Dean Guo and the others were not in a hurry, drinking tea and chatting, while waiting for the major medical records to be sent in.

About half an hour later, Zhang Jun knocked on the door and came in, still holding a large medical record that had just been written.

When Qi Damin saw Zhang Jun coming in, he asked, "Are you done writing?" ”

"Report to Section Chief Qi, my major medical records and records of the first diagnosis have been written, please ask a few teachers to look at them."

Qi Damin took the iron clip and handed it to Dean Guo, who was sitting in the middle.

Dean Guo was also not polite, opened the medical record and looked at it, after all, it was a college student, with standardized writing, clear handwriting, and clear organization, and indeed there were two brushes.

Dean Guo nodded and flipped through the pages until he turned to the diagnosis page, and his hands and eyes stopped.

"Xiao Zhang, your diagnosis is cholangiocarcinoma, right?"

Zhang Jun swallowed nervously: "Yes, Dean Guo." ”

"Oh, so what is the basis for your diagnosis?"

"My main diagnosis is based on B-ultrasound, the patient has intrahepatic bile duct dilation, gallbladder emptiness, and upper common bile duct soft tissue shadow, but the caliber of extrahepatic bile duct is normal, which can basically be judged to be hilar cholangiocarcinoma, and it is already in the middle and advanced stages."

Dean Guo smiled and didn't speak, but handed the medical record to Qi Damin next to him, and motioned for everyone to circulate it.

Just when Jin Peilin was the last to read the big medical record and didn't have time to praise Zhang Jun a few words, Chen Qi also knocked on the door and came in.

"Dean Guo, Section Chief Qi, Director Zhu, Director Jin, my major medical record has been written."

Qi Damin nodded: "You sit next to you for a while." ”

When Dean Guo got Chen Qi's medical records, the first thing he noticed was the beautiful pen handwriting, which was strong and powerful, which made him nod his head in his heart.

The entire medical record is written down, which is more detailed than Zhang Jun's, but if you really want to score, the scores of the two are about the same. But Zhang Jun is a college student, Chen Qi is a secondary school student, if the two have the same score, in fact, Zhang Jun lost first.

Dean Guo didn't express his opinion, and turned directly to the diagnosis page, and then his eyes lit up:

"Xiao Chen, did you diagnose hepatic hilar bile duct stenosis and cholangitis?"

As soon as these words came out, they instantly aroused the interest of everyone in the office, and everyone, who had been in a dull mood, suddenly became active.

Because Chen Qi and Zhang Jun's diagnoses are completely different, it means that this is not destined to be a draw, and there must be one person who loses completely, then there will be a good show.

Zhang Jun was also a little surprised when he heard Chen Qi's diagnosis:

"Chen Qi, didn't you see that the B-ultrasound sheet said that there is a soft tissue shadow in the upper part of the common bile duct, such an obvious tumor."

Dean Guo handed the medical record to Qi Damin next to him, and asked with a smile:

"yes, how did you get rid of such a big thing there? I'll show you two more test reports, which the patient did in the outpatient clinic in the morning, and the results have just been delivered. ”

Dean Guo handed over two pieces of paper,

One is a B-ultrasound imaging report, indicating that the lumen of the left and right hepatic ducts is stenosis, and a mass of 2.7cm*1.4cm can be seen at the common hepatic duct after contrast agent injection.

The other is an X-ray report, showing that the hilar bile duct is retried with stricture, and the upper intrahepatic bile duct is widely dilated, and the common bile duct and pancreatic duct are not stenosis and dilation.

After Zhang Jun saw it, he looked even more proud, feeling that his diagnosis was stable.

After Chen Qi read it, he just gently put the two report sheets on the table, and there was no frustrated expression on his face.

Dean Guo looked at Chen Qi playfully and asked with a smile:

"How about it, after the two students see these two reports, do they need to revise their preliminary diagnosis?"

Zhang Jun shook his head firmly: "These two reports confirm that my diagnosis is correct, and there is no need to change it." ”

Chen Qi smiled: "Yes, these two reports also made me more determined to rule out the diagnosis of malignant tumors. ”

Dean Guo leaned back in his chair, looked at the many doctors in the room and asked, "Come, tell me which diagnosis do you agree with?" ”

Li Jun was the first to stand up: "Dean Guo, I agree with Zhang Jun's diagnosis, this is a very obvious place, and it is also at the hilum of the liver, and the possibility of malignant tumor is the greatest." ”

Several other young doctors also nodded, apparently agreeing with Zhang Jun's diagnosis.

Dean Guo looked at a few veteran doctors again: "Lao Qi, Lao Zhu, and Director Jin, you all talk about it, today is a big discussion of cases in the department." ”

Qi Damin is from internal medicine, and after reading several reports and physical examination results on major medical records, he tends to have bile duct cancer.

Zhu Huoyan carefully looked at a few report sheets, and then glanced at Chen Qi, obviously, he was inclined to Chen Qi's diagnosis, but because Chen Qi had not specifically stated the basis for his diagnosis, he did not speak to support.

Jin Peilin was silent, a few bigwigs were there, so he, a small section director, should not be too expressive.

Dean Guo saw that everyone's opinions in the office were inclined to Zhang Jun, so he said with a smile:

"Xiao Chen, let's see it, everyone's diagnosis thinks that it is bile duct cancer is very likely, you want to say that it is ordinary cholangitis, then you can tell me the basis of your diagnosis. Pay attention, don't talk about it, we doctors must have a realistic attitude. ”

Chen Qi exhaled lightly, as a hepatobiliary surgeon in his previous life, he was confident that his diagnosis would not be wrong, after all, he had taken over too much bile duct cancer before.

"Dean Guo, several teachers, I judge from these perspectives.

One is that the patient's clinical manifestations are inconsistent, he has no jaundice, neither the results of the laboratory test nor his own face indicate jaundice, and the patient has no symptoms such as itchy skin, weight loss, indigestion and epigastric discomfort. ”

Chen Qi began to say that his diagnosis was based, and the office quickly fell silent.

We are all professional doctors, and although we have a tendency in our hearts, we also understand the truth of listening and listening.

Zhang Jun was willing to object, wanting to say that not every bile duct cancer will have the above clinical manifestations, but he held back, and he interrupted when others were reporting the condition, whether it was right or wrong, it would leave a bad impression on the leader.

Chen Qi didn't care about everyone's thoughts, and followed his own train of thought:

In addition, the two lists just given by Dean Guo suggest that if it is cancer, there is no intrahepatic metastasis and accompanying lesions, no vascular invasion and other phenomena have been found, and the hilar lymph nodes have not been enlarged, so inflammatory lesions cannot be ruled out.

There is another basis, that is, the tumor indicators on the physical examination list, you see, carbohydrate antigen 19-9 is normal. Therefore, just a bile duct stricture and a soft tissue shadow can be said to be a malignant tumor, and I don't think it is very likely. ”

As soon as these words came out, everyone began to ponder.