This Doctor is Great

In addition to the positive ELISA test results...

The stool test also came back with results.

The patient's feces collected at 1:00 noon were sent for testing. The sediment smears were taken using the method of sedimentation and egg collection. Eleven oval-shaped, light yellow, large eggs with an egg cover at one end were found in 3 consecutive sediment smears. Fluke eggs.

These eggs are undoubtedly in line with the characteristics of Fasciola hepatica eggs.

So far,

This patient is considered a dust settle!

The diagnosis was: hepatic fascioliasis!

Next, it's simple, Zhou Mo issued a doctor's order:

Oral piquinone, divided into 2 doses... (Note: Do not buy medicine by yourself, ask a doctor for a doctor's order)

(Piquinone, an anthelmintic drug for humans and animals, specifically treats tapeworms and trematodes. It is especially effective for schistosomes, Chinese liver flukes, and Schizophrenia grandis. It is one of the most basic and important drugs for public health in the world one.)

(The pagoda sugar that I ate when I was a child, the ingredient is piperazine phosphate. (Exposed age series))

"Are you sure, I am a parasite?"

Chen Qing was in a complicated mood.

Zhou Mo: "From the current point of view, it's a parasite... If you don't think it's safe, you can have an MRI to see if it's a tumor, and the price is not expensive..."

Chen Qing shook his head immediately: "Forget it, forget it, don't do it, I believe you, doctor..."

Zhou Mo: "By the way, you can be discharged from the hospital tomorrow."

Chen Qing was shocked: "Huh? Are you leaving the hospital so soon?"

Zhou Mo said as a matter of course: "Since the cause has been found, and it's not a major problem, of course I'll be discharged from the hospital. Don't tell me you want to live in the hospital?"

Because the patient Chen Qing is chronic, not acute, the treatment does not need to be so violent, and he does not need to be hospitalized. He can be discharged tomorrow morning.

Chen Qing shook his head: "Let's leave the hospital."

Zhou Mo: "I will start giving you medicine this evening, for deworming, and when you are discharged from the hospital, the medicine will be brought back to you. The nurse will explain to you how to take the medicine at that time. Just follow the doctor's order... Wait for the medicine After finishing the medicine, you will come back for a review..."

The re-examination method is still to re-examine the feces. As long as no eggs are found and the symptoms disappear, it means that the patient has recovered.

Patient Chen Qing nodded: "Okay, thank you doctor."

...

Wards, rounds, rounds...

Then go back to the duty room to modify the course of disease, doctor's orders, etc...

5 patients, (1 with upper gastrointestinal bleeding, 1 with acute gastritis, 2 with cirrhosis and ascites), the workload is still not small, but for Zhou Mo who has mastered the talent, the speed is still very fast. After all, for these few patients, Zhou Mo had deliberately scanned the relevant disease data and literature yesterday, so he saved the time to check the data today.

As for the patient with upper gastrointestinal bleeding, because of the poor hemostatic effect, he was forced to be sent to endoscopic hemostasis today, and he will be discharged tomorrow.

As for the two patients with acute gastritis and liver cirrhosis and ascites, they will stay for another two or three days.

18:00...

Zhou Mo finished all the patients.

Huang Yiming: "Brother Mo, are you done?"

Zhou Mo nodded: "My patients all continue from yesterday, and there is nothing that needs special treatment, so it is faster."

The 13 medical students around immediately brushed their heads together.

Shock!

So fast? !

With their own progress, they only started to get the data of 5 patients. Checking the literature and reviewing the guidelines is a headache!

Zhou Mo sat next to Huang Yiming and turned on the computer: "How much have you written? I'll review it for you..."

Huang Yiming flew up happily: "Brother Mo, no, Dad, you are too kind..."

Zhou Mo: "What's the patient's number?"

