The clinical manifestations of gastroparesis are mostly non-specific gastrointestinal symptoms, which overlap with the symptoms of other diseases (especially functional dyspepsia) and are easily misdiagnosed. Common symptoms include nausea, vomiting, gas, early satiety, postprandial fullness, weight loss, abdominal pain, etc., and the severity varies from person to person. Among them, nausea and vomiting are the most prominent symptoms of gastroparesis. Protein malnutrition and/or mineral and vitamin deficiencies may occur in severe cases, and there are often no obvious positive signs in mild cases.

Generally, it is almost difficult for patients with this disease to be diagnosed immediately, and it basically needs a little investigation before it can be slowly diagnosed.

It's no wonder that people in the gastroenterology department have been diagnosed for more than a day and still don't have much of a clue.

"The patient's condition has been vomiting and unable to eat. The drug treatment has not improved much, and it seems that it is not very related to ordinary digestive diseases. It is not due to appendicitis, gastritis, etc., nor is it gastrointestinal trauma. Ruan Bin spoke.

As soon as he spoke, everyone immediately looked at him.

"I think the patient is very likely to have gastroparesis!" Ruan Bin said lightly.

"Gastroparesis?" Guo Hui was slightly stunned, of course he knew about this disease, but it was very rare, anyway, he had never encountered a similar patient.

"Gastroparesis? No! If the patient has gastroparesis, most of them will have diabetes. Zhong Lin subconsciously shook his head.

"We gave him x-rays and gastroscopy and they looked normal, and x-rays and gastroscopy can generally make a preliminary diagnosis of gastroparesis. Li Chaoyang sneered.

"You say that you can make a preliminary diagnosis, but you don't mean that you can make a complete diagnosis. What if it is primary gastroparesis? So far, the cause of primary gastroparesis is not clear. Ruan Bin smiled faintly.

"Even primary gastroparesis can be initially diagnosed with X-rays and gastroscopy. I don't think it's gastroparesis!" Li Chaoyang still believes in the diagnosis of the examination.

Unless, unless it is a rare case.

And the patient now seems to have overlapping symptoms with many other diseases, if every test related to the overlapping symptoms is checked.

Yours do dozens of inspections, not only a waste of time but also a waste of money!

You don't have much convincing power at all, so why do you say it's gastroparesis?

Guo Hui saw that the two directors tried their best to think it was impossible, but Ruan Bin insisted that it was gastroparesis, which made him hesitate for a while.

On the one hand, he is a master of gastroenterology, and on the other hand, Ruan Bin has helped him to diagnose 100% of patients several times.

Ruan Bin saw that Li Chaoyang was still insisting, he smiled and said, "Okay, my suggestion is over, if there is nothing to do, I will go back first." ”

"Oh, Ruan Bin, I'll send you. Guo Hui also went out with him.

in the hallway.

"Ruan Bin, do you really think it's gastroparesis?" Guo Hui asked.

"If you believe me, you can ask your cousin to do a gastroparesis test. Anyway, there are so many items that are checked in the inspection, and there are not many of them. Ruan Bin smiled.

He also knew that Guo Hui was not able to speak in it just now.

After listening to Ruan Bin's words, Guo Hui suddenly felt that he had a decision in his heart.

Since you don't have a clue yet, let's give it a try!

What if not?

"Okay, thank you. Guo Hui patted Ruan Bin on the shoulder.

"Well, I'll go back first. Ruan Bin said lightly.

......

Guo Hui returned to the ward and said to Li Chaoyang and the two directors: "Two directors, I don't think I have a clue yet, so it's better to do a gastroparesis-related examination and take a look." ”

Guo Hui's words made Li Chaoyang and his faces a little unhappy.

It seems that this Guo Hui still believes the words of that yellow-haired boy!

"Dr. Guo, this examination is more complicated. First, the patient needs to undergo an initial examination, physical examination, and blood tests, and secondly, organic disease must be ruled out, and upper endoscopy or barium swallowography must be performed to evaluate for mechanical obstruction or mucosal damage, and biliary ultrasonography should be done if abdominal pain is significant. Third, an evaluation of delayed gastric emptying is performed to screen for the primary cause of gastroparesis. Finally, treatment trials with prokinetic agents and/or antiemetics may be used. If drug management is ineffective, further tests such as electrogastrogram, antral-duodenal endomanometry, enterography, anti-neuronal antibody testing, and tissue transglutaminase antibody testing should be considered. Are you sure you want to do it?" Zhong Lin said in a deep voice.

"Yes, trouble, trouble. Guo Hui insisted.

"Okay!" both of them didn't bother to say anything more when they saw each other say this. At that time, if a bunch of tests are not gastroparesis, it will be a waste of time!

............

The headquarters of the Doctor magazine.

"Editor-in-chief, this 30,000-word paper has also been submitted?" Sun Xiaowen looked at the 30,000-word paper in the editor-in-chief's hand, and suddenly wondered.

This kind of text is beyond so many papers, and it should be clicked off directly.

They are the most authoritative and famous in the country, and I don't know how many doctors and medical scholars want to publish their papers here.

"President Lin of the First Affiliated Hospital of Modu recommended it to me. Editor-in-chief Meng Longdao.

"Oh, it turned out to be Dean Lin, but you can't make an exception just because you have acquaintances, right?" Sun Xiaowen frowned.

"I guess it won't be over when the time comes!"

"Review a chicken feather, don't review it, just put it in tomorrow's issue of the monthly magazine. Meng Long rubbed his forehead and said.

"What? No need to review it? If it's not professional enough, it's not academic, and it will make a joke when you release it. Sun Xiaowen was stunned.

"There is no need to review it, this paper is written by the first doctor in China to do pre-hospital reboa, and it is the only one for scorpion! An hour ago, I asked several first-aid experts to read the paper, and they said that this paper is full of dry goods! It is even more detailed and dry than the pre-hospital reboa papers written by the London Sky Emergency Center and the Paris Air Emergency Center a few years ago!" Meng Long said.

"What? the first case in China?pre-hospital reboa?" In an instant, Sun Xiaowen was stunned!

At present, there are a total of three emergency teams in the world that can do pre-hospital REBOA, the first, the London air first aid team, the second is the Paris air first aid team, and the third is the Berlin air first aid team!

Well, this kind of first aid team belongs to a kind of private first aid company.

Even these people's papers are not as many as this dry article?

Joking, Ruan Bin began to have a world-class pre-hospital reboa level, with thousands of pre-hospital reboa emergency cases in his mind, and so many patients encountered, of course, it is not something that the above emergency teams can have.

They won't be able to save thousands of people in the past few years.

Therefore, Ruan Bin's experience and judgment, as well as cases, must be incomparable to the above three. So the quality of this paper is definitely beyond the previous ones. I want to talk about "Krypton Doctor" with more like-minded people, pay attention to "excellent reading literature" on WeChat, talk about life, and find confidants~