This Doctor is Great

Teacher Zhang Luojia judged that there was something wrong with the liver.

Then asked a lot of questions.

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

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

Have you had the hepatitis B vaccine before? (If there is a vaccine and antibodies, hepatitis B can be ruled out)

Have you ever had a blood transfusion?

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

Next, teacher Zhang Luojia gave the patient a chapter and did a physical examination.

A key change was found: the patient Duan Zhang had percussion pain in the liver area, and the liver seemed to become larger.

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

Then blood was drawn, routine blood tests, liver and kidney function, electrolytes, blood coagulation indicators, viral hepatitis, abdominal color Doppler ultrasound... and other series of tests.

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

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

"I knew I would go to the clinic, just prescribe some liver protection medicine and take it!"

Facing the doubts from the patient Duan Zhang, Teacher Zhang Luojia looked calm at the 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 more inspections."

Duan Zhang looked disdainful: "Your big hospital knows how to intimidate patients, go, wife, let's go to the clinic!"

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 thought that the possibility of acute hepatitis was very high, and he could be treated with some anti-jaundice and liver-protecting drugs, and he would get better after a few days of infusion.

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

The doctor at the clinic said that going to the hospital is of course okay, but this acute hepatitis is not a serious disease, and it can usually be controlled with 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 a big hospital and save a lot of inspection fees.

Next, the patient Duan Zhang took liver-protecting medicine, jaundice-reducing injection, and antipyretic medicine for 2 days in a row.

Although there is no fever anymore, the spirit of the person is still relatively exhausted, and the jaundice has not improved, but it seems to be more yellow. And the appetite is even worse, vomiting from time to time.

Now, the wife couldn't help it.

You can't make fun of your life!

Pulling her husband Duan Zhang, I came to the Second Provincial Hospital again. Coincidentally, all other doctors were fully booked this morning, and only the attending doctor, Zhang Luojia, had 2 numbers 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 checklist...

Then an admission ticket was issued.

So, after lunch, the couple came to the Department of Gastroenterology and were admitted to the hospital.

Entered the 77 beds that Zhou Mo was in charge of.

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 in the past, Duan Zhang might have looked down on young doctors like Zhou Mo, but after being tricked by the previous clinic, he realized the gap between the clinic and the big hospital.

He didn't dare to despise big hospitals anymore.

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

"Are you that 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!" His wife was overjoyed: "Doctor Zhou, I heard that your medical skills are very good!"

Zhou Mo hastened to be humble: "Thank you, every doctor in this department is a professional doctor with very good medical skills."

The wife enthusiastically said, "Doctor Zhou, my husband's illness is a great inconvenience to you."

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

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

Wife: "Of course you are famous..."

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

Zhou Mo was sweating profusely, and quickly interrupted: "Well, let me check your husband first, how about it?"

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

Next, Zhou Mo went through the consultation process, which was basically the same as Mr. Zhang Luojia's. Then he did a physical examination, and the patient Duan Zhang's liver did become a little bigger. The final diagnosis was also hepatitis, or liver abscess.

"When did you get your blood drawn?"

"Around 11 o'clock."

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

"I haven't done it yet. We can make an appointment at 3 o'clock tomorrow..."

Zhou Mo was helpless: "At 3 o'clock tomorrow, I've waited too long, I'll make one for you later..."

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

soon,

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

Final conclusion:

——Abdominal color Doppler ultrasound: the liver was slightly enlarged, and there were 3 multiple low-density lesions inside.

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

The largest one is as big as 2.5*3cm.

Judgment - liver abscess! !

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

(liver abscess picture)

Liver abscess is not the same thing as hepatitis.

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

...

13:40,

The patient's blood test results came out:

- High white blood cell count, obviously inflammation.

——The levels of bilirubin and transaminase increased significantly, indicating that the liver cells were destroyed, and it was inferred——hepatic inflammation.

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

Zhou Mo looked at these test results,

Combined with the results of the abdominal color Doppler ultrasound just now,

Therefore, the judgment of the patient in front of him should be:

— liver abscess!

Review the patient's clinical manifestations: fever, pain in the liver area, nausea and vomiting, etc., are indeed manifestations of bacterial liver abscess.

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

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

"Isn't it a bacterial liver abscess?"

"Amoebic liver abscess?"

"Amoebic liver abscess" is a liver abscess caused by 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 hesitated.

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

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

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