no bleeding point was found in the stomach or esophagus, so now we can't determine where the bleeding site is."

"Hey, this is strange. Hematemesis and black stools. The symptoms of upper gastrointestinal bleeding are very obvious. The lower gastrointestinal tract should not be vomiting blood. At least it must be vomiting of feces or intestinal contents."

At this time, a staff member of the medical department raised a question.

Wang Fang gritted her teeth and blushed a little:

"We, we think that the possibility of lower gastrointestinal bleeding also exists, so we also did a colonoscopy yesterday, but also found no problems."

The patient's family members were dissatisfied when they heard this:

"Doctor, I'm not bleeding from the upper or lower gastrointestinal tract. Where is the bleeding? Could it be that you can't find it? I came here from Yongbo City. I heard that your Yuezhong People's Hospital digested The level of internal medicine is so good that I came here to seek treatment, but it turned out that I couldn't even determine the bleeding site, this, this is too much, right?"

The words of the family members are equivalent to slapping the doctor in the face severely.

It was Lan Lijuan, the new director of the department who was hit in the face. If it spread, saying that even a stomach bleed could not be cured, it would be laughed out of the mouth by colleagues.

Qi Damin stood at the back, watching with cold eyes, wanting to see how the couple deal with this difficult problem.

Lan Lijuan glanced at Chen Qi, and Chen Qi also looked over at this time, and the two said in unison:

"Do another gastroscopy."

Who knew that the patient was dissatisfied:

"Doctor, don't do a gastroscopy, it's too uncomfortable. I kept vomiting after the gastroscopy, and I'm going to be stabbed to bleed. Besides, it costs 20 yuan to do a gastroscopy, which is half a month's wages for me. , don’t do it, don’t do it.”

Don't do gastroscopy? Then the treatment is the blind man touching the elephant, and it will really overturn.

Chen Qi had to come forward:

"Sister, let me tell you, our stomach is like a cloth bag, filled with things, it is like a bulging balloon. However, fasting is required for gastroscopy. If there is nothing in the stomach, the stomach will shrink. It is so small that the stomach wall is folded.

The gastroscope relies on a camera at the top, and pokes it into your stomach. If the bleeding point is just in the corner, or just in the folded part, it is normal that it cannot be detected. You see, you have black stools, which means that the bleeding has not stopped.

The bleeding in the stomach is uncontrollable, do you know what the consequences will be? That is gastric perforation, which is serious. At that time, an operation will be required to open the abdominal cavity and cut off part of your stomach. Think about it, how much damage will this do to your body, right? "

Patients and their families are easy to fool. These days, there are no mobile phones, no Baidu, and it is generally what the doctor says.

Frightened by Chen Qi, the patient nodded repeatedly:

"Yo, the doctor is right, let's continue to check, but it's not justified if it can't be found out this time."

Lan Lijuan was about to speak, but Chen Qi spoke first:

"Okay, this time I will perform the gastroscope myself to ensure that the bleeding point can be found."

Nonsense, of course he had to stand up for his wife at the critical moment, Chen Qi felt that it was his duty to do so, and it was also related to his sexual life after returning home.

Lan Lijuan was obviously very satisfied with her husband's performance, and said with a smile:

"Then please, Dean Chen, teach our gastroenterology doctors a good lesson today."

The middle-aged woman and her husband hesitated after seeing Chen Qi: "This doctor looks very young, is he an intern or a junior doctor?"

Only then did Liu Huichun open his mouth and say:

"Hey, you've been mistaken. The person in front of you is a true Buddha. He is the director of two international medical associations and the director of our People's Hospital."

"Ah, you became the dean at such a young age? You're only a few years older than my son."

"Okay, the level of being a dean must be good, then let's do this gastroscope."

Wang Fang was quite clever, and when she heard that the patient was willing to review the gastroscope, she hurriedly pushed the gastroscope into the ward.

The head nurse also quickly took the isolation gown, mask and hat, and put it on for Dean Chen herself. Look, this is the dean's treatment.

Qi Damin looked sourly from behind.

All the preparations were done, and Chen Qi also stood on the right side of the patient, ready to start the gastroscopy.

As soon as I heard that the dean was going to do a gastroscopy in his ward rounds, no matter whether they were curious or flattering, all the doctors in the Department of Gastroenterology rushed over anyway, and they didn't care about the morning ward rounds.

