Seeing Gu Weimian's appearance, Wu Mian was startled.

"Director Gu, you have been suffering from insomnia lately, and you haven't rested well?" Wu Mian asked, "Why are your eyes so dark?" ”

Gu Weimian thought to himself, didn't you make it, but he didn't dare to be tough with Wu Mian no matter how slanderous he wanted in his heart. There is such a thing as death, whether you can do it or not.

"Teacher Wu, you are really on time. Gu Weimian forced out a smile.

"Oh, I'm going to pick up the airport in a moment, and there's still two and a half hours to go. Wu Mian said, "I don't know if I can do it." ”

Two and a half hours, do a gastroscopy? Gu Weimian looked at him suspiciously, not knowing what Teacher Wu meant.

hesitated for a moment, and it wasn't until he finished changing his shoes that Gu Weimian decided to say something directly.

He asked, "Mr. Wu, don't you suspect that it's not esophageal cancer?" ”

"Probably not. Wu Mian said, "Didn't I tell you yesterday, the density is wrong." ”

"Density?"

"In fact, it is better to have a 64-slice CT film to see more clearly. But to do 64-slice CT is better than to do gastroscopy directly to see more clearly. Wu Mian said, "Esophageal stones, have you dealt with them here?"

"......" Gu Weimian was speechless. Wu Mian considered it to be esophageal stones? This is impossible! Stomach stones have been seen, and the esophagus goes straight up and down, and the probability of stones appearing is ridiculously small.

"Director Gu, if you haven't been in contact, you can send someone and the girl, she has a template. Wu Mian said.

Chu Zhixi smiled, and Gu Weimian looked confused.

Arranged for someone to take Chu Zhixi to do the writing work, Gu Weimian carefully recalled what Wu Mian had just said, he felt that it was impossible!

It's not impossible to say this, it's very unlikely.

Why is it extremely unlikely?

Gastrointestinal stones are usually lodged in the stomach and occur in the esophagus quite rarely, and the probability is very small.

Gastrolithiasis is a condition caused by ingested hair, plant fibers, such as persimmons or black dates, and minerals, which are not digested in the stomach and coagulate for a long time to form a clump.

It can be divided into three types: hair stones, plant stones and mixed stones.

Digestive tract stones such as persimmons are mostly formed in an environment with a pH of 4. Normally, the pH of the esophagus is about 6, and primary gastrointestinal stones are not easy to form.

Even if a hair is ingested by mistake, it is in the esophagus...... It's a pipe, it barely stops, and there are no conditions for stone formation.

Gu Weimian thought about it carefully and made sure that his idea was right. At least I have been doing thoracic surgery for more than 20 years, and I have never seen a similar patient.

Although he thought so, Gu Weimian was a little uneasy. I used to think that there were enough inspections, but now I see that there is still something missing.

A barium permeabilization image of the upper gastrointestinal tract is not enough to see, and although the lung CT scan carries the esophagus, the imaging department will expose the lungs, not all the organs can be seen clearly.

"Director Gu, are you a little tired? I feel like you're not in a state. Wu Mian saw that Director Gu was distracted again, so he asked.

Gu Wei smiled reluctantly, "Teacher Wu, I'm sorry, I didn't sleep well yesterday." ”

"I'm embarrassed. Wu Mian smiled, "I disturb your rest in the middle of the night, you can take care of it." ”

"Teacher Wu, you are too polite. To be honest, I have never seen esophageal stones, do you have any imaging features? Mr. Wu, are you very sure that it is esophageal stones, is there any trick?" Gu Weimian decided to ask first.

It's like the time on Lao Ou Mountain, I really didn't see the problem, and thought that the patient was hysteria. Who let himself capsize after thinking about a few calcification points, and until now he has been embarrassed to go to Lao Ou Mountain to see Daoist Lin.

"You and your colleagues in the imaging department are right, the oval filling defect is not obviously damaged, and it can be judged that it is an esophageal tumor. Wu Mian said.

"......" Gu Wei was stunned for a moment, he knew that there was but, it was a turn of God, and he couldn't speak.

Putting his ears up, Gu Weimian listened quietly.

"However, from another point of view, the image of esophageal stones is similar to that of bezoars, and it also shows an oval filling defect with an unsmooth surface and longitudinal walking, and there is no obvious damage to the mucosa.

Due to the limitation of the esophagus, it does not move like a gastric persimmon stone, and it is difficult to see the typical "snowball sign" and "bird's nest sign", nor does it have obvious morphological changes like esophageal cysts. ”

"Since there is only one CT of the lungs that can be used for reference, I am also guessing that the cardia area is a linear stenosis on the first esophageal barium swallow examination, and if there is no esophageal mass lesion, we can consider cardia loss. The patient had achalasia and gastric reflux, which led to a decrease in the pH value in the esophagus, which also created strong conditions for the production of esophageal stones. ”

Gu Weimian struggled to recall the images of the upper gastrointestinal barium penetration, and he and the other directors did seem to ignore the linear stenosis of the cardia area.

But the patients are all particularly esophageal cancer, who cares if there is a cardia failure?

In esophageal cancer surgery, the tumor is cut out, part of the stomach is removed, and the remaining stomach is pulled up to replace the esophagus. If there is a linear stenosis in the cardia area, there must be no problem after the operation, because this piece has been cut off and sent for pathology.

This is a blind spot, where all attention is focused on the tumor and information related to the tumor, and the cardia is completely ignored if it is a linear stenosis.

But even then, esophageal stones are just speculation. Gu Weimian led Wu Mian into the endoscopy room full of suspicion, and the patient was already lying on the bed waiting for an examination.

"Director Gu, you're here. The doctor who did the examination greeted casually, but out of the corner of his eye, he saw Gu Weimian bending over and leading a tall young doctor in.

The contrast between old and young, short and tall, humble and approachable, is so strong that the doctor in the endoscopy room was slightly stunned and immediately realized who this was.

Wu ...... Mr. Wu?!"

"Well, hello. Wu Mian smiled, "Do it, I'll watch it first." ”

"Mr. Wu, how do you have time today?" asked the doctor in the endoscopy room.

"Friend, let me help take a look at the situation, your name is Sui Liang, Deng Ming asked me to help you take a look. Wu Mian said to the patient with a gentle expression, "Little problem, don't worry. ”

"You are ......"

"I'm a doctor at Imperial Union Hospital. Wu Mian didn't mention his own name, he was young, and in the eyes of the patient, it was a shortcoming, saying that Wu Mian didn't know about others, and he thought that there was something wrong with this little doctor, so he signed up directly.

It's not so much your name as the hospital.

"Thank you, thank you. Sui Liang's expression was a little frustrated, and his words were insincere.

has a tumor, although the doctor said that it has not metastasized, but Sui Liang also knows that at this time, the doctor may tell the truth to his family, but it is absolutely impossible to tell the truth to himself.

Good news and bad news, that's probably it.