The clinic officially ends after two hours. Sun Lien did not leave the gastroenterology clinic in a hurry. He really wanted to see what this "black esophagus" was.

Due to the lack of manpower in the secondary peacekeeping hospital, the only gastroscope in the hospital was placed in the consultation room of the gastroenterology department. Only after the office had cleared could the doctors begin examining Peter. And there were some surprises during the inspection. Peter, who was a perennial alcoholic, did not respond well to the narcotics he took in his mouth. As soon as the probe entered his throat, it seriously caused Peter to retch and even vomit. After several attempts to no avail, the gastroenterology doctor could only administer general anesthesia to Peter with the help of an anesthesiologist. Then the gastroscopy began smoothly.

The black probe gradually penetrated into Peter's throat, and then appeared in front of the doctors, a scene that could be called "bizarre".

Peter's upper esophagus was normal. But when the probe enters the middle and lower esophagus, it looks much weirder - the inner wall of the middle and lower esophagus is full of white and black diffuse marks. Some of the black marks don't look too deep, they don't show well-defined boundaries on the mucous membranes, and some are greenish.

The description that Sun could find that best matched the image he saw was mold. Peter's esophagus looked like a moldy PVC tube with a moldy inner wall, and it was the type where the front half was completely normal and the back half suddenly started to mold. On the mucosa of Peter's esophagus, the boundary between the normal area and the whitish and black area is very clear. On the contrary, the boundary between the whitish and blackened areas is not clear.

"What ...... this?" the well-informed gastroenterologist was also a little blindsided when he saw this scene. He turned the probe around and said to himself, "This can't be moldy, right?"

"Do a biopsy?" the anesthesiologist clasped his hands on his chest on the side, also looking lively. "Anyway, I've already gotten off the gastroscopy, so let's take a sample. ”

The doctor in the department of gastroenterology was so kind that he was about to start the operation when his hand shook lightly and touched the probe.

The picture on the probe flickered, and when the picture stopped again, Sun Lien saw at a glance that a large piece of the white mucosa on the esophageal wall had fallen off. Underneath the detached mucosa, there were several pieces of bright red tissue that were slowly oozing blood.

"The esophageal mucosa can't be so fragile, right?" Sun Lien asked, he really hadn't seen much gastroscopy. However, if the esophageal mucosa falls off at the touch of this way, then the patient can say goodbye to solid food completely.

"No...... I usually don't have any reaction when I touch it. The doctor in the department of gastroenterology frowned, and manipulated the probe to look down, "The cardia mucosa is normal, and the lesion is limited to the middle and lower sections of the esophagus. He operated the forceps and pinched a piece of tissue in the lower and middle parts of Peter's esophagus, "I'll send the sample to the laboratory right now." ”

Sun Lien rushed to the laboratory department with the doctor from the Department of Gastroenterology, and the only people left in the consultation room of the Department of Gastroenterology were the anesthesiologist who was a little depressed because he couldn't follow the excitement, and Peter, who was gradually waking up. As for the Pakistani captain...... He enthusiastically said that he would stay at the door of the examination room and wait for Peter to wake up completely.

"What level is this patient? The sample still has to be sent by two people?" The doctor in the laboratory department was obviously suppressed by this battle. After he took the sample, he immediately began to perform the biopsy, "You go outside and wait, I estimate that it will be done in half an hour." ”

Sun Lien, who was waiting for the results at the door, chatted happily with the doctor from the Department of Gastroenterology. Sun Lien's reputation as a "little genius in diagnosis" has not yet been so loud that even the peacekeeping hospital in Polytavia can know about it. In the process of daily "case sharing" between the two doctors, Sun Lien continued to reap the amazement of the gastroenterologist in front of him. After the two chatted for a while, the other party vividly nicknamed Sun Lien, "You are Conan of the medical world!"

Sun Conan spread his hands and expressed helplessness about this, "I didn't find these things myself...... People sit at home, and things come to the door. ”

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The test report came out under the watchful eye of two doctors. The pathological examination results of the laboratory department were "considering erosion and inflammatory exudation, and a large number of acute and chronic inflammatory cell infiltrates were seen under the microscope". This test result is a match with the previous gastroscopy results, and the diagnosis is naturally coming out - acute esophageal necrosis (black esophagus).

"Hospitalize. The gastroenterology doctor scratched his head, but there was no helplessness in his tone - more excitement. In fact, it is also very easy to understand that the probability of occurrence of this esophageal disease is low and scary. Only one case has been reported in China in 17 years. With the addition of domestic reports, a total of seven cases have been reported globally. Now that the eighth case has happened in front of him, any doctor will be excited - with this alone, he has at least three articles to post.

The pathogenesis of acute esophageal necrosis remains unclear, and most of the seven reported patients had underlying medical conditions. Gastroesophageal reflux disease, alcoholism, and diabetic ketoacidosis are the most common. Alcoholic hepatitis and cirrhosis have also been reported as hepatic encephalopathy. Peter's case is more peculiar, he is the only patient who has been drinking alcohol for a long time and does not have alcoholic hepatitis or cirrhosis.

Yes, although Peter was severely dependent on alcohol, he miraculously did not suffer from cirrhosis or alcoholic hepatitis. Sun Lien and the gastroenterologist couldn't think of any possible explanation for this, and in the end everyone could only attribute it to the physical problems of the Russians. Acute esophageal necrosis is not a particularly serious lesion. At least seven cases were reported, only the patient with cirrhosis of the liver with hepatic encephalopathy died as a result of liver failure rather than esophageal necrosis.

"He was given antibiotics to fight the infection and omeprazole to control the damage. Metoclopramide is an antiemetic and the electrolyte balance needs to be corrected. After discussing with Sun Lien for a while, the doctor from the Department of Gastroenterology finalized the treatment plan. "The main focus is to control the injury and promote the body's natural perfusion recanalization. ”

Although doctors are unable to find the blood vessels that cause acute esophageal necrosis, the body's own compensatory ability allows the blood supply to this area to recover naturally. All they have to do is protect their esophagus, control further damage, and wait.

Sun Lien looked at the test results, and then made up his mind - he did not plan to directly participate in the treatment before returning to China.

This inexplicable rare disease constitution, I don't know what medicine to use to cure it.