"I see a medical record that says you have an inguinal hernia?" Ji Xiang "finally" remembered that he was a doctor and asked a question about medical treatment.

But Director Bai said he was helpless.

Although inguinal hernia is a medical category, it has nothing to do with bleeding after internal hemorrhoids.

"Bad, don't mention it. I have a sports hernia, and many people who play basketball have this problem, saying that it is a problem with the core muscles. When I was younger, I was thinking about surgery, but I was afraid of the pain, and I was busy with work, so I forgot about it. ”

Ji Xiang and the patient started talking along the inguinal hernia, and Ji Xiang even did a physical examination for the hernia.

If it were someone else, Director Bai would go up and kick him in the ass and tell him to get out.

The purpose of the consultation is to resolve the patient's postoperative bleeding of internal hemorrhoids, not an inguinal hernia after exercise!

As the name suggests, inguinal hernia after exercise refers to a disease that only occurs during strenuous exercise, and it can basically be repaid, and it can be strangled with a hernia belt, which is an indifferent disease.

Ji Xiang ......

It's a digression.

"Hello, Director Bai." Lin Jiu held a notebook in his hand, and greeted Director Bai with a harmless expression.

When he spoke, the patient's family was taken aback.

For five or six minutes, they didn't even notice that there was still someone standing here.

"Professor Lin, what do you think?" Director Bai looked ahead, not looking at Lin Jiuze at all.

As long as he didn't look at him, the dizziness felt much lighter, and Director Bai quickly found a way to deal with Lin Jiuze.

"It's weird, I don't have an opinion for the time being." Lin Jiu said helplessly, "Doctor Ji Xiang probably doesn't have an opinion. ”

Looking at Ji Xiang, who was examining the body and explaining the inguinal hernia to the patient, Director Bai also thought so.

"There aren't many patients like this at Massachusetts General Hospital."

"I don't know, my profession has nothing to do with this kind of disease."

Director Bai didn't say anything, he specialized in the art industry, and it was normal for Lin Jiu to not understand it.

Just now, Director Bai understood half of what Lin Jiu wrote in his notebook, which was about the same as the guesses of the directors in the office, but Lin Jiu also wrote about the treatment, which was more detailed.

Plus some very rare diseases.

Director Bai's judgment on Lin Jiuze is that his professional level is better than that of the directors of the Second Affiliated Hospital, even if hemorrhoids are not his own specialty.

Especially for the differential diagnosis of those rare diseases, when you really see the foundation, Lin Jiuze's technical level has nothing to say.

It seems that he can only consult with Xiehe, and Director Bai has a headache.

He generally doesn't want to use the relationship on the side of Concord, after all, it is very troublesome to maintain the relationship.

Ji Xiang was doing useless work, and Director Bai didn't bother him, but stood patiently at the door and watched.

"Dr. Ji Xiang's consultation is very strange, don't you think Director Bai?" Lin Jiu suddenly spoke.

"Okay."

"Your hospital really values talents." Lin Jiu said something brainless.

Director Bai smelled a little provocative.

But he still didn't say anything, and he didn't look at Lin Jiuze, just as if he didn't exist.

A few minutes later, Ji Xiang and the patient said goodbye with a smile, although the time was short, but the two seemed to have a good relationship, and they almost cut off the head of the chicken on the spot and burned yellow paper to worship the handle.

"I'll go and give my opinion, don't worry, it will be fine soon." Ji Xiang and the patient shook hands and said goodbye.

Out of the ward, Director Bai looked at Ji Xiang, and everything was silent as soon as possible.

"Director Bai, the patient's inguinal hernia is very weird." Ji Xiang said the first thing after going out.

Director Bai had a vague strange feeling.

He guessed that Ji Xiang had already made a clear diagnosis, but he didn't explain it, could it be that Lin Jiuze jumped out by himself and then hit him on the head?

But Lin Jiu is also a human spirit, and he doesn't speak at all, as if he really disappeared.

Director Bai couldn't see through Ji Xiang, and he didn't know whether his guess was true or false, so Ji Xiang immediately said, "I suggest doing a B-ultrasound." ”

"B-ultrasound has been done, but didn't you see it?" After Director Bai reminded him, he immediately realized that he seemed to be mistaken, "Xiaoji, what position do you want to see?" ”

"I think the patient has chronic Budd-Chiari syndrome and would like to look at the location and length of the hepatic vein and inferior vena cava occlusion at the top of the diaphragm and at the second hepatic hilum to determine if it is diaphragm."

“！！！”

“！！！”

Director Bai and Lin Jiu were both stunned for a moment.

This diagnosis,

Rambled.

Both of them are extremely smart, and they are also top medical figures, Ji Xiang said that after his diagnosis, both Director Bai and Lin Jiu had an epiphany almost at the same time.

Budd-Chiari syndrome is a type of posterior portovascular hypertension characterized by inferior vena cava hypertension caused by obstructive lesions of the hepatic veins and their openings caused by obstructive lesions of the superior inferior vena cava.

The disease is classified as acute, subacute, and chronic.

Most patients with chronic Budd-Chiari syndrome present with a cachexia state, or a spider-man state.

However, there are still a very small number of patients who do not have special body surface characteristics to suggest that in addition to a small amount of ascites effusion, there will be hernia and hemorrhoids.

Ji Xiang said that everything was connected in series, forming a perfect closed loop.

"Xiao Ji, how do you tell?" Director Bai asked with a frown.

"People ignore a small amount of ascites because the amount is small, and it's normal to ignore it, but I don't see it that way." Ji Xiang said, "Coupled with the patient's clinical symptoms of inguinal hernia and continuous bleeding after internal hemorrhoid surgery, my initial diagnosis is Budd-Chiari syndrome." ”

"The physical examination revealed a slight distension in the veins in the lower abdomen, including a slight distension in the jugular veins. Of course, these are all my guesses, so let's check them first. ”

Director Bai nodded, and he turned around and went to the office with Ji Xiang.

The moment he turned around, Director Bai was a little dizzy, and he immediately looked back at his physical discomfort.

Lin Jiu didn't go along, but stood in the ward and wrote something in his notebook, writing and writing, and he looked up at the patient.

Director Bai confirmed his guess, and turned around to correct his eye movements while chatting with Ji Xiang.

"Xiao Ji, how accurate do you estimate the diagnosis rate?" Director Bai asked.

"Eighty percent." Ji Xiang gave a reasonable answer.

"Yes, the surgery should be easy."

"It's very simple, you can do it in the vascular department, you can do it in the interventional department, and you can see who has done it. Similar conditions are rare, chronic Budd-Chiari syndrome + normal liver function and difficult to diagnose. Ji Xiang said.

Director Bai smiled slightly and looked sideways at Ji Xiang.

In contrast, Ji Xiang is kind and kind, while Lin Jiu looks like a devil.

"I didn't mean that." Ji Xiang saw what he wanted to say from Director Bai's gaze, and quickly explained.

"Hahaha, it's okay, I know you want to say something nice for the directors." Director Bai said, "Find a B-ultrasound consultation." By the way, Xiaoji, if you have any difficulties in the work of the provincial department, call me directly. ”

(End of chapter)