This Doctor is Great

"When the abdominal pain lasts, how long does it last? How often does it appear?"

"It lasts about a few hours each time... It's hard to say how long the interval is, sometimes it appears during the day, and sometimes it appears at night..."

"Did you have diarrhea? Nausea or vomiting?"

Patient Chen Qing shook his head: "No."

Zhou Mo's eyes lit up: "What about defecation? Has there been any change? Or is the poop black or red?"

Patient Chen Qing shook his head: "No... I just don't want to eat."

Loss of appetite.

For such a long period of abdominal pain, if it is an intestinal problem, nausea, vomiting, diarrhea, blood in the stool, changes in time and frequency...these should all be a little bit.

And this patient, no!

But I will lose my appetite again!

Peptic ulcer?

Gastrointestinal cancer?

Also, the pain in the upper right abdomen mentioned by the patient Chen Qing...

What's in the upper right abdomen?

Both the liver, gallbladder, pancreas and kidneys exist, and there may be problems in all of them.

The lungs are also possible.

And heart problems.

One of the great experiences I gained after my rotation in the Department of Cardiology is that pain below the shoulders and above the lower abdomen should be checked with an electrocardiogram.

"Have you had an EKG?"

"No……"

The patient Chen Qing came from the outpatient clinic, not the emergency department. If it was an emergency department, the doctor would probably give an electrocardiogram empirically.

"I'll check an EKG for you later."

Although this is the inpatient department of gastroenterology, but the electrocardiogram machine is a must, and the equipment is not only available in the cardiology department.

Zhou Mo walked out of the ward and said to the nurse in charge of the bed: "Miss Liang, go and get an electrocardiogram machine."

As a nurse, although she is a woman, it is no problem to be a man in the department.

Nurse Liang Meimei: "Okay, wait a minute, we are going through the admission procedures."

Zhou Mo returned to the ward.

Continue to ask questions.

In addition to the above organs, there may be infectious diseases.

"Have you had a cold or fever recently?"

"have."

"How long? How many degrees?"

"I had a fever the day before yesterday. I had a fever for 2 days. The highest temperature was 39.8 degrees..."

Is it really an infectious disease?

Zhou Mo was curious.

Write it down in your heart first.

Zhou Mo continued: "Are there any other symptoms?"

Chen Qing: "Yes...that's..."

Speaking of this, the patient Chen Qing was a little embarrassed.

Zhou Mo comforted: "Don't worry, I'm a doctor, you should take the initiative to tell the doctor if you have something to do... What's uncomfortable?"

Patient Chen Qing said coyly: "It's just that my hips and buttocks have some erythema, which is a little itchy..."

Zhou Mo understood in seconds: "I'll let the female nurse come over later and show you what it is...how is it?"

The patient Chen Qing nodded.

At this moment,

Nurse Liang Meimei came over with an EKG machine.

connect the electrodes,

Measurement,

Soon, the ECG results came out:

EKG is OK!

Then the nurse closed the curtain and checked the rash on the patient Chen Qing.

A normal rash, nothing special.

"In the outpatient clinic, have you done any checks?"

"I've done it, blood drawn."

The patient pointed to her baby and pulled out several checklists from it.

Zhou Mo took it over and took a look, urine routine, blood routine, liver function, kidney function, all have...

Results: Except for one eosinophilia, everything else is normal!

"Hey, this is strange!"

Zhou Mo was surprised, it seems that the digestive tract problem does not seem to be the case.

There is no problem with the liver function, but the liver and gallbladder may not be.

"What's the problem?"

Zhou Mo became interested.

I love weird cases like this.

Zhou Mo said to the nurse next to him: "Miss Liang, does our department have a bedside B-ultrasound?"

Nurse Liang Meimei: "Yes."

Zhou Mo: "Where is it? Can you get it for me?"

Beauty Liang was shocked: "You know how to use it?"

Under those shocked beautiful eyes, Zhou Mo said modestly, "I understand a little."

Beauty Liang is a little skeptical, after all, Zhou Mo is so young, can he get B-ultrasound? hell!

But she still went to help Zhou Mo get the B-ultrasound machine.

Taking advantage of this time, Zhou Mo asked about the medical history, but there was no special medical history.

Then a physical examination was performed on the patient.

Stomach, upper abdomen tenderness, soft.

His complexion is yellowish, but considering that his liver function is fine, it should not be jaundice, but his poor health due to long-term loss of appetite.

At this moment,

The teacher Zhang Luojia walked in.

"How is the patient?"

"The patient's condition is like this..."

Zhou Mo told all the results of his consultation and physical examination.

Zhang Luojia: "What do you think?"

Zhou Mo: "At first I thought it was hepatitis, cholecystitis or something, but it took so long to get sick, and then there was no problem with liver function or something, it might be a parasite..."

yes,

Parasites!

This is Zhou Mo's consideration.

Zhou Mo added later: "Of course...it may also be a tumor."

Teacher Zhang Luojia nodded upon hearing the words: "It's possible...then what will be the next inspection?"

Zhou Mo: "For parasites, do a fecal examination... For tumors, do MRI and draw blood for tumor markers."

Zhang Luojia nodded.

At this time, Zhou Mo continued to ask the patient Chen Qing: "Do you have the habit of eating raw food? For example, sashimi or something?"

Needless to say, sashimi is definitely the number one carrier of parasite patients.

Patient Chen Qing shook his head: "No."

Zhou Mo: "You don't need to answer me in a hurry, you can think about it carefully, did you eat anything raw in the six months before you got sick?"

Patient Chen Qing frowned, thinking hard.

At this moment,

The B-ultrasound was carried in by the nurse Liang Meimei.

Teacher Zhang Luojia immediately folded her chest and looked at it with great interest.

According to what she learned from her classmates in the cardiology department, Zhou Mo's heart color Doppler ultrasound is very good. Cardiac ultrasound is relatively difficult, knowing heart ultrasound, B-ultrasound like liver, should not have any problems.

Zhou Mo skillfully turned on the B-ultrasound machine under the surprised gaze of nurse Liang Meimei.

Power on, adjust parameters.

Real liver!

If it is a parasite or a tumor, the first place to suspect is the liver.

probe, couplant,

"I need to do a B-ultrasound for you, you lift your clothes, the upper right abdomen..."

"ah?"

"Don't be shy, I'm a doctor."

The patient Chen Qing looked at Zhou Mo's scumbag face, thought about it, forget it, even if he was scumbag, he didn't seem to lose.

Lift up the clothes, revealing fair and youthful skin.

Soon, she felt a greasy and cold touch, which made her a little uncomfortable.

The first is the liver as a whole,

Zhou Mo kept cutting the angle and measured it.

"Teacher, her liver seems to be bigger..."

"How many?"

"The length is about 27cm, the width is about 17cm, and the thickness is about 61cm...all are more than 1cm more than the normal range, and the width is 2cm more..."

"That's an enlarged liver."

"Yes."

Obviously, there is something wrong with the liver.

Nurse Liang Beauty Shocked!

Wow!

Dr. Zhou Mo can do B-ultrasound!

Too awesome, right?

At this time, Zhou Mo readjusted the parameters to cut the details inside the liver.

In about 1 minute, Zhou Mo found that the hepatic and bile ducts were dilated, and there were three places with relatively small hypoechoic nodules. Under normal circumstances, this kind of display may be a 'tumor'!

"Could it be a tumor?"

Zhou Mo continued to change angles, constantly...

Sudden!

"Huh!"

Zhou Mo discovered something special:

0.5cm round shadow!

shock!

"What is this?"

.