bookmarkrole Chapter 259
Chapter 259
Chapter 259
After Lin Feng coordinated the relationship with the urology department,
afternoon,
Continue to sit on the clinic.
The first patient.
This is an old man in his 70s.
Holding his chest, his feet trembled.
His 40-year-old son helped him into the consulting room.
“Old man, come, sit down first…”
Lin Feng supported the old man and sat down.
“Thank you doctor…”
“Old man, why are you uncomfortable?”
“I have chest pain for several days, and now I can’t stand it…”
“Have you had a medical history?”
“What?”
“I’m asking, was there any illness before?”
“Yes, chest pain, 10 years…”
“???10 years!”
After Lin Feng’s detailed consultation,
Patient’s main complaint:
·Patient Zhang Tieshan, 72 years old,
· Paroxysmal chest pain for 10 years, worsening for 5 days. Ten years ago, the patient had chest pain with no obvious cause. The left chest pain was severe, accompanied by sweating, and did not radiate to other places.
· No nausea, vomiting, no asthma, no blackness, no convulsions, rest or take “Suxiao Jiuxin Pill 10” for about 20-30 minutes to relieve.
· Occasional attacks, 1-2 times a year, never seen a doctor.
·A month ago, the patient had visited the outpatient and cardiology department of Harmony Hospital. The doctor considered “coronary heart disease” and gave conventional medication.
5 days ago, the patient had chest pain again with no obvious cause, the nature of which was the same as before, accompanied by sweating, mostly around 21:00, taking “10 Suxiao Jiuxin Pills” for about 1 hour to relieve it. One attack per day for 3 consecutive days.
Lin Feng fell silent.
Coming from the outpatient clinic…
The son said with a pleased smile at this time: “Dr. Lin, it’s difficult to get an expert number now. I heard that you are very good at facilitating medical treatment here, so I brought my dad over here directly.”
Lin Feng nodded.
Obviously, this son doesn’t believe the original Doctor Harmony who diagnosed the old man.
If “chest pain” is the main symptom,
According to the process, the four life-threatening diseases including “acute coronary syndrome”, “acute pulmonary embolism”, “acute aortic dissection” and “pneumothorax” need to be eliminated first!
Because of these four diseases, people can die at any time!
Therefore, you need to exclude them first.
And a month ago,
The outpatient department gave the patient detailed cardiac color Doppler ultrasound and electrocardiogram.
Lin Feng took a closer look,
Then, with a stethoscope, I listened to the voice of the patient’s chest.
Still no problem!
In other words,
These four major diseases can be ruled out!
Lin Feng breathed a sigh of relief.
“Come on, make an electrocardiogram…”
Lin Feng asked nurse Xiao Ai to connect the elderly with an electrocardiograph.
10 minutes later……
A long electrocardiogram has been produced.
The result shows: normal!
It’s no different from the ECG a month ago.
Lin Feng was surprised.
Isn’t it caused by heart disease?
Ruled out the four major diseases,
Then you can proceed to the next round of investigation: Diagnose one by one according to the circulatory system, digestive system, respiratory system, exercise system and other diseases manifested by chest pain…
Lin Feng continued to ask carefully: “Just now you said that this chest pain mostly occurs around 21:00…every day…between 20:00-21:00, have you done anything? Fixed, every day Everything…”
The son said without hesitation: “20: 00-21: 00… Eat, watch TV, eat fruit…”
Lin Feng suddenly refreshed
Have a meal,
That is digestion. It is very likely that there is a problem with the digestive system.
Lin Feng: “What time do you eat?”
The son thought back: “It’s hard to tell, but it’s around 8:30, because I go home late…”
Lin Feng continued to ask the elderly: “Did you feel uncomfortable when eating?”
The old man nodded: “One thing, when swallowing, it feels uncomfortable. After eating, it’s easy to burp…”
Hiccups,
“Full hiccups” and “full hiccups” are one of the common symptoms of various digestive tract diseases.
Lin Feng: “Are there any other discomforts? During and after eating…”
The old man thought for a while: “When eating hard and dry meals, it feels a little difficult to swallow. When drinking porridge, there is no such problem…”
Lin Feng nodded.
The more suspicion in my heart is the problem of the digestive tract.
Lin Feng suddenly thought of a question.
“Wait, I don’t seem to see a chest CT, didn’t you have a CT?”
Elderly: “I didn’t do it. There were too many inspections and it cost a lot of money, so I didn’t do it at the time.”
Lin Feng sweats wildly.
“Okay, go for a CT scan. For this painful location, I will call the CT room to tell… After the CT scan, I will come back to see…”
Lin Feng brushed and opened the order…
“Okay, thank you doctor!”
The son helped the elderly to go to the CT room.
…
2 hours later,
The old man came back with the Ct result.
·Examination result: the position of the cardia, showing a lump of soft tissue, cauliflower-shaped, leaf-shaped…
The murderer has appeared!
“Cardiac Cancer”! !
Cardia: Located at the junction of the esophagus and stomach, it is a part of the digestive tract. It has the function of muscle relaxation and contraction to prevent the food and gastric acid from entering the stomach from flowing back into the esophagus.
