"The patient now has a melena and has reported that the stool is positive for occult blood. Zhu Liangchen "reported" After finishing his medical history, he added.

This is the result of the report of his deputy director just now, there is nothing to hesitate about, the diagnosis is very clear, the patient has lower gastrointestinal bleeding.

There are a myriad of considerations for positive occult blood in the stool after surgery. However, after interventional surgery, it is not liver interventional surgery, and the patient himself has splenomegaly, liver cirrhosis, gastric varices, and positive fecal occult blood, which is too rare.

If he couldn't find the problem, Zhu Liangchen felt that he couldn't sleep.

Zheng Ren was not as polite as when he entered the house, and while listening to Zhu Liangchen talk about the treatment, he stared at the film.

Habitually, Zheng Ren's right hand supported his cheek, his left hand was placed under the right armpit, and his eyes narrowed.

After Zhu Liangchen reported his medical history, he also looked at the film.

This is not the latest film, will Boss Zheng directly say no, and he will go back and do another film? But what kind of examination do you have to do to find out?

Zhu Liangchen thought of countless possibilities in his heart, but fortunately, he reported to him at home that the patient's condition was stable and the blood in the stool did not worsen, so he was a little relieved.

After ten minutes, Zheng Rencai said, "The CT is not very clear. ”

Zhu Liangchen's heart was half cold, this is Tai Chi Kung Fu, a word, and experienced doctors will do it.

Does Boss Zheng not know, or is he perfunctory?

But as soon as the thought in his heart arose, Zheng Ren continued.

"But the ulcer surface at the pylorus has already been revealed. ”

"......" Zhu Liangchen and Director Kong both frowned.

CT does not show hollow organs, such as the gastrointestinal tract. If there is a large solid tumor, CT can be seen, but the patient is not a tumor.

"Director Zhu, I don't know if you have noticed, the patient's stomach wall has dilated. Zheng Ren continued.

"I noticed it, and I thought it was caused by the embolization of some arteries, the lack of blood supply, and the slowing down of gastric emptying. Zhu Liangchen said immediately.

Zheng Ren shook his head and said, "The problem is indeed the slowing down of gastric emptying, postoperative medication, and the doctor's order to show me." ”

This is a sentence in the east and a sentence in the west, but Zhu Liangchen did not refute it, but took out his mobile phone and called up the doctor's order to take pictures.

If you ask for someone, you must have an attitude of asking for someone, and just now Dr. Mehal came to watch the film, and the scene of a row of foreign experts standing against the wall completely shocked Zhu Liangchen.

He didn't have any other thoughts, he knelt very thoroughly.

After reading it, Zheng Ren had a treatment plan in his heart. He paused and said, "Director Zhu, go back and check a gastroscopy, remember to take a biopsy." ”

"Biopsy?" Zhu Liangchen was stunned, could it be that he had encountered a rare malignant tumor? No, he had watched the film so many times, why didn't he see it.

Zheng Ren just said to himself, the pace was a little slow, he didn't expect Zhu Liangchen to think about so many things at this moment.

"Biopsy the tissue, do a bacterial culture. Zheng Rendao.

"Bacterial culture? What do you suspect?" Zhu Liangchen wanted to ask, Helicobacter pylori?

"Are you familiar with the laboratory department?" Zheng Ren asked suddenly.

Even Su Yun felt that his boss was so elusive, could it be that after communicating with Dr. Mehal, he swelled into outer space?

"It's ok. ”

"When sending the specimens, Director Zhu, you personally greeted the acquaintances of the laboratory department, it is not an ordinary bacterial culture, it depends on whether there is octococcus gastricus. Zheng Rendao.

"......" Zhu Liangchen was speechless.

"......" Director Kong was also speechless.

Only Su Yun raised his eyebrows slightly, as if he had thought of something.

"Boss Zheng, what is that?" Zhu Liangchen really didn't know if Boss Zheng was embarrassed for himself, or if he was really how. He came today with a guilty plea, and Boss Zheng greeted him with a smile, which was already a special face-saving face. So he could only ask in a whisper, and didn't dare to say anything else.

"Octococcus gastricum is often stacked in a cube in eight cells in a cuboid shape, and is a micro-aerobic bacterium that is easily isolated from the soil and can also be found in the stomach contents of patients with gastric problems. ”

Zheng Ren pointed to the uneven density of a section on the film and said, "Here, I think it is a pyloric ulcer, and the area of the ulcer surface is not small. ”

"The growth of the baccoccus gastric in the human stomach causes certain pathological changes, such as pyloric ulcer and pyloric stenosis, which cause the flow of food to the human intestine to be slow. In this abnormal condition, the stomach is in acidic conditions, and the carbohydrates and other nutrients that grow in the food cause the rapid proliferation of the baccoccus gastric system. ”

Zhu Liangchen was stunned when he heard this, and asked in a trance, "And then?"

Zheng Ren was also a little surprised, and looked sideways at Zhu Liangchen, as if he saw something incomprehensible.

"The boss, the doctor who intervened was born in the video. Su Yun reminded in a whisper beside him.

"Oooh. Zheng Ren suddenly realized.

Director Kong and Zhu Liangchen's faces seemed to have been slapped a few times, and they really wanted to press Su Yun to the ground and beat him.

Isn't it a doctor who was born in the image?

"Professor Goodsir first discovered the baccoccus gastric in 1842 in the stomach of a patient. Its presence was also discovered in the blood of patients in 1872 by Professor Ferrier, who believed that its presence in the blood was related to a delay in gastric emptying. Zheng Ren then explained.

"It's normal for Director Zhu not to know, the most common department for octococcus in clinical practice is general surgery, and even gastroenterology is not very common. ”

"General surgery, why?" asked Director Kong.

"Because of the previous gastric band surgery, the possibility of gastric octococcus after surgery is quite high. Zheng Ren smiled, "That's why I said that the Johns Hopkins Hospital paper is debatable, and here's why." ”

"The paper did not mention how to prevent and treat gastric octococcus after surgery, nor did it mention any complications, but only said that the long-term effect was better. ”

"I still want to wait for Dr. Mehal to leave and think about it, but Director Zhu started first. Zheng Ren said very seriously, anyway, he couldn't hear the mockery from his tone, and Zhu Liangchen felt upset in his heart.

I really want to have a seizure, and I feel depressed if I don't have a seizure. Especially seeing Zheng Ren's honest face, he was even more helpless. Zheng Ren was not deliberately mocking himself, Zhu Liangchen knew this.

But the more this happens, the more stupid it seems that what I did before is extremely stupid.

Director Kong smiled bitterly, it turned out to be a common complication after gastric band surgery, no wonder Su Yun would remind Boss Zheng that those who engaged in intervention were all from imaging backgrounds.

I haven't had gastric band surgery, so who knows what bullshit gastric octococcus is.

Thinking about it, Director Kong couldn't stop wanting to scold his mother in his heart.

This is simply an insult to interventional doctors, but ...... People are right, what can they do?

Director Kong sighed.

。