Chen Qi will insert the tube from the patient's mouth, all the way through the throat, esophagus, stomach, and duodenum.

So everyone is staring at the TV screen. This gastroscope is sponsored by the Swedish Asrila Pharmaceutical Company for the Helicobacter pylori treatment research group. It belongs to the most advanced gastroscope in this era, and there are not many in China.

Since then, the doctor no longer has to look at the tube like a SLR camera when performing a gastroscope.

Chen Qi lowered the pipe very slowly, inspecting every inch carefully.

The esophageal mucosa is still very clean, and there is no rupture of esophageal varices. It is definitely not a problem with the esophageal veins. This part is ruled out.

Immediately afterwards, there was some blood in the stomach, which seemed to be old bleeding, because the color was wrong, it was dark red.

Chen Qi held the gastroscope tube, turned left and right, watched and rinsed repeatedly, but checked up and down, inside and out, and found no obvious bleeding focus.

At this time, a little doctor couldn't help exclaiming: "It's really not stomach bleeding."

This time Chen Qi was also scratching his head. In fact, he was confident at first, thinking that the bleeding point must be in the stomach. Now, the new director and new official turned over on the first day of taking office.

Isn't this a big joke.

Chen Qi still did not give up, and said to Lan Lijuan next to her:

"Don't worry, let me have a look at the duodenum again?

A gastroscope is a gastroscope in name. In fact, in addition to being able to see the esophagus and stomach, it can also be extended to see the duodenum below. No matter how far it is, it will not work.

The name of the duodenum is very strange. In fact, the origin of the name is also very simple. It is a section of intestine, which is connected under the stomach. Because this section of intestine is as long as the surgeon's twelve fingers are juxtaposed, it is named duodenum.

This is also the site where ulcers and bleeding are most likely to occur.

If the patient does not have a gastric ulcer, she probably has a duodenal ulcer, otherwise there is no way to explain her bleeding.

But Chen Qi looked carefully, and almost broke the tube of the gastroscope, and there was no obvious bleeding focus in the duodenum.

Looking at it along the way, apart from a little gastritis, the patient is far from an ulcer, and there is no way to explain the bleeding.

what happened?

Could it be the small intestine bleeding deeper below the duodenum? Chen Qi was puzzled.

It was quiet in the ward, and many little doctors had already quietly hid away, fearing that the dean would get mad later and they would become cannon fodder.

Liu Huichun seemed more anxious. Although she is not a doctor, she still has basic common sense in the hospital for so many years.

In case Dean Chen fails the ward round today, although it will not affect his position as dean, it will still deal a big blow to Chen Qi's personal prestige. After all, so many people watch Dean Chen's good show.

On the surface, Qi Damin was calm and calm, but in fact he was already happy in his heart.

This overturn not only hurt the reputation of Lan Lijuan, the new director of the department, but also hurt the reputation of the new director, Chen Qi, as a "miracle doctor".

When Chen Qi came to the stage, the main highlight is that he can see a doctor, knows how to see a doctor, and can see diseases that others cannot see.

It's all right now, I can't even diagnose a gastrointestinal bleeding, and I'm ashamed to say that I have the best medical skills in Vietnam, and I have the nerve to say that I am an international double director?

Chen Qi didn't think that much, or he didn't think about what the consequences of this car overturn would be like.

To see a doctor is to see a doctor, purely, it should not be mixed with too much fame and wealth, and it should not be done because of cherishing feathers, this is what old experts and professors will do.

He is still young, 26 years old, if he is wrong, he is wrong, and he has a chance to do it all over again.

Lan Lijuan reminded at this time: "Dean Chen, are you considering another colonoscopy?"

Who knew that as soon as these words came out, the patient's family members became irritable:

"Don't do it, don't do it, colonoscopy is even more painful. Will you see a doctor? It seems that the dean is nothing more than that. You Yuezhong don't know how to do it. Let such a young man be the dean, it must be Backdoor goods, the level is too poor."

At this time, the patient was speechless with a gastric tube inserted in his mouth, but his eyes were full of doubts, and he motioned to pull out the gastroscope quickly.

As soon as these words came out, Qi Damin really couldn't help wanting to cry up to the sky.

The other little doctors lowered their heads one after another, not daring to breathe.

