419 How much do you know about Mirizzi syndrome

"What's wrong with you?" Zhai Yuhan waited for Ji Xiang to come out of the ward, she closed the door with her hand and asked suspiciously.

"The patient's right upper quadrant pain was non-dissipating, intermittent progressive and severe pain, with a score of 6/10, no obvious aggravating or alleviating factors for the pain, unclear relationship with eating, and nausea, jaundice, darkened urine, light-colored stools, and self-felt."

"I didn't write these things in the medical records, Mr. Zhai, you and the director know about it."

"......" Zhai Yuhan was stunned for a moment, and then became angry in his heart.

Is Ji Xiang provoking himself?

As soon as he asked him and Zhao Mengmeng some simple basic clinical knowledge and consultation knowledge in the tone of a senior doctor, Ke Jixiang turned his head and began to fight back.

He's a very arrogant and aggressive young man.

"I'm thinking about doing an MRI to make sure, by the way, our department has an ERCP room." Ji Xiang asked very casually.

He had not yet been transferred to the Department of Hepatobiliary and Pancreatic Surgery in the Second Affiliated Hospital of Bai Medical University, and when he remembered empathizing with him, he remembered that the gastrointestinal surgery department of a large hospital had a gastroscope, so he asked.

Zhai Yuhan's face became even more ugly.

ERCP is done by gastroenterologists, and there are not many hepatobiliary and pancreatic surgeons in the country who can do ERCP, only the hepatobiliary surgery department of several hospitals in the imperial capital has an ERCP room.

Is this a slap in the face?

Seeing that Zhai Yuhan didn't speak, Ji Xiang hesitated and smiled bitterly, "I'm sorry, Mr. Zhai, it's okay if you don't have it, I suggest doing an emergency MRI, and then find a teacher from ERCP to consult tomorrow." ”

"Dr. Koji." Zhai Yuhan suppressed the anger in his heart and tried his best to be a little calmer in front of the camera, so as not to be criticized.

"Teacher Zhai, that's the case." Ji Xiang's eyes were very bright, and his face exuded a warm luster, as if a gaffer had hit a light on his face.

Zhai Yuhan was stunned and lost his mind instantly.

That's pretty good, isn't it?

She is not Yan Gou, but at this moment, Ji Xiang's surroundings seem to be in full swing, and Lun Yin is everywhere.

But Zhai Yuhan woke up quickly, slightly annoyed and angry.

"What do you think?" Zhai Yuhan asked unhappily.

She didn't want to deal with Ji Xiang at all, but after all, there was a camera.

"Mr. Zhai, the patient is a rare mirizzi syndrome, it should be fine, but an MRI is still needed to make a diagnosis."

"Mirizzi syndrome? Xiao Ji, the patient's gallbladder has been removed! Zhai Yuhan said solemnly.

"Mirizzi syndrome, not the gallbladder neck compressed by stones, but ......"

Ji Xiang said as he strode towards the doctor's office.

The team of photographers behind him is completely stupid, what kind of plot is this? Was it arranged by the director?

Are patients looking for extras too?

Ji Xiang's affirmative tone made them think that it was all arranged.

I was deceived, everything is a script, but the director is in control behind the scenes.

The photographer was a little sleepy, but he instantly woke up when he saw this scene.

……

……

In the comment room, the host's bald head was shiny, and he looked at Professor Shen blankly.

"Mirizzi syndrome ......" Professor Shen lowered his head and flipped through his phone to find the professional term Mirizzi syndrome.

He is not a hepatobiliary and pancreatic surgeon, and he needs to search the Internet when encountering such an extremely specialized term as mirizzi syndrome.

Soon, Professor Shen raised his head, his elegant face a little confused.

In his opinion, Ji Xiang is just a regular trainee, Zhai Yuhan is the general inpatient of the First Affiliated Hospital, and this patient is obviously an old patient of the First Affiliated Hospital, the director has seen it I don't know how many times, why did Ji Xiang give a new diagnosis?

Impossible,

It's not scientific!

But all these doubts were shaken in Ji Xiang's determined gaze.

The review room was quiet, and the atmosphere was a little awkward, but Director Fan was extremely excited, and his eyes were bright.

That's what he wants!

Ordinary people are interested in the work and life of doctors, which is one of the selling points of the show.

And everyone knows that little doctors will be ravaged in various ways when they enter the clinic, which is reasonable.

But if you want to make a hit, it needs to be reasonable and unexpected.

Now Ji Xiang shows all this in front of Director Fan.

Thinking of Ji Xiang with his own "working group", there is also an "old" director who graduated from Concord in the working group, and his expectations for Ji Xiang were suddenly full.

"First group, first group, keep up! The camera is on Ji Xiang. The second group, the side gives Dr. Zhai a shot. Director Fan ignored the presence of the host and guests in the review room, and began to direct his photographers to work.

……

……

The cameraman followed Ji Xiang's footsteps and trotted.

He said in his heart, Ji Xiang's legs are really long, he takes a big stride, and he has to trot to keep up.

Back at the doctor's office, Ji Xiang sat in front of the computer and called up the B-ultrasound image.

"Teacher Zhai, look here."

"Ultrasonography showed enlargement of the curled cystic structures at the gallbladder bed, consistent with an increase in gallbladder residue, and no ultrasound evidence of biliary stones."

Zhai Yuhan was stunned, "Doctor Xiaoji, do you know what you're talking about?" ”

"I know that although the image on the ultrasound is not certain, there is an image that is close to an artifact under the department."

Ji Xiang pointed to the screen.

"Don't you think there's something wrong with this image?"

"Something is wrong? What's wrong? Zhai Yuhan looked at the image of Ji Xiang's finger blankly, and didn't know what Ji Xiang was talking about.

"The images show that the bile ducts are slightly thicker than normal." Ji Xiang said, "If magnetic resonance cholangiopancreatography is done to further evaluate the bile duct tree, I estimate that I can find gallstones at the stump of the cystic duct, with compression of the common bile duct and dilation of the upstream bile duct. ”

"Well, this is this paragraph, although there is only a little afterimage, but with the patient's medical history, we can predict the situation inside."

“!

! ”

Zhai Yuhan was speechless.

Estimate?

With only a small piece of the image on the B-ultrasound report, he dared to say that?

"Mr. Zhai, there is no ERCP room in our department, so we can always make an appointment for an MRI at night."

Hearing Ji Xiang speak to himself in this tone, Zhai Yuhan really wanted to hold his ear and tell him that an MRI could indeed be done at night, but he needed a call from the director.

"Are you sure?" Zhai Yuhan asked.

"Almost, Mr. Zhai, how much do you know about Mirizzi syndrome."

Zhai Yuhan glanced at Ji Xiang cautiously, she saw Ji Xiang looking at the computer screen intently, not like provoking herself, but she was so competitive that she recalled the knowledge about Mirizzi syndrome again in her mind.

"Mirizzi syndrome mostly refers to incarceration and ...... due to gallbladder neck or cystic duct stones"

Zhai Yuhan is explaining the professional terminology, it is indeed the general inpatient of a high-level tertiary hospital, and the basic quality is particularly good.

But seeing this scene, everyone's eyes in the review room almost didn't fall out.

If everyone just felt that the roles of teachers and interns had been reversed before, then the question raised by Ji Xiang directly erased the word feeling.