Huang Yiming was about to answer,

At this time,

A resident doctor brother Wang Zhen came to the duty room quickly, and said to Zhou Mo:

"Junior Brother Zhou Mo, do me a favor. I just admitted a patient and I'm a little uncertain. Can you do a B-ultrasound for me? I'll treat you to supper tonight!"

"Okay, no problem." Zhou Mo nodded.

"Haha, thank you..." The inpatient brother Wang Zhen happily pulled Zhou Mo to bed No. 12.

Huang Yiming: "..."

grass!

...

12 beds,

This is a 37-year-old middle-aged woman.

Abdominal pain for 1 day, came from the outpatient clinic.

The specific symptoms are, there is no obvious incentive for abdominal pain, mainly in the right lower quadrant, persistent abdominal pain paroxysmal intensification, accompanied by abdominal distension, nausea, no vomiting, no diarrhea.

Outpatient examinations are:

——Blood routine: Hemoglobin, etc. are normal, white blood cells, etc. have increased, suggesting inflammation.

—— Chest and abdomen X-ray, no obvious abnormal X-ray signs.

peritonitis?

appendicitis?

The resident doctor Wang Zhen introduced Bingqing and said: "The patient's main complaint is that she didn't eat anything unclean. She ate it at home. She also ate with her mother-in-law and son. There is no problem..."

"In addition, McBurney's point is positive, it may be appendicitis... (picture)"

"In addition, I think there is another point, peritonitis, because when I did a physical examination on the patient, I felt that there was fluid, although it was not obvious, but it seemed to be..."

"As for gastroenteritis, it's not like that, because within a day, if there is gastroenteritis, diarrhea and vomiting should be present, but the patient did not."

After a series of analysis,

Zhou Mo nodded in agreement.

Senior Brother Wang Zhen: "So, I want to invite you to help with a B-ultrasound..."

Zhou Mo: "Okay."

The B-ultrasound has been brought over by the nurse in charge of the bed.

Zhou Mo turned on the machine, set the parameters, and began to explore the patient's abdomen.

This probe,

Spotted the problem right away!

The right abdominal intestinal tube dilation, effusion!

There is ascites!

Moreover, there is not only fluid accumulation, but also gas accumulation!

Whether it is fluid accumulation or gas accumulation, the amount is not very large, so it is difficult to find it during physical examination.

Then Zhou Mo took a B-ultrasound look at the appendix.

There is nothing wrong with the appendix, the shape of the appendix does not change much. Generally, appendicitis, when inflamed, will become larger and edema, which can be easily seen by B-ultrasound.

Appendicitis (picture)

So temporarily rule out appendicitis.

Zhou Mo told Senior Brother Wang Zhen about his results: "Appendicitis is ruled out for the time being, and there is another possibility that can be considered—small intestine (the position of the cecum) volvulus, or intestinal obstruction!"

volvulus (picture)

Upon hearing this, Senior Brother Wang Zhen nodded, "That should be a twisted bowel!"

Zhou Mo said again: "Senior brother, in fact, B-ultrasound is still not accurate for this intestinal twist. It can only be used as a reference. You can make an appointment for a CT to see if there is any abnormality..."

Senior Brother Wang Zhen thanked: "Okay, thank you. I'll treat you to dinner later when I'm done!"

...

1 hour later,

Brother Wang Zhen arranged for the patient to have an abdominal CT.

Abdominal CT results: abnormal position of the small intestine, and accumulation of blood.

CT teacher prompts: internal hernia? Torsion? Rule out the possibility of intestinal obstruction.

at last,

The patient was sent to the anorectal department for surgery.

When Senior Brother Wang Zhen went there, he greeted Zhou Mo: "Zhou Mo, I'm sorry, the patient was diagnosed with volvulus and hemorrhagic necrosis. I'm going to send the patient to the anorectal department for surgery. Supper can only be next time..."

Zhou Mo waved his hand to say ok!

...

Final Surgical Results:

volvulus 240 degrees

+

Small intestine necrosis 60cm

.