Chen Qi didn't care what other people were saying or thinking, all he thought about was how to find the real cause of the disease.

If it is necessary to determine whether it is the bleeding in the lower intestine, there are two ways to go to the hospital in his previous life.

One is to do capsule gastroscopy, swallow a capsule with a camera, the capsule enters from the mouth, passes through the intestinal tract, and then exits through the anus, if there is bleeding in the middle, the capsule endoscopy can see it.

But this was the 1980s, even if he had the capsule in the operating room in his space, he didn't dare to take it out.

Besides, capsule gastroscopy can only see if it can be treated, even if the bleeding point is found, there is no way to deal with it.

There is a second way, which is to send it over for interventional treatment. Through angiography, intestinal bleeding may be found.

Anyway, that's something for another time. The current gastroscope did not find any problems, which is embarrassing.

Chen Qi is not a fairy, he sighed a long time, cursed secretly in his heart, expressing that he admits that he was defeated, and was about to exit the mirror and return angrily.

At this time, not to mention the silence in the ward, it seemed that the entire Sixth Internal Medicine Department was eerily quiet.

The little nurses outside hung the needles and walked lightly. The atmosphere was so solemn that some little nurses hid in the dressing room and dared not come out.

Chen Qi glanced at the stern faces of the people around him, and smiled instead:

"Don't be so nervous. Gastroscopy is good. This is not a bad thing. At least we have ruled out the cause of upper gastrointestinal bleeding. Next, we will focus on checking the lower gastrointestinal tract. You see, the scope has narrowed, and it is far from the truth." One step closer."

He took another look at the angry faces of the patient and his family members, and comforted him patiently:

"You guys, don't worry. Medicine is like this. If this road is blocked, let's change another road. The disease will definitely be cured for us. If it can't be cured, we won't charge for the medical expenses. By the way, the cost of this gastroscope is 100%. Let it be reduced."

The doctor is most afraid that the patient will go crazy, and the impact will be bad if there is a disturbance at that time. If it is said that the new director + the new department director can't even handle a gastrointestinal bleeding?

Chen Qi was also afraid, so he could only appease the middle-aged couple first.

Sure enough, after hearing that the gastroscopy fee was waived, the faces of the patient and his family members looked much better. They felt that they were a little bit cheap and saved 20 yuan, so their anger was also calm.

But now it is not a question of money or not, but the problem that should be solved is still not solved.

At this time, the electronic gastroscope exits from the duodenum all the way through the stomach, esophagus, throat, and oral cavity.

"etc."

Lan Lijuan discovered the problem, she pointed to the electronic screen, and looked back at Chen Qi:

"See, there is blood in the patient's mouth. It was clean when I first entered. There is something wrong with it. Could it be the patient's mouth bleeding?"

Hearing this sentence, all the doctors in the ward widened their eyes.

Chen Qi also got serious, picked up the gastroscope lens and scanned the patient's teeth a few times.

Sure enough, it was found that the innermost molar on the lower left of the patient's tooth was bleeding continuously, and that tooth was probably carious.

Chen Qi and Lan Lijuan looked at each other, both of them breathed a sigh of relief, and then smiled tacitly.

Seeing the bleeding point, even though the bleeding point is not in the digestive tract as expected, I probably know what the cause is, and there is a high probability that the car will not roll over.

The dentist came quickly, and it was the old director Tang Weiyang.

Director Tang obviously heard that the dean was doing ward rounds, so the veteran went out in person, which actually meant flattering the new dean.

"Dean Chen, hello, I'm Lao Tang from the dentistry department. I heard that there is a consultation here. Didn't I come here in person, ha ha."

Chen Qi also smiled:

"Director Tang, don't be too polite. You don't know me, but I know you. When I was an intern, I have admired your name for a long time, hehe. Let me briefly introduce this patient.

The patient had hematemesis and melena, but currently he has no stomach pain or abdominal pain. We have done gastroscopy and colonoscopy and both showed normal, no obvious bleeding point. However, during gastroscopy, it was accidentally discovered that the patient's gums had been bleeding.

So now we suspect that the patient's hematemesis and black stools are not caused by gastrointestinal bleeding, but a lot of gum bleeding, so we want you to come to help with the consultation and check. "

When Director Tang heard such a simple consultation, he patted his chest confidently:

"Small idea, leave it to me, I promise you won't go on a business trip."