…
“Old man, it turned out that it was not a heart problem, but a ventral cancer… Your chest pain was caused by a ventral cancer.”
“Huh? Stomach cancer?”
The old man and his son do not know whether they should be happy or worried.
The heart is okay, that’s a great thing.
As a result, another cancer came!
“Wait, I will do the “Tumor Five Items” and “Esophageal Barium Meal Contrast”, so that we can get more accurate results…”
“Okay, thank you Doctor Lin!”
The father and son quickly took the checklist issued by Lin Feng and went for the check.
Soon after,
The result came out.
It is indeed “cardia cancer.”
The next step is to pay the bill, be admitted to the hospital, and try conservative treatment and chemotherapy.
Finally, Lin Feng did not accept the patient, but sent the patient to gastrointestinal surgery.
…
So here comes the problem,
The original Harmonious Heart Doctor did not find the cause, does it mean that he is poor?
Do not!
It’s just the questioning stage, something went wrong.
The patient does not understand the disease, so the description is sometimes unclear or even wrong, which can mislead the doctor.
The doctor’s questioning is like solving a case, and a series of seemingly unimportant symptoms during the questioning process may be the ‘truth’.
For example, this time “dysphagia, hiccups”, the cardiologist did not notice.
After all, he is a cardiologist, not a general practitioner…
…
Inpatient building.
The attending doctor Ding Guan was on duty today in the ward. He went downstairs to get something and then went back to the ward on duty.
In the elevator,
“what……”
He saw a familiar patient Zhang Tieshan (the old man who was just diagnosed by Lin Feng).
This patient was very special. When he said that he had chest pain, he was shocked. After investigation, it was normal coronary heart disease.
At this time, Zhang Tieshan had completed the admission procedures and was ready to move into the digestive surgery ward.
“Old man, have you been admitted to the hospital?”
Ding Guan was curious, why was he hospitalized suddenly? Obviously there is nothing wrong with the heart. It’s just common coronary heart disease. Just take medicine?
Zhang Tieshan snorted coldly when he saw Ding Guan.
Ding Guan: “???”
confused.
How can you help him diagnose the disease? There is no need for this attitude to yourself, right?
The son apologized: “Sorry doctor.”
Doctor Ding Guan was curious: “What’s wrong, your dad?”
The son said: “That’s right. In the past five days, my dad has had a terrible pain. Then we went to the emergency department to check with Dr. Lin. It was cardia cancer, not coronary heart disease.”
“what?”
“Not coronary heart disease? Cardiac cancer?”
“My diagnosis was wrong?”
Ding Guan was surprised!
At this moment, his face couldn’t help but blush.
It’s so embarrassing!
Ding Dong…
At this time, the 6th floor of the ward floor of the Department of Cardiology has arrived.
“Feel sorry……”
Ding Guan walked out of the elevator quickly, a little embarrassed.
Although cardia cancer is not a specialty he is good at, he can’t be blamed for this misdiagnosis, but there is still a lack of it.
Let’s go first!
…
at this time,
The complete preoperative examination results of the driver patient (anterior l gland tumor) have come out of 973.
bad news!
The tumor is getting bigger!
One-third bigger!
“Doctor Lin…this…”
When the driver heard the news, he almost cried!
Just because I wanted to find an expert professor to perform the operation, I abruptly registered 7 days.
It’s getting better now, not only has it been painful for another 7 days, but the tumor has also become bigger!
The tumor becomes larger, which means that the meat to be cut off for the fine naan needs more!
That’s the most important place for men!
Will it be abolished after the operation?
The driver was crying!
Lin Feng didn’t expect this to happen, so he could only pat the driver’s patient on the shoulder, silently comforting him.
awful!
…
The next three days were calm and calm.
The driver patient completed enema cleaning, shaving, etc. in accordance with the requirements of the operation…
On the third day,
The driver patient finally waited until the day of the operation.
In these three days, life is like a year!
He is really afraid that the tumor will become bigger again! !
…
Urology,
“At 17:00 in the afternoon, Dr. Lin Feng performed that operation, are you going to watch?”
“go!”
“Of course, Dr. Lin is going to extend the evil hand to our department. How can we not visit?”
“Yes, we are going to criticize! (righteous indignation filled with serious face·jpg)”
“Yes, let’s criticize together!”
not far away,
In Director Zhao’s office, Director Zhao smiled when he heard the comments of his subordinates outside the door.
Then I decided to check it out myself.
See if Lin Feng is as strong as the legend!
…
In the afternoon, 17:00
The patient is pushed into the operating room…
·Surgery: Resection of the anterior L gland behind the pubic bone
· Chief Sword: Lin Feng
·One assistant and two assistants: two attending doctors in urology department (upgraded, only Gui Pei was willing to be Lin Feng’s assistant before, now the attending doctor comes on his own initiative)
·Onlookers: Director Zhao Yingjun, there are 25 doctors in urology…
“Epidural block anesthesia!”
disinfect……
Lay the towel…
“Bladder catheter!”
. .