Dr. Feng leaned behind Leng Cen and stood on tiptoe to look at the B-ultrasound results, Leng Cen was taller than him, and he couldn't see it at all without tiptoeing.

The image of the B-ultrasound Dr. Feng did not see it very clearly, after all, the distance was far away, but he could see the judgment result of the B-ultrasound at the bottom: "There is no abnormality in the examination, and this result is only responsible for this examination......

There is no abnormality, that is, there are no stones in the patient's common bile duct at all, in other words, Director Leng has made a mistake in judgment.

It is said that there is nothing wrong in judgment, where is there a doctor who does not misdiagnose, and where is there who does not make a mistake in judgment?

According to the survey, 30% of doctors' diagnoses were misdiagnosed. If you see a doctor in an outpatient clinic, the misdiagnosis rate is 50%, if you are admitted to the hospital, the young doctor sees it, other doctors also see it, everyone also visits and discusses, and the B-ultrasound, CT, and laboratory tests that should be done are all done, and the misdiagnosis rate is 30%.

The human body is very complex, and every doctor hopes to get rid of the disease and minimize the misdiagnosis rate, but no matter how much it is controlled, it cannot be controlled. There is no way to avoid many misdiagnoses.

As long as you are a doctor, there is no one who is not misdiagnosed. As the saying goes, small doctors make small mistakes, big doctors make big mistakes, new doctors make new mistakes, and old doctors make old mistakes, because big doctors and old doctors encounter many difficult cases!

In fact, the misdiagnosis in China is a little lower than that in foreign countries. The misdiagnosis rate in the United States is about 40 percent, in the United Kingdom it is about 50 percent, and in China it is about 30 percent.

The causes of misdiagnosis are many, too complex, and some are even unclear.

Leng Cen's misjudgment just now is actually not a big deal, and this B-ultrasound examination is only an exclusion, not a final diagnosis, and Leng Cen's judgment just now is not even a misdiagnosis.

According to the normal process, from the beginning of the patient's visit to the doctor in the hospital, the doctor will investigate step by step based on his own experience, first determine the most likely condition, if not the possible condition, and so on.

The human body is very complex, let's just say abdominal pain, there are many, many causes of abdominal pain, and it is impossible for doctors to let patients do all the tests in one go.

It doesn't matter if the symptoms are not urgent, especially for some emergencies, a series of tests have been completed, and the patient may not be able to hold on before you are diagnosed.

Therefore, emergency patients are selectively screened.

For example, this patient has abdominal pain, jaundice, and fever, and Leng Cen speculates that the patient's common bile duct stones are likely to be very large according to the Charcot triad, so the patient is arranged to do B-ultrasound, and this B-ultrasound result is actually the final basis for diagnosis.

So Leng Cen's misjudgment is nothing.

But the problem is that the results didn't come out just now, so Leng Cen made a long speech very firmly, so it was a bit of a slap in the face when combined with the results of this examination.

The premise is that you have to build on the correct results, and the more surging you say on the wrong results, the more shameful it will be.

It's like doing a problem, a classmate asks you for a math problem, you explain to others for a long time, the head of the talk is the Tao, and the classmates who ask for advice also think that what you say is very reasonable, and they worship you, but in the end the answer is wrong......

It's embarrassing......

There is a saying that successful people's farts are fragrant, and even if you are poor and ugly, even if you say a wise saying, it is nonsense.

Dr. Feng quietly took two steps back, silently saying in his heart: "I didn't see it, I didn't see anything." ”

"Is it that the B ultrasound shows that there are no stones in the patient's common bile duct at all?" Fang Han on the side suddenly spoke.

Leng Cen slowly put down the B-ultrasound list in his hand: "How do you know?"

Doctor Feng also looked at Fang Han, as if Fang Han knew this result from the beginning, could it be that Fang Han had already made a judgment?

No, Fang Han had just read the patient's treatment data in the county hospital, but he didn't even start the diagnosis.

"Your expression tells me that. Fang Han said as a matter of course.

Just like your Director Leng was stunned just now, fools know that they have made mistakes in judgment, if there is no mistake, can this expression?

Leng Cen opened his mouth, not to talk to Fang Han, but muttered to himself: "No, the patient's symptoms are completely Charcot triad, how can it be?"

It is really strange that the patient obviously has the Charcot triad, but the B-ultrasound shows that there is no acquaintance in the common bile duct.

Dr. Feng said on the side: "Director Leng, why don't you do a CT scan, after all, there are also deficiencies in B-ultrasound." ”

Leng Cen nodded hurriedly: "Then do another CT." ”

Generally speaking, for gallbladder and kidney stones, B-ultrasound is indeed one of the fastest and more commonly used examination methods, but B-ultrasound does have limitations, some places may not be visible, correspondingly speaking, the resolution of B-ultrasound is not high enough, some small lesions are not easy to find, and some places covered by organs are not very clear.

CT is a computed tomography machine, which has a much higher resolution than B-ultrasound, and can take cross-sectional or stereoscopic images of the parts of the human body that are being examined, and even subtle lesions can be found.

Dr. Feng wrote the order, and the nurse sent the patient for CT.

