This Doctor is Great

Chapter 173 Diagnosis Error! Zhou Mo's first car rollover!

If the patient has liver abscess, it can explain why the medicine in the clinic is not effective for the patient.

Because the outer layer of the liver abscess has a protective film, it is difficult for antibiotics to enter.

And there are so many bacteria in it, even if antibiotics can get in, how can that amount be enough.

So why the patient has no effect at all after using antibiotics (the clinic prescribes medicines for hepatitis).

However, it is not known whether it is "bacterial liver abscess" or "amoeba liver abscess".

Further confirmation is required!

Zhou Mo returned to the ward,

"My temporary consideration is - liver abscess!"

Zhou Mo took the examination report and told the patient and his wife his answer.

The patient Duan Zhang was stunned for a moment: "What kind of abscess is this, what is it?"

Zhou Mo explained again: "The liver has a very rich pipeline system, such as the hepatic portal vein, the proper hepatic artery, the left and right hepatic ducts, and the hepatic vein... making it easy to be invaded by bacteria, fungi, etc., and then... Barabba... "

After hearing this, the patient and his wife said: "..."

I probably understand a little bit.

The patient's wife shook her dizzy head: "Then what should I do?"

Zhou Mo: "Take blood for culture, see if you can find bacteria from the blood..."

If it is a bacterial liver abscess, culture the blood to see if you can find the bacteria.

If it is amoebic liver abscess, check for amebic antibodies.

Or the most direct way is to puncture directly, draw out the pus, send it to the laboratory for examination, and everything comes out.

"puncture?"

The patient Duan Zhang hesitated for a while.

It sounds scary.

"Forget about the doctor, my fever is not very serious now, I'd better take blood for a test first..."

Zhou Mo nodded: "Okay, then follow your choice."

The next step is to draw blood and send it for inspection.

In addition, use antibiotics to suppress the patient's fever and relieve the condition. In addition, there are drugs such as protecting the liver and reducing jaundice.

...

In a flash, at 16 o'clock in the afternoon,

The patient's blood test results came out:

— Liver abscess bacteria, not found. (Not every time you will find it, it will take many times)

—Amoebic antibody, negative.

That is to say, this time the blood was drawn, but there was no result.

Zhou Mo told the patient Duan Zhang and his wife the results: "So far, no corresponding cause has been found... My personal suggestion is to do a puncture."

puncture,

It is to use a long, thin needle, under the guidance of the B-ultrasound image, to pierce the inner cavity of the abscess in the liver, and draw out the pus.

Duan Zhang started to burn again at this time, 38.5 degrees, and his mental state was not very good, feeling a little more serious than the previous few days.

The wife looked worried: "Doctor, is the puncture dangerous?"

Zhou Mo: "Puncture also has complications. For example, a puncture failed to pierce the core of the liver abscess, and pus was not drawn out...or it may pierce a blood vessel and cause bleeding. These are all possible...or ...(a bunch of complications, blah blah)..."

To do this puncture, you need to sign a consent form and give a lecture. You can't be sloppy, or you will be picked by the patient.

So Zhou Mo talked about all the complications, even though it sounded dangerous.

When the wife heard that there were still so many complications, she was terrified.

She hesitated: "doctor, how about you stop waiting and continue with the blood test in the morning?"

Zhou Mo nodded: "You can continue to wait... But what I want to say is that one of your husband's liver abscesses is as big as 2.5*3cm, and it has reached the standard of puncture and drainage. In the end, in order to be cured, puncture is still needed. drainage."

"Besides, this kind of operation is only done once. After it's done, you don't have to have a fever and feel uncomfortable...it's better than surgery..."

Then explain why the puncture and drainage are needed.

As I said before,

Simply using antibiotics is not enough to deal with liver abscess, because antibiotics cannot enter the abscess.

Therefore, we must find a way to puncture the abscess and let the pus drain out, so that the abscess can be cleaned up as soon as possible and the infection can be controlled.

The wife is still hesitating: "However, piercing seems very dangerous..."

Zhou Mo: "Don't worry, this technology has been developed for many years. It is considered a relatively mature technology in our department, and generally there is no danger."

at last,

The patient's wife agreed, and after the husband's fever subsided a little, he asked for his opinion.

The patient Duan Zhang was also tossed by repeated fevers, and finally agreed.

"I agree……"

Duan Zhang finally signed his name on the consent form.

After signing, Duan Zhang couldn't wait.

"Doctor, when can the puncture be performed?"

Zhou Mo looked at his watch.

16:58.

"It's almost time to get off work. It may be difficult to find a doctor for the puncture now... wait until tomorrow?"

"Huh? Wait until tomorrow?"

The husband and wife looked bitter.

They were ready to 'go to death', but Zhou Mo told them that they had no chance to 'go to death'.

What a pain in the ass!

the next day,

After the rounds, Zhou Mo found Teacher Zhang Luojia, who finally performed puncture and drainage on the patient Duan Zhang.

anaesthetization,

one needle down,

"????"

Teacher Zhang Luojia felt something was wrong once the needle was given.

On the one hand, it is not easy to wear.

On the other hand, she found that the needle went in, and it didn't seem to be able to draw any fluid.

It's different from what she imagined.

Imagine an abscess cavity with a size of 2.5*3cm, there must be a lot of pus inside.

But this time, why is there no pus?

"has a problem!"

Teacher Zhang Luojia frowned.

The wife looked nervous: "What's wrong?"

Teacher Zhang Luojia said: "The pus is only a little..."

Zhou Mo was also a little confused at this time.

No, it should be a liver abscess. How could there be no pus?

I overturned?

at last,

Teacher Zhang Luojia felt that there was a problem, discussed with the patient, and changed "puncture drainage" to "puncture biopsy".

That is, near the abscess cavity, some liver tissue is taken out for biopsy.

Patient Duan Zhang was a little angry, but because of his trust in the hospital, his wife's persuasion, and the fact that he had a large hole of 2.5*3cm in his liver, he was a little panicked... Finally, he agreed to "puncture biopsy" ".

remove the tissue,

Sent for inspection.

The next step is to wait for the biopsy results, and still use antibiotics + liver protection + jaundice reduction + fever reduction empirically...

The effect is still not very good.

Zhou Mo looked dazed at this moment, thinking that he should have overturned his car.

The condition of the patient Duan Zhang may not be liver abscess.

But if it's not a liver abscess, what exactly is it?

...

in the afternoon,

The results of the biopsy are here!

really!

Zhou Mo overturned!