However, CT results showed that no stones were found in the common bile duct.

Leng Cen took the CT film and looked at it again and again, and from the CT film, you can see the cross-section of the patient's common bile duct, and the cross-section of the common bile duct is not visible at all on the layers of scanned images.

B ultrasound did not find, CT did not find, this time Leng Cen is really a little embarrassed, it is a trivial matter to not be able to hang face, the patient has been in the hospital for more than two hours, and if it is delayed like this, the situation is not good.

"Director Leng, do you want to find a hepatobiliary expert for a consultation?" Dr. Feng suggested in a low voice.

At this time, he already regretted talking too much just now, he originally thought that the patient's problem was not very big, so he called Fang Han and Leng Cen, who knew that the patient's problem was so serious.

And Director Leng obviously wants to behave in front of Fang Han again, but now it's good, it's a shame to fail to perform.

Leng Cen didn't answer in a hurry, but frowned and groaned.

He was almost certain that the patient must have been a gallstone, but he couldn't find the location of the stone and it was really a person who died in a hurry.

All of the patient's current symptoms are caused by stones, and if the stones cannot be found, surgery cannot be performed, and the patient's condition will worsen.

Leng Cen really didn't want Dr. Feng to come to the hepatobiliary department, but if he didn't look for it at this time, he couldn't ignore the patient's life for the sake of face.

"In fact, Director Leng's judgment was right, the patient is gallstones. Just as Leng Cen was about to agree to let Doctor Feng call someone, Fang Han spoke slowly.

Leng Cen turned his head abruptly and looked at Fang Han in surprise, Fang Han actually recognized his judgment.

Fang Han was checking the patient's pulse at this moment, and he was talking while checking the pulse.

Doctor Feng was also a little puzzled, Fang Han also judged so?

"But neither ultrasound nor CT found stones. ”

Fang Han changed the patient's right hand again: "The stone should be at the junction of the patient's common bile duct and duodenum......."

Before Fang Han's words were finished, Leng Cen hurriedly grabbed the CT film again and looked directly at the junction between the common bile duct and the duodenum.

After careful observation, Leng Cen finally discovered an anomaly, the common bile duct near the duodenum was slightly dilated compared to the common bile duct elsewhere, and the diameter was about O.1 cm larger.

1 millimeter, it is simply insignificant, if it weren't for Fang Han's reminder, Leng Cen also looked at it very seriously, he would almost not have found it.

Don't underestimate this 1 millimeter expansion, in medicine, any one that cannot be easily ignored.

If the common bile duct is dilated by 1 mm, it means that the patient must have an obstruction, and if there is an obstruction, it is very likely that there is a stone.

"Immediately give the patient a duodenoscope, right here. Leng Cen commanded.

Dr. Feng hurriedly arranged for the nurse to do it, while he himself picked up the CT film that Leng Cen had put down, and looked carefully at the vicinity of the common bile duct and duodenum.

After looking at it for a while, Dr. Feng found an abnormality in the part where the common bile duct is about to enter the duodenum, which is very special and is indeed difficult to find by ultrasound and CT.

The nurses quickly brought the equipment, and the duodenoscopy entered from the patient's mouth, from the esophagus to the stomach, and then into the duodenum, and went down little by little, and there was an abnormality near the duodenal ** site, that is, where the duodenum and the common bile duct meet.

Leng Cen was a little excited, and hurriedly ordered: "Create a shadow agent!"

The nurse hurriedly injected a contrast agent, and the location of the stone was instantly clearly displayed on the display screen.

Leng Cen breathed a long sigh of relief: "Prepare for the operation, I'll do it." ”

"Okay. Dr. Feng answered, and then quickly began to schedule surgery.

Leng Cen subconsciously looked at Fang Han at this time, huh, why didn't he see anyone.

Doctor Feng happened to receive a call from Fang Han at this time: "Doctor Feng, Director Fang called just now, I won't stay for dinner, we'll talk another day." ”

"Doctor Fang, how can this work.....

Doctor Feng hurriedly kept it, today they were able to find this stone smoothly, it was Fang Han's credit, if it weren't for Fang Han, they might still be blind at this time.

The location of the stone was found, and Dr. Feng actually understood Leng Cen, this place is really difficult to find, and it is easy to ignore.

Thinking of this, Doctor Feng was shocked again: "How did Fang Han know?"

From beginning to end, Dr. Feng remembered that Fang Han had not seen the patient's B-ultrasound results at all, nor had he seen the patient's CT film, and he was sitting next to the patient to check the pulse while reminding him.

Is this based on pulse diagnosis?

Doctor Feng was puzzled, and Leng Cen was also puzzled at this time.

Could it be that Fang Han was really diagnosed by diagnosing the pulse, how could this be possible, could it be said that the diagnostic methods of traditional Chinese medicine are better than modern examination instruments?

It's really a dog, he originally planned to show it in front of Fang Han, but instead of acting it, he was slapped in the face by Fang Han.

What made people most angry was that Fang Han had disappeared at this time, and he still had a lot of doubts in his heart.

At this moment, Leng Cen's heart was like a cat scratch, how uncomfortable and uncomfortable it was......

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